Varnish Duraphat Research Articles

Assessment of Remineralization Ability of Different Fluoride Varnishes on Artificial Enamel Lesion of Primary Teeth - A Comparative Study.

The current study's aim was to evaluate the potential of various fluoride varnishes to remineralize artificial enamel lesions on primary teeth. For the study, 90 deciduous molar teeth that were implicated for extraction were taken. A window region with a size of 3 × 3 mm was located in the middle of the tooth's coronal surface. The remaining portion was given a coat of nail polish and given time to dry. A demineralizing solution was used to create the artificial enamel lesion. The samples were randomized into three experimental groups at random, with 30 samples in each group. Group 1: Application of Clinpro White Varnish, Group 2: Application of Duraphat Varnish, and Group 3: Application of MI Varnish. After 14 days, samples from each group were examined under scanning electron microscopy at a magnification of 1000× to determine whether remineralization had occurred. Microhardness was also determined using a microhardness tester. Before the intervention, the mean demineralized enamel lesion in the Clinpro White Varnish group was 134.44 ± 0.04, in the Duraphat Varnish group was 133.76 ± 0.12, and in the MI Varnish group was 133.89 ± 0.08. After intervention, the maximum remineralized area was found in the MI Varnish group (82.74 ± 0.18) followed by the Clinpro White Varnish group (101.43 ± 0.16) and the Duraphat Varnish group (104.11 ± 0.10). After the intervention, there was a statistically significant difference found between the groups. After the intervention, the maximum microhardness mean value improved in the MI Varnish group (257.03 ± 1.09 to 261.18 ± 1.20) followed by Clinpro White Varnish (258.78 ± 1.64 to 260.10 ± 1.22) and Duraphat Varnish group (255.24 ± 1.51 to 258.02 ± 0.89). According to the findings of the current investigation, all of the varnishes utilized in this in vitro experiment are capable of correcting early enamel defects on primary teeth. However, MI Varnish group was very effective compared to the Clinpro White Varnish group and the Duraphat Varnish group.

Effect of Dental Varnishes in Prevention of Enamel Demineralization Adjacent to Orthodontic Brackets.

The aim of the current research was to assess the ability of different dental varnishes in averting enamel demineralization adjoining the orthodontic brackets. Seventy-five premolars devoid of dental caries that were subjected to extraction for orthodontic purposes were employed in this research. The surface of enamel was etched with 37% phosphoric acid and subjected to primer application. Individual brackets were placed on the midregion of the buccal surfaces of the premolars with Transbond™ XT adhesive. Postbracket bonding, the dry premolar tooth samples were set aside cautiously. The samples were then allocated to three groups: Group I: Duraphat Varnish, Group II: Clinpro XT Varnish, and Group III: Profluorid Varnish. Every sample was independently subjected to immersion in demineralizing solution for a period of 96 h at 37°C in an incubator. Areas of demineralization were evaluated by documenting the microhardness along the severed surface using a microhardness tester equipped with a Vickers diamond. The highest surface microhardness was noted with Profluorid Varnish group at 328.48 ± 1.12 in pursuit by Clinpro XT Varnish group at 322.08 ± 0.04 as well as Duraphat Varnish group at 307.42 ± 0.28 with a statistically noteworthy dissimilarity amid the groups. In conclusion, the three varnishes employed had an influence on the prevention of enamel demineralization surrounding the orthodontic brackets. Profluorid varnish however exhibited maximum efficiency in avoiding enamel demineralization versus Clinpro XT varnish as well as Duraphat varnish group.

An In Vitro Comparison of Clinpro™ XT and Duraphat Varnish for Protecting Teeth from Discoloration during Orthodontic Treatment

