Stecksén-Blicks C, Renfors G, Oscarson N D, Bergstrand F, Twetman S
Department of Odontology, Paediatric Dentistry, Faculty of Medicine, Umeå University, Umeå, Sweden.
Caries Res. 2007;41(6):455-9. doi: 10.1159/000107932. Epub 2007 Sep 7.
The aim was to evaluate the efficacy of topical fluoride varnish applications on white spot lesion (WSL) formation in adolescents during treatment with fixed orthodontic appliances. The study design was a double-blinded randomized placebo-controlled trial with two parallel arms. The subjects were 273 consecutive 12- to 15-year-old children referred for maxillary treatment with fixed orthodontic appliances. The patients were randomly assigned to a test or a control group with topical applications of either a fluoride varnish (Fluor Protector) or a placebo varnish every 6th week during the treatment period. The outcome measures at debonding were incidence and progression of WSL on the upper incisors, cuspids and premolars as scored from digital photographs by 2 independent examiners. The attrition rate was 5%. The mean number of varnish applications was 10 (range 4-20) in both groups. The incidence of WSL during the treatment with fixed appliances was 7.4% in the fluoride varnish compared to 25.3% placebo group (p < 0.001). The mean progression score was significantly lower in the fluoride varnish group than in the placebo group, 0.8 +/- 2.0 vs. 2.6 +/- 2.8 (p < 0.001). The absolute risk reduction was 18% and the number needed to treat was calculated to 5.5. The results from the present study strongly suggest that regular topical fluoride varnish applications during treatment with fixed appliances may reduce the development of WSL adjacent to the bracket base. Application of fluoride varnish should be advocated as a routine measure in orthodontic practice.
本研究旨在评估在青少年使用固定正畸矫治器治疗期间，局部应用氟化物清漆对白斑病变（WSL）形成的疗效。研究设计为双盲随机安慰剂对照试验，设有两个平行组。研究对象为273名连续就诊的12至15岁因上颌固定正畸矫治器治疗前来就诊的儿童。在治疗期间，患者被随机分为试验组或对照组，每6周分别局部应用氟化物清漆（氟保护漆）或安慰剂清漆。去除矫治器时的观察指标为上颌切牙、尖牙和前磨牙上WSL的发生率和进展情况，由2名独立检查者根据数码照片评分。脱落率为5%。两组的清漆平均应用次数均为10次（范围4 - 20次）。使用固定矫治器治疗期间，氟化物清漆组WSL的发生率为7.4%，而安慰剂组为25.3%（p < 0.001）。氟化物清漆组的平均进展评分显著低于安慰剂组，分别为0.8 ± 2.0和2.6 ± 2.8（p < 0.00）。绝对风险降低率为18%，所需治疗人数计算为5.5。本研究结果强烈表明，在使用固定矫治器治疗期间定期局部应用氟化物清漆可能会减少托槽基底部附近WSL的发生。在正畸治疗中，应提倡将氟化物清漆的应用作为一项常规措施。
