Interproximal reduction (IPR) damages the caries protective superficial layer of the enamel, making the enamel surface prone to caries because of the increase in surface roughness. Remineralizing solutions can help in preventing these undesirable side effects. Therefore, this study aimed to compare the effect of nanohydroxyapatite (nHAp) and sodium fluoride (NaF) application on enamel remineralization after IPR and to evaluate changes in surface roughness, composition, and microhardness of the treated enamel.
A total of 25 patients with Angle’s Class I malocclusion, requiring 4 premolar extractions, were selected and randomly divided into 5 groups (n = 5). Group 1 served as the control. In group 2, the extraction of premolars was done immediately after IPR, and in group 3, the extraction of premolars was done 3 months after IPR. In group 4, the extraction of premolars was performed 3 months after IPR with weekly application of nHAp serum. In group 5, the extraction of premolars was performed 3 months after IPR, along with once-a-month application of NaF varnish. The proximal reduction of premolars in all the groups was done using Strauss IPR burs (Strauss Diamond Instruments, Palm Coast, Fla). The extracted teeth were sectioned, and the enamel surfaces were subjected to energy-dispersive x-ray spectroscopy to evaluate elemental composition. Vicker’s microhardness test was used to evaluate enamel hardness and atomic force microscopy for enamel surface roughness. Descriptive statistics were calculated for the 5 groups using a 1-way analysis of variance, and Tukey’s multiple post-hoc test was used for intergroup comparison.
Calcium-to-phosphorous ratio, enamel microhardness, and surface roughness were found to be closest to untouched enamel in patients treated with nHAp, followed by patients who were treated with NaF. A lower calcium-to-phosphorous ratio and weakened and roughest enamel surface was seen in teeth, which were extracted immediately after IPR.
Among the remineralizing agents tested, nHAp serum can be recommended for better remineralization of enamel surfaces after IPR.
This study evaluated the labial and lingual cortical bone remodeling characteristics of mandibular central incisors after retraction, which remain controversial among orthodontists.
Cortical bone remodeling and central incisor movement of 33 patients (aged 23.64 ± 4.30 years) who underwent mandibular first premolar extraction and incisor retraction at the crestal (S1), midroot (S2), and apical (S3) levels were analyzed using superimposed cone-beam computed tomography images on the basis of voxel-based registration of the mandibular stable region. Multivariate linear regression was used to explore the relationships between labial bone remodeling/tooth movement (BT) ratios and factors such as the ANB angle, mandibular plane angle (Mp-SN), and incisor movement patterns. The patients were divided into 4 groups according to the lingual cortical bone remodeling condition and the relationship between posttreatment incisor roots and the original lingual cortical bone border. At the 3 levels (S1, S2, and S3), the classifications of cortical bone remodeling of the mandibular incisors were calculated; t tests were used to compare the amount of labial and lingual bone remodeling, BT ratios, and lingual bone remodeling/root over the original border (BRo) ratios.
The mean labial BT ratios at all 3 levels were close to 1. Multivariate linear regression indicated that the tooth movement pattern negatively correlated with the BT ratio at the S2 and S3 levels (P <0.05). Lingual bone apposition occurs when the root penetrates the original lingual cortical bone border in most patients. BRo ratios can more accurately reflect the inherent remodeling ability of the lingual cortical bone than BT ratios. The mean lingual BRo ratios were (1) S1 level: mandibular left central incisor (T31), 0.87 ± 0.25 and mandibular right incisor (T41), 0.86 ± 0.25; (2) S2 level: T31, 0.81 ± 0.12 and T41, 0.80 ± 0.22; and (3) S3 level: T31, 0.76 ± 0.20 and T41, 0.83 ± 0.26. There was no significant difference between labial BT ratios and lingual BRo ratios at the S2 and S3 levels.
The amount of labial cortical bone resorption caused by mandibular incisor retraction showed varied relationships with the amount of tooth movement. Bodily retraction may decrease the labial BT ratios at the S2 and S3 levels. Active lingual cortical bone apposition occurred when the roots penetrated the original lingual border and exhibited strong remodeling ability.
White spot lesions (WSLs) represent a prominent pathology encountered during orthodontic treatment, originating from enamel demineralization induced by the accumulation of bacterial biofilms. The previously developed bioinspired enamel coating form of self-assembling antimicrobial peptide D-GL13K exhibited antimicrobial activity and enhanced acid impermeability, offering a potential solution to prevent demineralization. The primary aim of this investigation is to assess the in vivo anti-demineralization properties and biocompatibility of the D-GL13K coating.
A rat model was developed to assess the antimicrobial enamel coating during fixed orthodontic treatment. The anti-demineralization efficacy attributed to the D-GL13K coating was evaluated by employing optical coherence tomography, Vickers microhardness testing, and scanning electron microscopy. The biocompatibility of the D-GL13K coating was investigated through histologic observations of vital organs and tissues using hematoxylin and eosin.
The D-GL13K coating demonstrated significant anti-demineralization effects, evidenced by reduced demineralization depth analyzed through optical coherence tomography and enhanced Vickers hardness than in the noncoated control group, showcasing the coating’s potential to protect teeth from WSLs. Scanning electron microscopy analysis further elucidated the diminished enamel damage observed in the group treated with D-GL13K. Importantly, histologic examination of vital organs and tissues using hematoxylin and eosin staining revealed no overt disparities between the D-GL13K coated group and the noncoated control group.
The D-GL13K enamel coating demonstrated promising anti-demineralization and biocompatibility properties in a rat model, thereby suggesting its potential for averting WSLs after orthodontic interventions. Further research in human clinical settings is needed to evaluate the coating’s long-term efficacy.