Willmot D R
Department of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield S10 2TA, UK.
J Orthod. 2004 Sep;31(3):235-42; discussion 202. doi: 10.1179/146531204225022443.
To compare and measure the changes in size of post-orthodontic demineralized white lesion enamel lesions treated with a low fluoride (50 ppm) versus a non-fluoride mouthrinse/toothpaste regime.
An experimental double-blind prospective randomized clinical controlled trial.
A university dental school orthodontic clinic (Sheffield, UK).
Twenty-six patients identified as having post-orthodontic demineralized white lesions on removal of their fixed appliance. METHOD AND INTERVENTIONS: The participants were randomly and blindly assigned to either a low fluoride mouthrinse/toothpaste treatment regime or an inactive control. Computerized image analysis of calibrated photographic images taken under polarized light were used to measure the lesions.
Lesion size and proportion (DWL%t) and percentage reduction (ADPR) at debond, and at 12 and 26 weeks later.
Five participants dropped out of the study, 12 had the low fluoride regime and 9 did not. As a percentage of the total labial tooth area (DWL%t) the mean size of the lesions at debond was 8.1% (SD 3.7). After 12 weeks the mean size of lesion had reduced to 4.6% (SD 2.6), which was a significant reduction (p=0.03). After 26 weeks the mean size was 3.5% (SD 2.1), which was a very significant reduction (p<0.003). This confirmed statistically that post-orthodontic demineralized white lesions do reduce in size with time reflecting remineralization or other enamel surface changes. Intervention using a test low fluoride mouthrinse/toothpaste combination at 26 weeks showed an average difference percentage reduction (ADPR) of 54.3% (Upper 95% CI=62.08, Lower 95% CI=46.44%) compared with a non-active control combination, which showed an ADPR of 66.1% (Upper 95% CI=77.74, Lower 95% CI=54.51%). This failed to show any differences or therapeutic affect.
Post-orthodontic demineralized white lesions reduced in size during the 6 months following treatment by approximately half the original size. There was no clinical advantage in using the low fluoride formulation of mouthrinse/toothpaste in this study.
比较并测量用低氟（50 ppm）漱口水/牙膏方案与无氟漱口水/牙膏方案治疗正畸后脱矿白色病变釉质病变的大小变化。
一项实验性双盲前瞻性随机临床对照试验。
一所大学牙科学院的正畸诊所（英国谢菲尔德）。
26名在拆除固定矫治器后被确定患有正畸后脱矿白色病变的患者。方法与干预措施：参与者被随机、盲法分配至低氟漱口水/牙膏治疗方案组或无活性对照组。使用在偏振光下拍摄的校准照片图像进行计算机图像分析来测量病变。
在拆除矫治器时、12周和26周后病变的大小和比例（DWL%t）以及减少百分比（ADPR）。
5名参与者退出研究，12名采用低氟方案，9名未采用。以唇面牙齿总面积的百分比（DWL%t）计算，拆除矫治器时病变的平均大小为8.1%（标准差3.7）。12周后病变的平均大小降至4.6%（标准差2.6），这是显著降低（p = 0.03）。26周后平均大小为3.5%（标准差2.1），这是非常显著的降低（p < 0.003）。这从统计学上证实正畸后脱矿白色病变的大小确实会随着时间减小，反映了再矿化或其他釉质表面变化。在26周时使用测试的低氟漱口水/牙膏组合进行干预，与无活性对照组合相比，平均差异减少百分比（ADPR）为54.3%（95%置信区间上限 = 62.08，下限 = 46.44%），而无活性对照组合的ADPR为66.1%（95%置信区间上限 = 77.74，下限 = 54.51%）。这未显示出任何差异或治疗效果。
正畸后脱矿白色病变在治疗后的6个月内大小减少至约原来大小的一半。在本研究中使用低氟配方的漱口水/牙膏没有临床优势。
