Efficacy of fluoride varnish for preventing white spot lesions and gingivitis during orthodontic treatment with fixed appliances—a prospective randomized controlled trial

2016 ◽  
Vol 20 (9) ◽  
pp. 2371-2378 ◽  
Author(s):  
Christian Kirschneck ◽  
Jan-Joachim Christl ◽  
Claudia Reicheneder ◽  
Peter Proff
Keyword(s):  
Randomized Controlled Trial ◽  
Orthodontic Treatment ◽  
Controlled Trial ◽  
White Spot ◽  
Fluoride Varnish ◽  
White Spot Lesions ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Fixed Appliances

Fluoride varnish for white spot lesion prevention during orthodontic treatment: results of a randomized controlled trial 1 year after debonding

2020 ◽  
Author(s):  
Mikael Sonesson ◽  
Anna Brechter ◽  
Rolf Lindman ◽  
Salem Abdulraheem ◽  
Svante Twetman
Keyword(s):  
Randomized Controlled Trial ◽  
Placebo Group ◽  
Orthodontic Treatment ◽  
Controlled Trial ◽  
White Spot ◽  
Fluoride Varnish ◽  
White Spot Lesion ◽  
Randomized Controlled

Summary Background Topical fluorides are commonly recommended to prevent the development of white spot lesion (WSL) during treatment with fixed orthodontic appliances (FOAs), but the certainty of evidence is low, and long-term effects of fluoride preventive methods to reduce lesions seem to be rare. Objective To evaluate the long-term effectiveness of professional applications of a fluoride varnish containing 1.5% ammonium fluoride in preventing WSL development in adolescents undergoing multi-bracket orthodontic treatment. Subjects and methods We performed a randomized controlled trial in which 166 healthy adolescents (12–18 years) from three different clinics were enrolled and randomly allocated to a test or a placebo group. The randomization was performed by a computer program, generating sequence numbers in blocks of 15. The fluoride varnish or the non-fluoride placebo varnish was applied in a thin layer around the bracket base every sixth week during the course of the orthodontic treatment (mean duration 1.7 years). We scored the prevalence of WSL on the labial surfaces of the maxillary incisors, canines and premolars immediately after debonding (baseline) and approximately 1 year after debonding, from digital photos with aid of a four-step score. The examiners were not involved in the treatment of the patients and blinded for the group assignment. Results One hundred and forty-eight patients were available at debonding and 142 of them could be re-examined after 1 year (71 in the test and 71 in the placebo group). The 1-year attrition rate was 4.0%. On patient level, the prevalence of post-orthodontic WSLs (score ≥ 2) dropped by over 50% during the follow-up with no significant difference between the groups. On surface level, there were significantly fewer remaining WSLs in the test group compared with the placebo group (4.5% versus 10.4%; relative risk 0.44, 95% confidence interval 0.28–0.68). Limitations The compliance with fluoride toothpaste was not checked, and the patients’ general dentists may have instigated additional risk-based preventive measures. No cost–benefit analysis was carried out. Conclusions This follow-up study displayed a small beneficial long-term effect of fluoride varnish in reducing WSL development during treatment with FOA. Registration NCT03725020. Protocol The protocol was not published before trial commencement.

Fluoride varnish for the prevention of white spot lesions during orthodontic treatment with fixed appliances: a randomized controlled trial

2019 ◽  
Vol 42 (3) ◽  
pp. 326-330 ◽  
Author(s):  
Mikael Sonesson ◽  
Anna Brechter ◽  
Salem Abdulraheem ◽  
Rolf Lindman ◽  
Svante Twetman
Keyword(s):  
Placebo Group ◽  
Orthodontic Treatment ◽  
Test Group ◽  
Ammonium Fluoride ◽  
Dropout Rate ◽  
White Spot ◽  
Fluoride Varnish ◽  
White Spot Lesions ◽  
Randomized Controlled ◽  
Fixed Appliances

