Evaluation of enamel demineralization development around different types of orthodontic brackets in artificial saliva containing streptococcus mutans: İn-vitro study

In the presented application, it is aimed to compare the demineralizations that occur on the surfaces of the frents of different end abrasives kept in a non-formable environment. In this in vitro study, 90 extracted human premolars were used. The teeth were divided into 6 groups, each consisting of 15 samples, 5 study and 1 control group. Victory metal, Gemini metal, Clarity self-ligating ceramic, APC Clarity Advanced ceramic and Clarity Advanced ceramic brackets (3M Unitek, Monrovia, Calif) used in the study groups were bonded to the teeth with direct technique. The gingival, occlusal and proximal enamel surfaces of the brackets were measured with a DIAGNOdent pen (KaVo, Biberach, Germany) (T0). The teeth were then placed in cariogenic suspension medium containing Streptococcus mutans, sucrose and artificial saliva, and the medium was renewed every 48 hours. After 28 days, the teeth were removed from the suspension. The gingival, occlusal and proximal enamel surfaces of the brackets were re-measured with DIAGNOdent and recorded (T1). Whether the obtained data were homogeneously distributed or not was evaluated with the Kolmogorov-Smirnov test. Wilcoxon test was used for in-group comparison, while Mann-whitney U and Kruskal-wallis tests were used for intergroup comparisons. In all groups, demineralization values of enamel surfaces in the gingival, proximal and occlusal parts of the brackets were statistically significantly higher in the T1 period than in the T0 period (p<0.05). In the T1 period, the demineralization values of the gingival enamel surface of the Victory metal group were found to be statistically significantly lower than the Gemini metal, Clarity self-ligating ceramic, APC Clarity Advanced ceramic and Clarity Advanced ceramic groups (p<0.05). In the T1 period of Gemini metal, Clarity self-ligating ceramic and Clarity advanced ceramic groups, the demineralization values of the proximal enamel surfaces were found to be statistically significantly higher than the Victory metal and APC Clarity Advanced ceramic bracket groups (p<0.05). Again in the T1 period, the demineralization values of the occlusal enamel surfaces of the Victory metal, APC Clarity Advanced ceramics and control groups were found to be statistically significantly lower than the Gemini metal, Clarity self-ligating ceramic and Clarity Advanced ceramic groups (p<0.05). As a result of the study, a statistically significant increase in enamel demineralization values was observed as a result of the formation of increased retention areas for microbial dental plaque on the enamel surfaces adjacent to the bracket. Considering the importance of minimizing enamel demineralization in fixed orthodontic treatments, less enamel demineralization was observed in Victory metal and APC Clarity Advanced ceramic bracket groups.