Varnish Duraphat Research Articles

In vitro evaluation of fluoride products in the development of carious lesions in deciduous teeth

The purpose of this study was to evaluate the effect of the application of fluoride products on the development of enamel caries in deciduous teeth. A total of 108 deciduous teeth were chosen for the study. Acid-resistant varnish was applied on the teeth, leaving only one area of 5 mm x 1 mm of dental enamel exposed. The teeth were allocated randomly to one of the following groups: 1) control - toothpaste without fluoride; 2) 1.23% fluoride gel; 3) Duraflur fluoride varnish; 4) Duraphat fluoride varnish; 5) Fluorniz fluoride varnish; 6) Fluorphat fluoride varnish; 7) varnish with Duofluorid; 8) 12% silver fluoride diamine (Cariestop); 9) children's fluoride toothpaste (500 ppm). The tested products were applied on the teeth according to the manufacturer's recommendations and the teeth were stored in a moist environment for 24 hours. Each group of teeth was then subjected to a pH cycling model for 14 days, after which the teeth were cut through the center for an analysis of the depth of the carious lesion by polarized light microscopy. Comparisons were made between the treatments and the control group. The mean lesion depth values were 318 microm +/- 39 (control), 213 microm +/- 27 (fluoride gel), 203 microm +/- 34 (Duraflur), 133 microm +/- 25 (Duraphat), 207 microm +/- 27 (Fluor-niz), 212 microm +/- 27 (Fluorphat), 210 +/- 28 (Duofluorid), 146 +/- 31 (Cariestop) and 228 +/- 24 (fluoride toothpaste). None of the products used here was able to completely prevent the formation of lesions. The highest cariostatic effect was achieved by fluoride varnish Duraphat and the lowest by the fluoride toothpaste.

Urinary fluoride output in children following the use of a dual-fluoride varnish formulation

Objective:This study evaluated the bioavailability of fluoride after topical application of a dual-fluoride varnish commercially available in Brazil, when compared to Duraphat™.Material and methods:The urinary fluoride output was evaluated in seven 5-year-old children after application of the fluoride varnishes, in two different phases. In the first phase (I), children received topical application of the fluoride varnish Duofluorid XII (2.92% fluorine, calcium fluoride + 2.71% fluorine, sodium fluoride, FGM™). After 1-month interval (phase II), the same amount (0.2 mL) of the fluoride varnish Duraphat (2.26% fluorine, sodium fluoride, Colgate™) was applied. Before each application all the volunteers brushed their teeth with placebo dentifrice for 7 days. Urinary collections were carried out 24 h prior up to 48 h after the applications. Fluoride intake from the diet was also estimated. Fluoride concentration in diet samples and urine was analyzed with the fluoride ion-specific electrode and a miniature calomel reference electrode coupled to a potentiometer. Data were tested by ANOVA and Tukey's post hoc test (p<0.05).Results:There were significant differences in the urinary fluoride output between phases I and II. The use of Duofluorid XII did not significantly increase the urinary fluoride output, when compared to baseline levels. The application of Duraphat caused a transitory increase in the urinary fluoride output, returning to baseline levels 48 h after its use.Conclusions:The tested varnish formulation, which has been shown to be effective in in vitro studies, also can be considered safe.

Fluoride Varnish Application: Not Always Effective in Public Health Trials

Article Title and Bibliographic Information A Cluster Randomized Controlled Trial to Evaluate the Effectiveness of Fluoride Varnish as a Public Health Measure to Reduce Caries in Children Hardman MC, Davies GM, Duxbury JT, Davies RM. Caries Res 2007;41:371-6 Level of Evidence 1 Purpose The purpose of this study was to assess the effectiveness of twice-yearly application of Duraphat varnish as a public health measure to reduce dental caries in children living in relatively deprived communities. Source of Funding Information not provided. Type of Study/Design A Cluster Randomized Control Trial

A Cluster Randomised Controlled Trial to Evaluate the Effectiveness of Fluoride Varnish as a Public Health Measure to Reduce Caries in Children

This cluster randomised controlled study assessed the effectiveness of twice-yearly applications of fluoride varnish as a public health measure to reduce dental caries in children living in relatively deprived communities. The test (n = 334) and control (n = 330) children in 2 school years (unit of randomisation) attended 24 state primary schools and were 6–8 years of age at the start. Good baseline balance was found. Duraphat varnish was applied at school on 5 occasions over 26 months, by dental therapists. A combined visual and fibre-optic transillumination examination included all surfaces of primary and first permanent molars at baseline and after 26 months for small and large enamel and dentine lesions. At the final examination the only statistically significant difference was in the caries increment for small enamel lesions in the primary dentition, with the test children having fewer lesions. This study failed to demonstrate that the twice-yearly application of fluoride varnish provided at school reduced dental caries in children living in this community. The low level of response and a lower than expected caries increment had a major impact on the effectiveness of the intervention, since the children who participated were least likely to have benefited from the programme, whereas those who might have benefited did not consent.

