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Biomedical subjects

D T Millett

Publications and source records attributed to D T Millett.

At least 37 records · Page 2Linked to original sources

Effect of fluoride exposure on cariostatic potential of orthodontic bonding agents: an in vitro evaluation.

AIMS: The aims of this in vitro study were to compare the cariostatic potential of a resin modified glass ionomer cement (Fuji Ortho LC) to that of a resin control (Transbond) for bracket bonding and to compare the effect of extrinsic fluoride application on the cariostatic potential of each material. SETTING: Ex vivo study. MATERIALS AND METHODS: Orthodontic brackets were bonded to 40 extracted premolars, 20 with Fuji Ortho LC and 20 with Transbond. The teeth were subjected to pH cycling, pH 4.55, and pH 6.8, over a 30-day period. Ten teeth bonded with each material were immersed in a 1000 ppm fluoride solution for 2 minutes each day. Fluoride release was measured throughout the study from all teeth. After 30 days, the teeth were assessed visually for signs of enamel decalcification. RESULTS: Significant differences in decalcification existed macroscopically between all four groups of teeth, with the exception of those bonded with Fuji Ortho LC alone compared with Transbond alone (P = 0.22), and Fuji Ortho LC alone compared with Transbond with added fluoride (P = 0.3). Fluoride release from Fuji Ortho LC alone fell to minimal values, but with the addition of extrinsic fluoride the levels fell initially and then followed an upward trend. There was minimal fluoride release, from Transbond alone, but with daily addition of extrinsic fluoride, subsequent fluoride release was increased. Significant differences existed in the amount of fluoride released between all groups, except comparing Fuji Ortho LC alone and Transbond with added fluoride. CONCLUSIONS: The results of this study have indicated that with an in vitro tooth-bracket model, the creation of white spot inhibition could best be achieved by the use of a resin-modified glass ionomer cement, supplemented with fluoride exposure. The least protection was afforded by the composite control. The resin-modified glass ionomer cement alone and the composite with added fluoride demonstrated equivalent protection.

Acrylic Resins↗

Are facial expressions reproducible?

OBJECTIVES: To determine the extent of reproducibility of five facial expressions. DESIGN: Thirty healthy Caucasian volunteers (15 males, 15 females) aged 21 to 30 years had 20 landmarks highlighted on the face with a fine eyeliner pencil. Subjects were asked to perform a sequence of five facial expressions that were captured by a three-dimensional camera system. Each expression was repeated after 15 minutes to investigate intrasession expression reproducibility. To investigate intersession expression reproducibility, each subject returned 2 weeks after the first session. A single operator identified 3-dimensional coordinate values of each landmark. A partial ordinary procrustes analysis was used to adjust for differences in head posture between similar expressions. Statistical analysis was undertaken using analysis of variance (linear mixed effects model). RESULTS: Intrasession expression reproducibility was least between cheek puffs (1.12 mm) and greatest between rest positions (0.74 mm). The reproducibility of individual landmarks was expression specific. Except for the lip purse, the reproducibility of facial expressions was not statistically different within each of the two sessions. Rest position was most reproducible, followed by lip purse, maximal smile, natural smile, and cheek puff. Subjects did not perform expressions with the same degree of symmetry on each occasion. Female subjects demonstrated significantly better reproducibility with regard to the maximal smile than males (p =.036). CONCLUSIONS: Under standardized conditions, intrasession expression reproducibility was high. Variation in expression reproducibility between sessions was minimal. The extent of reproducibility is expression specific. Differences in expression reproducibility exist between males and females.

Adult↗

An appraisal of three methods of rating facial deformity in patients with repaired complete unilateral cleft lip and palate.

