Varnish Group Research Articles

Assessment of Remineralization Capacity of Various Remineralizing Agents on Artificial Enamel Lesions Using Confocal Laser Scanning Microscope: An In Vitro Study

The present study aimed at evaluating the effectiveness of diverse remineralizing agents on artificial enamel lesion using confocal laser scanning microscope (CLSM). Totally 80 mandibular premolars which were single rooted were included. All teeth were suspended in a demineralizing solution to create artificial enamel lesions on the exposed enamel. The samples were separated randomly into four groups (20 each) depending on the application of the remineralizing agents as follows: group 1: control; group 2: calcium sucrose phosphate (CaSP); group 3: fluoride varnish; and group 4: casein phosphopeptides-amorphous calcium phosphate (CPP-ACP). The samples in individual group were treated with the corresponding remineralizing agent (except for the control group) two times a day for 14 days. The experimental and control groups were exposed to CLSM assessment to analyze the data of remineralization and demineralization. The mean depth of remineralization of fluoride varnish group was slightly more compared to other groups. The highest mean depth of remineralization was found in the fluoride varnish group (122.26 ± 0.28) followed by CaSP (110.58 ± 1.34), CPP-ACP (107.08 ± 0.48), and control (157.78 ± 0.46) groups. The different comparisons among the remineralization material groups showed a statistically significant difference (p < 0.05) in almost all groups except group 2 vs group 4. This study concluded that improved remineralization of artificial enamel lesion could be achieved with the fluoride varnish group when compared to the CaSP and CPP-ACP groups. Remineralization as a treatment technique has received a lot of consideration from clinicians. The process of remineralization and demineralization is considered an active process categorized by the movement of calcium and phosphate in and out of the enamel. Presently, the attention has changed toward increasing the resistance of the tooth by applying remineralizing agents topically, which has led to the notable fall in dental caries.

Novel Management of Hypersensitive Dentin Using Propolis-based Herbal Desensitizing Agents: An In Vitro Scanning Electron Microscopic Study

The objective of this in vitro study was to assess the efficacy of novel propolis-based varnish against the two conventional varnishes on quantitative and qualitative assessments of occlusion of dentin tubules and resistance to erosive and abrasive wears employing scanning electron microscope (SEM). Thirty human premolars free from caries extracted due to orthodontic reasons were included in the study. Experimental group was done based on treatment received and divided into three groups. Group A: ClinProXT Varnish (n = 10), Group B: MI Varnish (n = 10), and Group C: Propolis Varnish (n = 10) were applied. Teeth were cleaned and decoronation of crown was done with dentin disks. Dentin specimens of dimension 4 × 4 × 2 mm were prepared and subjected to finishing and polishing. The sample specimens were submersed in EDTA solution for a period of five minutes to open up the dentinal tubules. This was followed by treatment with varnishes and subjection to acidic-abrasive challenge. The specimens were analyzed with an image analyzer connected to SEM for the verification of the number of opened dentin tubules. The parameter assessed in SEM includes size, topography and surface characteristics of dentinal tubule were assessed. The obliteration potential of dentinal tubules was assessed with SEM images. Additionally, the dentin surface loss and resistance to acidic and abrasive wear were also evaluated with SEM. Data were analyzed with two-way analysis of variance (ANOVA) with post hoc Tukey's test. MI Varnish caused higher obliteration of dentin tubules followed by ClinproXT Varnish. Propolis Varnish showed the least obliteration of dentinal tubules among tested experimental groups. After acidic-abrasive challenge, Propolis Varnish was found to be more efficient with less material loss among the experimental groups tested. There was an insignificant difference among the MI Varnish and ClinProXT Varnish groups. Simulation of hypersensitive lesions mimicking the clinical scenario was a challenging task in this in vitro study. All varnishes tested in the study had good efficacy in the management of dentin hypersensitivity (DH). Propolis-based varnish had good resistance to material loss after subjection to acidic-abrasive challenge among the tested materials. The casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP)-based MI Varnish had good efficacy to obliterate the dentinal tubules among the tested materials. It was prudent to select the varnishes with good long-term efficacy to survive in the clinical scenario which still remains a challenging task for the clinicians. The stability of the varnish plays a vital role in maintenance of its long-term efficacy. The chemical nature along with the ability of the material to interact with the substrate plays a major role in management of DH.

