Caries risk after interproximal enamel reduction. Enamel surfaces following interproximal reduction with different methods. Evaluating the effects of fluoride-releasing dental materials on adjacent interproximal caries. Periodontal tissue alterations following Emdogain treatment of periodontal sites with angular bone defects. A series of case reports. The modified papilla preservation technique. A new surgical approach for interproximal regenerative procedures. Effect of a hydrophobic tooth coating on gingival health, mutans streptococci, and enamel demineralization in adolescents with fixed orthodontic appliances Orthodontic bracket removal using conventional and ultrasonic debonding techniques, enamel loss, and time requirements. The effects of bracket removal on enamel. Four-year clinical evaluation of posterior resin-based composite restorations placed using the total-etch technique. A new in vivo interdental sampling method comparing a daily flossing regime versus a manual brush control. Enamel matrix proteins and guided tissue regeneration with titanium-reinforced expanded polytetrafluoroethylene membranes in the treatment of infrabony defects: a comparative controlled clinical trial. A comparison of second premolar extraction and mini-implant total arch distalization with interproximal stripping. Occurrence and severity of enamel decalcification adjacent to bracket bases and sub-bracket lesions during orthodontic treatment with two different lingual appliances Enamel matrix proteins and bovine porous bone mineral in the treatment of intrabony defects: a comparative controlled clinical trial. Microleakage under orthodontic brackets bonded with the custom base indirect bonding technique. The Effects of Composite Resin Types and Debonding Pliers on the Amount of Adhesive Remnants and Enamel Damages: A Stereomicroscopic Evaluation Demineralization of enamel in relation to the fluoride release of materials. Evaluation of enamel damages following orthodontic bracket debonding in fluorosed teeth bonded with adhesion promoter In vivo caries formation in enamel following argon laser irradiation and combined fluoride and argon laser treatment: a clinical pilot study. Bond strength of two adhesive systems to primary and permanent enamel. Clinical and laboratory evaluation of powered electric toothbrushes: comparative efficacy of two powered brushing instruments in furcations and interproximal areas. Microleakage under orthodontic brackets bonded with different adhesive systems The effect of argon laser irradiation on demineralization resistance of human enamel adjacent to orthodontic brackets: an in vitro study.
INTRODUCTION Air-rotor stripping ( ARS ) is a commonly used method to alleviate crowding in the permanent dentition . Its widespread acceptance , however , has been limited by the potential increase in caries risk of the abraded enamel surface . The aim of this study was to compare the susceptibility of ARS-treated enamel surfaces with intact surfaces in patients undergoing fixed orthodontic therapy . METHODS Forty patients treated with ARS were examined clinical ly and radiographically for caries 1 to 6 years after interproximal enamel reduction . All patients were seen by their dentists for prophylaxis at 6-month intervals during active orthodontic treatment and were exposed to fluori date d water and toothpaste . Topical fluoride agents or sealants were not applied on the abraded surface after any ARS session . Caries incidence was compared between ARS-treated and unaltered surfaces within subjects . The decayed , missing , filled tooth ( DMFT ) and surface ( DMFS ) scores were used to evaluate the subjects ' overall caries risk . RESULTS Totals of 376 test and 376 control surfaces were examined . The number of interproximal lesions detected was found to be low with no statistically significant difference detected between the groups ( test = 3 ; control = 6 ; P = .33 ] . The DMFT and DMFS scores increased significantly during the study period , indicating that these patients were clearly at risk of tooth decay ( P < .001 ) . CONCLUSIONS The findings indicate that the risk of caries is not affected by ARS . Furthermore , our data show that the application of topical fluoride on the enamel surfaces immediately after ARS in patients exposed to fluori date d water and fluoride-containing toothpaste may not provide any additional benefit OBJECTIVE To assess the surface roughness result ing after application of currently available interproximal polishing . MATERIAL S AND METHODS The analysis was carried out by means of digital subtraction radiography , profilometry , and scanning electron microscopy . The roughness of natural untreated enamel served as the reference . Five enamel reduction methods were tested ( Profin , New Metal Strips , O-Drive D30 , Air Rotor , and the Ortho-Strips ) and were applied in accordance with their manufacturers ' recommendations . Fifty-five teeth were treated by r and omly chosen methods , all of which were applied by one person . One proximal surface was only ground and left unpolished while the other received the finishing and polish recommended by the manufacturer . RESULTS Loss of tooth substance , as measured by subtraction radiography , was significantly lower ( P < .05 ) for the group treated with Ortho-Strips .  