OBJECTIVES: To evaluate the reliability of clinical assessment, two-dimensional color transparencies and three-dimensional imaging for evaluating the residual facial deformity in patients with repaired complete unilateral cleft lip and palate (UCLP) and compare the ratings of facial deformity made by health care professionals with those made by lay assessors. PATIENTS AND PARTICIPANTS Thirty-one randomly selected subjects aged 10 to 30 years with repaired complete UCLP. Five professionals and five laypersons evaluated each subject's residual cleft-related facial deformity using clinical assessment, two-dimensional color transparencies, and three-dimensional images. MAIN OUTCOME MEASURES: The facial deformity of the full face, lip, nose, and midface were scored using a 5-point ordinal scale on two occasions with a 1-month interval. Intra- and interexaminer agreements were calculated from weighted kappa statistics. Bootstrap permutation tests were used to detect any differences in agreement. RESULTS: Assessment of facial deformity showed good reproducibility across the three assessment media (kappa = 0.42 to 0.83, SE 0.08). Clinical assessment among lay assessors, however, was poor to moderate (kappa = 0.16 to 0.58, SE 0.07). For all assessors, there was no difference in the two nonclinical media relative to the standard clinical assessment for assessments of the full face (p =.377). For assessments of the lip or nose, transparency scores were in greater agreement with the clinical scores than were the three-dimensional assessment scores (p =.017 and.011, respectively). For rating the midface, the three-dimensional scores were in greater agreement with the clinical scores than were the color transparencies scores (p =.047). CONCLUSIONS: In comparison with lay assessors, clinical assessment among professionals was more reproducible. This was not so for nonclinical media. The equivalence of using the color transparencies and three-dimensional media relative to the clinical assessment depends on the region of the face being considered.

Adolescent↗

Powered vs manual tooth brushing in fixed appliance patients: a short term randomized clinical trial.

Sixty-three orthodontic patients wearing upper and lower fixed appliances were randomly assigned to use either a powered toothbrush fitted with a modified orthodontic brush head (Braun Oral-B Plaque Remover 3D) or a manual toothbrush (Reach Compact Medium). A trained hygienist instructed each patient on the proper use of the allocated brush. Measurements of plaque and gingival health were made at baseline, at four weeks, and at eight weeks. Data for each group were analyzed using paired t-tests. Patients using the powered toothbrush showed a significant reduction in percentage interdental bleeding scores from baseline to four weeks (-12.7, P = .003) and this was still apparent at eight weeks (-8.6, P = .028), although there were no statistically significant changes in either plaque or gingivitis scores for this group. Those patients using a manual toothbrush showed a significant reduction in mean plaque score from baseline (four weeks = -0.18, P = < .001; eight weeks = -0.12, P = .016), but gingivitis scores were only reduced significantly at four weeks. In this group, interdental bleeding scores reduced significantly at four weeks (P = .028), but were not significantly different from baseline at eight weeks (P = .0319). When the two patient groups were compared using two sample t-tests, there were no significant differences in any of the parameters measured at any time point in the study. Over an eight-week period, there were no measurable differences between the powered toothbrush with modified orthodontic brush head and a manual toothbrush with respect to mean change in plaque, gingivitis, or interdental bleeding scores when used by patients wearing fixed appliances.

Adolescent↗

Orthodontic adhesives: a systematic review.

OBJECTIVES: To evaluate which orthodontic adhesives (a). bond orthodontic brackets to teeth more reliably and (b). are more effective at preventing decalcification. DATA SOURCES: The search strategy for the literature review was carried out according to the standard Cochrane systematic review methodology. The Cochrane Clinical Trials Register and the Cochrane Oral Health Group Specialized Register were searched for randomized clinical trials and controlled clinical trials. All volumes that had not already been assessed by the Oral Health Group in the European Journal of Orthodontics, American Journal of Orthodontics, Journals of Orthodontics, and Angle Orthodontist were hand-searched. Inclusion and exclusion criteria were applied when considering the studies to be included in this review. DATA SELECTION: The primary outcome measure was the failure of the orthodontic adhesive. A secondary outcome of decalcification occurring around the orthodontic bracket was also recorded, if data were available. DATA EXTRACTION: Two randomized clinical trials and one controlled clinical trial were identified that fulfilled all the inclusion and exclusion criteria. The trials compared: (a). light- and chemically-cured composite; (b). chemically-cured composite and conventional glass ionomer cement; and (c). chemically-cured composite and light-cured compomer. DATA SYNTHESIS: Each paper was quality assessed by two people independently. A qualitative analysis of the trials in the review is presented. The data presentation, for the majority of the trials, precluded the use of suggested Cochrane Health Group statistical analysis. CONCLUSIONS: It is difficult to draw any conclusions from this review; however, suggestions are made for methods of improving future research involving orthodontic adhesives.

Compomers↗

Daily exposure to fluoride mouthrinse produces sustained fluoride release from orthodontic adhesives in vitro.

