Post-orthodontic White Spot Lesions Research Articles

The Application of Resin Infiltration Combined with Nano-Hydroxyapatite in the Treatment of Post-Orthodontic White Spot Lesions

This study aims to investigate whether the combination of resin infiltration and nanohydroxyapatite (nHA) can provide a synergistic treatment for post-orthodontic white spot lesions (WSL), thus establishing an experimental basis for its treatment. For this study, a total of 60 bicuspid teeth that required extraction due to orthodontics were collected. Orthodontic models were established for each tooth sample, and demineralization staining was conducted using Coca-Cola. The dental samples were randomly divided into 4 groups: control group, nHA group, resin infiltration group, and resin infiltration+nHA group. The demineralized samples were remineralized with 10% nHA and Icon resin infiltration, respectively. The samples were subjected to color difference observation, microhardness test, energy-dispersive X-ray spectrum analysis, and surface roughness detection. The results showed that the tooth surface of the control group was rough and dull after demineralization. The area around the bracket exhibited a brown color, greatly contrasting with the color of the surrounding tooth enamel. After the remineralization treatment with nHA and resin infiltration, the color difference decreased significantly and the microhardness increased. A significant difference was observed between the nHA group and the resin infiltration group (P < 0.05). However, the combination of resin infiltration and nHA exhibited superior staining resistance and improved WSL microhardness value. Additionally, nHA was found to enhance the mass ratio and molar ratio of calcium to phosphorus in WSL samples, while also reducing the surface roughness Ra, demonstrating a greater effectiveness compared to resin infiltration. The use of nHA following resin infiltration led to a significant improvement in mineral deposition and a substantial reduction in surface roughness. In conclusion, both resin infiltration and nHA play a crucial role in promoting enamel remineralization, offering their respective advantages in reducing color difference, increasing microhardness and calcium and phosphorus content, and reducing surface roughness in WSL samples. Remarkably, the combined application of resin infiltration and nHA enables resin infiltration to improve the remineralization and anti-coloring ability in WSL, while preserving its aesthetic effects. This combination demonstrates a positive application outcome.

White spot lesions after fixed appliance treatment-Can we expect spontaneous long-term (≥15 years) improvement?

To investigate the extent to which post-orthodontic white spot lesions (WSLs) change in appearance over a period of ≥15 years and whether an association with caries data exists. Seventy-two patients treated with a Herbst-Multibracket appliance at age 14.0 ± 2.7 years for 20.1 ± 5.1 months who attended a recall 18.3 ± 2.9 years post-treatment. Post-treatment (T1) intraoral photographs were assessed by a panel of five dentists using a modified version of the WSL-Index by Gorelick. For affected incisors, photographs from before treatment (T0) and recall (T3) were evaluated. In addition, the WSL-Change Index by Pancherz and Muehlich was assessed for all adequately visible incisors considering T1, T2 (if available), and T3. Radiographic (T0, T1, and T2-if available) and clinical (T3) MFT data were used. 37.5% of the patients exhibited WSLs on ≥ 1 incisor at T1; in total, 81 incisors (14.9%) were affected. At T3, 48% of the WSLs had improved. The modified WSL-Index decreased from 1.2 ± 0.4 to 0.8 ± 0.6 (P < .001), with a score 0 in 28% of the previously affected incisors. When comparing T2 vs. T3, additional improvement after T2 occurred in 11% of the teeth. While no difference existed at T0, the MFT values at T1, T2, and T3 were higher (P ≤ .05) in patients with WSLs at T1 than in those without. The homogeneity of the subjects was limited and no patient-reported outcome was assessed. Long-term, post-orthodontic WSLs showed spontaneous full recovery in 28% and improvement in 48% of the teeth. Patients affected with WSLs exhibited higher post-treatment MFT values.

Remineralization Potential of Grape Seed Extract Versus Fluoride Mouthwash in Management of Post-Orthodontic White Spot Lesions: A 6m Randomized Clinical Trial

Remineralization Potential of Grape Seed Extract Versus Fluoride Mouthwash in Management of Post-Orthodontic White Spot Lesions: A 6m Randomized Clinical Trial

Comparative evaluation of four treatments for postorthodontic white spot lesions: a randomized controlled trial.