Effect of casein-phosphopeptide amorphous calcium phosphate and fluoride with/without erbium, chromium-doped yttrium, scandium, gallium, and garnet laser irradiation on enamel microhardness of permanent teeth

Laser therapy, along with the use of fluoridated compounds is a novel technique suggested for caries prevention. Casein phosphopeptide amorphous calcium phosphate (CPP-ACP) is another product suggested for this purpose. This study compared the effect of CPP-ACP and fluoride with/without Erbium, chromium-doped yttrium, scandium, gallium, and garnet laser irradiation on enamel microhardness of permanent teeth. This in vitro experimental study evaluated 35 extracted third molars. The teeth were decoronated, and the crowns were split into buccal and lingual halves. The samples were randomly divided into seven groups (n = 10) of GC Tooth Mousse, MI Paste Plus, laser, fluoride varnish, laser + GC Tooth Mousse, laser + MI Paste Plus, and laser + fluoride varnish. The baseline microhardness was measured before the intervention. After the intervention, the samples were kept in artificial saliva for 1 h and were then immersed in the demineralizing solution for 3 h followed by 21 h of immersion in the remineralizing solution for a total period of 12 days. Finally, the teeth were kept in the remineralizing solution for 2 more days. The secondary microhardness of the teeth was then measured. Data were analyzed using the Shapiro-Wilk test, two-way ANOVA, and Tukey's Honestly Significant Difference test. The fluoride varnish (14.31%) and laser + fluoride varnish (18.79%) groups experienced minimum reduction in microhardness, while the GC Tooth Mousse group experienced maximum reduction in microhardness (91.64%) (P < 0.001). Laser irradiation before the application of remineralizing agents increased the microhardness only in laser + GC Tooth Mousse group (P < 0.001). Fluoride varnish increased the enamel microhardness, while GC Tooth Mousse had no such effect. Laser therapy before the application of remineralizing agents did not significantly enhance enamel resistance to demineralization.

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.

An In Vitro Analysis of the Antifungal Effect of Nystatin and Fluconazole Incorporated into Tissue Conditioner with and Without Using Varnish Containing Self-cured Resin and 1,1,1-Trichloroethane

Background: Incorporating antifungal drugs into liners has been proposed to treat denture stomatitis. Varnish application on tissue conditioners can decrease the porosities and irregularities, biofilm, and pathogens adhesion. In this study, we evaluated the effect of varnish application on releasing the antifungal drugs incorporated into tissue conditioners. Methods: Pure form of nystatin and fluconazole were mixed into tissue conditioner powder separately at 5% wt/wt concentration and prepared according to manufacturer’s instruction. Then, disk-shaped specimens (5 mm in diameter and 1 mm in thickness) were prepared at 30 nystatin and 30 fluconazole specimens. Varnish (containing 50 mL of 1,1,1-trichloroethane and 3 ml of self-cured resin) was applied on the surface of 15 disks of each drug and the other specimens were used as the control group (without varnish). Next, the disks were put in agar plates cultured with standard Candida albicans and incubated for 7 days. Mean inhibition diameter for each disk was measured with digital caliper at 24 hours, 3 days, and 7 days. Each step was performed in triplicate. Data was analyzed with one-way ANOVA and Friedman, Wilcoxon, and Mann-Whitney U tests. Results: The mean inhibition diameter (MID) at days 1, 3, and 7 in fluconazole without varnish group was 12.63, 3.90, and 3.67, respectively; in fluconazole with varnish was 3.00, 2.50, and 2.50, respectively; in nystatin without varnish was 5.78, 3.90, and 3.87, respectively; in nystatin with varnish group was 2.50, 0.00, and 0.00, respectively. fluconazole without varnish group exhibited significantly higher MID and nystatin with varnish group had lower MID. Conclusions: In this experimental study, fluconazole was more effective than nystatin. In groups without varnish, antifungal effect continued up to day 7. Using varnish in tissue conditioner can decrease antifungal effect.

Evaluation and Comparison of Self-applied Remineralizing Agents Using Confocal Microscopy: An In Vitro Study.