OBJECTIVES: To determine firstly, if sustained fluoride release can be achieved from five orthodontic adhesives: Ketac-Cem, Fuji ORTHO LC, Sequence, Transbond and Right-On, with daily exposure to fluoride mouthrinse in vitro, and secondly, if sustained fluoride release can be re-established from the same specimens, after an interruption in mouthrinse exposure. METHODS: Ten brackets were bonded to bovine incisors using each adhesive. Each adhesive group was divided equally into a test and a control sub-group. In phase 1 (42 days), the test sub-groups were exposed for 1min daily to fluoride mouthrinse (225 ppm), followed by immersion in de-ionised water for 42 days to deplete their fluoride reserves. Mouthrinse exposure was then resumed in phase 2 (28 days). Mean cumulative fluoride release (MCFR) was calculated for days 0-21 of phase 1 and for the plateau portion of the fluoride release curves in phase 1 (days 21-42) and phase 2 (days 7-28). RESULTS: During phase 1, the MCFR for each test sub-group was significantly greater than its control (p<0.05). There was no significant difference in MCFR between the curve plateau portion of phases 1 and 2 for all adhesives except Transbond, for which MCFR was less in phase 2 (p<0. 05). CONCLUSIONS: Sustained fluoride release occurred for each adhesive exposed daily to fluoride mouthrinse, at a level significantly greater than its control. After fluoride exhaustion, re-exposure to daily fluoride mouthrinse produced sustained fluoride release levels comparable to those prior to exhaustion, for all adhesives except Transbond.

Acrylic Resins↗

Bonded molar tubes--an in vitro evaluation.

This study aimed to evaluate the mean shear bond strength of molar tubes with micro-etched bases bonded with either a compomer (Ultra Band-Lok), a resin-modified glass ionomer cement (3M Multi-Cure or Fuji Ortho LC), or a light-cured resin adhesive (Transbond). The amount of adhesive remaining on the tooth surface following tube removal was assessed also. Finally, survival time of molar tubes bonded with each bonding agent was assessed following simulated mechanical fatigue in a ball mill. A total of 120 extracted human third molars were collected and randomly divided into 4 test groups. Thirty teeth (20 to assess debonding force and 10 to assess survival time) were bonded with each adhesive according to the manufacturers' instructions. Debonding was carried out using a Nene M3000 testing machine with a crosshead speed of 0.5 mm/min. The mean shear bond strength of tubes bonded with Transbond was significantly less than that of those bonded with 3M Multi-Cure (P = .0036) or Fuji Ortho LC (P < .0001). Tubes bonded with Ultra Band-Lok also had significantly lower mean shear bond strength than those bonded with Fuji Ortho LC (P = .020). Distribution of adhesive remnant index scores only differed significantly between tubes bonded with 3M Multi-Cure or Transbond. Only I molar tube, bonded with Transbond, debonded in the ball mill at 5 hours, but at 50 hours there was no significant difference in the survival time of tubes bonded with any of the bonding agents. Compomer or resin-modified glass ionomer cements appear to be viable alternatives to light-cured resin adhesive for bonding molar tubes.

Acrylic Resins↗

A clinical retrospective evaluation of 2 orthodontic band cements.

This study aimed to compare the time to first failure of stainless steel orthodontic first permanent molar bands cemented with either a modified composite (Band-Lok, Reliance Orthodontic Products) or a conventional glass ionomer cement (AquaCem, De Trey Dentsply). The effect of patient sex, patient age at the start of treatment, the presenting malocclusion, treatment mechanics, and the operator proficiency on band survival was also assessed. Data for 219 bands cemented with Band-Lok in 108 patients and for 395 bands cemented with AquaCem in 183 patients were analyzed. For each case, a single molar band, either the band that was first to fail or the band that had the shortest follow-up time, was chosen for analysis. For each cement, whether headgear was used or not, there was no significant difference in time to first band failure (P = .398). Twenty-six percent of patients had at least one band failure with Band-Lok, and 30% of patients had at least one band failure with AquaCem, representing an 18% band failure rate for each cement. There was no significant difference in time to first band failure for either cement with respect to sex of the patient (P = .842), patient age at the start of treatment (P = .257), presenting malocclusion (P = .319), or operator proficiency (P = .062). The use of headgear, however, reduced significantly the time to first band failure irrespective of cement type (P = .0069). Headgear use was identified as a predictor of first permanent molar band survival. Clinical performance of bands cemented with either cement appears to be similar and was influenced significantly by the use of headgear.

