scholarly journals Effect of topical fluoride gel and fluoride varnish in the prevention of white spot lesions in patients undergoing fixed orthodontic treatment: An in vivo study

2022 ◽  
Vol 11 ◽  
pp. 301-308
Author(s):  
Vivek Kumar Thakur ◽  
Raghuvinder S. Vats ◽  
M. P. Prasanna Kumar ◽  
Sanjeev Datana ◽  
Mohit Sharma ◽  
...  

Objectives: Our primary objective was to establish the efficacy of fluoride gel and fluoride varnish in the prevention of white spot lesions (WSLs) development during fixed orthodontic treatment. Materials and Methods: The study sample consisted of 60 adult patients in a prospective split-mouth study design. Interventions, that is, topical fluoride gel and topical fluoride varnish were assigned at the time of bonding to either the right or left halves of the dentition. In all subjects, repeated evaluation of demineralization was done on the facial surfaces of sample teeth in each quadrant. Evaluation using laser fluorescence and by direct visual observation under magnification was carried out at bonding (T0), 3 months (T1), and 6 months (T2). Results: The distribution of mean DIAGNOdent score at T1 (3.14 ± 1.00 vs. 2.81 ± 0.852) and T2 (4.17 ± 1.41 vs. 3.51 ± 1.13) was observed which is significantly higher in the Gel group compared to the Varnish group. In the Gel group, the distribution of mean DIAGNOdent score at T1 (3.14 ± 1.00) and T2 (4.17 ± 1.41) is significantly higher compared to mean DIAGNOdent score at baseline T0 (2.07 ± 0.66). In the Varnish group, the distribution of mean DIAGNOdent score at T1 (2.81 ± 0.852) and T2 (3.51 ± 1.13) is significantly higher compared to the mean DIAGNOdent score at T0 (2.07 ± 0.66). Visual scores also correlated with DIAGNOdent scores. Conclusion: Fluoride varnish is more efficacious than fluoride gel in reducing enamel demineralization. Initial application of fluoride varnish around the orthodontic bracket at bonding appointment can offer significant protection against WSLs.

2019 ◽  
Vol 42 (3) ◽  
pp. 326-330 ◽  
Author(s):  
Mikael Sonesson ◽  
Anna Brechter ◽  
Salem Abdulraheem ◽  
Rolf Lindman ◽  
Svante Twetman

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.


2021 ◽  
Vol 15 (1) ◽  
pp. 151-159
Author(s):  
Aravinthrajkumar Govindaraj ◽  
S.P. Saravana Dinesh

Aim: The aim of this study is to critically review the studies that studied the effect of Chlorhexidine varnish and fluoride varnish on White Spot Lesion (WSL) in patients undergoing orthodontic treatment. Materials and Methods: The electronic database PubMed, The Cochrane Library, Medline, Embase, Google Scholar, Web of Knowledge along with a complimentary manual search of all orthodontic journals till the first week of December 2019 was searched. English language study performed on humans, randomized or nonrandomized clinical trials, comparing the effect of fluoride and chlorhexidine varnish on WSL was included in the review. Quality assessment of included studies was performed. Clinical Significance: The need for an adjunct oral hygiene aid to reduce the incidence and prevalence of white spot lesions in orthodontic patients is necessary. The use of these varnishes will aid in the same and thus make the adverse effects of fixed orthodontic treatment negligible. Review of Literature: Enamel demineralization is a significant risk associated with orthodontic treatment when oral hygiene is poor. Prevention of demineralization during orthodontic treatment is one of the greatest challenges faced by clinicians despite modern advances in caries prevention. The development of White Spot Lesions (WSLs) is attributed to prolonged plaque accumulation around the brackets. Results: The search identified a total of 3 studies that were included in this review. One study had Low risk of bias and the remaining 2 studies had moderate overall risk. Results showed that there was a reduction in the incidence of white spot lesions in orthodontic patients after application of chlorhexidine and Fluoride varnish. Conclusion: Low level evidence is available to conclude that the use of chlorhexidine varnishes and fluoride varnishes reduces the prevalence of white spot lesions in patients undergoing fixed orthodontic treatment. Due to its limitations, the results of this systematic review should be handled with caution and further well-planned Randomized Clinical Trial (RCT) are needed to provide a discrete conclusion.