Objective. During orthodontic treatment, a higher caries risk has been reported, so fluorides and other remineralizing compounds have been proposed. Currently, fluoride varnish is commonly available in conventional and light-curable forms. This in vitro study was performed to evaluate the effectiveness of two different materials, Clinpro™ XT (light-curable forms) and Duraphat (conventional forms) varnish, whose main active principle according to their manufacturers is fluoride in preventing tooth discoloration during orthodontic treatment with appliances attached with metal brackets or resin. Materials and Methods. This study included 120 premolars free of white spot lesions and caries that were randomly divided into the following six groups (n = 20): resin control (RCTR), resin Clinpro (RC), resin Duraphat (RD), bracket control (BCTR), bracket Clinpro (BC), and bracket Duraphat (BD). All the samples were exposed to 180 ml of coffee (4 times × 5 min/day) for 7 or 28 days. When not immersed in coffee, the teeth were stored in artificial saliva, which was replaced every day. The lightness ( L ∗ ), red/green axis ( a ∗ ), and yellow/blue axis ( b ∗ ) values were recorded with a dental spectrophotometer (Easy shade Advance 4.0) on days 0 (baseline), 7, and 28. The color difference ( Δ E ∗ ) on days 7 and 28 was also calculated. Results. The data were statistically analyzed using one-way ANOVA and Bonferroni’s test (α = 0.05). Significant differences were observed between the Δ E ∗ , L ∗ , a ∗ , and b ∗ values of the Clinpro™ XT and Duraphat groups and those of the control groups after 7 and 28 days regardless of the attachment type ( P < 0.001). On day 7, no significant differences were observed between the Clinpro™ XT and Duraphat groups, whereas on day 28, the Duraphat groups with metal and resin attachments exhibited significant differences from the Clinpro™ XT groups ( P < 0.001). No significant differences correlated to the attachment type were observed throughout the discoloration procedure. Conclusions. The application of fluoride varnish during orthodontic treatment can significantly reduce tooth discoloration caused by the staining solution. Clinpro™ XT varnish showed a longer period of efficacy in protecting teeth from discoloration than Duraphat. No differences in tooth discoloration were observed between the groups with fixed and clear appliances.

The fluoride release, abrasion resistance, and cytotoxicity to hGFs of a novel cyanoacrylate-based fluoride varnish compared with conventional fluoride varnish.

The important factors contributing to the effectiveness of fluoride varnish are the amount of fluoride ion release and the retention time of the varnish on the tooth surface. Commercial fluoride varnishes are susceptible to mechanical removal; therefore, patients are informed to avoid eating or performing oral hygiene for at least 12-24 h, which results in patient inconvenience. However, cyanoacrylate-based fluoride varnish would not have these disadvantages. This study compared the daily fluoride ion release, abrasion resistance to brushing, and toxicity to human gingival fibroblasts (hGFs) between a newly-developed cyanoacrylate-based fluoride varnish and conventional fluoride varnish (Duraphat varnish). The results demonstrated that the cyanoacrylate varnish had a significantly higher fluoride release for 9 days after application, higher abrasion resistance to brushing, and slightly less toxicity to hGFs compared with Duraphat varnish. This novel cyanoacrylate varnish could be an alternative fluoride varnish for preventing dental caries.

Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study

Aim of the current study was to assess the anticariogenic effectiveness of different fluoride varnishes on artificially induced enamel lesions employing scanning electron microscope. Eighty healthy, normal premolars without dental caries that were extracted in course of orthodontic therapy with all the surfaces intact were included in this study. A window, 4 × 4 mm, was made discernible on the buccal surface of each sample tooth. A demineralizing solution at 37°C was used to immerse the teeth for 48 hours to induce artificial lesions on the surface of the enamel. Following preparation of the artificial enamel lesions, the 80 premolar teeth were allocated into the four groups (20 each) depending on the fluoride varnish system used as Group I: control, Group II: Duraphat varnish, Group III: MI Varnish, and Group IV: Clinpro White Varnish. The anticariogenic effectiveness of different fluoride varnishes was evaluated employing a scanning electron microscope (SEM). The MI Varnish (fluoride varnish) group exhibited slightly greater (127.20 ±0.14) mean demineralized lesions, pursued by Clinpro White Varnish use (126.88 ±0.09), the control group (126.36 ±0.10) and the Duraphat varnish (124.14 ±0.08) in that order. Greater mean areas of remineralization were found with use of MI Varnish (92.40 ±0.09), pursued by the Duraphat varnish use (106.68 ±0.12), use of Clinpro White Varnish (112.36 ±0.08), and then the control group (123.08 ±0.18) in that order. Statistically significant differences were noted between the experimental groups employing the various fluoride varnishes (p <0.001). The current research concluded that the MI Varnish group presented a superior protective potential in comparison with Duraphat varnish and Clinpro White Varnish groups. Mineral exchanges among teeth and saliva render incipient enamel lesions reversible. A 5% sodium fluoride varnish is the MI Varnish that is composed of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) to provide an excellent fluoride varnish that makes available additional bioavailable fluoride, calcium, and phosphate. Therefore, it may be fruitfully utilized in remineralization of initial carious lesions. CPP-ACP may be employed in clinical practice for drawing back or ceasing initial carious lesions. Rani KBS, Ramanna PK, Mailankote S, et al. Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study. J Contemp Dent Pract 2021;22(7):774-777.