To evaluate the treatment efficacy of fluoride toothpaste alone and those of adjunctive use of resin infiltration, sodium fluoride varnish, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on white spot lesions (WSLs). Seventy-nine patients (356 teeth) with WSLs after orthodontic treatment were randomly allocated into four groups. The WSLs of the participants received resin infiltration only at baseline, and the other groups received fluoride varnish, CPP-ACP mousse, and placebo treatment every 6months, respectively. A toothpaste containing 1400ppm fluoride and toothbrushes were distributed to all participants, and oral hygiene instructions were provided. Photos of the teeth with WSL were taken to compare the change between groups which was measured by ImageJ software. Twelve months later, different degrees of reduction in the area of WSLs were observed in all groups. The percentage of lesion area reduction in WSLs in the resin infiltration group was 46.6%, which was significantly higher than that in fluoride varnish group (26.6%), CPP-ACP group (28.6%), and control group (29.8%), and the differences were statistically significant (p < 0.001). This study shows that after 1-year follow-up, the use of fluoride toothpaste, with or without the use of fluoride varnish or CPP-ACP, can reduce the area of WSLs. While resin infiltration can immediately improve dental aesthetics and continuously improved in 12months, resin infiltration groupshowed much better results than other groups. Clinical Trials Registration Number: ChiCTR2000032516. The use of fluoride toothpaste, with or without adjunctive use of fluoride varnish and CPP-ACP, can reduce the area of WSLs, while resin infiltration treatment has additional effect and can immediately improve dental aesthetics.

EFFICACY OF NOVEL BIOACTIVE GLASS IN THE TREATMENT OF ENAMEL WHITE SPOT LESIONS: A RANDOMIZED CONTROLLED TRIAL✰

to evaluate the efficacy of 2 types of bioactive glass (45S5) compared to casein-phosphopeptide stabilized-amorphous calcium phosphate (CPP-ACP) in the treatment of orthodontically-induced white spot lesions (WSLs). Sixty post-orthodontic WSLs (ICDAS II score 2) were randomly allocated to a double blind randomized controlled trial with 3 parallel arms (n = 20). Test group I (Bio-BAG) received BiominF slurry and toothpaste, and test group II (N-BAG) received Novamin slurry and toothpaste. While the positive control group (CPP-ACP) received Recaldent paste. Products were applied daily in-office during week 1, and boosted by self-administered home application for 4 weeks (week 1-4). Standard oral hygiene care was performed by all participants twice daily during months 2-6. All patients were assessed for change in WSL dimensions using computer assisted analysis based on standardized digital intraoral photographs in addition to laser fluorescence DIAGNOdent assessment before treatment (T0) and at 1 week (T1), 1 month (T2), 3 months (T3,) and 6 months (T4) follow up periods. Kruskal Wallis test was used (P < .05 for all). At T4, a statistically significant (P < .001) regression of WSL was disclosed in all 3 groups compared to baseline, and a highly significant lesion size percent reduction in Bio-BAG group compared to the control group (P < .001). The mean area of the lesions decreased by 64.8%, 32.2%, and 31.6% for groups I, II and III respectively (P = .001). DIAGNOdent findings largely reflected the clinical scores (Mean scores at baseline/T4 for groups I, II, and III respectively; 16.57/3.62, 16.93/7.90, 21.95/19.27). No adverse effects were reported. The combined in-office and home-application of BiominF paste for 4 weeks resulted in greater esthetic improvements of post-orthodontic WSLs compared to Novamin and CPP-ACP. In addition, BiominF showed a significant reduction in fluorescence intensity which indicates potential lesion remineralization. Post-orthodontic WSLs can be diminished using bioactive glass remineralization therapy.

