Effectiveness of Fluoride Varnishes for White Spot Lesion Prevention and Remineralization during Orthodontic Treatment: A Randomized Controlled Trial.

IF 2.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Caries Research Pub Date : 2024-07-24 DOI:10.1159/000540375

Samanta Mascarenhas Moraes, Larissa Ayumi Koshino, Thamyris de Souza Carvalho, Beatriz Martines de Souza, Heitor Marques Honorio, Ana Carolina Magalhães, Daniela Gamba Garib, Marília Afonso Rabelo Buzalaf

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Abstract

Introduction: This study investigated the effectiveness of titanium tetrafluoride (TiF4) varnish compared to sodium fluoride (NaF) varnish for preventing and remineralizing white spot lesions (WSLs) in individuals undergoing orthodontic treatment.

Methods: This randomized, placebo-controlled, and double-blinded study was conducted with sixty-five adolescents who were selected based on caries activity and then randomized into three parallel groups: G1 (placebo varnish), G2 (5%-NaF varnish) and G3 (4%-TiF4 varnish). Volunteers received varnish application weekly for the first 4 weeks, after 6 (T1) and 12 (T2) months. The measured outcomes included: prevention of new WSLs, and reversal/progression of WSLs, assessed by Nyvad and ICDAS indices, as well as quantitative light-induced fluorescence (QLF). Chi-square, ANOVA, and Kruskall-Wallis tests were applied. The level of significance was set at 0.05, and post hoc Bonferroni test for p values were performed to correct for multiple comparisons.

Results: 1,274 teeth were included; 70.5% were Nyvad 0, and 29.5% were Nyvad 1, with no differences between the groups at baseline (T0). Regarding ICDAS, 70.5% were ICDAS 0, 21.6% were ICDAS 1, and 7.9% were ICDAS 2. G1 showed an increasing prevalence of WSLs at T1 and maintained stable at T2; G2 exhibited a decline at T2, while G3 experienced a decrease at T1 and T2 (p < 0.01). Incidence of WSLs at T2 was 10.2% (G1), 5.6% (G2) and 1.4% (G3). The percentage of teeth initially scored as Nyvad 0 that progressed to Nyvad 1 was 13%, 6.8%, and 1% for G1, G2, and G3, respectively. Conversely, the percentage of teeth initially scored as Nyvad 1 that regressed to Nyvad 0 or Nyvad 2 (T0-T2) was 14%, 49.3%, and 74.4%, respectively (p < 0.001). As for ICDAS index, regression was observed in 6.5%, 17.8% and 24%, while progression was observed in 14.9%, 7.7% and 0.9% for G1, G2 and G3, respectively (p < 0.001). Significant differences among the 3 groups for integrated fluorescence loss (mean±SD, G1: -14.28±9.47, G2: -11.10±11.49 and G3: -6.77±11.00) were found at T2 (p < 0.01).

Conclusion: Both varnishes demonstrated the ability to prevent and remineralize WSLs. However, TiF4 varnish exhibited the most effective control over WSLs during the 12-month orthodontic treatment.

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氟化物清漆对正畸治疗期间白斑病预防和再矿化的效果：随机对照试验

简介：本研究调查了四氟化钛（TiF4）清漆与氟化钠（NaF）清漆在预防和再矿化正畸治疗患者白斑病（WSL）方面的效果：这项随机、安慰剂对照和双盲研究以 65 名青少年为对象，根据他们的龋齿活动情况将其随机分为三个平行组：G1组（安慰剂清漆）、G2组（5%-NaF清漆）和G3组（4%-TiF4清漆）。志愿者在前 4 周、6 个月（T1）和 12 个月（T2）后每周涂抹一次光油。测量结果包括：通过尼瓦德指数和 ICDAS 指数以及定量光诱导荧光（QLF）评估预防新的 WSL 和 WSL 的逆转/进展。采用了卡方检验、方差分析和 Kruskall-Wallis 检验。显著性水平设定为 0.05，并对 p 值进行事后 Bonferroni 检验，以校正多重比较：共纳入 1 274 颗牙齿；70.5% 为 Nyvad 0，29.5% 为 Nyvad 1，两组在基线（T0）时无差异。在 ICDAS 方面，70.5% 为 ICDAS 0，21.6% 为 ICDAS 1，7.9% 为 ICDAS 2。G1 在 T1 期的 WSL 发病率呈上升趋势，在 T2 期保持稳定；G2 在 T2 期呈下降趋势，而 G3 在 T1 期和 T2 期均呈下降趋势（p < 0.01）。在 T2 期，WSL 的发生率分别为 10.2%（G1）、5.6%（G2）和 1.4%（G3）。在 G1、G2 和 G3 中，最初被评分为 Nyvad 0 的牙齿进展到 Nyvad 1 的比例分别为 13%、6.8% 和 1%。相反，最初评分为 Nyvad 1 的牙齿退步到 Nyvad 0 或 Nyvad 2（T0-T2）的百分比分别为 14%、49.3% 和 74.4%（p <0.001）。至于 ICDAS 指数，G1、G2 和 G3 分别有 6.5%、17.8% 和 24% 的人出现退变，而有 14.9%、7.7% 和 0.9% 的人出现进展（p <0.001）。在 T2 阶段，3 组的综合荧光损失（平均值±SD，G1：-14.28±9.47，G2：-11.10±11.49 和 G3：-6.77±11.00）存在显著差异（p <0.01）：两种清漆都具有预防和再矿化WSL的能力。结论：两种清漆都具有预防和再矿化WSL的能力，但在为期12个月的正畸治疗中，TiF4清漆对WSL的控制最为有效。

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来源期刊

Caries Research 医学-牙科与口腔外科

CiteScore

6.30

自引率

7.10%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Caries Research'' publishes epidemiological, clinical and laboratory studies in dental caries, erosion and related dental diseases. Some studies build on the considerable advances already made in caries prevention, e.g. through fluoride application. Some aim to improve understanding of the increasingly important problem of dental erosion and the associated tooth wear process. Others monitor the changing pattern of caries in different populations, explore improved methods of diagnosis or evaluate methods of prevention or treatment. The broad coverage of current research has given the journal an international reputation as an indispensable source for both basic scientists and clinicians engaged in understanding, investigating and preventing dental disease.