In Vitro Evaluation of Desensitizing Agents Containing Bioactive Scaffolds of Nanofibers on Dentin Remineralization.

This study evaluated the effect of the incorporation of bioactive nanofibers in desensitizing agents on dentin permeability. Sixty disks of dentin were randomly distributed in four groups (n = 15). Distribution was based on the desensitizing agents, fluoride varnish and self-etching adhesive, and the presence of nanofibers: C (self-etching adhesive Clearfil SE Bond), CN (Clearfil SE Bond with 1% nanofiber), D (Duraphat varnish), and DN (Duraphat varnish with 1% nanofiber). Dentin permeability was determined using hydraulic conductivity. For a qualitative analysis, confocal laser microscopy and scanning electron microscopy were performed. The C group showed the lowest hydraulic conductance (Lp%) (89.33), while the DN group showed the highest Lp% (116.06). No statistical significance was observed in the Lp% values in all groups after the treatment and 6% citric acid challenge (p > 0.239). In the images, the CN group presented a higher superficial and intratubular deposition. In addition, this group presented a more homogeneous dentin surface and wide occlusion of dentinal tubules than the other treatments. Despite there being no statistical differences among the treatments employed, the images showed that the CN group presented a higher surface and intratubular deposition compared to the other treatments, even after the acid challenge.

THERAPEUTIC EFFECT OF TWO FLUORIDE VARNISHES INTENSIVE MODE ON WHITE SPOT LESIONS (RANDOMIZED CLINICAL TRIAL)

Background: Fluoride varnish has been used as therapeutic agent for white spot lesions. Bio-active calcium and phosphate was included in the varnish in order to provide better subsurface remineralization. One of the most promising modifications is the addition of casein phosphopeptide amorphous calcium phosphate to fluoride varnish (MI varnish). Objectives: Evaluate the therapeutic effect of intensive application of casein phosphopeptide amorphous calcium phosphate fluoride (CCP-ACPF) varnish and fluoride varnish on the activity of enamel white spot lesions (WSLs) in primary teeth over a 6 weeks follow-up period. Materials and Methods: Forty-four participants with at least 4 active WSLs each were divided randomly into two groups. Test group (22 participants) received three times intensive professional application of MI varnish with two weeks apart. Control group (22 participants) received three times intensive professional application of Duraphat with two weeks apart. Lesions’ activity in both groups was assessed using DIAGNOdent and visio-tactile lesion activity index at baseline and at 6 weeks. Results: Both groups had a significant decrease in mean DIAGNOdent scores and number of active WSLS when compared to their baseline mean score. However when comparing the results of both groups, the control group (Duraphat varnish) had a significant decrease in DIAGNOdent mean score and number of active WSLs when compared to the test group (MI varnish). Conclusions: Intensive application of fluoride varnish decreases caries lesion activity which may lead to the arrest of the early caries lesions. Duraphat varnish is superior to MI varnish in remineralization of early caries lesions.

Remineralization and fluoride uptake of white spot lesions under dental varnishes.