Profilometric analysis of enamel roughness showed that the use of Ortho-Strips , O-Drive D30 , and New Metal Strips in the grinding mode produced equally rough surfaces ( P > .05 ) . The Air Rotor and Profin system in the grinding mode produced the significantly ( P < .05 ) roughest surfaces . A significant ( P < .05 ) reduction of the mean roughness values was registered in all groups when treatment was followed by polishing . The Profin system and Ortho-Strips achieved the significantly smoothest surfaces ( P < .05 ) with polishing . CONCLUSIONS In general , interproximal enamel reduction should be followed by thorough polishing . Furthermore , oscillating systems seem to be advantageous BACKGROUND The authors examined several restorative material s to evaluate their ability to inhibit demineralization and enhance remineralization of incipient carious lesions on the interproximal enamel of teeth adjacent to those restored with the material s. METHODS Twenty-one subjects in need of a crown on a m and ibular molar and a Class II inlay on an adjacent tooth took part in this six-phase study . Artificial enamel lesions were created and positioned within the interproximal portion of a crown . Lesions were photographed with polarized light microscopy and characterized before and after 30-day intraoral exposures . Each phase included the placement of a new section in the crown model and a new Class II inlay restorative material in the adjacent tooth . RESULTS Results demonstrated that nonfluori date d resin composite , fluori date d resin composite and resin-modified glass ionomer restorative material s , when placed in subjects who brushed with a fluori date d dentifrice , demonstrated significantly ( P < .05 ) less enamel demineralization than the nonfluori date d resin composite control placed in subjects who brushed with a nonfluori date d dentifrice . The resin-modified glass ionomer cement , however , even when brushed with a nonfluori date d dentifrice , exhibited significantly ( P < .05 ) less demineralization than the nonfluori date d resin composite control brushed with a nonfluori date d dentifrice . CONCLUSIONS Resin-modified glass ionomer cement appears to significantly inhibit demineralization of interproximal enamel of teeth adjacent to those restored with the material . CLINICAL IMPLICATION S Resin-modified glass ionomer cement restorations can enhance prevention of enamel demineralization on adjacent teeth UNLABELLED The aim of the present study was to assess the predictability of probing attachment gain and probing pocket depth reduction following Emdogain treatment at sites with deep angular bone defects . MATERIAL AND METHODS 108 consecutively-treated periodontal patients ( mean age 55.8 years ) were included . Each subject exhibited at least 1 deep interproximal intrabony defect that could be identified as an experimental site based on the inclusion criteria : ( i ) probing pocket depth > or = 5 mm , ( ii ) probing attachment loss > or = 6 mm , ( iii ) radiographic evidence of an interproximal bone defect with a > or = 3 mm intrabony component . A total of 145 defects met the criteria for inclusion . All subjects received non-surgical periodontal therapy .  This included subgingival instrumentation in all parts of the dentition . At least 6 months after the completion of this treatment , a baseline examination was performed to characterise the experimental site . Reconstructive therapy was subsequently performed . Full-thickness periodontal flaps were elevated , and the root surface scaled and planed . No bone recontouring was performed . A gel containing 24 % EDTA was applied on the exposed root and was kept in place for 2 min . A preparation of enamel matrix proteins was applied to the root surface and adjacent defect space . The flaps were replaced and closed with sutures . The experimental sites were re-examined 12 months after reconstructive surgery . RESULTS The re-examination demonstrated that a treatment including the application of enamel matrix proteins at periodontal sites with angular defects result ed in a mean probing attachment level gain of 4.6 mm and a probing pocket depth reduction of 5.2 mm . 87 % of all sites treated exhibited a probing attachment gain of > 2 mm . One site suffered probing attachment loss . The radiographic assessment s revealed that the bone defect had been reduced in depth by 2.9 mm on average . The reduction in defect size corresponded to an average bone fill of 69 % of the original defect . In 43 % of the defects , the bone fill amounted to > or = 80 % . CONCLUSION The overall probing pocket depth reduction , probing attachment level gain , and soft tissue recession , that results following Emdogain therapy , is similar to the corresponding outcome variables following GTR A modification of the papilla preservation technique has been applied to achieve primary closure of the interproximal tissue over barrier membranes placed coronal to the alveolar crest . Fifteen patients with deep intrabony interproximal defects were treated . Defects had a  probing attachment level loss of 9.9 + /- 3.2 mm and a recession of the gingival margin of 1.7 + /- 1.6 mm . The depth of the intrabony component was 5.5 + /- 2.9 mm ; while the suprabony component was 5.9 + /- 2.0 mm . Titanium-reinforced teflon membranes were placed 1.3 + /- 0.7 mm from the cemento-enamel junction , 4.5 + /- 1.6 mm coronal to the interproximal alveolar bone crest . Primary closure over the interproximal portion of the membrane was obtained in 93 % of cases . In 73 % of the cases complete coverage of the membrane was maintained until its removal at 6 