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.

The effect of various fluoride products on dentine lesions during pH-cycling

This study compared the effect of topically applied fluoride products on dentine lesions in an in vitro experiment. Demineralized bovine dentine specimens were treated once with either SDF solution (35,400 ppm F), NaF varnish (22,600 ppm F), TiF4 solution (9,200 ppm F), SnF2 gel (1,000 ppm F), no treatment (control) or preserved as baseline lesions. After the application and subsequent removal of the fluoride products, the specimens were subjected to pH-cycling. Calcium loss and uptake in the de- and remineralization buffers were assessed daily. Fluoride release into the buffers was analyzed on day 1, 2, 3, 5, 8 and 13. After the pH-cycling period, mineral distribution throughout the lesion depth was analyzed using transversal microradiography (TMR). X-ray energy-dispersive spectroscopy (EDS) examined the deposition of silver, titanium and tin after application of SDF, TiF4, and SnF2, respectively. Overall, calcium loss and uptake analysis in the de- and remineralization buffers revealed that the SDF product was the most effective in inhibiting lesion progression, followed by the TiF4, NaF, and SnF2 products. Fluoride analysis disclosed a steep reduction of the amount of fluoride released into de- and remineralization buffers with time. The fluoride effects on de- and remineralization continued beyond the days that fluoride was released into the buffers. TMR analysis showed significant remineralization in the outer zone of the dentine lesions for all fluoride products, with SDF giving hyper-mineralization in this zone. In the inner zone, lesions developed in all fluoride groups, with the smallest in the SDF group. EDS showed silver and titanium deposition in depth up to 85 μm and 8 μm, respectively, while no tin deposition was observed. The silver in the dentine lesions did not contribute significantly to the density of the TMR profiles in the SDF group. In conclusion, all topical fluoride products protected the dentine lesions against lesion progression, but at different degrees. SDF showed a superior effect in protection against further demineralization and enhancement of remineralization. This was probably attributed to its fluoride concentration that was the highest among the fluoride products.

The Evaluation of the Effect of Topical Fluoride on the Micro Hardness of Various Restorative Materials- an in Vitro Study

Introduction: Dental caries considered to be a multifactorial disease requires meticulous management and prevention. For prevention the most successful and commonly used agent is fluoride and if applied topically by means of APF gel it has a success rate of around 60%. Aims and objectives: To evaluate and compare the micro hardness of the restorative materials after the application of APF gel. To evaluate the effect of topical fluoride on the micro hardness of various restorative materials using universal testing machine as well as to compare the micro hardness of the restorative materials after the application of APF gel. Materials and methods: 80 standardized restorative pellets made with various restorative materials constituted the sample size for the evaluation of micro hardness with and without the application of APF gel on the prepared restorative pellets. The prepared 80 molds were equally distributed for the preparation of 20 restorative pellets of four restorative materials each (viz.) Glass Ionomer Cement, Zirconomer, Amalgomer, Cention-N. Out of 20 samples prepared 10 samples were considered as control, which were tested without the application of APF gel. While 10 samples were taken as experimental, which were conditioned with APF gel before the test. Results: The result of the microhardness test after the application of fluoride gel showed that the highest microhardess was shown by Group III Amalgomer CR with mean 52.62 ± 0.65. The other materials in the order of decreasing hardness were Group IV Cention N 50.52 ± 0.69, Group II Zirconomer 46.80 ± 0.68 and least for Group I conventional Gic 43.38 ± 0.53. The percentage reduction of micro hardness after application of APF gel was recorded highest in GIC type IX followed by Amalgomer CR, Cention N and Zirconomer. Zirconomer has the least percentage reduction of micro hardness after application of APF gel amongst all the restorative materials. Keywords: APF gel, Amalgomer CR, Cention N, micro hardness, topical fluoride, Zirconomer.

Arrest of root caries with an adjuvant chlorhexidine–fluoride varnish over a 12-months observation period: a QLF-analyzed, placebo-controlled, randomized, clinical trial (RCT)

This study aimed at evaluating the effectiveness of an adjuvant chlorhexidine–fluoride varnish (Cervitec F) for prevention and arrest of root caries on elderly participants using quantitative light-induced fluorescence (QLF). 23 participants with two or three non-cavitated root carious lesions were included and assigned to three groups of different varnishes (CF: Cervitec F, P: placebo, DP: Duraphate). Agents were applied once to root surface at baseline and in follow-up after 3, 6 and 9 months. The lesions were assessed clinically and with QLF. QLF-images were analyzed regarding fluorescence loss (ΔF), lesion volume (ΔQ) and bacterial activity (ΔR) before (t0), after 14 days (t1), 6- (t2) and 12-months (t3). CF showed a significant difference between t0 and t3: ∆F (− 12.51 [15.41] vs. − 7.80 [16.72], p = 0.012), ∆Q (− 2339.97 (20,898.30) vs. − 751.82 (5725.35), p < 0.001), ∆R (23.80 [41.70] vs. 7.07 [37.50], p = 0.006). Independently of the varnish application, preventive care seems positively influence the root caries progress. Although within CF group the strongest effect was observed, no superiority of a specific varnish application was confirmed over a 12-months QLF observation period. Extra topical fluoride can help remineralise dentin lesions and QLF can be used as a measurement method to determine changes in the dentin lesions.

Comparison Adhesive strength of Resin Composite between Total-etch and Self-etch Techniques on Enamel After Fluoride Application

Background : White Spot Lesion (WSL) is caused by Streptococcus Mutan which causes demineralization of teeth. One of the treatments of WSL is topical application of fluoride which aims to remineralize the teeth. However, if topical fluoride treatment does not give satisfactory results, alternative treatments can be made using restorative treatments, one of which is veneers. The procedure for applying veneers requires the application of an adhesive system. The adhesive system used to apply veneers is self-etch and total-etch. Several references state that the application of fluoride which aims to remineralize teeth can influence the adhesiv strength of the restorative material using self etch and total-etch techniques. Purpose : To determine the effect of composite resin adhesion strength between total-etch and self etch techniques on enamel after fluoride application. Review : Literature sources used in the preparation of the article through several databases with descriptions of the effects of fluoride application before total-etch and/or self etch administration. From the existing references, it was found that the application of fluoride before the total-etch system had a less significant effect on the adhesiv strength. Whereas in the self etch system, fluoride application has a significant effect on the adhesiv strength. Conclusion : More references say that the application of fluoride before the total-etch system has a better adhesive strength than the application of fluoride before the self etch system