Evaluation of the remineralizing effect of biomimetic self-assembling peptides in post-orthodontic white spot lesions compared to fluoride-based delivery systems: randomized controlled trial

ObjectivesTo evaluate the clinical performance of self-assembling peptides versus fluoride-based delivery systems in post-orthodontic white spot lesions.Materials and methodsThe participants were randomly assigned into two groups (n = 58) according to the remineralizing agent used, where (A) group represented participants receiving a varnish containing 22.600 fluoride ppm and tricalcium phosphate, while the second group (B) represented participants receiving self-assembling peptide. The remineralizing process of the white spot lesion was assessed using the DIAGNOdent pen and ICDAS scoring system according to the time when the remineralizing agent was used (T), where T0 represented the score taken at baseline. T1 represented the score taken after 3 months of follow-ups and T2 score represented the score taken after 6 months of follow-up. Data were collected and statistically analyzed. The parametric data: two-way ANOVA was used to test the effect of interaction among different variables. The non-parametric data: Mann–Whitney test was used. The significance level was set at p ≤ 0.05.ResultsThere was a quantitative statistically significant difference via DIAGNOpen readings between Group A (fluoride material) and Group B (self-assembling peptides). The highest mean value of 10.51 was found in Group A, while the least mean value of 6.45 was found in Group B. Besides, there was a significant difference in each group concerning the time factors T0, T1, and T2 groups where (p < 0.001. As for the qualitative results concerning the ICDAS score, there was no significant difference between the two groups along with the follow-up periods T0, T1, and T2 where the p value is equal to 0.064, 0.087, and 0.277 respectively.ConclusionsThe visual assessment using ICDAS reveals that the biomimetic remineralization using self-assembling peptides and the fluoride-based varnish material showed a similar effect in masking post-orthodontic white spot lesions. However, the laser fluorescence using DIAGNOpen showed that the self-assembling peptides reveal higher performance in subsurface remineralization than the fluoride-based varnish material. Therefore, self-assembling peptides are considered a promising material for lesion regression in post-orthodontics white spot lesions.Clinical relevanceSelf-assembling peptide SAP-14 is a new approach to reverse and mask off post-orthodontics white spot lesions.

Correlation of quantitative light-induced fluorescence and qualitative visual rating in infiltrated post-orthodontic white spot lesions.

The aim of this prospective, clinical single-centre study was to evaluate the masking efficacy of post-orthodontic resin infiltration after 12-month follow-up and correlate quantitative and qualitative outcome measures. Patients with completed fixed orthodontic treatment and the presence of one or more vestibular active non-cavitated white spot lesion/s (WSL) [ICDAS 1 or 2 (International Caries Detection and Assessment System)] were provided with resin infiltration 3-12 months after bracket removal. All patients (n = 31) participating before (t0) intervention were invited again and examined after 12 months (t2). Enamel demineralization was scored using quantitative light-induced fluorescence [QLF (DeltaF[flourescence], DeltaQ[lesion volume], White Spot Area)] and qualitative visual rating [11-point Likert-scale from 0 (no lesions visible on any tooth) to 10 (all teeth affected on the entire vestibular surface)]. In 17 patients (7 female and 10 male) 112 WSL (ICDAS 1: n = 1; ICDAS 2: n = 111) in 112 teeth were (re)examined. Before treatment (t0) a significant, weak (DeltaF), and moderate (DeltaQ, White Spot Area) correlation was observed between the quantitative and the qualitative rating (P < 0.002) [median DeltaF: -7.31 (-10.4/-6.58)%; DeltaQ:-2.25 (-10.8/-0.41)% mm2; White Spot Area: 0.34 (0.05/1.16) mm2; visual rating:3.7 ± 1.2]. Resin infiltration led to significantly increased fluorescence and decreased visual scores (P < 0.001) 7 days (t1) and 12 months (t2) after treatment. No significant changes based on DeltaF [-6.55 (-7.29/-6.08)%] and on visual ratings [1.0 ± 1.0] were observed between t1 and t2 (P = 1.000). After 7 days (t1) the correlation between the quantitative and the qualitative ratings remained significant, weak to moderate (P < 0.002). After 12 months (t2) the correlation was (non-)significant and weak for DeltaF, DeltaQ, and White Spot Area (P ≤ 0.097). Since the overall masking efficacy of resin infiltration has been shown previously, an untreated control group was omitted. When assessing the masking efficacy of infiltrated post-orthodontic WSL only a weak to moderate correlation was found between QLF values and visual ratings. Furthermore, over time this correlation decreased. Thus, it remains unclear if QLF is a viable method to assess and quantify infiltrated post-orthodontic WSL over time. German Clinical Trials Register (DRKS-ID:DRKS00005067).