Aim and objectiveThe study was conducted to assess and compare the remineralization ability of fluoride varnish, casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF), bioactive glass-ceramic, and nanohydroxyapatite crystals using a confocal microscope.Materials and methodsEighty premolars and 80 deciduous central incisors were included in this study. Two windows of approximately 3 × 3 mm were created on the labial surface of the premolars and 2 × 2 mm on deciduous maxillary incisors. Artificial caries like lesions was created by demineralizing the sample windows. The teeth sections were then randomly assigned into four groups (n = 20). Specimens of the first group were once painted with fluoride varnish, while those in CPP-ACPF, bioactive glass-ceramic, and nanohydroxyapatite were brushed twice daily for 2 minutes each for 40 days, respectively. 150–200 μm longitudinal sections were obtained and were photographed under a confocal laser scanning microscope. They were quantified using a computerized imaging system for demineralization and later for remineralization. The recorded values were tabulated and analyzed using Fisher's test, analysis of variance (ANOVA), and post hoc Bonferroni's test.ResultsAll the materials used in the study showed remineralization potential at the end of 40 days in both permanent and deciduous teeth. The highest remineralization potential was observed in the fluoride varnish group followed by bioactive glass, CPP-ACFP, and nanohydroxyapatite in both permanent and deciduous teeth. In permanent teeth, the difference in the remineralization potential of fluoride varnish and bioactive glass was not statistically significant.ConclusionThe present study showed that self-applied bioactive glass has similar remineralization potential to fluoride varnish in permanent teeth. Therefore, bioactive glass can be used for the management of incipient caries lesions daily.How to cite this articleGoel T, Singhal A, Singh I, et al. Evaluation and Comparison of Self-applied Remineralizing Agents Using Confocal Microscopy: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(S-1):S34–S39.

Time-Dependent Anti-Demineralization Effect of Silver Diamine Fluoride.

This study compared the demineralization resistance of teeth treated with silver diamine fluoride (SDF) to that treated with fluoride varnish. A total of 105 healthy bovine incisors were divided into control, fluoride varnish, and SDF groups. The enamel surface density change was then measured by micro-computed tomography (micro-CT) at three depths. The demineralized zone volume was measured on 3D micro-CT images to evaluate the total demineralization rate. The enamel surface morphology was assessed by scanning electron microscope. The enamel density had continuously decreased while demineralization increased in the control and fluoride varnish groups. The enamel density had increased in the SDF group till the 7th day of demineralization treatment and decreased thereafter. However, the decrease in the SDF group was less severe than that in the other groups (p < 0.05). The demineralized enamel volume had increased through treatment and was the highest in the control group, followed by the fluoride varnish and SDF group. The enamel surface morphology was the roughest and most irregular in the control group, followed by the fluoride varnish group and SDF groups.

Antibacterial effect of amorphous calcium phosphate-casein phosphopeptide varnish against Streptococcus mutans: An exploratory in vivo randomized controlled trial

Background: Nowadays, amorphous calcium phosphate-casein phosphopeptide and tricalcium phosphate are being incorporated into fluoride varnishes to enhance remineralization potential which might interfere with antibacterial effect of fluoride in varnishes. Aim of study was to evaluate and compare the antimicrobial property of sodium fluoride varnish reinforced with amorphous calcium phosphate-casein phosphopeptide and tricalcium phosphate against streptococcus mutans.Methods: In the clinical setting, trial was conducted involving 18, 14-15 year old school children, randomly allocated into three interventional groups, Group A (5% Sodium fluoride varnish, Fluoritop-SR varnish), Group B (5% Sodium fluoride - Tricalcium phosphate varnish, Clinpro White varnish) and Group C (5% Sodium fluoride- amorphous calcium phosphate-casein phosphopeptide varnish, MI Varnish) to receive the varnish application. Saliva samples were collected at the end of one hour after varnish application for S Mutans count estimation. Student’s paired ‘t’ test and One way-ANOVA tests were used for statistical analyses.Results: Significant reductions in salivary streptococcus mutans count at one hour was achieved with application of B & C varnishes compared to varnish A. Conclusion: amorphous calcium phosphate-casein phosphopeptide and tricalcium phosphate varnish groups exhibited better antimicrobial property against streptococcus mutans compared to Sodium fluoride varnish at one-hour post intervention.