weeks . These data indicate that the modified papilla preservation technique can be successfully applied to obtain primary closure of the interdental space in regenerative procedures with barrier membranes The effect of an anti-adhesive enamel coating on plaque accumulation , gingival health , and enamel demineralization was evaluated in 39 adolescents undergoing treatment with fixed orthodontic appliances using a prospect i ve split-mouth design . Immediately after bracket insertion , the polymer was r and omly applied after enamel etching to the buccal surfaces of the teeth in the left or right upper quadrant , leaving the opposite quadrant as an untreated control ( 218 test and 216 control teeth ) . Reapplications were carried out every 3rd month during the course of the study . The following data were collected at baseline and at design ated follow-ups : visible plaque index , total viable counts and proportion of mutans streptococci in plaque sample s , gingival bleeding index , and amount of gingival crevicular fluid . The incidence of enamel demineralization adjacent to the appliances was scored clinical ly at the termination of the orthodontic treatment . The observation time ranged from 6 - 24 months , during which the participants used fluoride rinses and toothpaste daily . A slightly impaired gingival health and increased levels of mutans streptococci compared with baseline was disclosed during the treatment . Five subjects showed enamel demineralization on a total of 30 teeth at the time of de-bonding . The results indicated no statistically significant differences between the enamel-coated and untreated teeth with regard to the studied variables at any follow-up . In conclusion , the present findings did not support a clinical ly beneficial effect of the polymeric tooth coating in a low-caries group of adolescents treated with fixed orthodontic appliances The purpose of this study was to examine the effects of ultrasonic orthodontic bracket removal and cleanup and compare them with conventional debonding and cleaning of the enamel surfaces with burs and polishing disks . The amount of enamel loss and time for bracket removal and clean-up were also addressed . Thirty extracted human premolars were collected . The teeth were r and omly placed in one of the three debonding groups : debonding with orthodontic pliers and enamel clean-up with finishing burs and polishing disks ( group 1 ) , debonding with orthodontic pliers and ultrasonic clean-up of the enamel surface ( group 2 ) , and ultrasonic debonding enamel clean-up ( group 3 ) . The teeth were stored for 48 hours in 100 % humidity before bracket removal . All brackets were then removed . Polyvinyl siloxane impressions were made before and after bracket removal . Direct measurements of the teeth in micrometers were made at all steps . An additional 30 teeth were similarly prepared , and the brackets were debonded and cleaned-up as in the three groups previously described . The total time for bracket removal and enamel clean-up for each group was recorded in seconds . ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND Enamel cracks , which may develop during debonding orthodontic brackets , may jeopardise the integrity of the enamel and detract from the appearance of the teeth . AIM To compare the adhesive remnant scores ( ARI ) , the number , lengths and directions of enamel cracks before bonding and after debonding metal orthodontic brackets with three different methods . METHODS Metal brackets were bonded with a self-curing orthodontic adhesive to the buccal surfaces of 75 recently extracted upper and lower premolars . The teeth were r and omly divided into three groups , and the brackets removed either with a side-cutter , a single-blade bracket remover or a two-blade bracket remover . The number , directions and lengths of the enamel cracks before bonding and after debonding were compared . The number of ' pronounced ' cracks ( i.e. cracks that could be identified with the naked eye ) and the ARI scores in each group were also compared . RESULTS After debonding , the number of enamel cracks and pronounced cracks , and the lengths of the enamel cracks increased in all groups ( p < 0.001 ) . There were no statistically significant differences between the groups . The ARI scores and the direction of propagation of the enamel cracks were not influenced by the debonding method used ( p = 0.73 ) . CONCLUSIONS Concerns about the enamel damage caused by the three methods of debonding justify caution . Despite widespread use of these methods , it would be sensible to search for methods that result in less enamel damage PURPOSE To report the 4-year clinical performance of  posterior resin-based composite restorations placed using the total-etch technique . MATERIAL S AND METHODS Over a period of 1 year , 726 restorations ( 248 molars , 478 premolars ; 260 Class I , 466 Class II ; 540 replacements , 186 primary decay ) were placed on conservative preparations , using the incremental placement technique in a clinical environment . Baseline data were collected , and the restorations were evaluated after 4 years . Z100 and Scotchbond Multi- Purpose ( SBMP ) ( 3 M Dental Products , St. Paul , Minnesota ) were used as the restorative system . The criteria evaluated were color match , marginal adaptation , anatomic form , cavosurface marginal discoloration , axial contour , interproximal contact , secondary caries , postoperative sensitivity , and tooth