The aim of this study was to evaluate white spot lesion (WSL) remineralization and fluoride uptake by the application of fluoride varnishes directly onto artificial WSLs in vitro. MI varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and 2.26% fluoride and Duraphat varnish containing 2.26% fluoride (no added calcium) were compared with a placebo varnish (no added calcium or fluoride). Two WSLs were prepared in enamel slabs and varnish applied to cover one of the two lesions. Each slab was immersed in artificial saliva for 14days at 37°C. Mineral content was determined using transverse microradiography and fluoride uptake using electron probe microanalysis. The data were statistically analysed using a linear mixed model. Both MI and Duraphat varnishes significantly remineralized the covered and uncovered WSLs when compared with the placebo varnish (P<0.001). The WSLs covered with varnish showed greater remineralization than those uncovered. MI varnish produced the highest level of remineralization and significantly greater fluoride uptake (0.44±0.08 wt%) compared with Duraphat (0.24±0.03 wt%) and the placebo varnish (0.06±0.05 wt%). Varnish containing fluoride and CPP-ACP was superior to varnish containing fluoride alone in promoting WSL remineralization and fluoride uptake.

Analysis of efficacy of the self-assembling peptide-based remineralization agent on artificial enamel lesions.

The objective of this in vitro study was to analyze and compare the biomimetic remineralizing efficacy of the self-assembling peptide (P11-4) with agents containing casein phoshopeptide-amorhous calcium phosphate fluoride (CPP-ACFP) and sodium fluoride (NaF) on artificial caries lesions using DIAGNOdent and micro-computed tomography (μCT). Artificial enamel lesions were prepared on extracted impacted sound mandibular third molars. The samples were randomly allocated to four groups (n = 8): Group 1, P11-4 (Curodont Repair, Credentis AG, Switzerland); Group 2, CPP-ACFP (MI Varnish, GCCo., Japan); Group3, NaF (Duraphat Varnish, Colgate, Colgate-Palmolive, NY, USA); Group 4, artificial saliva (control). The agents were applied to demineralized surfaces according to manufacturers' instructions; all specimens were stored in artificial saliva for 1 month. Demineralization and remineralization on enamel surfaces were analyzed and quantified by DIAGNOdent (KaVo, Germany) and μCT (SkyScan1174, Belgium) for lesion depth/area/volume/mineral density (MD). The remineralization efficacy of the agents was evaluated by DIAGNOdent on 1st, 7th, 30th days and by μCT on 30th day. Data were statistically analyzed by ANOVA, Kruskal-Wallis, T test, and Wilxocon tests. The highest remineralization efficacy findings in all periods were determined in Group 1, followed by Groups 2, 3, and 4. The remineralization findings for fluorescence, MD, lesion depth in Group 1 were found significantly higher (p < 0.01) than Group 3; and no significant differences (p > 0.05) were found between Groups 1-2 and Groups 2-3. The area and volume change values in Groups 1, 2, and 3 have shown no significancy (p > 0.05). A significant correlation (p < 0.01) was found between μCT and DIAGNOdent methods. The data of this study have demonstrated that P11-4 has showed the best remineralization efficacy, followed by CPP-ACFP and NaF. It is concluded that self-assembling peptide-based remineralization agent can be used successfully for biomimetic remineralization of enamel subsurface lesions.

Effects of treatment with three types of varnish remineralizing agents on the microhardness of demineralized enamel surface.

BackgroundRemineralization of incipient caries is one of the goals in dental health care ,especially in pediatric dentistry. The present study aimed at comparing the effects of MI varnish (3M (United states)) , Nano paste( FGM(Brezil) ), 5% sodium fluoride varnish) DuraphatColgate (united states) ) on remineralization of enamel lesions.Material and MethodsIn this in-vitrostudy, 60 intact human pre-molars, were randomly allocated to four groups of 15. Baseline surface microhardness in three points in the center of the polished area was measured. After two days of immersion in demineralizing solution, microhardness of all samples was measured. Afterward, groups 1-3 under-went treatment with MI varnish, nano paste, 5% sodium fluoride varnish and then again microhardness was measured. The results were analyzed by one-way analysis of variance (ANOVA), repeated measures ANOVA, and Bonfreni table was used.ResultsDuraphat varnish in comparison with control group, significantly increased surface microhardness and in comparison with Nano and MI paste varnish groups significant differences was shown between groups. (P< 0.05). MI paste varnish and Nano paste similary showed more increases in surface microhardness in comparison with Duraphat varnish and control groups (P≈1).ConclusionsAccording to the results of this study, all three varnishes, Duraphat , MI paste and Nano paste increase the enamel surface microhardness and remineralization of incipient caries. MI paste and Nano paste compared to Duraphat Varnish, significantly showed more increases in enamel surface microhardness but Nano paste and MI paste were almost the same. Key words:CPP-ACP, Nano varnish, fluoride varnish, microhardness, demineralization, remineralization.

