Journal: |
BMC Oral health
Springer Nature
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Volume: |
24
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Abstract: |
Objective White spot lesions are initial sign of enamel caries that compromise esthetic appearance following
orthodontic treatment. Thus, the systematic review was conducted to evaluate the remineralization potential of
orthodontic adhesives on early-enamel lesions surrounding orthodontic bracket.
Methods Search strategy was performed through three databases (PubMed, Web of Science, and Scopus). A total
number of 1712 studies were identified for being potentially relevant, 62 among them were further assessed. Finally,
24 studies were included in this systematic review after adopting the eligibility criteria. The methodologies used to
assess enamel remineralization were micro-computed tomography, cross-sectional microhardness, and polarized
light microscopy for evaluating remineralization extent; surface microhardness, color change, and laser-induced
f
luorescence for evaluating superficial surface mineralization; Fourier Transform InfraRed, and Energy Dispersive
Spectroscopy technique for chemical characterization.
Results Bioactive glass (BAG), nano-hydroxyapatite (n-HAP), nano-amorphous calcium phosphate (n-ACP), nano
calcium fluoride (n-CaF2), fluorinated amorphous calcium phosphate nanoparticles (AFCP), and ammonium-based
methacrylate monomer were incorporated into orthodontic adhesives. Seven out of the 24 included studies
utilized commercially available orthodontic adhesives. While the remaining studies utilized experimental bioactive
adhesives; 13 studies evaluated adhesives containing (BAG), two studies evaluated adhesives containing (n-ACP), one
study evaluated adhesives containing (AFCP), and one study evaluated adhesives containing (n-HAP). Orthodontic
adhesives containing the previously mentioned additives showed significant remineralization power compared
to control group. Majority of studies that evaluated bioactive-based orthodontic adhesives revealed significant
remineralization effect in comparison with their corresponding control groups. Out of 24 studies, 8 have assessed ion
release. However, few numbers of included studies evaluated the ion-release peak values. The output of most studies
reported a significant increase of ion-release over time. Only one study reported a mark decrease of calcium and
phosphate ions after 72 h. Following the high risk of bias in the majority of studies, and lack of standard evaluation
protocol, meta-analysis was not conducted.
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