Evaluation of Resin Infiltration, Fluoride and the Biomimetic Mineralization of CPP-ACP in Protecting Enamel after Orthodontic Inter-Proximal Enamel Reduction

Abstract

Background: This study investigated the effect of using different agents for protecting enamel proximal surfaces against acidic attack after interproximal reduction (IPR) using the trans micro radiography technique. Methods: Seventy-five sound-proximal surfaces were obtained from extracted premolars for orthodontic reasons. All teeth were measured miso-distally and mounted before being stripped. The proximal surfaces of all teeth were hand stripped with single-sided diamond strips (OrthoTechnology, West Columbia, SC, USA) followed by polishing via Sof-Lex polishing strips (3M, Maplewood, MN, USA). Three-hundred micrometers of enamel thickness was reduced from each proximal surface. The teeth were randomly divided into 5 groups: group 1 (control un-demineralized) received no treatment, group 2 (control demineralized) had their surfaces demineralized after the IPR procedure, group 3 (fluoride) specimens were treated with fluoride gel (NUPRO, DENTSPLY, Charlotte, NC, USA) after the IPR, group 4 (Icon) resin infiltration material (Icon Proximal Mini Kit, DMG, Bielefeld, Germany) was applied after IPR, group 5 (MI varnish) specimens were treated with Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing varnish (MI Varnish, G.C, USA, St. Alsip, IL, USA) after the IPR. The specimens in (groups 2–5) were stored in a 4.5 pH demineralization solution for 4 days. The trans-micro-radiography (TMR) technique was conducted to evaluate the mineral loss (∆Z) and lesion depth of all specimens after the acid challenge. The obtained results were analyzed statistically using a one-way ANOVA at a significance level of α = 0.05. Results: The MI varnish recorded significant ∆Z and lesion depth values compared to the other groups p > 0.05. There was no significant difference in ∆Z and lesion depth between the control demineralized, Icon, and fluoride groups p < 0.05. Conclusion: The MI varnish increased the enamel resistance to acidic attack, and thus can be considered an agent capable of protecting the proximal enamel surface after IPR.

The Role of Interproximal Reduction (IPR) in Clear Aligner Therapy: A Critical Analysis of Indications, Techniques, and Outcomes

“…Almansouri et al concluded that the use of minimally invasive (MI) varnish, a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing varnish, proved to be the most effective agent in protecting proximal enamel surfaces after IPR against acidic attack. The MI varnish demonstrated significant improvements in enamel resistance compared to the other groups, including Icon resin infiltration, and fluoride-treated groups [44].…”

Visualization of etching cycles efficacy at the resin infiltration into artificial enamel caries: in-vitro study on bovine teeth

“…For smaller and more superficially located lesions, a single etching cycle may be sufficient, whereas the aesthetic healing of larger and deeper lesions requires further etching procedures [32,33]. A single 120 s etching cycle before infiltration has been performed in some studies [34,35]. However, it has been argued that esthetic outcomes might be improved with increased etching duration or increased number of cycles, as this could enable greater resin penetration [36].…”

Using Resin Infiltration Technique and Direct Composite Restorations for the Treatment of Carious Lesions with Different Depths

“…On the other hand, Almansouri et al [ 17 ] reported that resin infiltration application would not provide a greater benefit than other protective applications. Still, the vast majority stand behind the protective properties of resin infiltration.…”