Deposition of fluoride on enamel surfaces released from varnishes is limited to vicinity of fluoridation site

The aim of the in-situ study was to determine fluoride uptake in non-fluoridated, demineralized enamel after application of fluoride varnishes on enamel samples located at various distances from the non-fluoridated samples. All enamel samples used were demineralized with acidic hydroxyethylcellulose before the experiment. Intra-oral appliances were worn by ten volunteers in three series: (1, Mirafluorid, 0.15% F; 2, Duraphat, 2.3% F and 3, unfluoridated controls) of 6 days each. Each two enamel samples were prepared from 30 bovine incisors. One sample was used for the determination of baseline fluoride content (BFC); the other was treated according to the respective series and fixed in the intra-oral appliance for 6 days. Additionally, from 120 incisors, each four enamel samples were prepared (one for BFC). Three samples (a–c) were placed into each appliance at different sites: (a) directly neighboured to the fluoridated specimen (=next), (b) at 1-cm distance (=1 cm) and (c) in the opposite buccal aspect of the appliance (=opposite). At these sites, new unfluoridated samples were placed at days 1, 3 and 5, which were left in place for 1 day. The volunteers brushed their teeth and the samples with fluoridated toothpaste twice per day. Both the KOH-soluble and structurally bound fluoride were determined in all samples to determine fluoride uptake and were statistically analyzed. One day, after fluoridation with Duraphat, KOH-soluble fluoride uptake in specimen a (=next) was significantly higher compared to the corresponding samples of both the control and Mirafluorid series, which in turn were not significantly different from each other. At all other sites and time points, fluoride uptake in the enamel samples were not different from controls for both fluoride varnishes. Within the first day after application, intra-oral-fluoride release from the tested fluoride varnish Duraphat leads to KOH-soluble fluoride uptake only in enamel samples located in close vicinity to the fluoridation site.

A field trial on semi-annual fluoride varnish applications among the special needs schoolchildren

This study assessed cariostatic effect of one fluoride varnish Duraphat among children with a low caries risk and compared this effect to group of a moderate caries risk, belonging to same ethnic group with same socioeconomic background. Results of this study showed that fluoride varnish had cariostatic effect in a group of children with a moderate caries risk but not among those with a low caries risk.

Effect of a fluoride varnish on the margin leakage and retention of luted provisional crowns

Statement of problem. Provisional crowns cemented with provisional luting agents are susceptible to washout, margin leakage, and secondary caries when placed for a prolonged period. Purpose. This study was conducted to determine the effect of combining a varnish containing 2.26% NaF with 2 provisional luting agents on the margin leakage and retention of provisional crowns. Material and methods. Acrylic resin provisional crowns were fabricated for 8 shoulder-prepared molars. The eight provisional (N=24) crowns were luted individually with Temp-Bond (TB), Freegenol (FG), or Duraphat (DU). Specimens were thermocycled 500 times (5° and 60° C) with a 1-minute dwell time, stored in 100% relative humidity at 37° C for 6 days, and then immersed in a 0.5% Gentian violet solution for 24 hours. Seven days after cementation, a removal test of the crowns (shear retention test) was conducted with a universal testing machine at a crosshead speed of 5 mm/min. Retention was determined as the maximum recorded force needed for crown dislodgment. DU varnish was applied to the inner surface of the dislodged crowns with no removal of the cement layer TB, FG (N=16). The crowns were relined with a 0.5-mm layer of acrylic resin and luted with a combination of luting agent and DU (TB, FG) N=16. No luting agent (NC) served as the control (N=8). Results were analyzed with the Wilcoxon matched-pairs signed-ranks test. Leakage at the margins was assessed with a 4-level dye penetration scale, and statistical differences were identified with a χ2 test. All hypothesis testing was conducted at the 95% level of confidence. Results. The mean 7-day retention forces were as follows: 44.5 N (Temp-Bond), 51.6 N (Freegenol), and 35.9 N (Duraphat). There were no significant differences among these values. Duraphat combined with Freegenol decreased the retention of provisional crowns, but Duraphat combined with Temp-Bond increased the retention of provisional crowns by 69-145%. Duraphat alone and in combination with both provisional luting agents significantly reduced margin leakage (P<.05). The least margin leakage was evident when the provisional crowns were luted with Duraphat alone. Conclusion. With regard to retention and margin leakage, the results of this study suggest that Duraphat varnish can be successfully used as provisional luting agent for single provisional crowns. (J Prosthet Dent 2003;89:70-5.)