vitality . RESULTS At baseline , 24 % of the teeth restored presented postoperative sensitivity ; 86 % of the sensitive teeth were from the replacement group . At 4 years , all teeth were vital to cold test . Eighteen restorations ( 2.5 % ) presented clinical ly detectable marginal fracture . The shade was acceptable in all restorations . Cavosurface marginal discoloration was observed in 47 restorations ( 6.5 % bravo scores ) . Axial contour , interproximal contact , and marginal adaptation received 100 % alfa scores . No secondary caries was diagnosed in any of the teeth examined . None of the examined restorations required replacement . CLINICAL SIGNIFICANCE Under controlled clinical conditions , posterior resin-based composite restorations placed with the total-etch technique and restorative Z100/SBMP have the potential to present a high success rate at 4 years . None of the examined restorations required replacement , and there was no clinical ly detectable wear in any of the restorations . Simultaneous etching of enamel and dentin followed by the application of a resin adhesive can be considered an adequate modality of pulp protection in nonexposed tooth preparations OBJECTIVE The impact of flossing the interdental space is typically assessed by visual methods of question able reliability , such as clinician observations and evaluations for scoring of plaque on visual tooth surfaces . The objective of this study was to develop and vali date a method to measure interproximal quantities of dental plaque , thereby permitting quantitative evaluations of between-teeth cleaning and biofilm removal . METHODOLOGY Laboratory studies were performed correlating the quantity of bacteria to the amount of measured protein in a sample using a st and ardized protein assay ( Bio-Rad Protein Assay ) and sample s containing single bacterial species and saliva/bacterial pellets . Analysis of the plaque was st and ardized against a bovine serum albumin ( BSA ) control . Pilot studies helped develop a technique for hygienist-applied interproximal flossing , reducing contamination from saliva and other possible sources of indeterminate error . Repeated sampling experiments were carried out to optimize the technique needed to remove the majority of quantifiable plaque , the best choice of flossing material , and establish the technique for collection . A pilot clinical trial assessed the benefits of daily flossing in reducing measurable quantities of interproximal plaque using the developed method . Thirty-nine subjects had six interdental sites ( distributed across all four quadrants , pre-molar and molar boundaries ) sample d on either side , over a three-week treatment period , in two balanced and equally sized treatment groups , with twice-daily manual brushing with or without daily flossing .  RESULTS Laboratory studies confirmed the accuracy of the protein detection kit in assaying bacterial plaque loads from single species or complex biofilms . In pilot developmental screens , single flossing sweeps with appropriate dental floss were sufficient to remove the majority of quantifiable biomass from interproximal sites . The clinical study demonstrated that after three weeks , interdental plaque in floss users was significantly reduced versus baseline scores . Non-floss users showed no significant reduction . In direct comparison , less interdental plaque was recovered from subjects who had followed a daily flossing regime compared to subjects who had used a manual toothbrush alone ( p = 0.0866 ) . CONCLUSION The sampling method quantified the cleaning effects of daily flossing on interproximal plaque levels . Daily flossing significantly reduced the amount of plaque found between the teeth compared to a manual brushing regimen alone . This new method should be useful in future studies on the evaluation of mechanical or chemical means of interproximal plaque control BACKGROUND Several studies have documented the clinical efficacy of guided tissue regeneration ( GTR ) with non-resorbable exp and ed polytetrafluoroethylene ( ePTFE ) membranes and enamel matrix proteins ( EMP ) in the treatment of infrabony defects . The objective of this controlled clinical study was to compare the clinical outcomes of 3 surgical modalities in the treatment of deep interproximal infrabony defects . METHODS Ninety ( 90 ) defects in 90 healthy subjects affected by chronic periodontitis were assigned to 1 of 3 treatment groups by blocking to prognostic variables . The test group was treated with the application of EMP and the simplified papilla preservation ( SPP ) technique ; the second group was treated with titanium-reinforced ePFTE membranes and the SPP technique ; and the third group was treated with the SPP technique used as access flap control procedure . No differences were observed in terms of baseline oral hygiene and defect characteristics among the 3 groups , indicating that the blocking approach was effective . A stringent infection control program was adopted for 1 year . RESULTS The 1-year results indicated that : 1 ) all treatment modalities result ed in clinical ly significant improvements in clinical attachment levels ( CAL ) and reduction in probing depth ( PD ) ; 2 ) a statistically significant treatment effect was demonstrated comparing the EMP test , the membrane control , and the flap control groups in terms of CAL gains ; 3 ) both the EMP test and the membrane control groups showed significant CAL gains compared to