Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California at San Francisco, 707 Parnassus, San Francisco, CA, 94143, USA.
Division of Orthodontics, Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, 707 Parnassus, San Francisco, CA, 94143, USA.
Clin Oral Investig. 2018 Jul;22(6):2229-2239. doi: 10.1007/s00784-017-2314-9. Epub 2018 Jan 4.
White spot lesions (WSLs) are a complication of orthodontic therapy. This study investigated the effect of MI (minimally invasive) Paste Plus (MIPP) and MI Varnish (MIV) on WSLs in orthodontic patients during a 12-month, randomized, single-blind, prospective, standard-of-care controlled clinical trial.
Forty subjects, recruited from the UCSF School of Dentistry Orthodontics Clinic, were randomly assigned to the experimental (twice-daily 1100 ppm fluoride toothpaste, daily MIPP, quarterly MIV application) or control group (twice-daily 1100 ppm fluoride toothpaste, fluoride rinse recommendation). Facial surfaces of incisors, canines, and first bicuspids were evaluated at baseline, 3, 6, and 12 months using the enamel decalcification index (EDI) and the international caries detection and assessment system (ICDAS).
Findings from 37 subjects are reported. At 12 months, teeth receiving experimental treatment were at lower but not significantly different odds of increased EDI scores (odds ratio, OR 0.63; intra-patient cluster-adjusted 95% CI 0.43, 1.18) and not associated with increased ICDAS scores (OR 0.99; 95% CI 0.64, 1.54). There was no statistically significant difference in mean patient-level EDI sum (experimental group 40.2; control 41.3; t test p = 0.80), ICDAS score (experimental 22.3; control 22.6; Mann-Whitney U test p = 0.80), or percentage of scored surfaces with ICDAS > 0 (experimental 54.6%; control 55.2%; t test p = 0.88). Salivary fluoride levels were significantly higher at 12 months for the experimental than for the control group (0.20 ± 0.26 versus 0.04 ± 0.04 ppm, Mann-Whitney U test p < 0.01).
Applying daily MIPP and quarterly MIV resulted in no statistically significant differences in EDI sum and ICDAS scores. Higher salivary fluoride levels in the experimental group suggest that MIPP and MIV effectively deliver fluoride when used clinically.
Daily MIPP and quarterly MIV applications do not appear to reduce significantly WSLs incidence during fixed orthodontic treatment.
白色斑点病变（WSLs）是正畸治疗的并发症。本研究通过一项为期 12 个月、随机、单盲、前瞻性、对照临床试验，调查 MI（微创）糊剂 Plus（MIPP）和 MI 清漆（MIV）对正畸患者 WSLs 的影响。
从 UCSF 牙科学院正畸诊所招募了 40 名受试者，将其随机分配到实验组（每日两次 1100ppm 氟化物牙膏，每日 MIPP，每季度 MIV 应用）或对照组（每日两次 1100ppm 氟化物牙膏，氟化物漱口水推荐）。在基线、3、6 和 12 个月时，使用釉质脱矿指数（EDI）和国际龋病检测与评估系统（ICDAS）评估切牙、尖牙和第一前磨牙的颊面。
报告了 37 名受试者的发现。在 12 个月时，接受实验治疗的牙齿出现 EDI 评分增加的可能性较低，但无统计学意义（比值比，OR 0.63；患者内聚类调整 95%CI 0.43，1.18），且与 ICDAS 评分增加无关（OR 0.99；95%CI 0.64，1.54）。患者平均 EDI 总和（实验组 40.2；对照组 41.3；t 检验 p=0.80）、ICDAS 评分（实验组 22.3；对照组 22.6；Mann-Whitney U 检验 p=0.80）或 ICDAS>0 的评分表面百分比（实验组 54.6%；对照组 55.2%；t 检验 p=0.88）均无统计学显著差异。实验组唾液氟化物水平在 12 个月时明显高于对照组（0.20±0.26 与 0.04±0.04ppm，Mann-Whitney U 检验 p<0.01）。
每日应用 MIPP 和每季度应用 MIV 对 EDI 总和和 ICDAS 评分无统计学显著差异。实验组唾液氟化物水平较高表明，MIPP 和 MIV 在临床应用时能有效输送氟化物。
在固定正畸治疗期间，每日 MIPP 和每季度 MIV 应用似乎不能显著降低 WSLs 的发生率。
