Abstract
The aim of this randomized clinical trial study was to evaluate the therapeutic effect of two varnish formulations (G1 = 5% NaF, G2 = 6% NaF + 6% CaF(2)) on the remineralization of white spot lesions (WSL). The sample was composed of 15 (7- to 12-year-old) children with 45 active WSL in anterior permanent teeth. The children were randomly divided into two groups providing 22 lesions for G1 and 23 for G2. The children were submitted to weekly varnish applications 4 times. The WSL were evaluated twice: baseline and on week 4. Maximum lesion dimensions (mesiodistal and incisogingival) were measured in millimeters and classified in four grades of size. WSL were also assessed regarding lesion activity by one calibrated examiner. The Pearson chi-square and Fisher's exact tests were used (P < 0.01). WSL reductions were observed in both varnish groups (Chi-square = 0.15, d.f. = 1, P = 0.90), and with similar magnitude (in mm): 1.19 and 1.29 for G1 and G2, respectively. Thirty-six WSL (15 in G1 and 21 in G2) were classified as inactive on week 4, reaching an overall value of 80%. No difference was observed between G1 and G2 regarding activity scores (Fisher's exact test, p > 0.01). It was concluded that after 4 applications the two varnish formulations tested produced similar clinical effects, indicating the reduction and the control of carious activity in most WSL.
Highlights
The concept of dental caries, initially based on a model proposed by Paul Keyes in 1962, has changed over time
Many reports support that the early diagnosis or detection of white spot lesions (WSL) and the use of non-invasive therapies such as fluoride are important strategies for controlling the development of a carious lesion.[6]
Several studies indicate that fluoride varnishes can reverse or arrest, as well as prevent, the demineralization process of an incipient carious lesion, when combined with other preventive measures such as diet control and dental biofilm control.[7,8,9,10,11,12,13,14,15]
Summary
The concept of dental caries, initially based on a model proposed by Paul Keyes in 1962 (host, diet and microorganisms), has changed over time. The current concept for dental caries etiology and treatment includes social and behavioral factors regarding individual variables.[1]. White spot lesions (WSL) represent the first clinical observation of demineralization in the enamel and can be regarded as a sign of dental caries.[2,3,4] A WSL is generally characterized by enamel demineralization of the subsurface, with increasing porosity due to the removal of minerals into the outer surface.[5] It may be active, with a rough and opaque enamel surface, or inactive, presenting a smooth and shiny enamel surface.[4]. Several studies indicate that fluoride varnishes can reverse or arrest, as well as prevent, the demineralization process of an incipient carious lesion, when combined with other preventive measures such as diet control and dental biofilm control.[7,8,9,10,11,12,13,14,15]
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