Evaluation of Prevention of Initial Enamel Lesions around Orthodontic Brackets by Using Different Remineralizing Agents: An Original Research
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Updated: Jun 11, 2025

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Published on: July 10, 2014
Velusamy Pavethynath1, Bhupendra Singh Rathore2, N Mothi Krishna3
1Department of Orthodontic Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Objective:
The purpose of this study was to compare the efficacy of various remineralizing agents in stopping the early enamel lesions surrounding orthodontic brackets from progressing.
Techniques:
Four groups were randomly allocated to a total of 100 participants: the control group (no treatment), calcium phosphate, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and fluoride varnish. Remineralizing chemicals were administered in accordance with manufacturer recommendations, and enamel lesions were created around orthodontic brackets. At baseline and follow-up visits, enamel lesion development was evaluated by visual inspection, quantitative light-induced fluorescence, and microhardness tests.
Results:
All treatment groups showed significant improvements in microhardness and decreases in lesion size compared to the control group (P < 0.05). Of all the treatment groups, CPP-ACP showed the most notable improvement in microhardness. Regarding the reduction of lesion size, there were no notable variations between the therapy groups (P > 0.05).
Conclusion:
Initial enamel lesions surrounding orthodontic brackets can be effectively prevented from progressing with the use of fluoride varnish, calcium phosphate, and CPP-ACP. Promising improvements in microhardness indicate that CPP-ACP may be a better treatment choice. Larger sample sizes and longer follow-up times are needed for future studies to validate these results and clarify the best strategy for maintaining the health of enamel throughout orthodontic treatment.
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