the flap control group ; 4 ) a statistically significantly greater amount of CAL gain was demonstrated in GTR-treated compared to EMP-treated patients ; 5 ) deeper residual probing depths but smaller increases in gingival recession were demonstrated following EMP therapy ; and 6 ) smoking habits reduced the clinical outcomes of both regenerative procedures . CONCLUSIONS The use of a regenerative procedure is indicated in the treatment of deep vertical bony defects since both the regenerative techniques ( GTR and EMD ) in the present study result ed in clinical ly and statistically significant improvements in clinical parameters compared to the access flap procedure . The use of EMP can be helpful in esthetically-sensitive sites and in reducing patient morbidity OBJECTIVE The effect of total arch distalization using orthodontic mini-implants ( OMIs ) combined with interproximal stripping ( IPS ) and second premolar extraction was investigated in Class I malocclusion patients . MATERIAL S AND METHODS A total of 66 consecutively treated Class I malocclusion ( Class I molar relationship ; 0 mm < overbite and overjet < 4.5 mm ) patients ranging in age from 17 to 44 years who received single-phase treatment were included in this study . Pre- and posttreatment lateral cephalograms and dental casts were measured and compared statistically . RESULTS In the distalization with IPS group , 3.6 mm and 3.8 mm of crowding in the upper and lower arches , respectively , were resolved , and 3.8 mm and 3.2 mm of upper and lower incisor retraction , respectively , were achieved simultaneously by the treatment . As a result of the second premolar extraction treatment , 3.9 mm and 3.6 mm of crowding in the upper and lower arches , respectively , were resolved , and 3.3 mm and 3.2 mm of incisor retraction , respectively , were achieved during treatment . There was no statistically significant difference in the amount of crowding and incisor retraction between the two groups . CONCLUSIONS Total arch distalization using an OMI with IPS did not yield a significantly different treatment result compared to second premolar extraction treatment Summary Background : Using lingual enamel surfaces for bracket placement not only has esthetic advantages , but may also be suitable in terms of reducing frequencies of enamel decalcifications . Objective : To test the null-hypothesis that there is no significant difference in enamel decalcification or cavitation incidence adjacent to and beneath bracket bases between two  lingual multi-bracket ( MB ) appliances  that are different in terms of design , material composition , and manufacturing technology ( group A : WIN , DW-LingualSystems ; group B : Incognito , 3M-Unitek ) , taking into account patient- and treatment-related variables on white spot lesion ( WSL ) formation . Methods : St and ardized , digital , top-view photographs of 630 consecutive subjects ( 16214 teeth ; n Incognito = 237/6076 teeth ; n WIN = 393/10138 teeth ; mean age : 17.47±7.8 ; m/f 43.2/56.8 % ) with completed lingual MB treatment of the upper and lower permanent teeth 1–7 were screened for decalcification or cavitation adjacent to and beneath the bracket bases before and after treatment , scored from 0 to 7 . Non-parametric ANOVA was used for main effects ‘ appliance type ’ , ‘ gender ’ , ‘ treatment complexity ’ , ‘ grouped age ’ ( ≤16/>16 years ) , and ‘ treatment duration ’ as covariable , at an α-level of 5 % . Results : About 2.57 % [ 5.94 % ] of all teeth in group A [ B ] developed decalcifications . Subject-related incidence was 9.59 % [ 16.17 % ] for upper incisors in group A [ B ] , and 12.98 % [ 25.74 % ] for all teeth 16–46 . There were significant effects by gender , age , and treatment duration . Conclusion : The null-hypothesis was rejected : sub-bracket lesions were significantly less frequent in group A , while frequencies of WSL adjacent to brackets were not significantly affected by appliance type . In view of the overall low incidences of lingual post-orthodontic white-spot lesions , the use of lingual appliances is advocated as a valid strategy for a reduction of enamel decalcifications during orthodontic treatment BACKGROUND Various clinical studies have demonstrated that applying commercially available enamel matrix proteins ( EMP ) on the instrumented root surface during access flap surgery promotes clinical ly significant gains of clinical attachment and bone in intrabony defects . The aim of the present controlled clinical trial was to evaluate the adjunctive effect of filling the intrabony lesion with bovine porous bone mineral ( BPBM ) to a simplified papilla preservation ( SPP ) flap and EMP surgical procedure . METHODS Sixty deep interproximal intrabony lesions in 60 patients with chronic periodontitis were treated with the SPP flap and EMP . In the 30 test defects , the intrabony component was filled with BPBM particles previously reconstituted with the EMP gel . A stringent infection control program was adopted for 1 year . The clinical and radiographical reevaluation was made 1 year after surgery . RESULTS Both techniques result ed in clinical ly and statistically significant improvements between baseline and 1 year , in terms of clinical attachment level ( CAL ) gain , probing depth ( PD ) reduction , and radiographic bone fill ; however , the BPBM test treatment showed statistically significantly greater CAL ( 5.8 + /- 1.1 versus 4.9 + /- 1.0 ) and radiographic bone ( DEPTH ) level gains ( 5.3 + /- 1.1 versus 4.3 + /- 1.5 ) , and less increase in gingival recession ( 0.4 + /- 0.6 versus 0.9 + /- 0.5 ) than the control surgical procedure . CONCLUSION The present study data supported the hypothesis that the adjunctive use of BPBM in grafting intrabony defects has the ability to improve clinical and radiographical outcomes achievable with EMP alone The aim of this in vitro study was to compare microleakage of orthodontic brackets between enamel-composite and composite-bracket interfaces at the occlusal and gingival margins , bonded using indirect bonding systems with that of a conventional direct bonding method . Forty freshly extracted human maxillary premolar teeth were r and omly divided into two groups . In group 1 , the brackets were bonded to teeth directly according to the manufacturer 's recommendations . Group 2 consisted of 20 teeth bonded indirectly with Transbond XT ( 3M-Unitek ) , as the adhesive , and Sondhi Rapid Set A/B Primer ( 3M-Unitek ) , a filled resin primer . After bonding , the specimens were further sealed with nail varnish , stained with 0.5 per cent basic fuchsine for 24 hours , sectioned and examined under a stereomicroscope , and scored for microleakage at the enamel-composite and composite-bracket interfaces from both the occlusal and gingival margins . Statistical analyses were performed using Kruskal-Wallis and Mann-Whitney U-tests with Bonferroni correction . The gingival sides of group 1 displayed a higher median microleakage score than the occlusal side at the enamel-composite interface but this was not statistically significant ( P > 0.05 ) . All occlusal margins in both groups showed no microleakage under orthodontic brackets at the enamel-composite or composite-bracket interfaces . Comparisons of the microleakage scores between the direct and the indirect bonding groups at the enamel-composite and composite-bracket interfaces indicated no statistically significant microleakage differences at the gingival and occlusal margins ( P > 0.05 ) . The type of bonding method ( direct versus indirect ) did not significantly affect the amount of microleakage at the enamel-composite-bracket complex Background and aims . This in vitro study was design ed to evaluate the effect of composite resin types and orthodontic debonding pliers on the amount of adhesive remnants and enamel damages using a novel method of measurement . Material s and methods . 120 extracted human premolars were r and omly divided into four groups ( n = 30 ) . The st and ard edgewise metallic brackets were bonded to the teeth with light-cured composite resin “ Transbond XT ” in the first and second groups , and No-mix composite resin “ Unite ” in the third and fourth groups . Bracket debonding was carried out with Lift Off Debonding Instrument “ LODI ” ( 3 M Unitek ) in the first and third groups , and with Bracket Removing Pliers ( Dentaurum ) in the second and forth groups . yStereomicroscopic evaluation was performed by unbiased sterelogy . All teeth were evaluated for the amount of adhesive remnants and the number and length of enamel cracks . The obtained data on each step was analyzed by two-way ANOVA , chi-square , Wilcoxon , and Kruskal-Wallis . Results . Teeth in group 4 had the lowest adhesive remnants on the enamel surface ( p < 0.01 ) ; and the highest increase in the number of enamel cracks ( p < 0.01 ) among the groups . In addition , groups bonded with Unite showed the highest increase in the length of enamel cracks . Conclusion . Dentaurum debonding pliers with sheer – peel force , when used with the Unite adhesive ( group 4 ) , decreased the amount of adhesive remnants on the enamel surface while it increased enamel damages PURPOSE To examine the reduction in enamel demineralization provided by fluoride release from a conventional glass-ionomer , a resin-modified glass-ionomer and an experimental fluoride-releasing resin-based composite compared to a conventional resin-based composite control , and to correlate the level of fluoride release with demineralization . MATERIAL S AND METHODS Enamel surfaces of extracted human incisors had a 0.4 mm thick layer of the specified test material carefully placed in a b and across the mid-facial enamel to simulate a cement layer beneath an orthodontic bracket . The top surface of the test material was covered with nail varnish , leaving only the edges of the material exposed to release fluoride . The teeth were additionally covered with nail varnish to within 1 mm of the test material . Each group of teeth was placed into separate volumes of unstirred demineralizing solution at a pH of 4.7 for 4 days . The specimens were sectioned and examined by polarized light microscopy . Lesion areas were measured at distances from 100 - 800 microm away from the test material . Fluoride release for the test material s was measured for periods up to 5 months . RESULTS All of the fluoride-releasing material s demonstrated a statistically significant ( P < 0.05 ) degree of protection of enamel from demineralization compared to the non-fluoride control material . The degree of protection was greatest near the material , but lesion areas increased with distance in an inverse relationship to the amount of fluoride release . Lesions were displaced from the region near the material s and the mean displacement was directly related to amount of fluoride release . The mean lesion areas for each distance decreased with the logarithm of the cumulative fluoride release