Four‐year study of caries inhibition of intensive Duraphat application in 11–15‐year‐old children

The purpose of the study was to evaluate the caries preventive effect and cost of an intensive application of Duraphat varnish, added to the regular preventive program for 11-15-yr-old children in a Swedish Dental Community Clinic. In 1987, the 134 11-yr-old children in Floda were divided into two groups, every second child to each. Children with fixed orthodontic appliances were excluded. The test group received three applications of Duraphat varnish during 1 week, once a year, by a dental nurse. The control group received one application at the annual check-up. Both groups were included in the regular preventive program at the clinic. The total time cost for the clinic was estimated and used to calculate the cost per hour for dentists and nurses. The caries increment and progression were estimated both by routine diagnosis and by a careful study of radiographs taken at the beginning and end of the study period. There was a small caries increment and progression in the test group as compared to the control group. The difference was statistically significant for all aspects studied. The costs were about the same in both groups but more time was used in the test group. The administrative effort for the staff was considerable for the intensive Duraphat application.

Effect of fluoride varnish on the retentive strength of provisional crowns luted with various temporary cements

The retention of temporary crowns was studied with the use of a fluoride varnish (Duraphat) combined with various temporary cements. The mixture of Duraphat varnish and cement improved retention, with the exception of Opotow cement. Applying Duraphat varnish to the tooth surface before cementation enhanced the retentive strength of Tempbond, weakened the retention of Freegenol, but had no effect on Opotow cement. A “transfer effect” was observed, inasmuch as the Duraphat varnish encouraged adherence of the cement to the tooth structure rather than to the temporary crown.

Caries incidence after topical application of varnishes containing different concentrations of sodium fluoride: 3-year results

Previous studies have shown that topical application of the fluoride varnish Duraphat reduces caries incidence. The aim of the present study was to compare the caries inhibiting effect of a new fluoride varnish (Carex) containing 1.8% fluoride (F) with that of Duraphat (2.26% F). Informed consent was obtained from the guardians of 495 children 10-12 yr old in Voss Dental Health District (low F area). The children were randomly allocated to two groups. One group of subjects received 6-monthly application of Duraphat (n = 185), the other Carex (n = 165). Ethical considerations precluded the use of a placebo varnish. All participants received dental examinations including one pair of posterior bitewing radiographs and necessary dental care annually. One trained examiner interpreted bitewing radiographs blindly. Total 3-yr net DFS increment for 24 posterior approximal surfaces was 2.63 (SD = 3.81) in the Duraphat group and 2.12 (SD = 3.50) in the Carex group. DMFS increments based on 40 posterior occlusal and approximal surfaces were 5.21 (SD = 5.79) and 4.04 (SD = 4.92), respectively. Thus the results indicate a comparable efficacy for Carex and Duraphat at the caries activity level exhibited by these study participants.

Caries-Inhibiting Effects of Different Modes of Duraphat Varnish Reapplication: A 3-Year Radiographic Study

One hundred and sixty 11-year-olds were randomly allocated to two experimental groups, one test (group 1) and one control group (group 2), for a 3-year clinical test comparing different modes of fluoride varnish treatment. In the test group, children received Duraphat varnish treatments 3 times a week, once a year. The children in group 2 were treated with Duraphat every 6 months. During the experimental period, children in group 1 received 9 fluoride varnish applications, and in group 2, 6 applications. Four bitewing radiographs were taken in each child each year for the measurements of the incidence and progression of proximal caries. Repeated fluoride varnish treatment with Duraphat, 3 times a week once a year, appears to inhibit proximal caries progression and development since the children in this group showed even a lower caries status, 1.3 +/- 0.3 DS, at the end of the study compared to 1.6 +/- 0.2 DS at the outset. In group 2, the children increased their caries status from 1.7 +/- 0.2 to 2.4 +/- 0.4 DS during the experimental period. The caries difference was statistically significant (p less than 0.05) between the two groups. A health economic comparison of the two modes of application showed 30% lower costs for the children in the test group based on time used for preventive measures and assumed filling therapy.

