Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Am J Orthod Dentofacial Orthop. 2011 Sep;140(3):291-7. doi: 10.1016/j.ajodo.2010.04.034.
This article illustrates a new treatment method and evaluates the effect of the frequent use of fluoridated chewing sticks (miswaks) on the remineralization of white spot lesions (WSLs) diagnosed at debonding.
Thirty-seven orthodontic patients (mean age, 17.2 years), with a minimum of 4 WSLs on the buccal surfaces of the maxillary incisors, canines, premolars, and first molars after orthodontic therapy, were enrolled in a double-blind, randomized, longitudinal trial lasting 6 weeks. The subjects were divided into 2 groups using fluoridated miswaks impregnated in 0.5% sodium fluoride (test group, n = 19) and nonfluoridated miswaks (control group, n = 18). A custom-made mouth tray, covering half of the maxillary dentition, was used while brushing with the miswaks 5 times per day. The WSLs were scored by using a DIAGNOdent pen (KaVo, Biberach, Germany) and with the International Caries Detection and Assessment System (ICDAS II) index, at baseline and 2, 4, and 6 weeks after debonding.
Both the DIAGNOdent readings and the ICDAS II index of the WSLs decreased in the test group on the uncovered side of the dentition but not on the covered side during the 6-week trial (P <0.0001). There was also a slight improvement in the control group (not significant). There was a strong correlation between the DIAGNOdent values and the ICDAS II index when all the data were pooled (P <0.001).
The frequent use of fluoridated miswaks had a remineralizing effect on WSLs. The DIAGNOdent pen might be a useful tool for diagnosing and monitoring changes of WSLs over a relatively short period of time.
本文介绍了一种新的治疗方法，并评估了频繁使用含氟牙线（miswaks）对正畸治疗后牙釉质白斑（WSL）再矿化的影响。
37 名正畸患者（平均年龄 17.2 岁），正畸治疗后上颌切牙、尖牙、前磨牙和第一磨牙颊面至少有 4 个 WSL，参与了一项为期 6 周的双盲、随机、纵向试验。将受试者分为 2 组，使用 0.5%氟化钠浸渍的含氟 miswaks（实验组，n=19）和非氟化 miswaks（对照组，n=18）。使用定制的覆盖上颌半口的托盘，每天用 miswaks 刷牙 5 次。在正畸治疗结束后 2、4 和 6 周时，使用 DIAGNOdent 笔（德国 KaVo，Biberach）和国际龋病检测和评估系统（ICDAS II）指数对 WSL 进行评分。
在正畸治疗结束后的 6 周试验中，实验组未覆盖牙列的 WSL 的 DIAGNOdent 读数和 ICDAS II 指数均降低，但覆盖牙列的则没有（P<0.0001）。对照组也有轻微改善（无统计学意义）。当所有数据合并时，DIAGNOdent 值与 ICDAS II 指数之间存在很强的相关性（P<0.001）。
频繁使用含氟牙线对 WSL 具有再矿化作用。DIAGNOdent 笔可能是一种有用的工具，可用于在相对较短的时间内诊断和监测 WSL 的变化。
