Abstract
Abstract Objectives To systematically review the effectiveness of 5% sodium fluoride varnish (FV) in the treatment of orthodontically-induced white spot lesions (WSLs). Methods A literature search of three independent databases (Medline, Cochrane Library and Web of Science) was performed from inception to November 2020. This systematic review included randomised/quasi-randomised clinical trials (RCTs) that used FV for patients who had at least one WSL as a result of fixed orthodontic treatment. Exclusion criteria were split-mouth study designs or studies that failed to report WSLs as the outcome variable or studies with less than 3 months follow-up. An Inverse-Variance fixed-effect method was performed for continuous variables. Changes in the mean difference (MD) for the DIAGNOdent (DD) scores following FV application were calculated at the 95% confidence interval (CI). Results Three of the four included studies showed significant improvement in the remineralisation of WSL after treatment with FV in comparison to control subjects. Three studies were conducted on patients after fixed orthodontic treatment and one study was conducted during treatment. The studies included a total of 284 participants with the majority in the age range of 10 to 25 years. The distribution of the participants was approximately equal in the FV and control group. When compared with the control group, there was a statistically significant reduction in the mean DD readings for the FV group at the 3-month (MD = -3.43; 95% CI: -4.72 to -2.15; p < 0.001) and at the 6-month (MD = -4.47; 95% CI: -4.72 to -2.15; p < 0.001) follow-up visit. Conclusions Although few studies have shown the effectiveness of FV application in the treatment of orthodontically-induced WSLs, the limited number of robust clinical trials, makes it difficult to draw a definitive conclusion.
Highlights
Despite the rapid advances in science and nanotechnology, more than three billion people still suffer from untreated dental caries globally.[1]
The initial search identified a total of 513 articles (Figure 1)
A subsequent review of title and the abstract of the articles based on inclusion and exclusion criteria resulted in the shortlisting of 16 articles for full-text screening
Summary
Despite the rapid advances in science and nanotechnology, more than three billion people still suffer from untreated dental caries globally.[1] It has remained one of the two most prevalent human diseases alongside untreated periodontal disease. ALREBDI, ERICSON, QASIM, ALBAHOTH, AL-SULIMANI AND BASKARADOSS demineralisation” that presents as “a milky white opacity” when located on smooth surfaces.[2,3] During the first month after the placement of orthodontic appliances these enamel lesions appear as minor lines adjacent to attachments, whilst in some patients, they might progress to large decalcified areas without cavitation.[1] Depending on the types of examination techniques, the estimates, prevalence and incidence of WSLs may vary. Earlier reports suggested a wide prevalence of 23.4 to 96%.4,5
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