Chlorhexidine Varnish Research Articles

Effect of Chlorhexidine and Fluoride Varnish on the Incidence of White Spot Lesion in Orthodontic Patients

Effect of Chlorhexidine and Fluoride Varnish on the Incidence of White Spot Lesion in Orthodontic Patients

Effectiveness of Chlorhexidine Varnish in Preventing Dental Caries in Patients with Cleft Lip and Palate

Effectiveness of Chlorhexidine Varnish in Preventing Dental Caries in Patients with Cleft Lip and Palate

Assessment and prevention of tooth decay in children

It has been solidified by science that dental decay is transmittable. Despite improvements in other age groups, there is indication that dental decay in young children is on the rise. There has not been an improvement in practice as a result of risk assessment research. Although definite trials are required, antiseptics, chlorhexidine varnish, and polyvinylpyrrolidone iodine (PVI-I) may be useful. Despite not being extensively distributed to the most vulnerable, fluorides continue to be the most beneficial interventions. Although conclusive trials have not been carried out, fluoride varnish is a fairly efficient topical preventative for young children. The promise of silver diamine fluoride must be studied in the US. Xylitol is safe and reliable, according to the data, although it is not widely used. Despite numerous studies, wide adoption of dental sealants has not taken place, despite being a fundamental component of public policy. We draw the conclusion that while research has demonstrated the negative public health impact of tooth decay, not enough of it has been conducted to address the growing incidence of pediatric dental disease globally. Technology must be translated from studies to practice in order to stop childhood teeth decay. This should include conducting translational studies and putting the latest technological and scientific developments into use.

Engineering peptide-polymer hybrids for targeted repair and protection of cervical lesions.

By 2060, nearly 100 million people in the U.S. will be over age 65 years. One-third of these older adults will have root caries, and nearly 80% will have dental erosion. These conditions can cause pain and loss of tooth structure that interfere with eating, speaking, sleeping, and quality of life. Current treatments for root caries and dental erosion have produced unreliable results. For example, the glass-ionomer-cement or composite-resin restorations used to treat these lesions have annual failure rates of 44% and 17%, respectively. These limitations and the pressing need to treat these conditions in the aging population are driving a focus on microinvasive strategies, such as sealants and varnishes. Sealants can inhibit caries on coronal surfaces, but they are ineffective for root caries. For healthy, functionally independent elders, chlorhexidine varnish applied every 3 months inhibits root caries, but this bitter-tasting varnish stains the teeth. Fluoride gel inhibits root caries, but requires prescriptions and daily use, which may not be feasible for some older patients. Silver diamine fluoride can both arrest and inhibit root caries but stains the treated tooth surface black. The limitations of current approaches and high prevalence of root caries and dental erosion in the aging population create an urgent need for microinvasive therapies that can: (a) remineralize damaged dentin; (b) inhibit bacterial activity; and (c) provide durable protection for the root surface. Since cavitated and non-cavitated root lesions are difficult to distinguish, optimal approaches will treat both. This review will explore the multi-factorial elements that contribute to root surface lesions and discuss a multi-pronged strategy to both repair and protect root surfaces. The strategy integrates engineered peptides, novel polymer chemistry, multi-scale structure/property characterization and predictive modeling to develop a durable, microinvasive treatment for root surface lesions.

Comparative Evaluation of the Efficacy of Chlorhexidine, Fluoride and the Combined Use of Chlorhexidine and Fluoride Varnishes on Salivary Streptococcus mutans Count in Children with Mixed Dentition: An In Vivo Study.

AimTo study the effect of combination of chlorhexidine and Fluoride on the growth and colonization of cariogenic bacteria (Streptococcus mutans) in children with mixed dentition.Materials and methodsSixty children of age 6–14 years with mixed dentition and S. mutans count > 1 × 105 CFU/mL of saliva were divided: group I–chlorhexidine varnish; group II–Fluoride varnish; group III–Combination of chlorhexidine and Fluoride varnish. chlorhexidine and Fluoride varnishes were applied to teeth once every week for four consecutive weeks in respective groups. Salivary S. mutans count was estimated and evaluated at baseline, 1, 3, and 6 months.ResultsNo significant difference was seen in group I and II at the end of 1, 3, and 6 months (p > 0.001) but the reduction in S. mutans count was statistically more significant in group III after a period of 6 months (p < 0.001). Maximum reduction in count was noted in group III at all intervals of varnish application.ConclusionThe concomitant use of chlorhexidine and fluoride varnish would prove to be more effective than individual components over a longer period of time and especially in high caries risk children.How to cite this articleMore VP, Hugar SM, Sogi S, et al. Comparative Evaluation of the Efficacy of Chlorhexidine, Fluoride and the Combined Use of Chlorhexidine and Fluoride Varnishes on Salivary Streptococcus mutans Count in Children with Mixed Dentition: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(3):267-272.

