Effects of different fluoride recharging protocols on fluoride ion release from various orthodontic adhesives

Objective: The purpose of this study was to find the most effective fluoride recharging protocol for orthodontic adhesives. Methods: Five orthodontic adhesives were used: a non-fluoride-releasing composite, a fluoride-releasing composite, a polyacid-modified composite (compomer), and two resin-modified glass-ionomer cements (RMGICs). Each specimen was placed into deionized water (DW) and the initial fluoride ion release was measured for 2 months. Each specimen was then subjected to four different treatments to simulate a fluoride recharge: 1000 ppm NaF solution, acidulated phosphate fluoride gel (APF), fluoride-containing dentifrice and DW (control). After topical fluoride treatment, each specimen was submitted to fluoride re-release tests. Results: Fluoride-containing adhesives initially showed higher rates of fluoride ion release, but significantly declined to lower levels. The overall cumulative fluoride ion release during the initial period was RMGICs > compomer > fluoride-containing composite > non-fluoride-releasing composite. After topical fluoride treatment, the amount of fluoride ion re-released was proportional to the amount of fluoride ion previously released from the adhesives. However, the amount of fluoride ions released only lasted for 2 days and then returned to the levels before fluoride application. The overall cumulative fluoride ion re-release according to the fluoride treatments was APF and NaF solution > dentifrice. Conclusion: This study suggests that using the combination of RMGICs and a fluoride-containing mouth rinse solution is the most effective protocol for long-term fluoride re-release from orthodontic adhesives, given the difficulty of routine use of APF at home, although all topical fluoride treatments can recharge fluoride ion in adhesives.