Clinical Assessment Of Bonding Agent v/s Fluoride Varnish In Dentinal Hypersensitivity

Objective: To compare the mean reduction in pain scores between Bonding agent (GLUMA® Comfort® Bond+ Desensitizer, and Fluoride varnish. Methodology: The study was conducted at Operative Dentistry, Department at Altamash Institute of Dental Medicine, Karachi from July 2015 to August 2016. Total 152 patients were selected. Patients were randomly allocated into two groups A and B. Gluma comfort bond plus desensitizer® was applied to the patients in group A and Duraphet® was applied to the patients in group B. Initial assessment was done after the application of the above products and thermal test was performed. The outcomes were based on a Visual Analogue Scale (VAS). Re-Evaluation was done again after 30 days of treatment in terms of mean reduction in pain from baseline by applying thermal test on visual analogue scale. Results: The average age of the patients was 37.4 ±8.38 years. After 30 days, mean Visual Analog Scale was significantly low in Group A i.e. 2.95±0.0.86 as compared to Group B i.e. 4.01±0.79(p=0.0005). Significant more reduction in mean pain score was observed in Bonding agent (Gluma desensitizer) as compared to Fluoride varnish Duraphat. Conclusion: In our study we found that bonding agent ( Gluma Desensitizer) is more effective in treating Dentine Hypersensitivity compared to fluoride varnish (Duraphat desensitizer group).

Assessment of Enamel Surface Microhardness with different Fluoride Varnishes–An In Vitro Study

This study aimed to assess the microhardness of the enamel surface after fluoride varnish application. Thymol of 0.1% in distilled water was used to store the collected healthy sixty teeth. The samples were divided into three groups randomly as per the different applica -tion of fluoride varnish. Group A: Fluor protector varnish (FIV) application, group B: Duraphat varnish application and group C: Bifluorid 10 varnish application. The present study followed the pH cycling protocol. Microhardness tester was used to test the microhardness of enamel surface and was expressed as micro-hardness measurements of Vickers hardness number (VHN) which was performed at baseline, on the 3rd day andon 7th day. At baseline, group A samples mean SMH value was 230.64 ± 12.32 which was slightly more than group B with 229.45 ± 10.22 and group C with 230.10 ± 11.45. There was no significant difference showed with the analysis of variance between the groups. On the 3rd day, there was a slight increase in the mean SMH in group A with 235.39 ± 6.44 and no significant difference between the groups was seen statistically. On the 7th day, the group A showed high SMH value of 262.20 ± 4.89 compared to other groups which didn't show a significantly high statistical difference. On conclusion, post-application of fluorprotector varnish showed higher enamel surface microhardness compared to Duraphat and Bifluorid 10 varnishes. In young children, fluoride varnishes are effectively used as a noninvasive, anti-caries agent in the treatment of initial caries. Therefore, in routine dental practice, the knowledge about different fluoride varnishes is of importance.

Effect of Fluoride Varnish Containing CPP-ACP on Preventing Enamel Erosion.

This study aimed to investigate the effect of a fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate treatment on the prevention of enamel erosion, and it compared the results with those of other fluoride varnishes. Fifty enamel specimens obtained from bovine incisors were randomly divided into five groups (n = 10) based on the type of surface pretreatment used: intact enamel (Group 1); intact enamel+erosive cycles (Group 2); intact enamel+MI varnish+erosive cycles (Group 3); intact enamel+Clinpro White varnish+erosive cycles (Group 4); and intact enamel+Duraphat varnish+erosive cycles (Group 5). The specimens were subjected to erosive cycles for five days. The surface roughness was evaluated using atomic force microscopy. The results were statistically analyzed using one-way ANOVA and Tukey's tests. Group 1 had the smoothest surfaces. After the erosive cycles, the greatest surface roughness values were observed in Group 2, followed by Groups 5, 4, and 3, respectively. Statistically significant differences were observed among all groups (p < 0.05). The application of fluoride varnishes had some positive effects on preventing enamel erosion; however, the most effective agent was fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate.