Subsurface enamel remineralization by Lyophilized Moringa leaf extract loaded varnish

ObjectiveThe objective of this study was to investigate enamel remineralization using lyophilized extract from Moringa Oleifera Leaves (MOL). Materials and methodsA total of seventy-five teeth were selected and randomly divided into 5 equal groups (n = 15). All teeth were air dried for 30 s, two windows (right and left) were drawn on the labial surface of each tooth. The right window was set as the control and no etching or treatment was performed. The left window was etched for 30 s for all five groups. After etching, group I received no treatment, group II received plain varnish, group III received fluoride varnish, and finally groups IV and V received plain varnish loaded with 50 mg/ml and 200 mg/ml of lyophilized MOL extract respectively. All samples were then immersed in artificial saliva for 14 days. The specimens were examined under scanning electron microscope (SEM) and energy dispersive x-ray (EDX). ResultsSEM micrographs revealed that MOL extract loaded-varnish groups IV & V showed the most re-establishment of normal enamel architecture. Elemental analysis of the treated surfaces of Groups IV and V showed the surfaces treated by MOL loaded-varnish groups had significantly higher Ca, P, and O deposition than the fluoride varnish group. ConclusionMOL might be considered as a biomimetic material capable of guiding enamel tissue remineralization.

Comparative Evaluation of the Effects of Fluoride Varnish, Propolis based Chitosan Varnish and Salvadorapersica Varnish on Streptococcus mutans and Lactobacilli count

ABSTRACT Objective of this study to evaluat the effects of fluoride varnish, propolis based chitosan varnish and salvadorapersica varnish on streptococcus mutans and lactobacilli count . Patients & Methods : The sample size wsa estimated to be 48 randomly selected Egyptian children were divided into 4 equal groups. Before application of varnish, oral prophylaxis was carried out for subjects.The teeth was then isolated. Approximately 0.1 mL of the designated varnish will be applied to all the teeth of subjects in all the three groups. Varnish was allowed to dry . The varnish was applied once every 3 days for all the three groups in the same manner as above. The follow-up plaque samples from all the three varnish groups was taken at the end of 48 h, at 1 m, at the end of 3 m and at the end of 6 m and assessed for bacterial counts . Result: There was a statistically significant difference in the count of streptococcus mutans and lactobacillus between all groups in which the highest bacterial count was found in Group D group followed by Group A and Group B, while the least bacterial count was found in Group C . Conclusions: All varnishes containing natural products had a significant antibacterial effect against S. mutans and lactobacillus bacteria compared to patient without varnish application .

Effect of fluoride varnishes on the surface hardness of bovine teeth under demineralization/remineralization cycling

We investigated whether fluoride varnishes recover the hardness of bovine teeth under 20 days of demineralization/remineralization cycling. The fluoride varnish groups (two commercial fluoride varnishes [V-varnish (Vericom, Korea) and CavityShield (3M ESPE, USA)] and an experimental fluoride varnish including 5 wt.% NaF were compared with a control group without fluoride varnish. Vickers hardness was measured at baseline, 3 days after immersion in caries-inducing solution, 24 hours after application of a fluoride varnish, and after 10 and 20 days of demineralization/remineralization cycling. Afterward, tooth surfaces were observed by scanning electron microscope. After fluoride varnish application and the cycling 10 and 20 days, the experimental varnish group showed the highest hardness, while the CavityShield and the control groups demonstrated the lowest hardness. The experimental varnish group recovered the hardness of the baseline at 24 hours after application of the varnish, while it was recovered after 20 days of the cycling in case of the V-varnish. However, the CavityShield and the control groups did not recover the hardness even after 20 days of the cycling. The experimental fluoride varnish with fast recovery in the hardness of the baseline can be used as an effective fluoride varnish to resist demineralization and to facilitate remineralization.