Evaluation of Remineralization Potential of Remin Pro Forte vs Remin Pro on White Spot Lesions: A Randomized Clinical Trial

This study was conducted to evaluate the remineralization potential of Remin Pro Forte vs Remin Pro remineralizing agents on white spot lesions (WSLs) post-orthodontic treatment. Twenty patients with post-orthodontic WSLs were divided into the following two equal groups based on treatment (n = 10): (1) A 3-month program of hydroxyapatite, fluoride, xylitol, ginger, curcuma-containing cream (Remin Pro Forte) as intervention group; (2) A 3-month cream regimen including hydroxyapatite and fluoride, xylitol (Remin Pro) as control group. The main outcomes including caries regression (assessed by ICDAS II), mineral content (assessed by VistaCam iX camera), and color of WSLs (assessed by digital image analysis by Adobe photoshop) were measured at the time of enrollment and 1, 2, and 3 months afterward. Mann-Whitney test used to compare between tested groups. The statistical significance was set at p <0.05. Both Remin Pro Forte and Remin Pro elicited much better caries regression and significantly higher mineral content in WSLs over a 3-month period (p <0.05). However, the difference in mineral content of WSLs between groups did not reach statistical significance (p = 0.414). In both experimental groups, the appearance of WSLs improved significantly (p <0.05). Both Remin Pro Forte and Remin Pro were successful in reducing caries, increasing mineral content, and enhancing the appearance of demineralized enamel, indicating that both products could be suggested for post-orthodontic WSL management. Natural herbal products could be employed as remineralizing agents and included into tooth preventive measures. It is a less harmful alternative to traditional chemical remineralization methods.

Evaluation of fluoride varnish treatment of postorthodontic white spot lesions by visual inspection and laser fluorescence-A randomized controlled study.

ObjectivesWhite spot lesions (WSLs), as a side effect of orthodontic therapy, can be treated with fluoride varnish, with the difference in efficiency reported.Material and methodsPatients with buccal WSLs were consecutively included in a randomized controlled double‐blind study. At first inspection and at three follow‐ups over 6 months, 0.1% fluoride varnish and placebo (water) were applied in the test group (N = 21) and control group (N = 21), respectively. The maximum laser fluorescence value (LFV) of WSLs was recorded using DIAGNOdent. Between the groups, differences in the mean numbers of WSLs and the mean LFV of WSLs per patient at different time points were analyzed with mixed‐design analysis of variance. Orthodontic therapy duration (OTD) was included in the model as a covariate.ResultsA decrease in the mean WSLs number and LFV was observed; however, there were no significant differences between study groups at any time point. OTD was in interaction only with LFV. Analysis showed a different pattern of mean LFV changes for patients with OTD of >48 months compared to patients with OTD of ≤24.ConclusionThe changes in numbers of WSLs and LFV over the study period indicated regression of WSLs, but an additional effect of FV was not confirmed.

EFFECTIVENESS OF RESIN INFILTRATION IN MANAGEMENT OF POST ORTHODONTIC WHITE SPOT LESIONS - A CLINICAL STUDY

Objective: To assess the effectiveness and durability of resin infiltration (ICON, DMG, Hamburg, Germany) in the management of post orthodontic white spot lesions. Material &amp; Methods: A clinical trial was conducted among 30 children who had undergone fixed orthodontic therapy presented with white spot lesions (WSLs) on maxillary or mandibular incisors and canines after debonding. Identification of WSLs was done with International Caries Detection and Assessment System (ICDAS) II criteria. The clinical photographs recorded were used to measure the size of lesion. The color assessment of the lesion and sound adjacent enamel was recorded by using spectrophotometer. Area of the lesion was calculated using Image analyzing software. The selected samples were treated with Resin infiltration- Icon, DMG, Germany, The WSLs were evaluated immediately following resin infiltration, 1, 3, 6 and 12 months. Results: There was significant reduction in lesion area, and improvement in color of white spot lesions treated with resin infiltration. Conclusion: Resin Infiltration have desired and durable esthetic improvement in terms of reduction in the area as well as color of post orthodontic white spot lesions.

