Determinants of enamel decalcification during simulated orthodontic treatment. Academic Article uri icon


  • OBJECTIVE: To determine the relative effects that phosphoric acid etching, metal brackets, composite resin adhesives, and filled resin sealants have on enamel decalcification. MATERIALS AND METHODS: One hundred and fifty teeth were randomly divided into six groups to test the effects of acid etching, brackets, and a composite resin adhesive. The right side of each tooth was sealed. The teeth were submitted to a simulated carious challenge by Streptococcus mutans in a nutritive media for 42 days. Scanning electron photomicrographs (SEMs) were used to qualitatively evaluate the tooth surfaces. DIAGNOdent laser fluorescence was used to quantify the decalcification changes that occurred. RESULTS: SEMs showed normal enamel on the control teeth, etching patterns on the acid-etched teeth, surface degradation on the teeth that had resin, and sealant tags on the sealed side. The untreated control group showed significantly less decalcification (P ≤ .05) than did all groups except the no etch+bracket group. The no etch+bracket group showed significantly less decalcification than did the etch+bracket, no etch+resin, and the etch+resin groups. Acid-etched teeth demonstrated significantly more decalcification (34%) than did those that were not etched. The teeth with resin showed significantly more decalcification (24%) than did those without resin. There was no significant difference between teeth that did and did not have brackets. The unsealed side of the teeth showed small amounts of--but significantly more--decalcification (5%) compared to the sealed side. CONCLUSIONS: Acid etching and composite resin adhesives increase enamel decalcification in vitro, while brackets do not. Filled resin sealants protect the teeth from decalcification.

published proceedings

  • Angle Orthod

altmetric score

  • 5.25

author list (cited authors)

  • Hess, E., Campbell, P. M., Honeyman, A. L., & Buschang, P. H

citation count

  • 16

complete list of authors

  • Hess, Elizabeth||Campbell, Phillip M||Honeyman, Allen L||Buschang, Peter H

publication date

  • September 2011