Cost-effectiveness of adding fluoride varnish to a preventive protocol for early childhood caries in rural children with no access to fluoridated drinking water

ObjectivesEvidence of the cost-effectiveness of fluoride varnish in the prevention of caries is not yet fully conclusive. The aim of this study was to assess the incremental cost-effectiveness ratio (ICER) of the community-wide application of fluoride varnish in the prevention of early childhood caries (ECC) in non-fluoridated areas. Materials and methodsA cost-effectiveness analysis was carried out based on a clinical decision tree from the payer’s perspective. The effectiveness and cost of the varnish were determined from a two-year follow-up triple-blind randomized control trial in 275 two- to three-year-old children. Costs and benefits were discounted at 3% per year. Only direct costs were evaluated, expressed in Chilean pesos (CLP) valued in July, 2019 (exchange rate USD = CLP686.06). A univariate deterministic sensitivity analysis was carried out. ResultsIncidence of ECC was 45 % for the varnish group and 55.6 % for the placebo group with a two-year follow-up. The weighted cost to intervene and treat the consequences of ECC was CLP 67,757 (USD98.76) for the fluoride varnish and CLP 67,739 (USD98.74) for the control group. The ICER was CLP 173 (USD0.25) for each extra healthy child in favor of fluoride varnish. The sensitivity analysis showed that the increase in caries was the variable which most influenced the ICER. ConclusionsThe protocol that included fluoride varnish is more effective and less costly in the prevention of ECC in non-fluoridated areas, compared with a placebo. Clinical significanceFindings support the application of fluoride varnish as a cost-effective community strategy to prevent ECC in non-fluoridated areas.

Comparison between Fissure Sealant and Fluoride Varnish on Caries Prevention for First Permanent Molars: a Systematic Review and Meta-analysis

The high prevalence and heavy socio-economic burden for caries of first permanent molars (FPMs) make the prevention of this disease a major public health goal. Current guidelines recommend a preference of fissure sealant (FS) over fluoride varnish (FV) based on two recent systematic reviews. However, evidences of these two studies are weak because of scarce data and some limitations. Besides, an up-to-date large scale randomized controlled trial (RCT) reported commensurate effectiveness of these two techniques. Thus, in order to more accurately compare the clinical efficacy between FS and FV on caries prevention for FPMs, we carried out this systematic review and meta-analysis. A total of 8 RCTs involving 3289 participants and 6878 FPMs fulfilled the inclusion criteria. Our meta-analysis for the first time showed that there was no statistical difference on caries incidence or occlusal DMFS increment between sealant group and fluoride varnish group at 2~3 years’ follow-up. In that sense, biannual applications of FV or FS may be equally effective on caries prevention for FPMs. These results do not support routine recommendation of FS over FV, thus shedding light on current conceptions. Our findings endow clinicians with a window to reconsider the choice between these two techniques.

Effect of fluoride varnish with functionalized tri-calcium phosphate on post-orthodontic white spot lesions: an investigator-blinded controlled trial.

To investigate the effect of a 5% sodium fluoride varnish with functionalized tri-calcium phosphate (fTCP) on post-orthodontic white spot lesions. A secondary aim was to study if the patients and their clinicians perceived clinical improvements. Fifty-nine patients with at least two visible WSLs on their maxillary incisors, canines, or first premolars present at the debonding of fixed appliances (baseline) were enrolled and assigned to a Varnish group (Clinpro White Varnish, 3M Espe) receiving topical applications at baseline and after 8 weeks, or a Control group treated with a fluoride-free mock product. The primary endpoint was white spot lesion appearance after 16 weeks, assessed from photographs using the modified ICDAS white spot lesion score (0 to 3). The patients and the dental examiners rated the white spot lesions subjectively with aid of a visual analog scale. Fifty-seven patients completed the study. After 16 weeks, 62% of the white spot lesions in the Varnish group were completely reversed (score 0) compared to 39% in the Control group. The treatment effect was statistically significant (OR 0.22; 95% CI 0.08 to 0.59, P = .003) after adjusting for baseline oral hygiene index and type of tooth. A significant correlation (P < .05) was observed between patients' and orthodontists' perception of the lesions. The 5% sodium fluoride varnish with fTCP appeared clinically effective in reversing post-orthodontic white spot lesions 16 weeks after debonding. The patients and the clinicians agreed on the obtained esthetic improvements.