Antimicrobial effectiveness of Nano Silver Fluoride Varnish in reducing Streptococcus mutans in saliva and plaque biofilm when compared with Chlorhexidine and Sodium Fluoride Varnishes.

BackgroundThis in vivo study was done to investigate the antimicrobial effectiveness of Nano Silver fluoride, Sodium fluoride and Chlorhexidine when used as a varnish on Streptococcus mutans (S.mutans) in saliva and plaque biofilm. Material and Methods120 caries free subjects, aged 8-10 years were randomly assigned to four different groups (n=30) - group I: Control, group II: Chlorhexidine varnish (CHX), group III: Sodium fluoride varnish (NaF), group IV: Nano Silver fluoride varnish (NSF). Varnish application was done once at baseline. Saliva and plaque samples were collected at baseline (T0), at the end of 1 month (T1) and 3 months (T3) to evaluate S.mutans levels by culture method, optical density and PCR. OHI-S Index was also recorded for clinical evaluation. ResultsNSF, CHX and NaF were effective against S.mutans activity. The intragroup comparision of CFU/ml and OD/ml count showed a highly significant reduction from baseline to 3 months for all the 3 varnish groups (p=0.001). PCR result revealed that maximum reduction was seen in NSF and CHX followed by NaF group. ConclusionsNSF reduces S.mutans level in both saliva and plaque biofilm and it is more advantageous than CHX and NaF as it has dual properties of acting as an antibacterial as well as a remineralizing agent. Key words:Chlorhexidine, Nano Silver fluoride, Sodium fluoride, S. mutans, varnish.

Effectiveness of Chlorhexidine Varnish on the Prevention of Root Caries: A Narrative Review

Root surface caries is a common problem encountered in elderly dental patients. It is an increasingly serious problem; especially amongst the institutionalized elderly population where poor oral hygiene arises primarily from the lack of appropriate supervision and support from care staff. The prevention of caries on the root surface is targeted at the control of plaque. As it is difficult to ensure adequate plaque removal by mechanical means, there lies an interest in the use of antimicrobial agents as replacements or to be adjuncts to the mechanical approaches. Among all chemical plaque control agents, chlorhexidine has proven to be effective. Chlorhexidine (CHX) has been studied as an antimicrobial agent for the chemical control of plaque formation and the prevention of root caries. It is bactericidal at higher concentrations. Its antibacterial spectrum covers Gram-positive and Gram-negative bacteria, fungi, yeast, and virus. The inhibition of Streptococcus mutans was persistent with CHX varnishes (CHX-V), followed by gels and mouthwashes, and also helped to control established root lesions and also reduced the root caries lesion incidence. This article provides a review regarding the effectiveness of CHX-V on the prevention of root caries.

Prevention of demineralization during multi-bracketed fixed orthodontic treatment: An overview of systematic reviews.

Demineralization during multi-bracketed fixed orthodontic treatment is a well-known problem. To systematically evaluate the evidence for the prevention of enamel demineralization during multi-bracketed fixed orthodontic treatment. Systematic reviews (with or without meta-analysis) that have appraised the primary studies on the prevention of demineralization during multi-bracketed fixed orthodontic treatment were searched systematically and included as per pre-defined eligibility criteria. The risk of bias of the included reviews was assessed by two authors using the ROBIS tool and AMSTAR-2 tool. Twenty-nine reviews conducted on 128 exclusive primary studies were included for the present overview; 23 of these reviews were assessed to be of a high risk of overall bias, 5 were of low risk, and 1 review was of unclear risk of bias. Predominantly, the published reviews have focused on fluorides, whereas some reviews have also studied the role of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), reminder therapy, lasers, and sealants. Professional fluorides, sealants, reminder therapy, and lasers might be valuable interventions to prevent demineralization during orthodontic treatment based on the conclusions of reviews with high quality; however, further studies are required to elucidate the role of CPP-ACP, chlorhexidine varnish, and powered toothbrushes.

