REV.CHIM.(Bucharest)♦70♦No.8 ♦2019 http://www.revistadechimie.ro 2873 * email: pancu.galina@yahoo.com ; stoleriu_simona@yahoo.com Assessment of the Remineralisation Products Efficiency in Incipient Caries Lesions Adjacent to the Fixed Orthodontic Appliances GALINA PANCU*, GIANINA IOVAN, SIMONA STOLERIU*, NICOLETA TOFAN, ANTONIA MOLDOVANU, EMILIA DIMBU, GEORGIANA MACOVEI, SORIN ANDRIAN Grigore T. PopaUniversity of Medicine and Pharmacy of Iasi, Faculty of Dental Medicine, 16 Universitatii Str., 700115 Iasi, Romania The aim of the study is to asses, by using microhardness technique, the remineralization effect of some products used in the treatment of early dental caries adjacent to fixed orthodontic appliances. The study was performed on a group of 32 patients receiving fixed orthodontic therapy. The patients were randomly divided in two groups, accordingly to the administered preventive protocol: in group 1 (control) toothpaste Splat Professional Biocalcium (without fluoride) was applied twice a day; in group 2 (study group) toothpaste and mouthwash Vitis anticaries with natrium monofluorophosphate 1450 ppm F, respectively 226 ppm F, twice a day were used. After 60 days, the extraction of premolars was made and the preparation of the samples was done. The microhardness analysis was performed using the device CV 400 DAT (Namicon). The analysis of the results found lower microhardness for the samples submitted to brushing with fluoridated toothpaste and rinsing with fluoridated mouthwash solution, comparing to control (samples submitted only to brushing with non-fluoridated toothpaste). The conclusions of this study confirm the effectiveness of a proper prophylactic protocol (toothbrushing with fluoridated toothpaste, mouth rinsing with fluoridated mouthwashes) associated to the fixed orthodontics therapy, in the prevention of the early enamel demineralization onset adjacent to brackets. Keywords: enamel demineralization, orthodontic brackets, remineralization, microhardness Nowadays we assist to an increased demand for fixed orthodontics therapy for children, teenagers, and young adults. Despite of the high effectiveness of the fixed orthodontic treatment [1], it is recorded a high incidence of the dental and periodontal complications, especially in pourly treated cases [1, 2]. The additional retention areas for the bacterial plaque due to the fixed orthodontic appliances (brackets, rings, fixed bonded retainers) contribute to the onset of quantitative and qualitative changes of the bacterial flora, increasing the pathogenity and contributing to the formation of new enamel areas vulnerable to the cariogenic attacks [3-5]. One of the most frequent complication is represented by early acute dental caries (white-spot) onset adjacent to the orthodontics brackets [1-7]. Almost one third of the patients with poor oral hygiene, receiving fixed orthodontic therapy, develop at least one carious lesion due to the bacterial plaque formed around fixed orthodontic appliances [ 8]. In the oral cavity, the remineralization and demineralization processes are in a permanent dynamic balance. When the cariogenic factors are involved, the demineralization processes are favoured [4, 9-12]. If the cariogenic factors are removed, the evolution of the demineralization can be stopped [2, 3, 5, 13]. Some researches found a fast increase of the bacterial plaque volume following the application of the fixed orthodontic appliances. Also, in these situations, the bacterial plaque has a lower p H comparing to the patients that are not treated by fixed orthodontic therapy [14]. The change of the bacterial flora composition was observed in the dental areas adjacent to the fixed orthodontic appliances. The levels of acidogenic bacteria (Streptococcus mutans, lactobacillus) increase significantly [15]. Thus, the evolution of the cavitated carious lesions is accelerated to the patients receiving fixed orthodontic therapy. Despite the numerous oral hygiene products recommended for the prevention-therapeutic approach of the early enamel demineralizations associated to bacterial plaque [13, 16-18], the prevention of these carious lesions is a challenge regulated by other associated factors, as proper selection of the product and the application time of the recommended preventive method [16, 17, 19-22]. Other major factors involved are as follows: cariogenic risk, dental tissues resistance to the cariogenic attack, quantity and quality of saliva, pathogenity of the bacterial flora, diet [16, 17, 19, 22]. The aim of this study is to assess in vivo changes of the enamel associated to the retention of some orthodontic appliances and the ability of some oral hygiene products to counteract these changes. Experimental part The study followed all the regulations imposed by Ethics and Research Committee of Dental Medicine Faculty, Gr.T.Popa University of Medicine and Pharmacy Iaºi and in accordance to some published models [23]. The study was performed on a group of 32 patients (aged between 18 and 28 years), receiving fixed orthodontic therapy. All patients signed an informed consent. The inclusion and exclusion criteria for the patients’ selection are presented in table 1. The research protocol is described in table 2. Before the beginning of the study, it were performed the professional mechanic toothbrushing and the assessment of the enamel quality of the premolars, using KAVO DiagnoPen (KaVo Germania). Values under 13 confirmed the absence of hypoplasia or demineralization. The indications for proper oral hygiene were given to all patients. The use of the oral hygiene products was recommended, accordingly to the preventive protocol. The patients were divided in two groups: control; study groups.