Economic evaluation of fluoride varnish application of daily supervision versus daily supervision and additional six-monthly intervals in Scotland (Protecting Teeth @ 3): a randomised controlled trial

BackgroundEconomic evaluations of public health interventions aid decision makers in efficient resource allocation. Our aim was to do an economic evaluation of a subintake of the Protecting Teeth @ 3 Study (PT@3), a Scottish, 2 year, parallel group, randomised controlled trial, which explored the additional preventive value of fluoride varnish application at six-monthly intervals in nursery settings over and above daily supervised toothbrushing in nursery settings (treatment as usual). MethodsFrom Nov 21, 2012 to Aug 31, 2017, eligible children were randomly assigned to receive either fluoride varnish plus treatment as usual (fluoride varnish group) or treatment as usual in a 1:1 ratio. The economic evaluation was a within-trial, cost-utility analysis comparing the fluoride varnish group with the treatment as usual group. Cost-utility analysis was done from a National Health Service perspective. Within-trial costs included intervention and health-care resource use costs. Health outcomes were expressed in quality-adjusted life-years (QALYs) accrued over the 2 year period. The Child Health Utility 9 Dimensions questionnaire was used to obtain utility scores. Staff travel and labour costs were collected using a staff costs form. Information on other costs was requested from the trial coordinators. National reference costs were used, a discount rate of 1·5% for public health investments was adopted, multiple imputation methods for missing data were employed, sensitivity analyses done, and incremental cost-effectiveness ratios calculated. Ethical approval was from the West of Scotland Research Ethics Service. This trial is registered with EudraCT, 2012-002287-26. FindingsThe data for 534 participants from the 2014–15 intake were used in the analyses. Of these, 265 were assigned to fluoride varnish and assigned to 269 treatment as usual. The mean difference in costs between the fluoride varnish and treatment as usual group was GBP£36·64 (95% CI –48·51 to 111·47; p=0·64). The mean difference in QALYs was –0·0044 (95% CI –0·0168 to 0·0065; p=0·64). The fluoride varnish intervention had higher costs and resulted in less QALYs than that of the treatment as usual. The probability that the fluoride varnish intervention was cost-effective at the £30 000 threshold was 18·5%. InterpretationOur results indicate that there was no substantial difference in costs and QALYs between the two groups. Applying fluoride varnish in nursery settings in addition to daily supervised nursery toothbrushing seems not to be good value for money. We recommended that the funds could be used better on other more cost-effective oral health interventions. FundingPT@3 was funded by the Scottish Government.

Enamel protection after stripping procedures: An in vivo study

Interproximal enamel reduction (IPR) is a clinical procedure that has been in use since the advent of non-extraction orthodontic techniques. However, such a procedure affects the surface condition of the enamel and may predispose patients to cavities and hypersensitivity. The use of a remineralizing agent is recommended to prevent these side effects. The objective of our study was to evaluate the evolution of stripped proximal dental surfaces after exposure to the oral environment for 4 months with and without fluoride protection. Our sample consisted of 14 premolars (PM) from 6 patients of the Dentofacial Orthopaedics Department of the Consultation and Dental Treatment Centre of Rabat (CDTC) who required orthodontic treatment with PM extraction and had given their informed consent. The teeth were divided into 5 groups: group 1: intact enamel; group 2: intact enamel+fluoride varnish+4-month oral exposure; group 3: IPR (manual and mechanized)+extraction; group 4: IPR (manual and mechanized) without varnish+4-month oral exposure; group 5: IPR (manual and mechanized)+fluoride varnish+4-month oral exposure. Proximal surfaces were subjected to qualitative analysis by scanning electron microscopy and quantitative analysis by Dispersive Energy Spectroscopy (DES) to quantify the percentage of mineral elements. Exposure of stripped dental surfaces to the oral environment for 4 months with or without fluoride protection showed the persistence of surface irregularities caused by stripping. We noted an improvement in the percentage of mineral elements for both groups with and without fluoride protection. However, the percentages of calcium (Ca) and phosphorus (P) were close to that of intact enamel in the fluoride varnish group. Protecting stripped surfaces with fluoride varnish could help preserve the integrity of the enamel surface by restoring some of the mineral elements lost during stripping.