The effect of Miswak varnish on streptococcus Mutans count and gingival inflammation in orthodontic patients

Objective: Primary objective: To evaluate the effect of Miswak extract varnish on streptococcus mutans (S.mutans) counts in saliva and plaque, gingival bleeding index (GBI) and plaque index (PI) in orthodontic patients. Secondary objective: to suggest an appropriate frequency Miswak varnishes application to produce maximum efficiency. Material and methods: Enrolled patients (n=75) were randomly and equally divided into 3groups. Chlorhexidine varnish group, Miswak varnish group and control group. S.mutans counts in plaque and saliva, GBI and PI were evaluated at different time points; T0: before brackets bonding, T1: two weeks after brackets bonding, T2: one months after brackets bonding and T3: three months after brackets bonding. Results: Both chlorhexidine and Miswak varnishes reduced plaque S.mutans counts significantly at T2 compared to the controls, with no significant difference between Chlorhexidine and Miswak varnishes at this timepoint. After 3 months, chlorhexidine varnish group had the lowest S.mutans plaque counts followed by Miswak varnish group, while the control group had the highest counts. GBI was reduced significantly in both chlorhexidine and Miswak varnishes groups, when compared to the control group at both one month and 3 months timepoints with no statistically significant differences between chlorhexidine and Miswak neither at one month nor at 3 months. PI showed no statistically significant differences between the 3 study groups at different timepoints. Conclusions: Miswak varnish can be an acceptable natural substitute to chlorhexidine varnish as an anticariogenic agent if applied at monthly basis. Mechanical brushing is mandatory to reduce plaque accumulation and maintain proper gingival health.

Effect of Chlorhexidine Varnish and Fluoride Varnish on White Spot Lesions in Orthodontic Patients- a Systematic Review

Aim:The aim of this study is to critically review the studies that studied the effect of Chlorhexidine varnish and fluoride varnish on White Spot Lesion (WSL) in patients undergoing orthodontic treatment.Materials and Methods:The electronic database PubMed, The Cochrane Library, Medline, Embase, Google Scholar, Web of Knowledge along with a complimentary manual search of all orthodontic journals till the first week of December 2019 was searched. English language study performed on humans, randomized or nonrandomized clinical trials, comparing the effect of fluoride and chlorhexidine varnish on WSL was included in the review. Quality assessment of included studies was performed.Clinical Significance:The need for an adjunct oral hygiene aid to reduce the incidence and prevalence of white spot lesions in orthodontic patients is necessary. The use of these varnishes will aid in the same and thus make the adverse effects of fixed orthodontic treatment negligible.Review of Literature:Enamel demineralization is a significant risk associated with orthodontic treatment when oral hygiene is poor. Prevention of demineralization during orthodontic treatment is one of the greatest challenges faced by clinicians despite modern advances in caries prevention. The development of White Spot Lesions (WSLs) is attributed to prolonged plaque accumulation around the brackets.Results:The search identified a total of 3 studies that were included in this review. One study had Low risk of bias and the remaining 2 studies had moderate overall risk. Results showed that there was a reduction in the incidence of white spot lesions in orthodontic patients after application of chlorhexidine and Fluoride varnish.Conclusion:Low level evidence is available to conclude that the use of chlorhexidine varnishes and fluoride varnishes reduces the prevalence of white spot lesions in patients undergoing fixed orthodontic treatment. Due to its limitations, the results of this systematic review should be handled with caution and further well-planned Randomized Clinical Trial (RCT) are needed to provide a discrete conclusion.

Clinical and Antimicrobial Evaluation of Copaifera langsdorffii Desf. Dental Varnish in Children: A Clinical Study.

Background The objective of this study was to evaluate the clinical and microbiological efficacies of (C. langsdorffii) dental varnish in children at high risk of dental caries.. Methods This is a longitudinal, randomized, controlled clinical trial. Ninety high-risk caries-free children (ICDAS II = 0) were recruited and randomly divided into three groups: C. langsdorffii, chlorhexidine, or fluoride. The varnishes were applied on the second deciduous molars for three times: baseline (D0), after 90 days (D90), and after 180 days (D180). Saliva was collected on D0, D90, D180, and D360 to evaluate S. mutans reduction. Statistics were carried out by ANOVA, Tukey's test, and the paired t-test. Results Copaiba varnish demonstrated significant S. mutans reduction: D360 versus D0 (p < 0.0001), D180 versus D0 (p < 0.001), D360 versus D90 (p < 0.001), D180 versus D90 (p < 0.001), and D360 versus D180 (p < 0.05). Chlorhexidine varnish significantly reduced S. mutans at D180 versus D0 (p < 0.05). Fluoride reduced at D180 versus D0 (p < 0.001). Conclusions Three annual applications of this varnish showed substantial antimicrobial activity against S. mutans and caries prevention for up to 12 months.