Acrylic Resins↗

Modified composite or conventional glass ionomer for band cementation? A comparative clinical trial.

The time to first failure, the position of band failure at deband, and the change in enamel white spot lesions of teeth bonded with a modified composite or a conventional glass ionomer were compared in a randomized half-mouth trial over the full course of orthodontic treatment. One hundred forty band pairs were cemented in 98 subjects. Overall band failure rates of 5% and 2.8% were recorded for the modified composite and the conventional glass ionomer, respectively, with no significant difference found between their times to first band failure. At the end-of-treatment deband, the position of band failure was predominantly at the enamel-cement interface for the modified composite and at the band-cement interface for the conventional glass ionomer (P <.001). A comparison of changes in mean enamel white spot lesion scores during treatment did not reveal significant differences between the cement groups (P =.16).

Adolescent↗

Varnish or polymeric coating for the prevention of demineralization? An ex vivo study.

OBJECTIVE: The ability of an experimental coating, Odyssey, to prevent demineralisation ex vivo was compared with that of a fluoride varnish, Duraphat and a chlorhexidine-containing varnish, Cervitec. DESIGN: an ex vivo single-blind study. SETTING: Hard tissue research laboratory. MATERIALS AND METHODS: thirty bovine enamel blocks 0.5 cm x 1.5 cm were divided into 6 groups of 5 specimens. The enamel blocks were then allocated to one of 6 surface treatments. INTERVENTIONS: (1) surface left unprepared (control), (2) Duraphat application, (3) Cervitec application, (4) experimental polymer coating, (5) enamel conditioned with 10% citric acid and coated with the experimental polymer coating Odyssey (O + C), (6) enamel etched for 30 sec with 37% phosphoric acid and coated with the experimental coating (O + E). All specimens were cycled for 7 days through a daily procedure of demineralisation for 4 hours and remineralisation for 20 hours, and exposed to an equivalent of 2 months toothbrushing. A single operator blinded to the treatment allocation of each specimen carried artificial lesion depth assessment out using computer-assisted transverse microradiography. RESULTS: The control group had the greatest mean lesion depth (97.16 + 29.8 microm) with the Duraphat group exhibiting the lowest mean lesion depth (24.53 + 15.44 microm). The Duraphat, Odyssey, O + C and O + E groups all had significantly less lesion depth when compared with no surface preparation (p < 0.05 for all comparisons). There were no significant differences between any of the Odyssey groups. CONCLUSIONS: The efficacy of Duraphat application in preventing demineralisation ex vivo has been demonstrated in the present study, but clinical trials are required to assess its usefulness in orthodontic practice.

Analysis of Variance↗

A comparative clinical trial of a compomer and a resin adhesive for orthodontic bonding.

The study aimed to compare the survival time and cariostatic potential of a compomer to that of a resin adhesive when used to bond stainless steel orthodontic brackets to labial segment teeth only. The effect of the patients' sex, age at the start of treatment and presenting malocclusion on bracket survival time was assessed also. Forty-five consecutive patients who attended for fixed appliance therapy were randomly selected. Four hundred twenty-six brackets were bonded (213 with compomer and 213 with resin adhesive) with a split mouth design; the right or left side allocation of compomer in either arch was alternated. Color transparencies of the maxillary incisors, mandibular incisors, or both, and transparencies of the canines, were taken before treatment. At the debond stage, the transparencies were projected (20x) and assessed by an experienced examiner, who used a caries index. The survival time distributions for brackets bonded with each bonding agent were not significantly different (P = .74, paired Prentice-Wilcoxon test; P = .75, Akritas test), with bracket failure rates of 17% and 20% recorded for compomer and resin adhesive, respectively. Neither the patients' sex (P = .85) nor malocclusion (P = .26) appear to affect significantly bracket survival, but patient age was identified as a useful prognostic indicator of bracket survival (P < .001). On average, there was more decalcification related to brackets bonded with resin adhesive than with compomer (P = .0075). Survival time distributions of brackets bonded with compomer or resin adhesive appear comparable, but decalcification was reduced significantly by bonding with compomer.

Adolescent↗

Evaluation of skeletal stability following surgical correction of mandibular prognathism.

