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

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.

Effect of Flouride Varnish in Prevention of Dental Caries

Objective: To assess the effect of 5% sodium fluoride (NaF) varnish application in prevention of caries in mixed dentition rural Jamshoro school children over the course of 6 months. Methods: children with lower stage caries aged 7 to 10 years were included. Students were equally divided in two groups. In Group-A students, 5% fluoride varnish was applied. While in children of control group necessary instructions were given to the student about dietary control. After 3 months, varnish applied teeth on both group’s children were examined again and the rate of caries were documented by using DMFT. After 3 months fluoride varnish was applied to both groups using same method and same directives. Dental caries was examined using the DMFT score after six months of application of fluoride varnish in both groups. All the data was recorded in the proforma. Results: In this study total 108 children were studied, there was no significant difference according to age and brush frequency among both groups p-value 0.146 and 0.088 respectively. Most of the children were using brush among both groups. A starting of the trail mean of DMFT was 1.22+0.24 in group A and 1.39+0.56 in group B. After 3 months it was almost equal among both groups as, while on six months assessment DMFT was raised in control group in contrast to test group p-value 0.012 Conclusion: It was concluded there was significant preventive effect/impact of fluoride varnish on dental caries. DMFT was raised in control group during 6 months rather than test group. Keywords: Children, Dental caries, Fluoride varnish

Fluoride formed on enamel by fluoride varnish or gel application: A randomized controlled clinical trial

Although fluoride varnish (FV) and acidulated phosphate fluoride gel (APF-gel) are considered clinically effective to reduce caries, in vitro studies have shown that FV reacts slowly with enamel because most NaF present in the formulation is not solubilized in the FV. Therefore, we conducted a clinical study to evaluate if the time that FV remains on dental surfaces could overcome its slower chemical reactivity when compared with APF-gel. Sixty-eight volunteers were randomly allocated into four groups: Negative control (Control, no treatment), APF -gel application (1.23% F applied for 4 min), and FV application (Duraphat®, 2.26 % F) for 4 h (FV-4h) or 24 h (FV-24h). To evaluate fluoride formed and retained on enamel, acid biopsies were made on the buccal surfaces of the maxillary central incisors before, at the end of the application of fluoride products (immediately after gel application, or after 4 or 24 h of varnish application) and after 7 and 28 days. Fluoride concentration in dental biofilm was also analyzed before and up to 28 days after initial application. The data were analyzed by 2-way ANOVA, considering treatment and time as factors. The APF-gel and FV-24h groups formed greater fluoride concentration on enamel than the FV-4h and the control group at the end of application (p=0.0001), with no difference from each other (p=0.99). The groups did not differ regarding fluoride in biofilm, fluid (p=0.73) and solids (0.40). In conclusion, fluoride varnish needs to remain in contact with the teeth for prolonged times (>4 h) to reach the same reactivity obtained by a 4-min application of APF-gel.

PENCEGAHAN KARIES GIGI MELALUI APLIKASI FLUORIDE VARNISH TERHADAP MURID SD ISLAM TELADAN AL HIDAYAH

Murid masa usia sekolah dasar merupakan kelompok resiko tinggi kerusakan gigi oleh karena karies salah satunya karena faktor perilaku anak yang secara umum belum paham cara pemeliharaan kesehatan gigi yang baik, sekolah dasar sebaiknya memiliki program yang pemeliharan kesehatan gigi salah satunya adalah pencegahan karies gigi pada murid. Tujuan kegiatan pengabdian masyarakat adalah melakukan upaya pencegahan karies gigi dengan aplikasi fluoride varnish terhadap murid kelas I & II SD Islam teladan Al Hidayah. Sasaran mitra kegiatan pengabdian masyarakat adalah kepala sekolah, orangtua dan murid-murid kelas 1 & II Sekolah dasar Islam Teladan Al Hidayah. Bentuk kegiatan pengabmas yaitu dengan melakukan advokasi, penyuluhan pencegahan karies gigi dan aplikasi fluoride varnish. Hasil kegiatan memberikan dampak yaitu terlaksana nya kegiatan advokasi, penyuluhan dan praktek aplikasi pengolesan fluoride varnish dengan baik, meningkatnya pengetahuan dan keterampilan orang tua dalam upaya pencegahan karies gigi kepada anaknya. Kesimpulan terlaksananya dengan baik rangkaian kegiatan upaya pencegahan karies gigi dengan aplikasi fluoride varnish terhadap murid kelas I & II SD Islam teladan Al Hidayah.