Clinical efficacy of diode laser alone and in combination with desensitizing varnish in dentinal hypersensitivity treatment (Randomized Controlled Trial)

This study aimed to evaluate the efficacy of diode laser alone and with topical sodium fluoride varnish on reducing dentine hypersensitivity (DH) in patients with chronic periodontitis. Materials and Methods: Forty patients having stage I and Stage II periodontitis were selected according to the criteria of AAP (2017) with complaint of (DH) after routine periodontal therapy . Patients were randomly divided into two groups: group1- received NaF varnish then diode laser application at 1 W (PW) ,(CW) for 30 seconds using 320µ fiber. Group-2, treated with laser irradiation only. Each tooth received three application Dentine hypersensitivity evaluation was by tactile, air-blast, and thermal stimuli and measured using VAS scores. The patient’s response was recorded at baseline, one month and 3 month after the applicationResults : The results were statistically analyzed, significant pain reduction was showed in both groups. However , it was found that in the laser plus varnish group, tangible reduction in dentine hypersensitivity scores more than in laser alone group on the three tested stimuli at one and three months. VAS score differences between the groups were statistically significant Conclusion : It was concluded that diode laser plus NaF varnish is more effective than laser alone in reduction of patients’ dentine hypersensitivity among chronic periodontitis patients.

The effect of chlorhexidine-thymol and fluoride varnishes on the levels of Streptococcus mutans in saliva in children aged 6-8 years.

Streptococcus mutans is considered as the main pathogenic factor for initiation and progression of dental caries. Fluoride is one of the most effective agents used to control caries. Chlorhexidine (CHX) is the most antimicrobial agent against S. mutans and dental caries. The study aimed to compare the effectiveness of antimicrobial activity of CHX-thymol (CHX/T) and fluoride varnishes on S. mutans levels in children's saliva aged from 6 to 8 years old. The total number of children involved in this study is sixty, ages 6 and 8 years old. The participants were divided into three groups by block randomization: Group 1 CHX/T varnish, Group 2 fluoride varnish (f varnish, and Group 3 control group. Varnish was applied onto all tooth surfaces of the participants. At the baseline conditions, saliva samples were collected from the participants for bacterial examination test. This procedure was repeated in week 1, 4, and 12. Bacterial quantitative test was performed, and the number of S. mutans was estimated. The results revealed the significant efficacy of the two groups (fluoride and CHX/T varnishes) in reducing salivary S. mutans numbers when compared to the control group (P < 0.05). In terms of salivary colony-forming unit counts reduction of S. mutans, no significant difference was observed between the fluoride and CHX/T varnish groups (P > 0.05). The outcomes showed that there was a significant reduction in S. mutans counts in children's saliva following the application of fluoride and CHX/T varnishes.

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.

Comparing the effects of three different fluoride-releasing agents on white spot lesion prevention in patients treated with full coverage rapid maxillary expanders.

The aim of this study was to assess the effects of three different fluoride-releasing agents on preventing white spot lesions that occur during treatment with full coverage rapid maxillary expanders. A total of 48 patients with transverse maxillary deficiency were randomly assigned to four equal groups. A fluoride-containing agent was applied to teeth before cementation of the full coverage acrylic-bonded rapid maxillary expanders in the three experimental groups (gel, varnish, and sealent in groups 1, 2, and 3, respectively), while the control group received no agent application. Quantitative light-induced fluorescence (QLF) images of the patients were obtained before cementation and after decementation of the appliances. Four parameters (ΔF, ΔFmax, A, and ΔR) were evaluated on maxillary ten anterior teeth. In the fluoride gel group, upper central and lateral incisors, right first and left second premolars showed significant decreases in fluorescence levels indicating demineralization. Right central and left lateral incisors showed significant white spot lesion formation in the fluoride varnish group. Right and left central incisors and left first premolar were the teeth that mineral loss was observed in the sealent group, while all of the teeth except canines and first premolars showed significant demineralization in the control group. Multifluorid varnish and Proseal sealant were effective on preventing demineralization and should be applied to teeth clinically before appliance cementation. Demineralization is a major problem during orthodontic treatment. The application of effective fluoride-releasing agents could prevent this major iatrogenic complication.