This retrospective study was designed to assess skeletal stability after the correction of mandibular prognathism by sagittal split osteotomy (SSO) and intraoral vertical subsigmoid osteotomy (VSO). We used lateral cephalographs of 31 patients taken before, immediately after, and at least one year after the operation. We recorded euclidean distance matrix analysis, linear and angular measurements, and x and y co-ordinates of cephalometric landmarks for each cephalograph. There were no significant differences in extent of the mandibular retrognathia or magnitude of change between the two groups. The main significant changes in both groups were reduction of the total mandibular length, and posterior shifting in the mandible. One year after the operation the main change was the mean forward relapse of 2.5 mm in the SSO group and the mean posterior relapse of 0.5 mm in the VSO group. The difference in skeletal stability between the groups was significant (P< 0.05), and we conclude that VSO is the more effective technique for correcting mandibular prognathism.

Adolescent↗

Fluoride release from orthodontic bonding agents: a comparison of three in vitro models.

The aim of this in vitro study was to compare fluoride release from two cement disc models (partially varnished and unvarnished) of three orthodontic bonding materials with fluoride release from the same materials when used to bond an orthodontic bracket onto a tooth surface. A resin-modified glass ionomer cement (Vitremer) and a compomer material (Dyract Ortho) were compared with a conventional resin adhesive (Right-On). Ten discs (3.0 mm diameter and 1.5 mm thick) of each material were manufactured in a silicone mould and ten premolar teeth were bonded with orthodontic brackets using each material. All the premolar teeth were covered with nail varnish up to the bracket periphery and five of the discs for each material were coated with nail varnish on both upper and lower surfaces which halved the surface area. The fluoride released into 2 ml of deionised water, from each tooth or disc, was measured at regular intervals over 60 days. At 60 days, cumulative fluoride release was highest from the unvarnished discs, less for the varnished discs and least from the tooth-bracket model for both test materials. Despite having twice the surface area, the unvarnished disc model released only 1.2 to 1.5 times more fluoride than the varnished disc model. Compared with the tooth-bracket model, the unvarnished discs released 3.0 to 4.5 times more fluoride, whereas the varnished discs released only 2.2 to 3.7 times more fluoride. For the materials tested in this study, halving the surface of the discs did not reduce the cumulative fluoride release by half. The tooth/bracket model with minimal bonding material demonstrated substantial cumulative fluoride release. The pattern of fluoride release was similar for all models tested.

Analysis of Variance↗

The effect of saliva on enamel and dentine erosion.

The present study aims to assess the ability of saliva, both in vitro and in situ, to prevent surface mineral loss from enamel and dentine when exposed to an erosive challenge. Fifteen groups of four varnished thin tooth sections were stored in saliva collected from individuals taking part in the in situ study and a further eight groups, each containing four sections, were stored in deionised water. In vitro, sections were stored in saliva or water for 14 days. In addition, fifteen subjects each wore an appliance with four varnished sections. Appliances with sections were worn for 14 days. All sections were exposed to 25 ml of erosion solution for 5 min twice daily. Microradiography and image analysis of the recovered sections demonstrated significant protection of surface mineral loss from enamel and dentine by saliva in vitro and in situ compared with deionised water (p < 0.05). Significantly less mineral loss (p < 0.05) was observed for enamel and dentine stored in situ compared with storage in saliva in vitro. Generalised linear modelling demonstrated both the subject and protocol had significant effect on mineral loss. A weak positive correlation (r = 0.64) was noted when in situ and in vitro mineral loss from enamel were compared, demonstrating greater reactivity of the in vitro enamel specimens to the erosion challenge. The dentine data did not show any linear correlation. Saliva protected against mineral loss by erosion and, for enamel, in vitro results demonstrated a weak positive correlation with in situ results.

Dental Enamel↗

Fluoride release, microbial inhibition and microleakage pattern of two orthodontic band cements.

