An Investigation of Fluoride Release from Orthodontic Elastomeric
Ligatures
Nuttachai Viriyakosol
1,a
, Surachai Dechkunakorn
1,b
, Niwat Anuwongnukroh
1,c
,
Peerapong Tua-ngam
2,d
, Wassana Wichai
2,e
1
Department of Orthodontics, Faculty of Dentistry, Mahidol University, Thailand
2
Research office, Faculty of Dentistry, Mahidol University, Thailand
a
iamxpotter@hotmail.com,
b
surachai.dec@mahidol.ac.th,
c
niwat.anu@mahidol.ac.th (Corresponding Author),
d
peerapong.tua@mahidol.ac.th,
e
wassana.wic@mahidol.ac.th
Key words: Elastomeric ligatures, Fluoride mouthrinse, Fluoride release, Decalcification, White
spot lesion
Abstract. The study aimed to investigate the amount of fluoride release from 3 brands of
elastomeric ligatures in vitro, after exposure to daily fluoride mouthrinse. The study used 3 brands
of elastomeric ligatures (Morelli, Brazil; Unitek, USA; Thai, Thailand). Two elastomeric ligatures
from each brand were moistened by de-ionized water and then divided into control and test groups
(n=5 per group). In both groups, elastomeric ligatures were placed in individual plastic bottle with 3
ml of de-ionized water. However, In the test group, They were exposed to fluoride mouthrinse (250
ppm fluoride/0.05%NaF) for 1 minute daily. All samples were stored at 37°C for 1, 3, 5, 7 days.
After the end of each observation period, the amount of fluoride release in de-ionized water was
measured by fluoride ion electrode. The data were analyzed by Kraskal-Wallis and Mann-Whitney
U tests (p<0.05).
Amount of fluoride release in test group was greater than in the control group in all 3 brands.
Within 7 days of daily fluoride exposure, the fluoride released from elastomeric ligatures was
continuously increased. Fluoride release from Morelli (0.067±0.013 ppm) and Unitek (0.067±0.012
ppm) were significantly higher than Thai (0.040±0.03 ppm). The fluoride level measured from
Morelli and Unitek were not significantly different. The orthodontic elastomeric ligatures can
absorb fluoride from mouthwash and release the detectable amount of fluoride within seven days.
This fluoride might help prevention of enamel decalcification adjacent to the bracket during
orthodontic treatment.
Introduction
Enamel decalcification, that manifested as a white spot lesions, adjacent to orthodontic brackets is a
problem in orthodontic treatment with fixed appliance. This lesions can take only 1 month to
develop [1-4]. Many fluoride-releasing materials, such as orthodontic adhesives and elastomeric
ligatures, were used to aid in preventing demineralization and enhance remineralization of enamel
during treatment.
Fluoride-releasing adhesives include conventional glass ionomer cements (GICs), resin-modified
glass ionomer cements (RMGICs) and poly-acid modified composite resins [5] . These adhesives
have attracted considerable interest, because fluoride is deposited directly to the area around
bracket. However, the highest amount of fluoride is released during the first few days with a rapid
decline to much lower levels [6-9]. Systematic review showed weak evidence that GICs and
RMGICs is more effective than composite resin in preventing white spot formation [10, 11].
Fluoride-impregnated elastomeric ligatures were developed to provide long-term low-dose
fluoride release [12, 13]. The fluoride sources are replenished at each orthodontic visit by simply
changing the elastomeric rings. Clinical studies have demonstrated favorable results with reduction
of enamel decalcification [14, 15]. Nevertheless, studies published afterwards reported
contradictory results [16-18]. In addition, fluoridated elastomers have been reported to poor
Advanced Materials Research Vols. 1025-1026 (2014) pp 787-791 Submitted: 27.06.2014
Online available since 2014/Sep/12 at www.scientific.net Accepted: 11.07.2014
© (2014) Trans Tech Publications, Switzerland
doi:10.4028/www.scientific.net/AMR.1025-1026.787
All rights reserved. No part of contents of this paper may be reproduced or transmitted in any form or by any means without the written permission of TTP,
www.ttp.net. (ID: 202.28.179.5-13/10/14,04:54:55)