A Randomized Controlled Trial to Investigate the Efficacy of BioactiveMaterials in Orthodontic Brackets for Reducing Decalcification

Enamel decalcification, manifesting as white spot lesions, remains a prevalent complication during fixed orthodontic treatment.This randomized controlled trial aimed to evaluate the efficacy of orthodontic adhesives incorporating bioactive materials-specifically bioactive glass (BAG), amorphous calcium phosphate (ACP), and calcium fluoride nanoparticles (nCaF)-in mitigating enamel demineralization adjacent to brackets.A total of 120 patients undergoing fixed orthodontic therapy were randomly assigned to four groups: BAG, ACP, nCaF, and a control group using conventional adhesive.Demineralization was assessed using DIAGNOdent readings and quantified via micro-computed tomography at baseline, 3 months, and 6 months.Statistical analysis revealed significant reductions in lesion depth and mineral loss in the BAG and nCaF groups compared to control (p < 0.001), with the ACP group showing moderate improvement.The BAG group demonstrated the most substantial remineralization, indicating the superior efficacy of BAG-infused adhesives in preventing enamel decalcification.These findings suggest that incorporating bioactive materials into orthodontic adhesives offers a promising strategy to enhance enamel integrity during treatment.