Comparative evaluation of antimicrobial efficacy of silver diamine fluoride, chlorhexidine varnish with conventional fluoride varnish as a caries arresting agent. An in vivo sodium dodecyl sulfate-polyacrylamide gel electrophoresis study.

Silver diamine fluoride (SDF) is employed as an adjunct cariostatic agent in the management of dental caries in high-risk population. Other than fluorides, chlorhexidine (CHX) is the most potent antimicrobial and efficacious agent against Streptococcus mutans. The aim of this study is to evaluate and differentiate the efficacy of 38% silver diamine fluoride, CHX varnish, and fluoride varnish on carious primary teeth. Ninety children having a count of ≥1 carious lesion were recruited. Thirty-eighty percent silver diamine fluoride or fluoride varnish and CHX varnish were topically applied on the lesion. The primary outcome measured was the arrest of carious lesion (lesion rendered inactive as per the Nyvad criteria) after a follow-up of 14-21 days. Dental biofilm sample was obtained from each child and subsequently assessed for microbial composition by colony-forming unit method before and after treatment followed by protein analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis method. Average proportion of arrested caries lesions in the SDF group was higher followed by CHX and fluoride varnish groups. Decreased total protein amount was found in SDF group. This proves that there is decrease in microbial load posttreatment in SDF group. Thirty-eight percent SDF is more effective than CHX varnish and fluoride varnish in arresting dentin carious lesions in young children.

Evaluation of the sealing ability of antibacterial sealing gel versus chlorhexidine varnish at the implant-abutment interface: An in vitro study

Background: Lack of complete wall-to-wall adaptation between implant and abutment of two-piece implants results in microgap at the implant-abutment interface (IAI). Leakage of bacteria and the endotoxins produced by them at the IAI play a major role in inflammatory reactions of surrounding soft tissues, which in turn lead to crestal bone loss. Objectives: The objective of the study is to compare the sealing ability of antibacterial sealing gel and chlorhexidine (CHX) varnish at the IAI by assessing the growth of Escherichia coli on agar plates. Materials and Methods: A total of 36 implants and abutments were selected for the study and divided into three groups. Sealing agents were applied at the IAI of implant groups and a control group without any sealing agent. Abutments were connected to the implants, and bacteria were inoculated. Bacterial percolation was evaluated by culturing the specimen from the internal aspect of implants on agar plates after incubation. Efficacy was evaluated by counting the colonies (colony-forming units) on the agar plates. The results were analyzed by using Kruskal–Wallis analysis of variance followed by pairwise comparison using Dunn-Bonferroni test. Results: Mean of colony-forming units for control was calculated to be 178.38 cfu, for antibacterial sealing gel was 4.75 cfu, and for CHX varnish was 18.63 cfu. In the present study, least value of colony-forming units of bacteria was exhibited by IAIs sealed with antibacterial sealing gel, and the maximum value was given by the control group with no sealing agent at IAI. Conclusion: Application of CHX varnish and antibacterial sealing gel can reduce the bacterial leakage through IAI, whereas complete seal was not attained with either of the materials.

Assessment of Inhibition of Biofilm Formation and Plaque Bacterial Count of Fluoride Varnish Containing Chlorhexidine and Cetylpyridinium Chloride Versus Conventional Fluoride Varnish

Assessment of Inhibition of Biofilm Formation and Plaque Bacterial Count of Fluoride Varnish Containing Chlorhexidine and Cetylpyridinium Chloride Versus Conventional Fluoride Varnish

Effect of Chlorhexidine and Fluoride Varnishes on Streptococcus mutans Count and Dental Plaque Index

