Abstract

This 12-week clinical study evaluated the impact of 10% CPP-ACP and 5% sodium fluoride varnish regimes on the regression of nonorthodontic white spot lesions (WSLs). The study included 21 children with 101 WSLs who were randomised into four treatment regimes: weekly clinical applications of fluoride varnish for the first month (FV); twice daily self-applications of CPP-ACP paste (CPP-ACP); weekly applications of fluoride varnish for the first month and twice daily self-applications of CPP-ACP paste (CPP-ACP-FV); and no intervention (control). All groups undertook a standard oral hygiene protocol and weekly consultation. Visual appraisals and laser fluorescence (LF) measurements were made in weeks one and twelve. The majority of WSLs in the control and FV groups exhibited no shift in appearance, whereas, in the CPP-ACP and CPP-ACP-FV groups, the lesions predominantly regressed. The visual and LF assessments indicated that the extent of remineralisation afforded by the treatments was of the following order: control ~ FV < CPP-ACP ~ CPP-ACP-FV. Self-applications of CPP-ACP paste as an adjunct to standard oral hygiene significantly improved the appearance and remineralisation of WSLs. No advantage was observed for the use of fluoride varnish as a supplement to either the standard or CPP-ACP-enhanced oral hygiene regimes.

Highlights

  • Dental caries is the destruction of tooth tissue in the presence of organic acids produced by cariogenic bacteria located in the dental biofilm [1, 2]

  • This study evaluated the impact of CPP-ACP and fluoride varnish regimes, applied separately and in combination, on the regression of nonorthodontic incipient carious lesions

  • The findings of this study have indicated that four weekly clinical applications of 5% sodium fluoride varnish as a supplement to the standard oral hygiene programme did not afford any remineralisation advantage

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Summary

Introduction

Dental caries is the destruction of tooth tissue in the presence of organic acids produced by cariogenic bacteria located in the dental biofilm [1, 2]. It is possible to reverse the early stages of enamel caries, during which the surface remains intact and the net dissolution of calcium and phosphate ions occurs from the body of the lesion [1,2,3]. The substitution of smaller spherical fluoride ions for hydroxide ions in hydroxyapatite strengthens the bonds within the lattice and reduces the solubility product [1]. This means that fluorapatite is less soluble than its unfluoridated counterpart, and that it will recrystallise more readily at lower concentrations of its component ions

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