2017 ◽  
Vol 4 (08) ◽  
pp. 1513 ◽  
Author(s):  
Farshad Rahimi ◽  
Masoud Sadeghi ◽  
Hamid Reza Mozaffari

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.


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Zeynep Aslı Güçlü ◽  
Alev Alaçam ◽  
Nichola Jayne Coleman

This 12-week clinical study evaluated the impact of 10% CPP-ACP and 5% sodium fluoride varnish regimes on the regression of nonorthodontic white spot lesions (WSLs). The study included 21 children with 101 WSLs who were randomised into four treatment regimes: weekly clinical applications of fluoride varnish for the first month (FV); twice daily self-applications of CPP-ACP paste (CPP-ACP); weekly applications of fluoride varnish for the first month and twice daily self-applications of CPP-ACP paste (CPP-ACP-FV); and no intervention (control). All groups undertook a standard oral hygiene protocol and weekly consultation. Visual appraisals and laser fluorescence (LF) measurements were made in weeks one and twelve. The majority of WSLs in the control and FV groups exhibited no shift in appearance, whereas, in the CPP-ACP and CPP-ACP-FV groups, the lesions predominantly regressed. The visual and LF assessments indicated that the extent of remineralisation afforded by the treatments was of the following order: control ~ FV < CPP-ACP ~ CPP-ACP-FV. Self-applications of CPP-ACP paste as an adjunct to standard oral hygiene significantly improved the appearance and remineralisation of WSLs. No advantage was observed for the use of fluoride varnish as a supplement to either the standard or CPP-ACP-enhanced oral hygiene regimes.


PRILOZI ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 161-168 ◽  
Author(s):  
Efka Zabokova-Bilbilova ◽  
Lidija Popovska ◽  
Biljana Kapusevska ◽  
Emilija Stefanovska

Abstract The formation of white spot lesions, or enamel demineralization, around fixed orthodontic attachments is a common complication during and following fixed orthodontic treatment, which marks the result of a successfully completed case. This article is a contemporary review of the risk factors and preventive methods of these orthodontics scars. Preventive programmes must be emphasized to all orthodontic patients. The responsibility of an orthodontist is to minimize the risk of the patient having decalcification as a consequence of orthodontic treatment by educating and motivating the patients for excellent oral hygiene practice. Prophylaxis with topical fluoride application should be implemented: high-fluoride toothpastes, fluoride mouthwashes, gels and varnishes during and after the orthodontic treatment, especially for patients at high risk of caries.


Author(s):  
Susi Sukmasari ◽  
Wan Nurfazliyana binti Wan Fauzi ◽  
Zati Balqis binti Mohammed Azme ◽  
Anisa Kusumawardani ◽  
Iswan Zuraidi Zainol

2017 ◽  
Vol 30 (2) ◽  
pp. 21-24
Author(s):  
Claudia Butrón-Téllez Girón ◽  
J. Mariel-Cárdenas ◽  
M. Pierdant-Pérez ◽  
J.F. Hernández-Sierra ◽  
J.E. Morales-Sánchez ◽  
...  

Dental caries is an infectious disease that can occur in children, sometimes as soon as the teeth eruption starts. Nanotechnology provides effective strategies in prevention and treatment of dental caries. The purpose of this study was to determine the effectiveness of the addition of silver nanoparticles to a fluoride varnish for the remineralization of primary teeth with white spot lesions. A trial was carried out in children with dental demineralization (white spot lesions) on both maxillary dental teeth. One of the teeth received three applications of a fluoride varnish with silver nanoparticles, and the other one, three applications of the same varnish without the silver nanoparticles. We measured the mineral content of the teeth with a laser cavity detection device (DIAGNOdent®) before the first application of the varnishes, and 3 months after the last application. The results show significant differences between teeth treated with silver nanoparticles. Teeth have been treated with fluoride varnish added with silver nanoparticles  seemed to enhance dental structure than teeth treated with conventional varnish, and this effect was also found between basal and final measurements in this group. The fluoride varnish added with silver nanoparticles seems to be more effective in the dental remineralization. This strategy may be used as a prophylactic measure to avoid development of caries.


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