Management of Post Orthodontic White Spot Lesions Using Resin Infiltration and CPP-ACP Materials- A Clinical Study

The purpose of this present study was to assess and compare the effectiveness and durability of topical application of remineralizing agent Casein Phospho Peptide (CPP-ACP, Toothmousse, GC corporation, Germany, Europe) and Resin infiltration (ICON, DMG, Hamburg, Germany) in the management of post orthodontic white spot lesions. A Randomized Control clinical trial was conducted among 60 children who had undergone fixed orthodontic therapy presented with white spot lesions (WSLs) on maxillary or mandibular anteriors after debonding. Identification of WSLs was done with International Caries Detection and Assessment System (ICDAS II) criteria. The clinical photographs recorded were used to measure the size of lesion. The color assessment of the lesion and sound adjacent enamel was recorded by using spectrophotometer (Vita-Easy shade 4.0, VITA Zahnfabrik, Germany). Area of the lesion was calculated using Digimizer software (Digimizer, MedCalc Software, Belgium). The selected samples were randomly allocated into two groups: Group I- Resin infiltration- Icon, DMG, Germany, (n=30) and Group II- Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP)-GC Toothmousse, GC Corporation, Germany, (n=30). The WSLs were evaluated immediately following resin infiltration, and in CPP-ACP group after 1 month. In both the groups lesions were evaluated at 1, 3, 6 and 12 months. There was significant reduction in lesion area, and improvement in color of white spot lesions with both of the treatment modalities. Both the resin infiltration and CPP-ACP have desired and durable esthetic improvement in terms of reduction in the area as well as color of post orthodontic white spot lesions.

Effect of Remineralization Agents on White Spot Lesions: A Systematic Review.

Objective:The goal of this systematic review was to evaluate the therapeutic efficacy of Casein Phosphopeptide Amorphous Calcium Phosphate (CPP-ACP) remineralizing potential to that of other remineralizing treatments and placebo in both naturally occurring and postorthodontic white spot lesions (WSL) in vivo.Materials and Methods:From 2005 to 2020, the literature search used electronic databases PubMed, Embase, Science Direct, and Google Scholar to find studies published solely in English and randomized controlled trials (RCTs) employing CPP-ACP as an intervention. All eligible studies were reviewed by two independent reviewers.Results:Excluding duplications, 72 articles were identified. s of 58 articles were reviewed independently, 19 articles were excluded, 36 full text articles were retrieved; finally selecting 14 studies.Conclusion:The CPP-ACP was found to have efficacious remineralizing potential on naturally occurring and postorthodontic WSL compared to placebo or other preventive measures. Further well-performed RCTs are needed to determine the therapeutic significance of remineralizing medicines, and long-term follow-ups are required.

Resin Infiltration Versus Acid Micro-Abrasion In The Treatment Of Resin Infiltration Versus Acid Micro-Abrasion In The Treatment Of White Spot Lesions In Fixed Orthodontic Patients

Background: White spot lesions (WSls) are frequently occurring side effects of fixed orthodontic treatment. The lesions may progress to cavities. Their treatment is costly and time-consuming. Icon infiltrant and Opalustre are painless micro-invasive procedures that improve the color of the WSLs. Aim: The aim of this randomized clinical trial was to compare resin infiltration and acid micro-abrasion. Materials and Methods: Twelve patients, with ninety post-orthodontic white spot lesions, were randomly divided into two groups. Icon resin infiltrant was applied in one group and Opalustre acid micro-abrasion in the other. The caries score was measured with ICDAS-II. The patients recorded their satisfaction on a VAS scale. Wilcoxon signed-rank test compared the two groups and the Friedman test compared the outcomes over time. Results: Compared to the pre-treatment, the ICDAS-II scores statistically decreased immediately after treatment, after 3 months, and after 6 months, in both groups. Compared to pre-treatment, the patient satisfaction increased immediately after treatment, after 3 months, and after 6 months, in both groups. Conclusion: Icon and Opalustre improve the color of WSLs. Color is stable over time. Patients are satisfied with the treatment results

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a systematic review and meta-analysis

