Enamel demineralization adjacent to orthodontic brackets bonded with hybrid glass ionomer cements: an in vitro study.

Enamel demineralization is recognized as a possible side effect of bonding orthodontic brackets with composite resins. Fluoride-releasing restorative materials have been shown to inhibit tooth demineralization. The purpose of this study was to evaluate two fluoride-releasing hybrid glass ionomer bonding agents for inhibition of enamel demineralization surrounding orthodontic brackets under two experimental conditions. This in vitro study used 72 extracted human premolars. Twenty-four teeth were bonded with Advance resionomer, 24 were bonded with Fuji Ortho LC hybrid glass ionomer and 24 were bonded with Transbond XT composite resin as the control. The teeth were cycled in an artificial caries challenge three times daily for 30 days. Half of the teeth in each group were brushed twice daily with a fluoridated dentifrice, and the other half were not brushed. Demineralization of enamel surrounding orthodontic brackets was evaluated with polarized light microscopy. Enamel lesions were photographed under maximum illumination. Images were projected, and demineralized areas were traced. Both average depth and area were measured with a sonic digitizer. Analysis of variance (P <.0001) and Duncan's test (P <.05) indicated significant differences in depth and area of demineralized enamel such that lesion size was: Transbond XT no brush > Transbond XT brush > Advance no brush = Advance brush = Fuji Ortho LC no brush = Fuji Ortho brush. The promising results of this in vitro study warrant further clinical investigation of hybrid glass ionomer adhesives as orthodontic bonding agents to minimize enamel demineralization.