Clinical and Investigative Orthodontics · Published 2026-05-14 · DOI 10.1080/27705781.2026.2669434
Rahul Raj, Dilip Srinivasan, Srinidhi Ramasundaram, Ravi Kannan
Purpose To evaluate and compare the efficacy of fluoridated bioactive-glass varnish, silver diamine fluoride (SDF) and resin infiltration technique in the management of artificially induced initial enamel lesions by assessing surface microhardness, surface topography using scanning electron microscopy (SEM), and calcium-to-phosphate (Ca/P) ratios using energy-dispersive X-ray spectroscopy (EDX).Materials and methods Seventy-five extracted premolars were divided into five groups: sound enamel, demineralized enamel, bioactive-glass fluoride varnish, the SDF, and resin infiltration groups. A controlled demineralization protocol was used to create artificial initial enamel lesions followed by remineralization procedures. Surface microhardness was assessed using the Vickers microhardness tester, while SEM-EDX was used to evaluate surface changes and Ca/P ratio. Statistical analysis was performed using one-way ANOVA and Tukey’s post-hoc test (p < 0.05).Results Sound enamel showed the highest surface microhardness values, while demineralized enamel showed the lowest. Among the intervention groups, bioactive-glass-containing fluoride varnish demonstrated higher surface microhardness, followed by SDF and resin infiltration, respectively. SEM analysis revealed a dense mineralized layer in the bioactive-glass group, silver deposits in the SDF group, and resin-filled micro-porosities in the resin infiltration group. The fluoridated bioactive-glass varnish showed the highest Ca/P ratio, comparable to sound enamel.Conclusion Within the limitations of this study, it was found that fluoridated bioactive-glass varnish exhibited a greater improvement in surface hardness, Ca/P ratio and surface morphology compared to other groups. These findings suggest that fluoridated bioactive-glass varnish may function as a promising non-invasive strategy for the management of initial enamel lesions associated with orthodontic treatment.
Abstract from DOAJ. Public domain (CC0 1.0).
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Raj, R., Srinivasan, D., Ramasundaram, S., et al. (2026). Evaluation of fluoridated bioactive-glass varnish for the management of initial enamel lesions compared with silver diamine fluoride and resin infiltration technique: an in-vitro study. Clinical and Investigative Orthodontics. https://doi.org/10.1080/27705781.2026.2669434