To analyse clinical studies investigating coating agents such as sealants and other bonding materials to prevent the initiation or inhibit the progress of white spot lesions (WSL) during orthodontic treatment with fixed appliances. Electronic databases (Pubmed, CENTRAL, EMBASE) were screened for studies. No language restrictions were applied. Study selection, data extraction and quality assessment were done in duplicate. Primary outcome included assessment of WSL with visual-tactile assessment and/or laser fluorescence measurements. Twenty-four studies with 1117 patients (age: 11–40 years) and 12,809 teeth were included. Overall, 34 different sealants or bonding materials were analysed. Fourteen studies analysed fluoride and 14 studies non-fluoride releasing materials. Meta-analysis for visual tactile assessment revealed that sealants significantly decreased the initiation of WSL compared to untreated control (RR [95%CI] = 0.70 [0.53; 0.93]; very low level of evidence). Materials releasing fluoride did not decrease initiation of WSL compared to those with no fluoride release (RR [95%CI] = 0.84 [0.70; 1.01]; very low level of evidence). For laser fluorescence measurements no meta-analysis could be performed. The use of sealants seems to be effective in preventing the initiation of post-orthodontic WSL. Furthermore, there is no evidence supporting that fluoride-releasing sealants or bonding materials are more effective than those without fluoride release. No gold standard prevention strategy to prevent WSL during treatment with fixed orthodontic appliances has been established yet. However, based on only a limited number of studies the use of sealants seems to be effective in preventing the initiation of post-orthodontic WSL.

A comparison of resin infiltration and microabrasion for postorthodontic white spot lesion

The objective of this research was to evaluate and compare the effectiveness of microabrasion and resin infiltration for white spot lesions (WSLs). Patients with postorthodontic WSLs were enrolled and randomly assigned to the control, microabrasion, and resin-infiltration groups. Intraoral photographs were taken before and after (6months later) treatment. WSL sizes were determined through ImageJ (Wayne Rasband, Kensington, Md). Integrated optical density (IOD) was determined for a WSL and its surrounding normal enamel through Image-Pro Plus (version 6.0; Media Cybernetics, Rockville, Md), and their differences of IOD were considered as the IOD surrogate for that WSL. The color change of WSL were measured through ΔE. A total of 27 eligible patients were enrolled; 9 subjects were assigned to each group, resulting in 56 teeth in the control group, 72 in the microabrasion group, and 58 in the resin-infiltration group. The ratios of WSL size (after/before) were similar between the microabrasion and resin-infiltration group (43.94±0.03% vs 45.02±0.03%; P=0.96>0.05), but those of the 2 groups were significantly lower than those of the control group (92.15±0.02%) (P<0.001). Moreover, the ratios of IOD (after/before) were significantly lower in the resin-infiltration group (22.94±0.02%) than in the microabrasion (78.11±0.03%) and control (83.79±0.02%) (P<0.001) groups. The highest ΔE improvement was obtained by infiltration, but there was no significant difference between microabrasion and control group. Resin infiltration and microabrasion are comparably effective in reducing the sizes of WSL, but resin infiltration enjoys an esthetic advantage over microabrasion.

REMINERALIZATION EFFECT OF EGGSHELL POWDER ON POST-ORTHODONTIC WHITE SPOT LESIONS COMPARED TO CPP-ACP: A RANDOMIZED CONTROLLED CLINICAL TRIAL

ABSTRACT: Aim: White spot lesions are the only carious process lesions that can be remineralized non-invasively. The focus of modern dentistry is stopping the caries process without unnecessary damaging the tooth structure. The present clinical trial aimed to assess the remineralizing effect of eggshell powder (ESP) compared to Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) in carious post-orthodontic white spot lesions orthodontic treatment. Methodology: Twenty-Four patients were selected from the Clinic of Orthodontic Dentistry Department, Faculty of Dentistry, Cairo University. Patients were divided into two groups according to the treatment received either ESP gel or CPP-ACP paste (GC Tooth-Mousse). The participants were instructed to use pea size eggshell powder gel or GC Tooth Mousse on the teeth surfaces using a clean finger twice daily after brushing their teeth with Colgate Total Original Care toothpaste. WSLs were assessed at baseline, 1 month, 3months and 6 months by DIAGNOdent (Kavo, Germany). Results: Data were analyzed using Two-way ANOVA showed that there was no statistically significant difference in overall DIAGNOdent mean readings between ESP and GC Tooth Mousse groups at (P=0.136). Conclusion: Based on the data obtained in this study, it is suggested that ESP is effective and has a promising future in the treatment of post-orthodontic WSLs.

