Babadi Oregani Elham, Jafari Alireza, Masoud Sajedi Seyed, Reza Motamedian Saeed
Under graduate student, Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Prosthodontics, School of Dentistry, Bushehr University of Medical Sciences, Bushehr, Iran.
Turk J Orthod. 2022 Sep;35(3):223-230. doi: 10.5152/TurkJOrthod.2022.21050.
The current study aimed to systematically review the randomized clinical trials assessing the preventive effect of professional fluoride interventions on enamel demineralization in patients undergoing fixed orthodontic treatment.
The electronic search was performed in PubMed and Cochrane library in September 2021. No restriction was set on the publication date. Randomized clinical trials assessing the preventive effect of fluoride varnish, gel, mouthwash, and high-fluoride toothpaste on white spot lesions compared to the control group by clinical or radiographic methods in more than 10 patients were included.
A total of 7 articles consisting of 1418 participants were included. In 4 articles, fluoride varnish (contained a range of 1000-50 000 ppm fluoride) was applied multiple times (4-20 times) in test groups. Their results indicated that the test groups significantly had lesser new white spot lesions or advanced white spot lesions. One study used fluoride varnish only once at the beginning of treatment and reported no significant difference in white spot lesions compared to the control group. Application of high-fluoride toothpaste as well as fluoride mouthwash, also, showed significantly lower white spot lesions. Three studies were included in the meta-analysis and revealed that the relative risk of white spot lesions was 0.64 (95% CI = 0.40 to 0.89; P < .01) in favor of fluoride varnish.
Multiple applications (4-20 times) of fluoride varnish or daily use of fluoride mouthwash or high-fluoride toothpaste seem to reduce white spot lesions in patients undergoing orthodontic treatment. However, single use of fluoride varnish was not effective. Further research is needed to establish the required number of fluoride applications for the prevention of white spot lesions during orthodontic treatment.
本研究旨在系统评价随机临床试验，评估专业氟干预对接受固定正畸治疗患者牙釉质脱矿的预防效果。
2021年9月在PubMed和Cochrane图书馆进行电子检索。对发表日期没有限制。纳入了随机临床试验，这些试验通过临床或影像学方法评估氟漆、凝胶、漱口水和高氟牙膏与对照组相比对10例以上患者白斑病变的预防效果。
共纳入7篇文章，涉及1418名参与者。在4篇文章中，试验组多次（4 - 20次）应用氟漆（含氟量为1000 - 50000 ppm）。结果表明，试验组新出现的白斑病变或进展性白斑病变明显较少。一项研究在治疗开始时仅使用一次氟漆，报告与对照组相比白斑病变无显著差异。使用高氟牙膏以及含氟漱口水也显示白斑病变明显减少。3项研究纳入荟萃分析，结果显示氟漆组白斑病变的相对风险为0.64（95%CI = 0.40至0.89；P < 0.01）。
多次（4 - 20次）应用氟漆或每日使用含氟漱口水或高氟牙膏似乎可减少正畸治疗患者的白斑病变。然而，单次使用氟漆无效。需要进一步研究确定正畸治疗期间预防白斑病变所需的氟应用次数。