Nano-Hydroxyapatite Gel and Its Effects on Remineralization of Artificial Carious Lesions

Introduction. Nano-hydroxyapatite gel (NHG) has never been investigated for enamel remineralization. This study evaluated the effects of two concentrations of NHG on remineralization of an artificial carious lesion in comparison with nano-HA toothpaste (NHT) and fluoride varnish (FV). Materials and Methods. Carious lesions were prepared on 100 enamel samples and divided into 5 groups: FV, NHT, 20% NHG, and 30% NHG. One untreated (NT) group was left as control. The hardness of the surface was evaluated before, during, and after remineralization. Microhardness at various phases and the percent recovery of hardness (%HR) were determined and analyzed with ANOVA. Polarized-light micrographs (PLM) were evaluated for depth of the carious lesion. Results. Significantly different remineralization capability was indicated for tested agents ( p < 0.05 ). NHT was significantly capable of remineralization greater than NHG, FV, and NT ( p < 0.05 ). No noticeable difference in %HR between 20% NHG and 30% NHG ( p > 0.05 ) was found. Decreasing in the depth of caries lesion was notified by PLM as applying either NHT or NHG as greater than FV, with no reduction in the depth for NT. Conclusions. Nano-HA both in toothpaste and gel form was capable of remineralization better than fluoride varnish. Comparable remineralization of 20% versus 30% NHG was evidenced. NHG for both concentrations was recommended as a capable remineralizing agent for caries remineralization. Clinical Significance: This study indicated that an application of nano-HA gel is an attractive route to deliver the material and can be more effective and less toxic than conventional formulations and provide its effectiveness directly at the site of action, especially for a noncooperative young child and medicinally intimidated patients who may face with inconvenience in using toothbrush and toothpaste for hygiene control.

COMPARATIVE EVALUATION OF EFFECTIVENESS OF CASEIN PHOSPHOPEPTIDE AMORPHOROUS CALCIUM PHOSPHATE AND SODIUM FLOURIDE VARNISH IN DENTINE HYPERSENTIVITY

Objective: To determine efficacy of casein phosphopeptide amorphous calcium phosphate and sodium fluoride varnish in managing dentine hypersentivity. Study Design: Quasi-experimental study. Place and Duration of Study: Foundation University College of Dentistry, Islamabad, from Jun to Nov 2020. Methodology: Patients of both gender 20-60 years of age with ASA “American Society of Anesthesiologists physical status classification” status I (completely healthy fit patient) or status II (patient has mild systemic disease) diagnosed with dentine hypersensitivity of incisors, canines, premolars with clinical evidence of erosion, abrasion, gingival recession not requiring restorative treatment were enrolled in the study. At first visit baseline, dentine hypersentivity was recorded by means of tactile and evaporative stimuli, response was quantified using visual analogue scale. Patients were randomly divided in two groups 1-casein phosphopeptide amorphous calcium phosphate, 2-sodium fluoride varnish desensitizing agent was applied conferring to manufacturer instructions. Visual analogue scale readings were assessed at base line and post treatment valueswas recorded at 7th, 15th, 30th day. Results: Total 80 patients enrolled in the study with a mean age of 36.26 ± 8.91 years and age-range of 21-60 years. Visual analogue scale results of group-1 (n=40) were recorded at baseline as 5.9 ± 0 .94, 7th day 1.9 ± 0.92, 15th day 1.4 ± 0 .81 and 30th day 1.0 ± 0.71. In case of group-2 Visual Analogue Score recorded to be 6.2 ± 1.24,3.2 ± 0.81, 3.0 ± 0.52 and 2.7 ± 1.12 at baseline, 7th, 15th, and 30th day respectively. Conclusion: Casein phosphopeptide amorphous..................