REMINERALIZATION POTENTIAL OF GINGER AND ROSEMARY HERBALS VERSUS SODIUM FLUORIDE IN TREATMENT OF WHITE SPOT LESIONS: A RANDOMIZED CLINICAL TRIAL

ABSTRACT: Aim: The current study was conducted to evaluate the effectiveness of ginger and rosemary herbals versus sodium fluoride in remineralization of incipient enamel caries. Methodology: white spot lesions in anterior teeth of post orthodontic debanding patients received randomly two types of remineralizing agents, either ginger and rosemary gel or sodium fluoride varnish (bifluorid 10). White spot lesions were evaluated at base line one month and after 3, 6 months follow up periods by two blinded assessors to assess white spot lesion progression by Kavo DIAGNOdent. Results: Mann-Whitney test showed that there at baseline, sodium fluoride varnish group yielded similar readings as ginger and rosemary gel group (P=0.060). While at 1 month, ginger and rosemary gel group showed significantly higher readings compared to sodium fluoride varnish group (P<0.001). However, there were no statistically significant differences in readings of both groups at 3 months (P=0.302) and 6 months (P=0.070). Conclusion: Fluoride varnish and ginger and rosemary gel can decrease post-orthodontic white spot lesions. The herbals ginger and rosemary may be preferable for prevention purposes on initial remineralization of enamel lesions as more natural products are preferred today. Keywords: white spot lesions, ginger and rosemary in initial caries, sodium fluoride varnish, DIAGNOdent.

Evaluation and Compare Effectiveness and Durability of ICON Resin Infiltration and Acidulated Phosphorus Fluoride in Treatment of Post-Orthodontic White Spot Lesions

Evaluation and Compare Effectiveness and Durability of ICON Resin Infiltration and Acidulated Phosphorus Fluoride in Treatment of Post-Orthodontic White Spot Lesions

One Year Clinical Evaluation of White Spot Lesions with Newly Introduced Resin Modified Glass-Ionomer in Comparison to Resin Infiltration in Anterior Teeth: a split mouth randomized controlled clinical trial from Egypt

Objective: to compare the clinical performance of newly introduced resin modified glass ionomer varnish (Clinpro™ XT) versus resin infiltration in treatment of post-orthodontic white spot lesions. Material and Methods: Six participants (70 teeth) were enrolled with post-orthodontic white spot lesions. Randomization was performed according to patient selection for the sealed envelope containing which half will receive the control (resin infiltration (ICON, DMG) and the other will receive the intervention (resin modified glass-ionomer cement varnish (Clinpro™ XT, 3M)). Follow up was done after 1 day, 1 week, 1 month, and 3 months, 6 months and 12 months. The color was assessed by spectrophotometer while the degree of demineralization was measured by Diagnodent pen 2910. Patient satisfaction was assessed using (VAS) Visual analogue scale. Results: Regarding color change, significant improvement in lightness for ICON group, while Clinpro™ XT group, the change was insignificant. The demineralization data revealed significant decrease in demineralization with resin infiltration after immediate application. Clinpro™ XT showed also significant decrease after immediate assessment and significant increase in demineralization in 6 and 12 months. Conclusion: Resin infiltration can be considered more as an alternative treatment rather than fluoride varnish. Clinpro™ XTis considered as a preventive protocol, provided that renewal application is needed after 3 months. Keywords 3M Resin cement; Resin cements; Glass ionomer cements; Fluorides; Follow up studies; Glass ionomer.

Behandeling van postorthodontische wittevleklaesies

White spot lesions are early demineralisations and therefore constitute an impairment to healthy enamel. The emergence of white spot lesions is one of the main risks of damage during orthodontic treatment with fixed appliances. White spot lesions may partially recover, but will remain visible in most cases. The treatment for post-orthodontic white spot lesions is a step-by-step strategy. Treatment is aimed at remineralising the affected enamel, without hyper-mineralising the surface layer. Subsequently, treatment of post-orthodontic white spot lesions is aimed at reducing their visibility. Such treatment options focus on minimally invasive treatment techniques, before choosing an invasive treatment. More randomised clinical trials are needed to substantiate the evidence-based treatment of post-orthodontic white spot lesions. Clinical practice guidelines are being developed for the care and treatment of orthodontic white spot lesions.