OBJECTIVES: To compare, in vitro, the fluoride release, microbial inhibition and microleakage pattern of a conventional glass ionomer cement (Ketac-Cem) and an acid-modified composite (Ultra Band-Lok) for band cementation. METHODS: Fluoride release was measured from cement discs (3.0 mm diameter and 1.5 mm thick) at regular intervals over 40 days using a potentiometric method. Microbial inhibition was determined for each cement using an agar diffusion test against one of four different strains of Streptococcus mutans. Thirty pairs of banded third molars (15 banded pairs for each cement) were thermocycled and microleakage determined by a dye penetration method. The depth of microleakage was assessed by an index applied by two examiners independently to photographic records taken of the mid-buccal aspect of each tooth. RESULTS: The cumulative and daily fluoride release for days 5, 15 and 40 were significantly greater for Ketac-Cem than for Ultra Band-Lok (all p < 0.05). After the initial set, the anti-microbial activity was significantly greater for Ketac-Cem than for Ultra Band-Lok over the following 24 h period for all four strains of S. mutans (all p < 0.05). There was no significant difference between the two cement groups for microleakage at the cement/enamel interface (p = 0.66) but a borderline significance was detected for microleakage at the cement/band interface (p = 0.051). CONCLUSIONS: The fluoride release and anti-microbial activity of Ketac-Cem were greater than that of Ultra Band-Lok. There was no significant difference in microleakage between the cements at the cement/enamel interface but a borderline difference existed between the cements at the cement/band interface.

Composite Resins↗

Bonded molar tubes: a retrospective evaluation of clinical performance.

This study investigated time to first failure of stainless steel orthodontic first permanent molar tubes (Ormco Corp) bonded with a light-cured resin adhesive (Transbond) and assessed whether this was related to patient gender, age of the patient at the start of treatment, the presenting malocclusion, or the operator. All first molar tubes were bonded to intact buccal enamel, free of any restoration. Survival analysis was carried out on data from 483 patients with 1190 bonded first molar tubes. For each case, a single molar tube, either that which was first to fail or had the shortest follow-up time, was chosen for analysis. The median time until first bonded tube failure was 699 days with an overall failure rate of 21% recorded. There was no significant difference in time to first failure of molar tubes with respect to patient gender or presenting malocclusion but significant differences were recorded with respect to the patients' age at the start of treatment and the operator. Age at the start of treatment and operator were identified as independently useful predictors of bonded molar tube survival.

Adolescent↗

Laboratory evaluation of a compomer and a resin-modified glass ionomer cement for orthodontic bonding.

The mean shear debonding force of stainless steel orthodontic brackets with microetched bases bonded with either a compomer or a resin-modified glass ionomer cement was assessed. In addition, the amount of cement remaining on the enamel surface following bracket removal was evaluated. Finally, survival time of orthodontic brackets bonded with these materials was assessed following simulated mechanical stress in a ball mill. Debonding force and survival time data were compared with those obtained for brackets bonded with a chemically cured resin adhesive, a light-cured resin adhesive, and a conventional glass ionomer cement. There were no significant differences in mean shear debonding force of brackets bonded with the compomer, resin-modified glass ionomer, chemically cured resin adhesive, or the light-cured resin adhesive. Brackets bonded with a conventional glass ionomer cement had a significantly lower mean shear debonding force than that recorded for the other materials. The Adhesive Remnant Index (ARI) mode score indicated that significantly less cement remained on the enamel following debonding of brackets cemented with resin-modified or conventional glass ionomers compared with other adhesives. The median survival time for brackets cemented with the compomer, resin-modified glass ionomer, chemically cured resin, or light-cured resin were significantly longer than for brackets cemented with conventional glass ionomer. The compomer and the resin-modified glass ionomer adhesive appear to offer viable alternatives to the more commonly used resin adhesives for bracket bonding.

Acid Etching, Dental↗

Decalcification in relation to brackets bonded with glass ionomer cement or a resin adhesive.

Forty randomly selected patients had brackets bonded on one side of the of the maxillary labial segment with glass ionomer cement. Teeth on the opposite side were bonded with a resin adhesive. Teeth were assessed for decalcification pretreatment, at debond, and at review using a standardized photographic technique and a modified DDE index. The mean number of teeth affected by decalcification and the mean extent of decalcification per tooth increased during the treatment period, but from debond to review both of these measurements decreased for teeth bonded with either material (p)<0.01, t-test). Decalcification appears to become less severe posttreatment, but does not appear to be significantly affected during 12 to 18 months of orthodontic treatment by bonding with glass ionomer cement. Dietary and other environmental factors, including fluoride preparations, may be of greater importance in the prevention of decalcification during fixed appliance therapy.

Adhesives↗