Comparison of two different forms of varnishes in the treatment of dentine hypersensitivity: A subject-blind clinical study in Lagos State university teaching hospital

Background: Dentine hypersensitivity is a significant clinical problem affecting several age groups within a population. Aim: This subject-blind randomized clinical study was designed to determine the clinical outcomes of two different varnishes in the management of dentine hypersensitivity. Materials and Methods: Self-reporting, consenting patients (n = 56) referred to the restorative unit of the dental center, Lagos State University Teaching Hospital (LASUTH), were examined for dentine hypersensitivity using the air jet and tactile probe methods. Enlisted patients were randomly assigned into Duraphat or Cervitec Plus varnish groups in a split-mouth study design. The teeth were assessed for sensitivity, and this procedure was repeated on week(s) 1, 2, and 4 following the initial visit. The data collected were analyzed using SPSS version 20, and statistical significance was done using the Student's t-test. P ≤ 0.05 was considered statistically significant. Results: The most affected teeth were the first molars (27.8%) followed by the second premolars (17.6%). There was a significant reduction in sensitivity following application of both control and experimental varnishes on day 1 and much further reduction by week 4. At week 4, P value using the tactile method was 0.090 while that of the air jet was 0.101. However, there was no statistically significant difference in the efficacy of the control and experimental varnishes. Conclusion: Duraphat exhibited better efficacy in the reduction of dentinal hypersensitivity, though the difference was not statistically significant. The Duraphat and Cervitec Plus varnishes can be substituted one for the other, though the Duraphat varnish is more readily available in our environment and costs less than Cervitec Plus varnish.

Effect of fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate on bond strength to enamel

To investigate the effect of fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate on the shear bond strength (SBS) of two adhesive systems to enamel. Specimens obtained from permanent teeth were randomly distributed among four groups for enamel pretreatment [Control (no treatment, CNT), Duraphat varnish (DV), Clinpro White varnish (CWV), MI Varnish (MIV)], and each group was further divided into two subgroups according to adhesive [Etch&rinse (Adper Single Bond, ASB), self-etch (Clearfil SE Bond, CSE)]. Specimens were stored in distilled water at 37 °C for 24 h. Cylindrical composite specimens (2.3 mm in diameter, 3.0 mm in height) were then bonded to the enamel surfaces. SBS tests were performed and data were analyzed with two-way ANOVA and Tukey’s tests. For both CSE and ASB, SBS values of the CNT groups were significantly higher than those of all the enamel pretreatment groups (p < 0.05). Among the enamel pretreatment groups, SBS values with both adhesive systems were lowest in the MIV groups, followed by CWV and DV groups. In conclusion, pretreatment of enamel surfaces with fluoride-containing varnishes reduced bonding performance of adhesive systems to enamel. MIV appeared to cause greater enamel surface alterations and precipitation, which interfered with adhesive bonding mechanisms.

