Impact of Silver Diamine Fluoride and Cocoa Bean Husk Remineralization on Orthodontic Brackets Shear Bond Strength: Early and Long-Term Effects

Abstract This study aimed to investigate the effects of silver diamine fluoride (SDF) and cocoa bean husk (CBH) remineralization agents for white spot lesions (WSLs) on shear bond strength (SBS) of metallic orthodontic brackets, both in the short and long term. A total of 120 sound premolars were categorized into two main groups based on early and long-term effects (groups A and B, respectively). Each group was subdivided into four subgroups, corresponding to the two tested materials, along with two control groups (positive and negative). Prior to orthodontic bracket bonding, each tooth underwent demineralization followed by remineralization using the two tested materials. SBS was evaluated for groups A and B after 24 hours and 6 months of bonding, respectively, following incubation in an oral-like environment. CBH demonstrated the highest early SBS of 18.5408 (2.191) MPa, which was significantly different from all other groups (p = 0.00, analysis of variance). However, it decreased significantly to 9.070 (0.097) MPa after 6 months (p = 0.00, independent t-test). In contrast, SDF exhibited significantly lower SBS than CBH (Duncan multiple range test), with 8.5550 (0.059) MPa and 8.797 (0.295) MPa at early and after 6 months, respectively, with significant differences between the two tested intervals (p = 0.007, independent t-test). A p-value of ≥ 0.05 was considered nonsignificant. CBH effectively maintained appropriate SBS in both the short-term and long-term by remineralizing WSL associated with orthodontic treatment, despite a slight decline over time. In contrast, SDF treatment resulted in a lower SBS but exhibited greater stability over a longer duration.