Abstract

BackgroundWhite spot lesions and gingivitis represent common, yet challenging, dilemmas for orthodontists. Fluoride has shown some benefit as a protective measure against demineralization; however, this is usually insufficient for orthodontic patients with less than ideal oral hygiene. Dentifrices containing calcium sodium phosphosilicate bioactive glass (NovaMin) have been proposed to aid in prevention of white spot lesions and gingival inflammation. Thus, the purpose of this study was to determine if the use of NovaMin reduces the formation of white spot lesions and improves gingival health in orthodontic patients.MethodsThis was a prospective, double-blind, randomized controlled trial. Forty-eight patients undergoing orthodontic treatment were randomly allocated to two groups. The control group consisted of 24 patients who received over-the-counter fluoride toothpaste (Crest®), while the study group consisted of 24 patients who were given the test dentifrice (ReNew™) containing 5 % NovaMin and fluoride. Patients were followed up for 6 months on a monthly basis. Decalcification, gingival health, plaque, and bacteria levels were evaluated every 3 months. Statistical analysis was performed using both parametric and non-parametric tests to identify differences between groups at different time points.ResultsThere were no significant differences between the groups in regard to changes in white spot lesions, plaque, or gingival health (P > 0.05). There was a trend toward improvement in white spot lesions found in subjects using Crest® at the 3-month time point; however, this was not sustained throughout the study.ConclusionsOur results indicate that a toothpaste containing NovaMin does not differ significantly compared to traditional fluoride toothpaste for improving white spot lesions and gingivitis in orthodontic patients.

Highlights

  • White spot lesions and gingivitis represent common, yet challenging, dilemmas for orthodontists

  • Statistical analysis showed that the groups were similar regarding a number of variables at baseline, including age, time in treatment, decalcification index (DI), Gingival index (GI), and Plaque index (PI) scores (Table 1)

  • There was a trend toward improvement in white spot lesions (DI score) found in subjects using Crest® at the 3-month time point, which was statistically significant (P = 0.0403) (Fig. 2, Table 2)

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Summary

Introduction

White spot lesions and gingivitis represent common, yet challenging, dilemmas for orthodontists. White spot lesions (WSL) are the earliest macroscopic evidence of enamel caries [1] and represent a common, yet challenging, dilemma for orthodontists. Development of WSL during fixed appliance therapy can occur rapidly Studies by both O’Reilly et al [7] and Ogaard et al [8] both show development of clinically visible WSL in orthodontic patients that occurred in 4 weeks or less. This approximates a minimal time interval between consecutive orthodontic appointments. Maxillary lateral incisors showed the highest incidence of white spot lesions, followed by mandibular canines and first premolars

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