AbstractThe control of dental plaque by chemical means can be a valuable auxiliary resource for individuals who have difficulties in performing dental plaque control through regular oral hygiene procedures. The aim of this study was to evaluate the effect of chlorhexidine and fluorine varnishes on the levels of Streptococcus mutans (S. mutans) present in the dental biofilm and on the dental plaque index. The study was carried out in a sample comprised thirty-nine schoolchildren between 13 and 15 years of age, distributed into 2 groups. Group I received a single layer of varnish with chlorhexidine and thymol on the maxillary right first molar. Group II received the application of varnish with fluoride following the same methodology. S. mutans count and dental plaque index recording were performed 7 days before the application and 7, 15 and 30 days after the treatment. It was observed that chlorhexidine and fluoride varnishes significantly reduced the number of S. mutans in dental plaque for 30 days (p&lt;0.05). There was no difference between the varnishes. With regard to the dental plaque index, there was no alteration in any of the experimental time periods for both groups. It was concluded that varnishes, mainly those that contain fluoride, can be an interesting alternative for the prevention of dental caries in collective oral health programs. Keywords: Chlorhexidine. Fluorides. Dental Plaque. ResumoO controle da placa dental por meios químicos pode ser um valioso recurso auxiliar para indivíduos que apresentam dificuldades em realizar o controle da placa dental por meio de procedimentos regulares de higiene bucal. O objetivo neste estudo foi avaliar o efeito dos vernizes de clorexidina e de flúor sobre os níveis de Streptococcus mutans (S. mutans) presentes no biofilme dental e sobre o índice de placa dental. O estudo foi realizado em uma amostra composta por 39 escolares, entre 13 e 15 anos de idade, distribuídos em 2 grupos. O grupo I recebeu uma única aplicação de verniz com clorexidina e timol no primeiro molar superior direito. O grupo II recebeu a aplicação de verniz com flúor seguindo a mesma metodologia. A contagem de S. mutans e o índice de placa dental foram registrados 7 dias antes da aplicação e 7, 15 e 30 dias após o tratamento. Observou-se que os vernizes de clorexidina e flúor reduziram significativamente o número de S. mutans na placa dental por 30 dias (p &lt;0,05). Não houve diferença entre os vernizes. Com relação ao índice de placa dental, não houve alteração em nenhum dos períodos experimentais para ambos os grupos. Concluiu-se que os vernizes, principalmente aqueles que contêm flúor, podem ser uma alternativa interessante para a prevenção da cárie dentária em programas coletivos de saúde bucal. Palavras-chave: Clorexidina. Fluoretos. Placa Dentária.

How to Intervene in the Root Caries Process? Systematic Review and Meta-Analyses

The aim of this review as part of the preparation for a workshop organized by the European Federation of Conservative Dentistry (EFCD) in conjunction with the European Organisation for Caries Research (ORCA) was to systematically analyze available evidence of non-, micro- as well as invasive interventions for root caries lesions (RCLs). For each treatment strategy, a separate systematic review was either performed (micro-invasive and choice of restorative material) or updated (non-invasive and excavation technique) each of them following PRISMA guidelines, and if possible meta-analyses were performed. Besides the general advice to improve tooth brushing with fluoride toothpaste main findings for non-invasive interventions in RCLs, the use of dentifrices containing 5,000 ppm F^– as well as professionally applied chlorhexidine varnish or silver diamine fluoride seemed to be more efficacious to arrest root caries compared to conventional fluoride toothpaste or placebo respectively. However, this conclusion is based only on a few randomized clinical trials. For micro-invasive treatments, only 2 studies focusing on sealants were available without clear conclusions. A recent review on the comparison of atraumatic restorative treatment compared with conventional treatment concluded that there is insufficient data to clearly rule out if any difference with regard to restoration longevity between both techniques exists. When restoring coventionally, composites performed better than resin-modified and glass ionomer cements. However, all materials showed rather high annual failure rates in the majority of the studies and evidence is based on a low number of prospective studies with a rather high risk of bias.

