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Article Citation:
Elizabeth Hess, Phillip M. Campbell, Allen L. Honeyman, and Peter H. Buschang (2011) Determinants of enamel decalcification during simulated orthodontic treatment. The Angle Orthodontist: September 2011, Vol. 81, No. 5, pp. 836-842.
doi: http://dx.doi.org/10.2319/121710-726.1

Original Articles

Determinants of enamel decalcification during simulated orthodontic treatment

Elizabeth Hessa, Phillip M. Campbellb, Allen L. Honeymanc, and Peter H. Buschangd

aPrivate Practice, Baton Rouge, LA

bAssociate Professor and Department Chair, Department of Orthodontics, Baylor College of Dentistry, Dallas, Tex

cAssociate Professor, Biomedical Sciences, Baylor College of Dentistry, Dallas, Tex

dProfessor, Department of Orthodontics, Baylor College of Dentistry, Dallas, Tex

Abstract

Objective: To determine the relative effects that phosphoric acid etching, metal brackets, composite resin adhesives, and filled resin sealants have on enamel decalcification.

Materials and Methods: One hundred and fifty teeth were randomly divided into six groups to test the effects of acid etching, brackets, and a composite resin adhesive. The right side of each tooth was sealed. The teeth were submitted to a simulated carious challenge by Streptococcus mutans in a nutritive media for 42 days. Scanning electron photomicrographs (SEMs) were used to qualitatively evaluate the tooth surfaces. DIAGNOdent laser fluorescence was used to quantify the decalcification changes that occurred.

Results: SEMs showed normal enamel on the control teeth, etching patterns on the acid-etched teeth, surface degradation on the teeth that had resin, and sealant tags on the sealed side. The untreated control group showed significantly less decalcification (P ≤ .05) than did all groups except the no etch+bracket group. The no etch+bracket group showed significantly less decalcification than did the etch+bracket, no etch+resin, and the etch+resin groups. Acid-etched teeth demonstrated significantly more decalcification (34%) than did those that were not etched. The teeth with resin showed significantly more decalcification (24%) than did those without resin. There was no significant difference between teeth that did and did not have brackets. The unsealed side of the teeth showed small amounts of—but significantly more—decalcification (5%) compared to the sealed side.

Conclusions: Acid etching and composite resin adhesives increase enamel decalcification in vitro, while brackets do not. Filled resin sealants protect the teeth from decalcification.

Keywords: Dental enamel decalcification, White Spot Lesions (WSL), In vitro experiment, Acid etching, Composite resins, Filled sealants, Dental brackets

Received: December 2010; Accepted: March 2011 ;Published Online: May 5, 2011

Corresponding author: Peter Buschang, Department of Orthodontics, Baylor College of Dentistry, 3302 Gaston Avenue, Dallas, TX 75246 (e-mail: )