Objective : To evaluate shear bond strength ( SBS ) of the orthodontic brackets bonded to fluorosed and nonfluorosed teeth using Light Bond with and without adhesion promoters and compare their enamel damages following debonding . Material s and Methods : In this study , 30 fluorosed ( Thylstrup and Fejerskov Index = 4–5 ) and 30 nonfluorosed teeth were r and omly distributed between two subgroups according to the bonding material s : Group 1 , fluorosed teeth bonded with Light Bond ; Group 2 , fluorosed teeth bonded with adhesion promoters and Light Bond ; Group 3 , nonfluorosed teeth bonded with Light Bond ; Group 4 , nonfluorosed bonded with adhesion promoters and Light Bond . After bonding , the SBS of the brackets was tested with a universal testing machine . Stereomicroscopic evaluation was performed by unbiased stereology in all teeth to determine the amount of adhesive remnants and the number and length of enamel cracks before bonding and after debonding . The data were analyzed using two-way analysis of variance , Kruskal – Wallis , Wilcoxon Signed Rank , and Mann – Whitney test . Results : While fluorosis reduced the SBS of orthodontic bracket ( P = 0.017 ) , Enhance Locus Ceruleus LC significantly increased the SBS of the orthodontic bracket in fluorosed and nonfluorosed teeth ( P = 0.039 ) . Significant increasing in the number and length of enamel crack after debonding was found in all four groups . There were no significant differences in the length of enamel crack increased after debonding among four groups ( P = 0.768 ) while increasing in the number of enamel cracks after debonding was significantly different among the four groups ( P = 0.023 ) . Teeth in Group 2 showed the highest enamel damages among four groups following debonding . Conclusion : Adhesion promoters could improve the bond strength of orthodontic brackets , but conservative debonding methods for decreasing enamel damages would be necessary OBJECTIVE This in vivo pilot study investigated the role of argon laser irradiation and combined fluoride and argon laser treatment in accelerated natural caries development in sound enamel surfaces beneath plaque-retentive orthodontic b and s. METHOD AND MATERIAL S Five patients ( 3 female , 2 male , ages 19 to 28 years ) requiring tooth extraction prior to orthodontic treatment , participated in the study . Buccal surfaces were treated with either : ( 1 ) argon laser ( 250 mW for 10 seconds , ARGO-MOD ) ; ( 2 ) topical fluoride ( 0.5 % fluoride ion , Thera-Flur-N ) followed by argon lasing ; or ( 3 ) no treatment ( control ) . Orthodontic b and s with plaque-retentive slots on buccal surfaces were placed on the teeth slated for extraction ( n = 14 ) . Following a minimum of 5 weeks of intraoral exposure , the teeth were extracted for laboratory analysis . The teeth underwent serial longitudinal sectioning ( 12 sections per tooth ) . The sections were imbibed in water , and lesion depths were determined with each section , using polarized light microscopy . Comparisons were made among treatment groups ( analysis of variance , Duncan 's multiple range test for paired sample s ) . RESULTS Mean lesion depths were : 261 + /- 24 microm for the no treatment control group ( n = 84 sections ) ; 147 + /- 18 microm for the argon laser group ( n = 24 sections ) ; and 99 + /- 12 microm for the fluoride and argon laser group ( n = 60 sections ) . Both the argon laser ( 44 % ) and the fluoride and argon laser groups ( 62 % ) had significant lesion depth reductions compared to controls . The addition of fluoride treatment prior to argon lasing result ed in a 32 % reduction in lesion depth compared to argon laser treatment alone . CONCLUSIONS Within this clinical pilot study , in vivo natural caries formation was affected significantly by a single exposure to low fluence argon laser irradiation . Topical fluoride treatment in combination with argon lasing provided an even greater degree of resistance against in vivo enamel caries development . A simple technique for reducing the caries susceptibility of enamel may be a clinical reality The bonding performance of current adhesive systems to primary enamel has not been thoroughly research ed . This study compared the micro-shear bond strength of two adhesive systems to primary and permanent tooth enamel . Two commercially available resin adhesives , a self-etching primer system ( Clearfil SE Bond ) and a single-bottle adhesive system ( Single Bond ) used with a total-etch wet bonding technique were tested . A micro-shear bond test was used to examine the adhesive systems on mid-coronal buccal enamel of extracted primary or permanent teeth . In addition , etched enamel surfaces and etched-bonded enamel interfaces were examined using scanning electron microscopy ( SEM ) . No statistically significant differences of shear bond strength values were found between the primary and permanent enamel or the adhesive systems used ( p>0.01 ) . The SEM observations showed that both adhesive systems etched the primary enamel deeper than the permanent enamel , suggesting that the action of acid etch seemed to be more intense on primary enamel than on permanent enamel . Bonding of the adhesive systems to primary enamel was almost identical to permanent enamel The purpose of this study was to compare the efficacy of two powered brushing instruments ( Rota-dent , Pro-Dentec Inc. and Interplak , Bausch and Lomb Inc. ) for control of plaque and gingivitis in interproximal