Orthodontic treatment-related white spot lesions: A 14-year prospective quantitative follow-up, including bonding material assessment

Objective: to compare the clinical performance of newly introduced resin modified glass ionomer varnish (Clinpro™ XT) versus resin infiltration in treatment of post-orthodontic white spot lesions. Material and Methods: Six participants (70 teeth) were enrolled with post-orthodontic white spot lesions. Randomization was performed according to patient selection for the sealed envelope containing which half will receive the control (resin infiltration (ICON, DMG) and the other will receive the intervention (resin modified glass-ionomer cement varnish (Clinpro™ XT, 3M)). Follow up was done after 1 day, 1 week, 1 month, and 3 months, 6 months and 12 months. The color was assessed by spectrophotometer while the degree of demineralization was measured by Diagnodent pen 2910. Patient satisfaction was assessed using (VAS) Visual analogue scale. Results: Regarding color change, significant improvement in lightness for ICON group, while Clinpro™ XT group, the change was insignificant. The demineralization data revealed significant decrease in demineralization with resin infiltration after immediate application. Clinpro™ XT showed also significant decrease after immediate assessment and significant increase in demineralization in 6 and 12 months. Conclusion: Resin infiltration can be considered more as an alternative treatment rather than fluoride varnish. Clinpro™ XTis considered as a preventive protocol, provided that renewal application is needed after 3 months. Keywords 3M Resin cement; Resin cements; Glass ionomer cements; Fluorides; Follow up studies; Glass ionomer.

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Prevalence of White Spot Lesion during Orthodontic Treatment with Fixed Appliance

Update Dental College Journal ◽

10.3329/updcj.v9i2.43739 ◽

2019 ◽

Vol 9 (2) ◽

pp. 40-42

Author(s):

Md Ali Kawsar ◽

Md Nurul Islam ◽

Moutithi Sen ◽

Subodh Chandra Chakraborty ◽

Muhammad Tanvir Siddiqui

Keyword(s):

Orthodontic Treatment ◽

Demographic Data ◽

Significant Risk ◽

White Spot ◽

White Spot Lesion ◽

White Spot Lesions ◽

Orthodontic Appliance ◽

Fixed Appliance ◽

Group 12 ◽

Dentofacial Orthopedics

Background: White spot lesions (enamel demineralization) is one of the most common and a significant risk associated with orthodontic treatment. Objective: To determine the prevalence of white spot lesion during fixed orthodontic treatment. Method: This prospective observational study and was conducted in the Department of Orthodontics and Dentofacial Orthopedics from January 2016 to December 2017 over a period of two years. Patients with fixed orthodontic appliance age between 12-30 years of both sex attended for follow up were included in this study. After taking written consent, a questionnaire included socio-demographic data, clinical and outcome variables including routine clinical photographs to examine WSL were filled up for each patient. Routine clinical photographs to examine WSL were taken after 6 months and 12 months of fixing orthodontics appliance. Qualitative data were expressed as frequency distribution and percentage. Results: Maximum patients were in age group 12 – 16 years and prevalence of WSL was also sought maximum in this group. Out of 36 cases with WSL, 14 (38.9%) were male and 22 (61.1%) were female. Prevalence of WSL after six month of fixing orthodontic appliance was 21.8% and 26.1% after 12 months. Prevalence of WSL after six month of fixing orthodontic appliance in male was 26.4% & in female was 19.6% and after 12 month of fixing orthodontic appliance it was 30.2% in male and 24.1% in female. After six months of fixing orthodontic appliance 1-3 WSLs was found in 17.0% cases and ≥ 4 WSLs in 4.8% cases. After twelve months of fixing orthodontic appliance 1-3 WSLs was found in 19.4% cases and ≥ 4 WSLs in 6.7% cases. Maximum WSL was found in maxillary incisors. Conclusion: This study showed that 21.8% of the study subjects developed white spot lesions during orthodontic procedure and incisors were the most common affected teeth. Update Dent. Coll. j: 2019; 9 (2): 40-42

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

European Journal of Orthodontics ◽

10.1093/ejo/cjaa055 ◽

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.

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

European Journal of Orthodontics ◽

10.1093/ejo/cjz045 ◽

2019 ◽

Vol 42 (3) ◽

pp. 326-330 ◽

Cited By ~ 6

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.

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Spectrophotometric Evaluation of Enamel Color Variation Using Infiltration Resin Treatment of White Spot Lesions at One Year Follow-Up

Dentistry Journal ◽

10.3390/dj8020035 ◽

2020 ◽

Vol 8 (2) ◽

pp. 35 ◽

Cited By ~ 2

Author(s):

Roberto Lo Giudice ◽

Frank Lipari ◽

Francesco Puleio ◽

Angela Alibrandi ◽

Fabrizio Lo Giudice ◽

...

Keyword(s):

Color Change ◽

Statistical Significance ◽

Color Variation ◽

White Spot ◽

White Spot Lesions ◽

Color Changes ◽

The Difference ◽

One Year ◽

The Stability

The aim of this study is to evaluate the color changes and the stability at a 1-year follow-up of white spot lesions (WSLs) treated with an infiltrating technique by using etching and TEGDMA resin. The color of 22 white spot lesions and the sound adjacent enamel (SAE) were assessed with a spectrophotometer at T0 (baseline), T1 (after treatment), and T2 (1 year after). The color change ΔE (WSLs-SAE) at T0 vs. T1 were compared to evaluate the camouflage effect efficiency, and at T1 vs. T2 to assess the stability of outcomes. To evaluate the effect on the treatment outcome of gender, the presence or not of previous orthodontic treatment, WSLs onset more/less than 10 years, the age of the patient, and the ΔE WSL (T0 vs. T1) was analyzed. The difference between ΔE (WSLs-SAE) at T0 and T1 resulted in statistical significance (p < 0.01). No statistical difference was found between ΔE (WSLs-SAE) at T1 vs. T2. The variables considered showed no statistical differences in treatment outcomes. The results of our investigation show that the technique used is immediately effective and the camouflage effect keeps up and steady one year after treatment. Such results do not appear to be influenced by analyzed clinical variables.

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