Evaluation of the Remineralization Treatments of White Spot Lesions in Primary Teeth: A Systematic Review

Background: This study investigated the effect of the remineralization treatments on regression or disparition of white spot lesions (WSLs) in primary teeth. Materials and methods: Databases (Embase, MEDLINE, CENTRAL and CINAHL) were searched. The searches were limited to English and French languages publications and to within the abstract field. The searches were limited to the period from 01-12-2000 to 01-12-2018. Additional studies were identified by scanning the bibliographies of relevant reviews and full-text articles. Randomized controlled human clinical trials in which fluoride and non-fluoride agents were delivered by any method to treat white sopt lesions in primary teeth were considered. Results: Of the 2350 studies screened, 1706 full articles were scrutinized and 6 selected for inclusion in the final sample. Three chemical agents, namely fluoride, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and chlorhexidine were investigated in these included studies. There is evidence that fluoride varnish applications may be an effective measure in reversing active pit- and-fissure enamel lesions in the primary dentition, the combined application of chlorhexidine and fluoride varnish is more effective on plaque and remineralization of incipient caries after 3 months than the same agents applied separately and finaly the twice daily topical applications of CPP-ACP containing paste as an adjunct to a standard oral hygiene with fluoridated toothpaste, significantly improve the remineralisation of white spot lesions in primary teeth. However, quantitative synthesis could not be carried out because of the clinical and methodological heterogeneity of the included studies. Conclusion: A limited number of studies were included in this systematic review. Few of these has a low risk of bias, with most having high risk due to weaknesses in many quality items or due to other biases, such as problems associated with the evaluation method or inadequate study design. High quality human randomized controlled trials are needed in order to make a conclusive recommendation.

Effectiveness of caries-preventing agents on initial carious lesions within the scope of orthodontic therapy

ObjectiveTo evaluate the effectiveness of three different caries-preventing agents on artificial caries in a Streptococcus mutans-based caries model.MethodsSixty-five caries-free human molar enamel blocks were treated with a demineralization solution and a remineralization solution. The specimens were assigned to the following groups according to the caries-protective product applied: group A, chlorhexidine varnish; group B, fluoride-releasing chemically cured sealant; group C, fluoride-releasing lightcured sealant; group D, positive control (specimens that were subjected to de- and remineralization cycles without treatment with any caries-protective agents); and group E, negative control (specimens that were not subjected to de- and remineralization cycles). Samples in groups A–D were stored in demineralization solution with S. mutans and thereafter in artificial saliva. This procedure was performed for 30 days. Average fluorescence loss (ΔF) and surface size of the lesions were measured using quantitative light-induced fluorescence at baseline and on the 7th, 14th, and 30th days.ResultsAfter 30 days, group A demonstrated a significant increase in ΔF and the surface size of the lesions, no significant difference in comparison with the positive control group, and a significant difference in comparison with the negative control group. Group B showed no significant changes in both parameters at any of the measurement points. While group C showed increased ΔF after 14 days, no significant fluorescence change was observed after 30 days.ConclusionsBoth fluoride-releasing sealants (chemically or light-cured) show anti-cariogenic effects, but the use of chlorhexidine varnish for the purpose of caries protection needs to be reconsidered.

Iowa nursing facility oral hygiene (INFOH) intervention: A clinical and microbiological pilot randomized trial.

The aim of this pilot study was to evaluate feasibility and gather initial data for a definitive study to test the clinical and microbiological effectiveness of a nursing facility (NF) customized oral hygiene protocol, intended to be delivered by dental hygienists and NF personnel. A convenience sample of 8 Eastern Iowa NFs was recruited, and each NF was assigned to one of three intervention groups: (1) control (current oral hygiene practice), (2) educational program only, and (3) educational program plus 1% chlorhexidine varnish monthly application. Demographic information, systemic health data, patient centered data, oral health data, and microbiology samples were collected at baseline and after 6 months. Recruitment response rates were 21% for NFs and 23% for residents. A total of 81 residents were examined at baseline and of those, 49 were examined at 6 months (39.5% attrition). There were no statistically or clinically significant differences among the intervention groups at 6 months for any of the recorded clinical or microbiological outcomes. Recruitment and retention posed a significant challenge to this trial, even with a relatively short observation period. Results from this pilot study did not encourage further investigation of this customized oral hygiene protocol.

Effectiveness of Remineralization Treatments on Incipient Lesions: A Controlled Clinical Trial

Twenty-nine subjects with a total of 218 teeth with (Diagnodent Pen) DD values > 0 were included. Subjects were divided randomly into four groups: Control [7 subjects, 54 teeth]; 5% Sodium fluoride varnish (FL-V) [8 subjects, 59 teeth]; Chlorhexidine varnish: 1% chlorhexidine diacetate and 1% thymol (CHX-V) [7 subjects, 54 teeth], and 10% Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) [7 subjects, 51 teeth]. All patients used fluoride-containing toothpaste, and the control group received fluoride gel every 3 months during the first 6 months.