spaces and furcations . Thirty-five patients , r and omly selected from a pool of post-active therapy , periodontal surgical cases , completed this study . A split-mouth design was utilized in this twelve-week trial with each patient acting as his/her own control . Subjects alternately brushed one-half of their mouths with each of the instruments : a crossover in the brushing pattern occurred at six weeks . Single-blind clinical assessment s were made by a calibrated investigator at baseline , six and twelve weeks . Gingival Index ( GI ) , Plaque Index ( PI ) and Papillary Bleeding Index ( PBI ) were determined in interproximal and furcation areas . Mean percent reductions from baseline for GI , PI and PBI at the end of twelve weeks were 72 % , 61 % and 70 % , respectively for the Rota-dent , and 46 % , 43 % and 27 % , respectively for the Interplak . One-way analyses of variance ( ANOVA ) and co-variance ( ANCOVA ) indicate that the Rota-dent was significantly more effective ( p < 0.001 ) than the Interplak in controlling plaque and gingivitis in furcation and interproximal areas with clinical ly relevant differences in all indices measured Objective : This in vitro study aim ed to compare the microleakage of orthodontic brackets between enamel-adhesive and adhesive-bracket interfaces at the occlusal and gingival margins bonded with different adhesive systems . Material s and Methods : A total of 144 human maxillary premolar teeth extracted for orthodontic reasons was r and omly divided into four groups . Each group was then further divided into three sub-groups . Three total-etching bonding systems ( Transbond XT , Greengloo and Kurasper F ) , three one-step self-etching bonding systems ( Transbond Plus SEP , Bond Force and Clearfil S3 ) , three two-step self-etching bonding systems ( Clearfil SE Bond , Clearfil Protectbond and Clearfil Liner Bond ) , and three self-adhesive resin cements ( Maxcem Elite , Relyx U 100 and Clearfil SA Cement ) were used to bond the brackets to the teeth . After bonding , all teeth were sealed with nail varnish and stained with 0.5 % basic fuchsine for 24 h. All sample s were sectioned and examined under a stereomicroscope to score for microleakage at the adhesive-enamel and adhesive-bracket interfaces from both occlusal and gingival margins . Statistical Analysis Used : Statistical analyses were performed with Kruskal-Wallis and Wilcoxon signed-rank tests . Results : The results indicate no statistically significant differences between the microleakage scores of the adhesives ; microleakage was detected in all groups . Comparison of the average values of the microleakage scores in the enamel-adhesive and adhesive-bracket interfaces indicated statistically significant differences ( P < 0.05 ) . The amount of the microleakage was higher at the enamel-adhesive interface than at the bracket-adhesive interface . Conclusions : All of the brackets exhibited some amount of microleakage . This result means that microleakage does not depend on the type of adhesive used Argon lasers , because of their significant timesavings over conventional curing lights , have been investigated for use in bonding orthodontic brackets . They are also being investigated for their ability to confer demineralization resistance on enamel , which is of great interest in orthodontics . A two-part in vitro study on 86 human posterior teeth was conducted to determine the effects of a five-second argon laser exposure on shear bond strength and to evaluate the effects of a five- and 10-second argon laser exposure ( 250 mW ) on demineralization of enamel surrounding orthodontic brackets after exposure to an artificial caries bath . Brackets cured with the argon laser for five seconds yielded mean bond strengths similar to those attained with a 40-second conventional light-cured control ( n = 13 per group , 20.4 vs 17.8 MPa ) . Brackets cured with the argon laser for 10 seconds result ed in significantly lower mean lesion depth when compared with a visible light control ( n = 20 per group , 107.8 vs 137.2 microm , P = .038 ) . There were no statistically significant differences in lesion depth between the five-second argon laser and the visible light control groups . Overall , there was a 15 % and 22 % reduction in lesion depths for the five- and 10-second group , respectively . Poor correlations were found between the clinical appearance of decalcifications and their lesion depth .  Argon lasers used for bonding orthodontic brackets would save a significant amount of chair time while possibly conferring demineralization resistance upon the enamel
Complications of interproximal enamel reduction are hypersensitivity , irreversible damage of dental pulp , increased formation of plaque , the risk of caries in the stripped enamel areas and periodontal diseases .
CONCLUSION Interproximal enamel reduction is an important part of orthodontic treatment for gaining space in the dental arch , and for the correction of the Bolton index discrepancy
OBJECTIVE Interproximal enamel reduction is a part of orthodontic treatment for gaining a modest amount of space in the treatment of crowding .
Today interproximal enamel reduction has become a viable alternative to the extraction of permanent teeth , and helps to adjust the Bolton Index discrepancy .
The aim of the study is to evaluate various interproximal enamel reduction techniques , its indications , contraindications and complications presented in recent scientific studies .