Title Using Fluoride Containing Adhesives for Bonding Orthodontic Appliances Reduces Loss of Minerals in the Enamel Adjacent to the Appliances
Clinical Question For patients undergoing orthodontic treatment with fixed appliances, does bonding with fluoride containing adhesives reduce the incidence of mineral loss in the enamel adjacent to the bonded appliances?
Clinical Bottom Line There is weak evidence showing that fluoride containing adhesives reduce the incidence of mineral loss in the enamel adjacent to the bonded appliances but further research needs to be done.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
20889037Rogers/201010 studiesSystematic review of 5 randomized controlled trials and 5 clinical trials
Key resultsThis study concluded that there was weak evidence suggesting that using fluoride containing glass ionomer adhesives for bonding was more effective than composite resins, based on the analysis of the literature in the systematic review. Further research is needed on fluoride adhesives to determine their effectiveness in reducing demineralization.
11447960Wilson/200145 caries-free human molars and premolarsLaboratory study
Key resultsThis study demonstrated that, based on the MANOVA (P< .001) and Duncan’s test (P< .05), the fluoride-releasing resin composite (Light Bond) had significantly less demineralization of enamel in the area adjacent to the orthodontic brackets, compared to the non-fluoride-releasing resin composite.
Evidence Search "Orthodontics"[Mesh] AND (("fluorides"[MeSH Terms] OR "fluorides"[All Fields] OR "fluoride"[All Fields]) AND ("adhesives"[MeSH Terms] OR "adhesives"[All Fields] OR "adhesive"[All Fields]) AND demineralization[All Fields])
Comments on
The Evidence
Validity: There was only one systematic review and no meta-analyses found on the use of fluoride containing adhesives in reducing mineral loss in enamel during orthodontic treatment. The validity is questionable as most of the studies done were in-vitro, laboratory experiments. Further work should be done in in-vivo/clinical conditions in order to make definite conclusions. Perspective: I think further studies need to be done to come to a conclusion regarding the use of fluoride containing adhesives in bonding. The systematic review looked at 5 randomized control trials and 5 clinical trials, however, Rogers et al., 2001 mention that the studies they looked at were weak and not homogenous. They stated “it is not possible to determine whether the decalcification is spread across the population as a whole or confined to only a few at-risk patients.” Another concern is that the materials used in the studies were not homogeneous- they all contain fluoride but they can have different properties. The study by Wilson and Donly 2010 was in-vitro, and so it is hard to make conclusions about how well these materials perform intraorally.
Applicability The results of these studies are applicable to orthodontists and dentists because they indicate that using bonding adhesives containing fluoride can potentially reduce the incidence of mineral loss in the adjacent teeth enamel. This could influence the materials clinician’s use in their offices.
Specialty (General Dentistry) (Orthodontics)
Keywords Orthodontics, fluoride, adhesive, bonding, demineralization
ID# 3011
Date of submission 03/11/2016
E-mail farukhi@livemail.uthscsa.edu
Author Aalia Farukhi
Co-author(s) e-mail
Faculty mentor Peter Gakunga, BDS, MS, PhD
Faculty mentor e-mail gakunga@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available