Caries-Preventive Effects of Fluoride-Releasing Materials

Abstract

The plaque-retentive properties of fixed orthodontic appliances result in a severe challenge on surfaces generally not susceptible to caries. Lesions may develop within a month in the absence of fluoride, and clinical studies have shown that from 50 to 75% of orthodontic patients develop decalcifications on labial surfaces during treatment. Fluoride mouthrinses reduce the occurrence, although compliance is often poor. Orthodontic bonding agents and cements releasing fluoride, which reduce the need for cooperation, have been introduced. Few clinical studies have been done to prove the cariostatic properties of fluoride-releasing materials in orthodontics. In short-term caries model studies, glass ionomers and a glass filler containing light-cured adhesive that releases relatively large amounts of fluoride have shown cariostatic properties. However, during severe challenges such as occur with orthodontic appliances, fluoride alone has limited cariostatic properties. The combination of fluoride with antimicrobial agents, and the use of acidic fluoride solutions depositing acid-resistant coatings of calcium fluoride and titanium have shown to give better clinical effects than fluoride alone during extreme conditions. Fluoride-releasing materials may therefore be considered as useful supplements to these procedures.