Caries-Preventive Effectiveness of a Fluoride Varnish: A Randomized Controlled Trial in Adolescents with Fixed Orthodontic Appliances

ABSTRACT Background No randomized controlled trial has tried to compare transverse dental arch changes between the lingual and labial orthodontic fixed appliances in the early stage of treatment. Objective To compare upper dental arch changes between lingual and labial fixed orthodontic appliances after leveling and alignment. Design, setting Parallel-groups randomized controlled trial on patients with class I moderate crowding teeth treated at the University of Al-Baath Dental School in Hamah, Syria. Participants About 102 patients with crowded teeth and class I malocclusion were evaluated and 58 patients fulfilled the inclusion criteria. Randomization was performed using computer generated tables; allocation was concealed using sequentially numbered opaque and sealed envelopes. About 52 participants were analyzed (mean age 21.5 ± 3.2 years). They were randomly distributed into two groups with 26 patients in each (1:1 allocation ratio). Intervention Lingual vs labial fixed orthodontic appliances were used. Main outcome measure Intercanine width, interpremolar width, intermolar width, and arch length were measured on study models before brackets’ placement (T1), at the end of leveling and alignment stage (T2). Results Statistically significant increase was detected in the intercanine width in the lingual group (1.99 mm, p < 0.001) and in the labial group (1.22 mm, p < 0.001). The interpremolar width had a significant decrease in the lingual group (–0.70 mm, p < 0.001), whereas there was a significant increase in this width in the labial group (1.73 mm, p < 0.001). A significant decrease in intermolar width was detected in the lingual group (–0.79 mm, p < 0.001) whereas a significant increase was observed in the labial group (0.81 mm, p < 0.001). The differences between the two groups were significant for all comparisons (p < 0.001). Conclusion The labial appliance produced a significant increase in all horizontal transverse arch dimensions, whereas in the lingual appliance group the intercanine width increased significantly in conjunction with a significant narrowing of posterior segments. Funding The University of Al-Baath Postgraduate Research Budget (UBDS-00786223-PG). How to cite this article Khattab TZ, Hajeer MY, Farah H, Al-Sabbagh R. Maxillary Dental Arch changes following the Leveling and Alignment Stage with Lingual and Labial Orthodontic Appliances: A Preliminary Report of a Randomized Controlled Trial. J Contemp Dent Pract 2014;15(5):561-566.

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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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