Efficacy of 1.23% acidulated phosphate fluoride gel on non-cavitated enamel lesions: a randomized clinical trial

Gabriela Maltz Goldenfum,Berenice Barbachan E Silva,Matheus Neves,Ingrid Dos Anjos Almeida,Natália Caldeira Silva,Jonas Almeida Rodrigues,Juliana Jobim Jardim

doi:10.1590/1807-3107bor-2021.vol35.0038

Gabriela Maltz Goldenfum, Berenice Barbachan E Silva + Show 5 more

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https://doi.org/10.1590/1807-3107bor-2021.vol35.0038

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Abstract

A randomized controlled parallel clinical trial was conducted to evaluate the efficacy of the association of 1.23% topical professional acidulated phosphate fluoride (APF) gel with oral hygiene and dietary instructions on the arrest of active non-cavitated lesions in permanent, mixed, and temporary dentition in children between 3 and 12 years of age. Ninety-eight caries-active children were randomly divided into two groups: a fluoride gel group (n = 49) and a non-fluoridated gel group (n = 49). Each group received up to eight weekly applications of gel, weekly professional toothbrushing with oral hygiene instructions and dietary counselling. Caries lesions were assessed qualitatively through visual-tactile criteria performed in three stages: initial, intermediate, and final. Regression models were applied to identify risk indicators for caries control. Between-group comparison regarding the time taken to arrest the lesions was performed using Chi-squared and Fisher's exact tests. Seventeen children did not receive the allocated intervention, and one was lost to follow-up (n = 80). There was no difference between the control and placebo groups regarding the time to the arrest of the lesion (p >.05). The treatments showed similar results without significant statistical difference (p = 0.33; 95%CI: 0.32-1.48). No adverse effects were observed. It can be concluded that no additional effect of the association of 1.23% APF gel with oral hygiene using fluoride dentifrice and dietary instructions on the arrest of active non-cavitated lesions could be established. We can also confirm the importance of toothbrushing frequency and, consequently, the visible plaque reduction in the control of caries activity. RBR-37V5S3.

Highlights

Studies still show a considerable number of children presenting with dental caries worldwide
Efficacy of 1.23% acidulated phosphate f luoride gel on non-cavitated enamel lesions: a randomized clinical trial dentition is a predictor of an increase in caries in permanent dentition.[5]
The null hypothesis was that there is no additional effect of the association of 1.23% acidulated phosphate fluoride (APF) gel with oral hygiene using fluoride dentifrice and dietary instructions on the arrest of active non-cavitated lesions

Summary

Introduction

Studies still show a considerable number of children presenting with dental caries worldwide. The level of dental caries continues to be high in low-income and low educational-level populations.[1,2] The disease consists of a dynamic de- and remineralization process resulting in a loss of minerals over time, varying clinically from a white spot to a cavity. Efficacy of 1.23% acidulated phosphate f luoride gel on non-cavitated enamel lesions: a randomized clinical trial dentition is a predictor of an increase in caries in permanent dentition.[5]. Understanding the dynamic nature of the caries process, in which progression can be disrupted at any stage, increases the importance of clinically assessing the status of the lesion.[6] The possibility of stopping the progression of enamel lesions through non-invasive treatments has encouraged professionals to better understand the disease process. The arrest of an active non-cavitated lesion is fundamentally related to the triad of oral hygiene, diet control, and fluoride

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