Caries-preventive effectiveness of two different fluoride varnishes: A randomised clinical trial in patients with multi-bracketed fixed orthodontic appliances. 2023

Divesh Sardana, and Manikandan Ekambaram, and Yanqi Yang, and Colman P McGrath, and Cynthia K Y Yiu
Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR.

BACKGROUND Patients with multi-bracketed fixed orthodontic appliances are at a higher risk of developing enamel demineralisation. OBJECTIVE To compare the efficacy of the quarterly application of two varnishes in preventing white spot lesions (WSLs) during multi-bracketed fixed orthodontic treatment. METHODS Ninety-nine patients were randomly allocated into three intervention groups: Group A-standard oral hygiene instructions (OHI); Group B-5% sodium fluoride (NaF) varnish with standard OHI; and Group C-NaF plus tricalcium phosphate varnish with standard OHI. The outcome was assessed at 6-monthly intervals using a quantitative laser fluorescence device, clinical evaluation and photographic evaluation on six maxillary anterior teeth. A logistic regression model using generalised estimating equations with the intervention group, time and their interaction was used to compare the occurrence of WSLs, whereas the independent-samples Kruskal-Wallis test was used to compare the means of fluorescent values among different groups at p = .05. RESULTS Generalised estimating equations (with intervention and time as predictors) showed that only the effect of time was found to be significant (p < .001), whereas there was no significant difference among the three intervention groups (p = .305) using clinical assessment or photographic assessment (p = .599). At the 18-month follow-up, sodium fluoride (NaF) varnish with standard OHI was shown to reduce the odds of WSLs by 55% (p = .200), and NaF plus tricalcium phosphate varnish with standard OHI by 42% (p = .327). CONCLUSIONS The study failed to demonstrate that the quarterly application of both the study varnishes with OHI provided additional benefits compared with standard OHI alone in preventing WSLs, taking the effect of time of follow-up into consideration. There were higher odds of developing WSLs with an increased duration of orthodontic treatment.

UI MeSH Term Description Entries
D003731 Dental Caries Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. Caries, Dental,Carious Lesions,Dental Cavities,Dental Cavity,Dental Decay,Dental White Spots,Carious Dentin,Decay, Dental,Dental White Spot,White Spot, Dental,White Spots, Dental,Carious Dentins,Carious Lesion,Cavities, Dental,Cavity, Dental,Dentin, Carious,Dentins, Carious,Lesion, Carious,Lesions, Carious,Spot, Dental White,Spots, Dental White
D005460 Fluorides, Topical Fluorides, usually in pastes or gels, used for topical application to reduce the incidence of DENTAL CARIES. Fluoride Varnishes,Topical Fluorides,Varnishes, Fluoride
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077744 Orthodontic Appliances, Fixed ORTHODONTIC APPLIANCES attached to the teeth by adhesive material which cannot be removed from the mouth by the patient. These devices apply force to the teeth and supporting structures, thereby producing changes which control their growth and development. Bonded Retainer,Fixed Appliances,Fixed Functional Appliances,Fixed Retainer,Permanent Retainer,Appliance, Fixed,Appliance, Fixed Functional,Appliance, Fixed Orthodontic,Appliances, Fixed,Appliances, Fixed Functional,Appliances, Fixed Orthodontic,Bonded Retainers,Fixed Appliance,Fixed Functional Appliance,Fixed Orthodontic Appliance,Fixed Orthodontic Appliances,Fixed Retainers,Functional Appliance, Fixed,Functional Appliances, Fixed,Orthodontic Appliance, Fixed,Permanent Retainers,Retainer, Bonded,Retainer, Fixed,Retainer, Permanent,Retainers, Bonded,Retainers, Fixed,Retainers, Permanent
D012969 Sodium Fluoride A source of inorganic fluoride which is used topically to prevent dental caries. Fluoristat,Ossin,Zymafluor,Fluoride, Sodium,Fluorides, Sodium,Fluoristats,Ossins,Sodium Fluorides,Zymafluors

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