Evaluation of the Efficacy of Various Topical Fluorides on Enamel Demineralization Adjacent to Orthodontic Brackets: An In Vitro Study.

AIM: White spot lesions (WSLs) occur frequently after fixed orthodontic treatment. This in vitro study was undertaken to compare the efficacy of 2.26% fluoride varnish, 1.23% APF gel, 0.21% fluoride toothpaste and 0.04% sodium fluoride mouthwashes in preventing enamel demineralization around orthodontic brackets in extracted premolars. MATERIALS AND METHODS: The sample for this study included 100 premolars free of caries and enamel cracks. They were divided into five groups of 20 samples each. Group 1 (FV): light-curable Fluoride varnish (Clinpro™ XT 3M ESPE, Pymble, New South Wales, Australia), group 2 (FG): 1.23% APF gel (Patterson NE. International, USA), group 3 (FTP): 0.21% w/w sodium fluoride toothpaste with tri-calcium phosphate (Clinpro™ Tooth Crème, 3M ESPE, Australia), group 4 (FMW): sodium fluoride 0.044% (w/v) mouthwash (Colgate® Phos-Flur® Ortho Defense Rinse, Colgate-Palmolive, NY) and group 5 (C): control. The samples were subjected to laboratory pH cycling. The demineralization changes in the enamel were assessed before the start of the experiment and after 14 days. RESULTS: There was a significant change in the mean Diagnodent score value (p <0.001) in all groups from day 1-day 14. The mean values were significantly different among groups at day 1 (p = 0.002), day 14 (p = 0.001) and also the change from Day 1 to Day 14 was significantly different among Groups (p = 0.001). The least change in the mean value from baseline to 14 days was seen in group 1 (FV) followed by group 3 (FTP), group 2 (FG), and group 4 (FMW) and then the group 5 (C). CONCLUSION: All the topical fluorides tested were able to reduce the demineralization when compared to the control group under similar testing conditions, but to varying degrees. light-curable fluoride varnish outperformed all the topical fluorides followed by 0.21% w/w dodium fluoride toothpaste with tri-calcium phosphate, 1.23% Acidulated phosphate fluoride gel and sodium fluoride 0.044% (w/v) mouthwash. The control group where no topical fluoride was applied showed the least resistance to demineralization. CLINICAL SIGNIFICANCE: Within the limitations of this study, routine application of light cured fluoride varnish (Clinpro) can be recommended to prevent enamel demineralization to prevent white spot lesions in patients receiving orthodontic treatment.

Neurofibromatosis, Down's syndrome, and acquired abnormalities.

We report a patient with Down's syndrome and neurofibromatosis who presented with a keloid, sebaceous cyst and acanthosis nigricans, along with dental and ophthalmological defects. The coexistence of neurofibromatosis type 1 and Down's syndrome which are two unrelated genetic conditions is itself a rarity.

Marquardt's Facial Golden Decagon Mask and Its Fitness with South Indian Facial Traits.

INTRODUCTION: The mathematical ratio of 1:1.618 which is famously known as golden ratio seems to appear recurrently in beautiful things in nature as well as in other things that are seen as beautiful. Dr. Marquardt developed a facial golden mask that contains and includes all of the one-dimensional and two-dimensional geometric golden elements formed from the golden ratio and he claimed that beauty is universal, beautiful faces conforms to the facial golden mask regardless of sex and race. AIM: The purpose of this study was to evaluate the goodness of fit of the golden facial mask with the South Indian facial traits. MATERIALS AND METHODS: A total of 150 subjects (75 males & 75 females) with attractive faces were selected with cephalometric orthodontic standards of a skeletal class I relation. The facial aesthetics was confirmed by the aesthetic evaluation of the frontal photographs of the subjects by a panel of ten evaluators including five orthodontists and five maxillofacial surgeons. The well-proportioned photographs were superimposed with the Golden mask along the reference lines, to evaluate the goodness of fit. RESULTS: South Indian males and females invariably show a wider inter-zygomatic and inter-gonial width than the golden mask. Most of the South Indian females and males show decreased mid-facial height compared to the golden mask, while the total facial height is more or less equal to the golden mask. CONCLUSION: Ethnic or individual discrepancies cannot be totally ignored as in our study the mask did not fit exactly with the South Indian facial traits but, the beauty ratios came closer to those of the mask. To overcome this difficulty, there is a need to develop variants of golden facial mask for different ethnic groups.

Impacted canines: Etiology, diagnosis, and orthodontic management.

Impaction of maxillary and mandibular canines is a frequently encountered clinical problem, the treatment of which usually requires an interdisciplinary approach. Surgical exposure of the impacted tooth and the complex orthodontic mechanisms that are applied to align the tooth into the arch may lead to varying amounts of damage to the supporting structures of the tooth, not to mention the long treatment duration and the financial burden to the patient. Hence, it seems worthwhile to focus on the means of early diagnosis and interception of this clinical situation. In the present article, an overview of the incidence and sequelae, as well as the surgical, periodontal, and orthodontic considerations in the management of impacted canines is presented.

Adherence of Streptococcus mutans and Candida albicans to different bracket materials.

OBJECTIVE: To quantify the adherence of Streptococcus mutans and Candida albicans on brackets made of stainless steel, plastic, ceramic, titanium, and gold, and to evaluate the various sites of adherence of these microorganisms with scanning electron microscopy (SEM). MATERIALS AND METHODS: Brackets made of stainless steel, plastic, ceramic, titanium, and gold were used. The adherence of S. mutans and C. albicans were studied. The brackets were placed in flat-bottomed vials containing basal medium with 20% sucrose added; the flasks were inoculated with each of the microbial suspensions. The samples were incubated at 37°C for 48 h, after which the brackets were removed. The cells adhering to the glass were counted and the brackets were studied with SEM. RESULTS: When evaluated together, the adherence of S. mutans and C. albicans was increased in the ceramic bracket group. When evaluated separately, metallic brackets had increased number of colony-forming units (CFUs) of S. mutans and the use of titanium brackets increased the CFUs of C. albicans. SEM demonstrated that the adherence of S. mutans and C. albicans together varied according to the bracket materials, with ceramic having the greatest and stainless steel having the least adherence. CONCLUSIONS: Oral hygiene may be of greater concern with esthetic brackets since this study shows that microbial adhesion is greater with these brackets.