Residents' journal review

Poor oral hygiene has long been a problem in patients during orthodontic treatment. As a result of improper brushing and flossing, patients in braces can develop white spot lesions, which are areas of demineralized enamel. Casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP) are substances used to help remineralize enamel and dentin. The authors tested the effectiveness of varnishes containing CPP and ACP in remineralizing white spot lesions. Orthodontic brackets were bonded to 120 bovine incisors. Duraphat and MI Varnish (containing CPP and ACP) were applied around the brackets according to the manufacturer’s directions. The samples were put into 8 groups: 1, control, brushing only; 2, control, brushing + mouthwash; 3, Duraphat varnish application only; 4, Duraphat + brushing; 5, Duraphat + brushing + mouthwash; 6, MI Varnish application; 7, MI Varnish + brushing; and 8, MI Varnish + brushing + mouthwash. The test specimens were stored in demineralizing saliva for 22 hours and then in remineralizing saliva for 2 hours. Optical coherence tomography was used to evaluate the enamel microstructure. The groups that received MI Varnish showed the lowest mean depth of the caries lesions. Duraphat varnish was not effective when combined with brushing only, but its potential to reduce white spot lesions was perceived when it was combined with brushing and mouthwash. This dependence was not noted with the MI Varnish. It was concluded that application of varnish containing CPP and ACP irrespective of the association with brushing and mouthwash reduced the depth of caries lesions. Reviewed by Lori Tima Orthodontists have always sought ways to prevent relapse in postorthodontic treatment patients. Since their introduction, vacuum-formed retainers have become popular and are primarily made of 2 materials: polypropylene and polyethylene polymers. However, few studies have evaluated the resistance to wear of these materials. The authors of this study aimed to clarify which material was more resistant to simulated wear. One hundred four samples were divided into 4 groups: Essix C+, Essix ACE, Duran, and Tru-Tain. All samples were polyethylene copolymers except for the Essix C+ group, which was a polypropylene polymer. They were vacuum formed according to the manufacturer's guidelines and subjected to 1000 cycles of wear simulation. A wear simulation machine was custom built to antagonize each specimen with spheres of steatite. Evaluation was carried out by using noncontact, 3-dimensional surface profilometry to determine the wear depth of each material. It was found that Essix ACE was the most resistant to wear, followed by the Duran group, the Tru-Tain group, and the Essix C+ group. Essix ACE had significantly less wear than did the Tru-Tain group, but the difference between the Duran and Tru-Tain groups was not statistically significant. It was concluded that, as a group of materials, polyethylene copolymers significantly outperformed the polypropylene materials in wear resistance. In addition, polyethylene materials have superior esthetics, since they are transparent. Although polyethylene copolymers appear to be a superior material, it is prudent to evaluate them with caution because wear is a result of many factors such as abrasion, adhesive effects of the contacting surfaces, fatigue, and corrosive effects that can hinder cross-investigation reliability. Reviewed by Michael Ponikvar An association between maxillary canine impaction (MCI) and orthodontically induced root resorption (OIRR) has not been sufficiently established. The objective of this retrospective cohort study was to compare the severity of root resorption of the maxillary incisors during orthodontic treatment in patients with surgically exposed canines and subsequent forced eruption vs patients without impactions. The sample consisted of 48 patients undergoing comprehensive orthodontic treatment with fixed appliances. Of these patients, 24 had unilateral or bilateral MCI, and 24 were matched controls without MCI. Preoperative and postoperative panoramic tomograms were used to calculate OIRR. The mean amount of root resorption ranged from 0.48 to 1.17 mm. The maxillary left central incisors showed significantly more OIRR in the impaction group, with a mean difference in resorption of 0.58 mm (P = 0.04). Subjects in the impaction group had 0.38 mm more OIRR compared with the control group with no impactions. There was no significant difference in the amount of OIRR between the impaction and the nonimpaction groups according to the multivariate analysis (P = 0.35). However, the authors did find a positive correlation between initial root length and OIRR (P <0.001). The investigation found MCI to be a weak predictor of OIRR. Studies investigating OIRR might benefit from the use of cone-beam computed tomography, since panoramic films have been shown to underestimate OIRR. Therefore, the results of this investigation should be viewed with caution. Reviewed by Brittany Carpenter

Effectiveness of varnish with CPP-ACP in prevention of caries lesions around orthodontic brackets: an OCT evaluation.

To evaluate the in vitro efficiency of applying varnish containing casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP) in prevention of caries lesions around orthodontic brackets. For this purpose, brackets were bonded to the vestibular surface of bovine incisors, and eight groups were formed (n = 15) according to exposure of oral hygiene substances and enamel varnish: 1 (control) brushing only performed, 2 (control) brushing + use of mouth wash with fluoride, 3 Duraphat varnish application only (Colgate-Palmolive Ind. E Com. Ltda, São Paulo, SP, Brazil), 4 Duraphat + brushing, 5 Duraphat + brushing + mouth wash, 6 MI Varnish application (GC America, USA), 7 MI + brushing, and 8 MI + brushing + mouth wash. The experimental groups alternated between pH cycling and the procedures described and were kept in an oven at temperature of 37°C. Both brushing and immersion in solutions was performed in a time interval of 1 minute, followed by washing in deionized water three times a day for 28 days of experimentation. Afterwards, evaluation by optical coherence tomography (OCT) of the special type (Ganymede OCT/Thorlabs, Newton, USA) was performed. In each group, a scanning exam of the white spot lesion area (around the region where brackets were bonded) and depth measurement of caries lesions were performed. Groups 1 and 3 were shown to differ statistically from groups 5, 6, 7, and 8 (p = 0.000). MI Varnish was shown to be more effective in diminishing caries lesion depth, compared with Duraphat, irrespective of being associated with brushing and mouth wash, or not. The major limitation of this study is that it is a study in which demineralization was obtained with the use of chemical products, and did not occur due to the presence of Streptococcus mutans and its acid byproducts. Application CPP-ACP-containing varnish irrespective of being associated with brushing and mouthwash, or not, reduced depth of caries lesions around orthodontic brackets.