Summary Background Self-applied and professional fluorides are key elements to limit caries-related side-effects during orthodontic treatment with fixed appliances. Objective To evaluate the effectiveness of a new fluoride varnish formula containing 1.5% ammonium fluoride in preventing white spot lesions (WSLs) in adolescents undergoing multi-bracket orthodontic treatment. Subjects and methods The study employed a randomized controlled triple-blinded design with two parallel arms. One hundred eighty-two healthy adolescents (12–18 years) referred to three orthodontic specialist clinics were eligible and consecutively enrolled. Informed consent was obtained from 166 patients and they were randomly allocated to a test or a placebo group (with aid of a computer program, generating sequence numbers in blocks of 15). In the test group, fluoride varnish was applied in a thin layer around the bracket base every sixth week during the orthodontic treatment, while patients in the placebo group received a varnish without fluoride. The intervention started at onset of the fixed appliances and continued until debonding. The endpoint was prevalence and severity of WSLs on the labial surfaces of the maxillary incisors, canines, and premolars as scored from high-resolution pre- and post-treatment digital photos with aid of a four-level score. Results One hundred forty-eight patients completed the trial, 75 in the test group and 73 in the placebo group (dropout rate 10.8%). The total prevalence of WSL’s on subject level after debonding was 41.8% in the test group and 43.8% in the placebo group. The number of patients exhibiting more severe lesions (score 3 + 4) was higher in the placebo group (P < 0.05); the absolute risk reduction was 14% and the number needed to treat was 7.1. Limitations The multicentre design with somewhat diverging routines at the different clinics may have increased risk for performance bias. No health-economic evaluation was carried out. Conclusions Regular applications of an ammonium fluoride varnish reduced the prevalence of advanced WSL during treatment with fixed orthodontic appliances. Clinical trial registration ClinicalTrials.gov (NCT03725020). Protocol The protocol was not published before trial commencement.

scholarly journals Evaluation of Three Commercially Available Materials in Reducing the White Spot Lesions During Fixed Orthodontic Treatment: A Prospective Randomized Controlled Trial

2020 ◽  
Vol 54 (2) ◽  
pp. 100-105
Author(s):  
Sayeeda Laeque Bangi ◽  
Mujeeb Uddin Mehraj Mohd. ◽  
Prasad Konda ◽  
Ashok Kumar Talapaneni ◽  
Asma Fatima ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Orthodontic Treatment ◽  
Controlled Trial ◽  
White Spot ◽  
Control Group ◽  
White Spot Lesions ◽  
Randomized Controlled ◽  
Anterior Teeth ◽  
Group B ◽  
Tooth Mousse

Objectives: Treating white spot lesions (WSL) to create a sound and esthetically pleasing enamel surface is a question yet to be fully answered. The objective of this randomized controlled trial was to measure and compare the degree of regression of WSL during orthodontic treatment achieved by using three commercially available materials. Methods: A single-blinded randomized prospective clinical trial, comprising 80 patients categorized into four groups (one control group and three experimental groups, with 20 subjects per group) using block randomization, was conducted. Group A (control group): Colgate strong toothpaste; and experiments groups were Group B: GC tooth mousse, Group C: Phos-Flur mouthwash and Group D: SHY-NM. Subjects were instructed to use the designated dentifrice/mouthwash and photographs were taken at baseline, third and sixth months, and white spot lesions were reassessed in the maxillomandibular anterior teeth. Results: All the three groups had shown an improvement in WSL. But Group B has shown the greatest difference in mean values of decalcification index (DI) scores. Conclusion: All three commercially available products showed a regression of WSL over a 6-month duration. GC tooth mousse proved to be the most effective means of treating WSL over other regimens.

scholarly journals Efficacy of fluoride varnish for prevention of white spot lesions during orthodontic treatment with fixed appliances: A systematic review study

2017 ◽  
Vol 4 (08) ◽  
pp. 1513 ◽  
Author(s):  
Farshad Rahimi ◽  
Masoud Sadeghi ◽  
Hamid Reza Mozaffari
Keyword(s):  
Systematic Review ◽  
Orthodontic Treatment ◽  
White Spot ◽  
Fluoride Varnish ◽  
Cochrane Library ◽  
White Spot Lesions ◽  
Resin Infiltration ◽  
Fixed Appliances ◽  
Review Study ◽  
Orthodontic Devices

Background: White spot lesions (WSLs) are a problem commonly found in patients who use orthodontic devices. Fluoride varnish can reduce WSLs during orthodontic treatment with fixed appliances. The aim of this systematic review was to evaluate the efficacy of fluoride varnish compared with other agents for preventing WSLs during orthodontic treatment. Methods: Studies were searched from four databases- PubMed, Scopus, Web of Science and Cochrane Library- from January 1980 to May 2017; only studies with English abstracts were included. Results: Out of 432 studies searched from the databases, 33 studies were evaluated for eligibility. Of the 33 studies, 19 were excluded with reasons and 14 studies were included in the systematic review. Parameters of WSLs (decalcification score, prevalence, incidence, progression score, ΔQ and ΔZ and DiagnoDent (DD) pen score) were compared for the various treatments. Conclusions: Although there were some limitations for this systematic review study, the review showed that fluoride varnish combined with chlorhexidine (CHX) may be a good treatment for WSLs after orthodontic treatment, especially for a 6-month period, and that resin infiltration might also be effective for preventing WSLs. More studies are needed to further investigate these observations.

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