The aim of this in vitro study is to assess the mean lesion depth improvement and hardness of artificial white spot lesions by comparing the effects of bioactive glass toothpaste and resin infiltration (ICON).
White spot lesions are an adverse result of orthodontic treatment caused by poor oral hygiene. It is difficult to maintain oral hygiene during fixed orthodontic treatment.White spot lesions are subsurface enamel porosities due to demineralization of enamel. They are basically the early stages of caries and has milky white appearance. WSLs are usually formed four weeks after bracket placement.There are various methods for the treatment of white spot lesions. The invasive methods include crowns or veneers and microabrasion. The non-invasive methods are remineralizing agents like topical fluoride, bioactive glass, GC Tooth Mousse and resin infiltration material (ICON). Fluoride compounds are one of the first therapies for WSL. Fluoride varnishes inhibit the demineralization process and promotes the remineralization of enamel. The fluoride varnish forms the calcium fluoride on enamel surface and prolong the contact between fluoride and enamel.Previous studies have shown promising results achieved by bioactive glass as compared to other remineralizing agents. Resin infiltration has been introduced recently and there are few studies on the treatment of WSLs. The rationale of the study is to compare the effects of bioactive glass and resin infiltration through scanning electron microscopy and microhardness, as there is limited research on this topic. The purpose of this study is to compare and evaluate the lesion depth of artificial white spot lesions before and after the treatment with sodium fluoride varnish, bioactive glass and resin infiltration (ICON). The null hypothesis is that there are no significant differences among the three groups for the treatment of white spot lesions.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
90
A carbonated beverage (Coca Cola, Pakistan ltd) will be used for artificial white spot lesion formation. The pH of the beverage will be 4-4.5 at 37ºC. The teeth will be immersed in demineralization solution for 4 weeks before treatment. The solution will be changed every 48 hrs. to keep the pH constant. After demineralization specimens will be washed with distilled deionized water (DDW). The tooth will have a white spot lesion only on the buccal surface. A sufficient amount of 5% bioactive glass (Biomin F T/P) was applied on the tooth surface for three minutes using a tooth brush. The toothpaste remained on the surface for an additional 30 minutes.
A carbonated beverage (Coca Cola, Pakistan ltd) was used for artificial white spot lesion formation. The pH of the beverage was 4-4.5 at 37ºC. The teeth were be immersed in demineralization solution for 4 weeks before treatment. The solution was changed every 48 hrs. to keep the pH constant. After demineralization specimens were washed with distilled deionized water (DDW). The tooth would have a white spot lesion only on the buccal surface. Resin infiltration (ICON) infiltration will be applied according to manufacture as following: * Application of Icon Etch (15% HCL gel) for 2 minutes. * Water rinsing and air drying for 30 sec. * Application of Icon-dry (ethanol) for 30 sec. * Air drying * Application of Icon Infiltrant for 3 minutes. * Light curing for 40 seconds.
Islamic International Dental Hospital
Islamabad, Capital, Pakistan
Scanning Electron Microscopy
Changes in baseline lesion depth were assessed using scanning electron microscopy. Scanning electron microscopy is used to assess lesion depth before and after treatment with remineralizing agents. Lesion depth is measured in microns. Comparison is made by calculating the average depth of treated samples against untreated demineralized control samples.
Time frame: 4th week
Vickers Microhardness Test
Changes from baseline microhardness tests are used to measure changes in surface hardness before and after remineralization. Sound or artificially demineralized enamel (acid-etched or caries-like lesions) is tested first to set a control value. Agents like fluoride varnishes, CPP-ACP (Casein Phosphopeptide-Amorphous Calcium Phosphate), or bioactive glass are applied over cycles. The percentage surface hardness measures how much demineralized enamel is hardened after remineralization treatment relative to original healthy baseline.
Time frame: 4th week
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A carbonated beverage (Coca Cola, Pakistan ltd) was used for artificial white spot lesion formation. The pH of the beverage will be 4-4.5 at 37ºC. The teeth were immersed in demineralization solution for 4 weeks before treatment. The solution was changed every 48 hrs. to keep the pH constant. After demineralization specimens was washed with distilled deionized water (DDW). The tooth would have a white spot lesion only on the buccal surface. The teeth were cleaned and dried first. 5% Sodium fluoride (Enamelist) varnish was applied on tooth surface with disposable tooth brush. The varnish remained undisturbed on teeth for 4 hours.