Remineralization Potential of Calcium and Phosphate-based Agents and Their Effects on Bonding of Orthodontic Brackets

Purpose: To compare the remineralization potential of Clinpro Tooth Crème (CTC C, 3M Oral Care) containing functionalized tricalcium phosphate (fTCP), Tooth Mousse (TM, GC) containing casein phosphopeptide amorphous calcium phosphate (CPP-ACP), and Tooth Mousse Plus (TMP, GC) containing casein phosphopeptide amorphous calcium phosphate with fluoride (CPP-ACPF) and their effects on the shear bond strength (SBS) of orthodontic brackets to enamel. Materials and Methods: In Part I of the study, 51 premolars were divided into 3 groups: 1: fTCP; 2: CPP-ACP; 3: CPP-ACPF. Artificial carious lesions were created and immersed in remineralizing solution for 30 days. Specimens were evaluated using Knoop microhardness and transverse microradiography. The percentage of surface hardness recovery (%SHR), change in lesion depth (∆LD), and mineral loss (∆∆Z) were analyzed using one-way ANOVA. In Part II of the study, 80 premolars were divided into 5 groups: A: brackets bonded to sound enamel; B: brackets bonded to demineralized enamel (DE); C-E: demineralized enamel immersed in remineralizing solution containing fTCP (group C), CPP-ACP (group D), or CPP-ACPF (group E) before bracket bonding. The SBS of half of the specimens were tested immediately, while the other half were tested after thermocycling. Data were analyzed using two-way ANOVA. Results: TMP showed significantly higher %SHR, ∆LD and ∆∆Z compared to the other groups (p 0.05). Both control and TMP had the highest SBSs and demineralized enamel the lowest, irrespective of thermocycling. No significant difference in SBS was found between TM and TMP after thermocycling. Conclusions: Tooth Mousse Plus achieved significant remineralization of artificial enamel carious lesions without adverse effect on shear bond strength of orthodontic brackets to remineralized enamel. Keywords: calcium and phosphate-based agents, enamel bonding, orthodontic brackets, remineralization