Fluoride Varnish With Community-Based Oral Health Promotion May Reduce Surface-Level Caries Risk in Preschool Children

Article Title and Bibliographic Information Surface-specific efficacy of fluoride varnish in caries prevention in the primary dentition: results of a community randomized clinical trial. Divaris K, Preisser JS, Slade GD. Caries Res 2012;47(1):78-87. Reviewer Jaana Gold, DDS, PhD Purpose/Question To determine the surface-specific caries-preventive effect of a 2-year community-based oral program with fluoride varnish (FV) applications in the primary teeth of 3- to 5-year-old children Source of Funding Government: Australian National Health and Medical Research Council grant No. 320858. For-profit company: Colgate-Palmolive Pty Limited-provided free supplies of Duraphat varnish and low-cost toothbrushes and toothpaste for the program Type of Study/Design Cluster Randomized Clinical trial Level of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade N/A

Comparative evaluation of chlorhexidine varnish and fluoride varnish on plaque Streptococcus mutans count – an in vivo study

The aim of the study was to assess and compare the effect of chlorhexidine varnish and fluoride varnish application on Streptococcus mutans counts in plaque of occlusal pits and fissures of permanent mandibular first molars. The study was an in vivo comparative study, conducted among 50 schoolchildren aged 7-8 years under a field setting. The 50 subjects were randomly allocated into two groups. Baseline plaque samples were collected from all the subjects followed by the application of two varnishes, Cervitec and Duraphat. The varnish was applied to pit and fissures of occlusal surface of mandibular first molar. The varnish application was carried out on the first day, fifth day and tenth day after baseline plaque sampling. Subsequent plaque samples were collected at the end of 1 month and at the end of 3 months after the varnish application. The Cervitec varnish has shown a statistically significant reduction at the end of 1 month and at the end of 3 months (P < 0.05). Duraphat varnish did not show a statistically significant difference in reducing the plaque S. mutans count at the end of 1 month and third month (P > 0.05). Cervitec varnish was found to be effective in reducing S. mutans count for a 3-month period, when compared to Duraphat varnish.

Effect of a single application of TiF 4 and NaF varnishes and solutions on dentin erosion in vitro

Objectives This in vitro study aimed to analyse the effect of a single application of TiF 4 and NaF varnishes and solutions to protect against dentin erosion. Methods Bovine root dentin samples were pre-treated with NaF-Duraphat varnish (2.26%F, pH 4.5), NaF/CaF 2-Duofluorid varnish (5.63%F, pH 8.0), NaF-experimental varnish (2.45%F, pH 4.5), TiF 4-experimental varnish (2.45%F, pH 1.2), NaF solution (2.26%F, pH 4.5), TiF 4 solution (2.45%F, pH 1.2) and placebo varnish (pH 5.0, no-F varnish control). Controls remained untreated. Ten samples in each group were then subjected to an erosive demineralisation (Sprite Zero, 4× 90 s/day) and remineralisation (artificial saliva, between the erosive cycles) cycling for 5 days. Dentin loss was measured profilometrically after pre-treatment and after 1, 3 and 5 days of de-remineralisation cycling. The data were statistically analysed by two-way ANOVA and Bonferroni's post hoc test ( p < 0.05). Results After pre-treatment, TiF 4 solution significantly induced surface loss (1.08 ± 0.53 μm). Only Duraphat reduced the dentin loss overtime, but it did not significantly differ from placebo varnish (at 3rd and 5th days) and TiF 4 varnish (at 3rd day). Conclusions Duraphat varnish seems to be the best option to partially reduce dentin erosion. However, the maintenance of the effects of this treatment after successive erosive challenges is limited.