Fluoride-releasing Elastomeric Modules Reduce Decalcificatio

[tirath]

use of fluoride releasing elastomeric modules reduces the degree of decalcification experienced during orthodontic treatment. such kind of modules are used by orthodontics in india?

        

[sushantpatel_doc]

Enamel demineralisation and the need for patient co-operation in its prevention has been a continual challenge for the orthodontist. This paper seems to address both these issues directly and has interesting and clinically relevant outcomes. The authors have focussed on the value of long duration low-dose fluoride release in preventing enamel damage using fluoride-releasing elastomerics in full-banded therapy. A review of most of the other relevant modalities of preventing enamel decalcification emphasises the clinical relevance of this randomised controlled clinical trial. Well-defined inclusion criteria, blinding procedures and a meticulous statistical design contribute to the definitive outcome of this trial. The authors have ensured a pretreatment equivalence and matching of the two groups for relevant variables. The outcome of the trial indicates a reduction of both incidence as well as the severity of decalcification. The overall 47% reduction in decalcification scores in comparison with the control group is clinically significant and well worth the effort. The results also support the finding of some previous in vitro studies that low dosage prolonged fluoride release from elastomerics would provide significant enamel protection in full-banded therapy. Although fluoride-releasing elastomerics show a rapid deterioration in the oral environment, there was no prolongation of treatment time. The authors indicate only a minor disadvantage of the fluoride-impregnated elastomerics being less elastic and more prone to discoloration and swelling. Fluoride-impregnated elastomerics certainly have a clinically significant role in reducing enamel decalcification in fixed bonded orthodontics.

Non-aesthetic white-spot lesions or larger unattractive areas of decalcification around orthodontic brackets remain a significant problem during fixed-appliance treatment. These areas of demineralisation of enamel around orthodontic attachments usually occur after a period of 1 month. Stannous fluoride-releasing elastomeric modules and chain may provide additional protection against enamel decalcification through fluoride release. This study supports the use of fluoride-releasing elastomerics and is probably the first of its kind to prove the clinical efficacy of these fluoride-releasing elastomerics.

        

[drsushant]

 To determine the effects of fluoride and pH on enamel de- and remineralization, a study by Dr. Frank Lippert, et al used quantitative light-induced fluorescence to in­vestigate enamel lesions under conditions designed to resemble plaque fluid. Pre­formed enam­el lesions were exposed to partially-saturated lactic acid solutions with varying fluoride concentrations (0.0 ppm, 0.1 ppm, 0.5 ppm, 1.5 ppm, and 4.0 ppm) and pH levels (4.9, 5.2, and 5.5). The average fluorescence loss was monitored for 11 days. Then, the enam­el lesions were demineralized in a partially-saturated acetic acid solution for 2 periods of 24 hours each. The lesions in the plaque fluid of a 4.0-ppm fluoride concentration and a 5.5-pH level were found to show the most remineralization after 11 days and the most demineralization after exposure to acetic acid. Increasing the fluoride concentration resulted in more remineralization regardless of the pH level, and increasing the pH level resulted in more remineralization. The lesions exposed to no fluoride showed no remineralization regardless of the pH level. The study found that fluoride had a stronger effect on remineralization and net mineral change than pH.

        

[Drsumitra]

To determine the effects of fluoride and pH on enamel de- and remineralization, a study by Dr. Frank Lippert, et al used quantitative light-induced fluorescence to in­vestigate enamel lesions under conditions designed to resemble plaque fluid. Pre­formed enam­el lesions were exposed to partially-saturated lactic acid solutions with varying fluoride concentrations (0.0 ppm, 0.1 ppm, 0.5 ppm, 1.5 ppm, and 4.0 ppm) and pH levels (4.9, 5.2, and 5.5). The average fluorescence loss was monitored for 11 days. Then, the enam­el lesions were demineralized in a partially-saturated acetic acid solution for 2 periods of 24 hours each. The lesions in the plaque fluid of a 4.0-ppm fluoride concentration and a 5.5-pH level were found to show the most remineralization after 11 days and the most demineralization after exposure to acetic acid. Increasing the fluoride concentration resulted in more remineralization regardless of the pH level, and increasing the pH level resulted in more remineralization. The lesions exposed to no fluoride showed no remineralization regardless of the pH level. The study found that fluoride had a stronger effect on remineralization and net mineral change than pH.

 

        

[drmithila]

To determine if a novel dual camera imaging system employing both polarized white light (PWL) and quantitative light induced fluorescence imaging (QLF) is appropriate for measuring enamel fluorosis in an epidemiological setting. The use of remote and objective scoring systems is of importance in fluorosis assessments due to the potential risk of examiner bias using clinical methods.

Methods
Subjects were recruited from a panel previously characterized for fluorosis and caries to ensure a range of fluorosis presentation. A total of 164 children, aged 11 years (±1.3) participated following consent. Each child was examined using the novel imaging system, a traditional digital SLR camera, and clinically using the Dean’s and Thylstrup and Fejerskov (TF) Indices on the upper central and lateral incisors. Polarized white light and SLR images were scored for both Dean’s and TF indices by raters and fluorescence images were automatically scored using software.

Results
Data from 164 children were available with a good distribution of fluorosis severity. The automated software analysis of QLF images demonstrated significant correlations with the clinical examinations for both Dean’s and TF index. Agreement (measured by weighted Kappa’s) between examiners scoring clinically, from polarized photographs and from SLR images ranged from 0.56 to 0.92.

Conclusions
The study suggests that the use of a digital imaging system to capture images for either automated software analysis, or remote assessment by raters is suitable for epidemiological work. The use of recorded images enables study archiving, assessment by multiple examiners, remote assessment and objectivity due to the blinding of subject status.
There are a number of effective strategies available to prevent dental caries, which include the use of fluorides including community fluoridation schemes (water, salt and milk), fluoridated toothpastes, and other fluoride delivery systems, such as tablets, drops, and varnishes. The US Surgeon General has reported that community water fluoridation is an effective, safe, and ideal public health activity that benefits individuals of all ages across all socioeconomic strata [1] Indeed, the Centers for Disease Control and Prevention has listed community water fluoridation as one of the top ten public health achievements in the past century

        

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