Caries preventive effect of fluoride varnish applications performed two or four times a year

The efficacy of Duraphat varnish applications performed two or four times a year was compared in a 2-yr clinical trial. 254 children aged 9-13 yr and having higher than average DMFS values participated in the study. The children were randomly divided into two treatment groups. Clinical and radiographical examinations were performed at baseline and after 2 yr by one dentist. For the group receiving applications every 3 months, the 2-yr DMFS increment was 2.90 (SD 4.45) and for the group receiving applications every 6 months, 2.92 (4.47). There were no significant differences in DMFS increments between the groups for any type of tooth surfaces. Neither was there any difference between the groups when the children were divided into two subgroups on the basis of baseline DMFS values. The increments for the children with high (greater than or equal to 10) baseline DMFS values were 4.25 (4.81) and 4.30 (5.53) in the groups receiving applications four times and twice a year, respectively. The results suggest that fluoride varnish applications performed more frequently than twice a year may not provide additional caries protection in a population with relatively low caries activity.

The role of 'CaF2-like' material in topical fluoridation of enamel in situ.

In this paper the role and importance of 'CaF2-like' material deposited on enamel (Fon) by means of an APF gel and the varnishes Duraphat and Fluor Protector are described and discussed. The amount of Fon, determined by KOH extraction, is a measure of the amount of CaF2-like material on the enamel surface. Fluoride in the enamel (Fin), determined by etching, is the amount of F- bound in the solid enamel. Fon and Fin data are presented after various F- treatments and after wearing enamel slabs in dentures for a period of 1 week. The results of this work show that if we compare the three fluoridating agents, APF gel, Duraphat varnish, and Fluor Protector varnish in situ, only Fluor Protector shows a measurable amount of Fon after 1 week. The amounts of Fon acquired by the enamel surface (one application) rank as APF gel approximately Duraphat much less than Fluor Protector. Most likely, Fon in situ leaches away through the pellicle, with an apparent diffusion coefficient of about 10(-6) cm2.sec-1. The Fin data show that after APF gel or Duraphat treatment a substantial amount of Fin leaches away during 1 week in situ; the Fin values of Fluor Protector do not change. The efficiency of the fluoridating agents is most likely determined by the application period and fluoride availability. For APF gel, Duraphat, and Fluor Protector about 5%, 1%, and 44% of the available fluoride participates in the fluoridation process. CaF2-like globules are known to precipitate after gel or varnish treatment on the enamel surfaces and can be dissolved in KOH solution.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevention of caries progress in xerostomic patients by topical fluoride applications: a study in vivo and in vitro.

Fluoride uptake by the surface enamel of teeth was studiedin vivo andin vitro in xerostomic patients and in extracted human teeth respectively, following various topical fluoride applications (Duraphat varnish, 2·26 per cent F; APF gel, 1·23 per cent F; Elmex gélee, 0·4 per cent F). Fluoride increments known to be effective for inhibition of caries in xerostomic patients were achievedin vivo andin vitro from all preparations. Arrest of caries was observed only in patients who were cooperative in the preventive fluoride programme. It was concluded, on the basis that the fluoride incorporation found in the experimentsin vitro was not stable, that topical fluoride applications in xerostomic patients had to be used frequently to ensure a prophylactic success.

Fluoride uptake by cavity walls following application of Duraphat around amalgam restorations.

This study aimed to assess possible fluoride uptake by cavity walls following a single application of Duraphat around class V or I amalgam restorations which were inserted in seventeen human premolars in vitro and in vivo. Six cavities were lined with one layer of Copalite before insertion of the restorations. After a week in vivo and 12--24 h in vitro, 200--300 micrometers thick longitudinal sections passing through the cavities were prepared. By electron probe microanalysis F concentrations ranging from 2000 to 6000 ppm were measured near the surface of the cavity walls. Copalite seemed to inhibit F uptake. The study indicates that F ions released from the Duraphat varnish have been taken up by the cavity walls. Such uptake may influence development of secondary caries (wall lesions) in connection with amalgam restorations.

Plasma fluoride concentration and urinary fluoride excretion in children following application of the fluoride-containing varnish Duraphat.

Plasma fluoride (F) concentration and urinary output of F were studied in 4 children, 4, 5, 12 and 14 years of age, after oral application of a F-containing varnish (Duraphat®). The F dose was found t