Effect of Topacal C-5 on enamel adjacent to orthodontic brackets. An in vitro study.

Abstract

BACKGROUND: Enamel demineralisation leading to 'white spots' can occur during orthodontic treatment. Casein phosphopeptides may reduce demineralisation during orthodontic treatment. AIMS: To determine if a casein phosphopeptide preparation, Topacal C-5 (Enamel Improving Cream, NSI Dental Pty Ltd, Leighton, Hornsby, Australia), will inhibit demineralisation of enamel adjacent to orthodontic brackets. Methods: Twenty-four pairs of human premolars from 24 subjects were used. One premolar in each pair was randomly assigned to the control group and the contralateral premolar was assigned to the experimental group. A stainless steel orthodontic bracket was bonded to the buccal surface of each tooth and a window of enamel (4 mm x 1 mm) left open to acid attack. The teeth were cycled alternately through an artificial saliva medium (11 hours) and an acid medium (1 hour) for 31 days. Topacal C-5 was applied to the exposed enamel windows in the experimental group after immersion in the acid medium. After 31 days the teeth were sectioned longitudinally and the depths of the enamel lesions measured by polarised light microscopy. RESULTS: Significantly deeper demineralisation occurred in the control teeth not protected by Topacal C-5 and at sites close to the brackets in both groups. CONCLUSIONS: In this in vitro system, Topacal C-5 partially reduced the depth of enamel demineralisation compared with teeth not covered with Topacal C-5. Topacal C-5 may reduce enamel demineralisation in patients with fixed orthodontic appliances.