Reddy Rishika, Manne Ranjit, Sekhar G Chandra, Gupta Seema, Shivaram Nemani, Nandalur Kulashekar R
Department of Orthodontics and Dentofacial Orthopaedics, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Kamalanagar, Dilsukhnagar, Hyderabad, Telangana, India, Mobile: +919885382279, e-mail:
Department of Orthodontics and Dentofacial Orthopaedics, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Kamalanagar, Dilsukhnagar, Hyderabad, Telangana, India.
J Contemp Dent Pract. 2019 Jan 1;20(1):89-93.
White spot lesions (WSLs) occur frequently after fixed orthodontic treatment. This study was undertaken to compare the efficacy of 2.26% fluoride varnish, 1.23% APF gel, 0.21% fluoride toothpaste and 0.04% sodium fluoride mouthwashes in preventing enamel demineralization around orthodontic brackets in extracted premolars.
The sample for this study included 100 premolars free of caries and enamel cracks. They were divided into five groups of 20 samples each. Group 1 (FV): light-curable Fluoride varnish (Clinpro™ XT 3M ESPE, Pymble, New South Wales, Australia), group 2 (FG): 1.23% APF gel (Patterson NE. International, USA), group 3 (FTP): 0.21% w/w sodium fluoride toothpaste with tri-calcium phosphate (Clinpro™ Tooth Crème, 3M ESPE, Australia), group 4 (FMW): sodium fluoride 0.044% (w/v) mouthwash (Colgate® Phos-Flur® Ortho Defense Rinse, Colgate-Palmolive, NY) and group 5 (C): control. The samples were subjected to laboratory pH cycling. The demineralization changes in the enamel were assessed before the start of the experiment and after 14 days.
There was a significant change in the mean Diagnodent score value ( <0.001) in all groups from day 1-day 14. The mean values were significantly different among groups at day 1 ( = 0.002), day 14 ( = 0.001) and also the change from Day 1 to Day 14 was significantly different among Groups ( = 0.001). The least change in the mean value from baseline to 14 days was seen in group 1 (FV) followed by group 3 (FTP), group 2 (FG), and group 4 (FMW) and then the group 5 (C).
All the topical fluorides tested were able to reduce the demineralization when compared to the control group under similar testing conditions, but to varying degrees. light-curable fluoride varnish outperformed all the topical fluorides followed by 0.21% w/w dodium fluoride toothpaste with tri-calcium phosphate, 1.23% Acidulated phosphate fluoride gel and sodium fluoride 0.044% (w/v) mouthwash. The control group where no topical fluoride was applied showed the least resistance to demineralization.
Within the limitations of this study, routine application of light cured fluoride varnish (Clinpro) can be recommended to prevent enamel demineralization to prevent white spot lesions in patients receiving orthodontic treatment.
固定正畸治疗后白斑病变（WSLs）频繁出现。本研究旨在比较2.26%氟化漆、1.23%酸性磷酸氟（APF）凝胶、0.21%含氟牙膏和0.04%氟化钠漱口水在预防正畸托槽周围釉质脱矿方面的效果，研究对象为拔除的前磨牙。
本研究样本包括100颗无龋且无釉质裂纹的前磨牙。将它们分为五组，每组20个样本。第1组（FV）：光固化氟化漆（Clinpro™ XT 3M ESPE，澳大利亚新南威尔士州皮姆布尔），第2组（FG）：1.23% APF凝胶（美国帕特森NE国际公司），第3组（FTP）：0.21%（重量/重量）含磷酸三钙的氟化钠牙膏（Clinpro™ Tooth Crème，3M ESPE，澳大利亚），第4组（FMW）：0.044%（重量/体积）氟化钠漱口水（高露洁® 防蛀固齿正畸漱口水，高露洁棕榄公司，纽约），第5组（C）：对照组。样本进行实验室pH循环测试。在实验开始前和14天后评估釉质脱矿变化。
从第1天到第14天，所有组的平均Diagnodent评分值均有显著变化（P<0.001）。第1天（P = 0.002）、第14天（P = 0.001）各组平均值有显著差异，且第1天到第14天的变化在各组间也有显著差异（P = 0.001）。从基线到14天平均值变化最小的是第1组（FV），其次是第3组（FTP）、第2组（FG）、第4组（FMW），然后是第5组（C）。
在相似测试条件下，与对照组相比，所有测试的局部用氟化物均能不同程度地减少脱矿。光固化氟化漆效果优于所有局部用氟化物，其次是0.21%（重量/重量）含磷酸三钙的氟化钠牙膏、1.23%酸性磷酸氟凝胶和0.044%（重量/体积）氟化钠漱口水。未使用局部用氟化物的对照组对脱矿的抵抗力最弱。
在本研究的局限性范围内，可推荐常规应用光固化氟化漆（Clinpro）预防正畸治疗患者的釉质脱矿，以预防白斑病变。
