Prevention of Demineralization During Fixed Orthodontics: Randomized Controlled Clinical Trial

Abstract

Objectives: This randomized controlled clinical trial investigated the efficacy of two different fluoride varnishes in the prevention of enamel white spot lesions (EWSLs) during fixed orthodontics. Methods: Ninety-nine patients (63 females and 36 males) about to undergo fixed orthodontic treatment were randomly allocated (block randomized) to one of the three groups: Group A: application of 5% NaF varnish (Duraphat®, Colgate-Palmolive (UK) Ltd., Guildford, Surrey, UK) every 3 months; Group B: application of 5% NaF varnish containing tri-calcium phosphate (Clinpro white varnishTM, 3M ESPE, St Paul, MN, USA) every 3 months; and Group C: control group with no varnish (usual care). Standardized oral hygiene instructions, toothbrushes & fluoridated toothpastes were provided. The presence of EWSLs and laser fluorescence values (DIAGNOdent Pen 2190, KaVo, Biberachan der Riss, Germany) were recorded on maxillary anterior six teeth at baseline, just after bracket bonding and 6-month follow-up. Statistical significance was checked within groups (at tooth level and patient level) using repeated measures ANOVA and among three groups (at tooth level and patient level) using ANOVA at p<0.05. General linear model was used to study the within-group changes in the mean DIAGNOdent values at p<0.05. Results: There was no loss to follow-up. The mean age of the study participants was 19.14 years (SD=±5.95 years). The profile of the groups was similar at baseline in terms of the prevalence of oral hygiene scores and Diagnodent readings (P=0.329). All three groups showed statistically significant changes in mean DIAGNOdent scores within groups (P<0.05). No statistically significant difference (p=0.790) in mean DIAGNOdent scores was observed among the three groups at follow-up. General linear model using repeated measures ANOVA also did not show any significant changes in mean DIAGNOdent scores over the follow-up periods (Figure). Conclusions: A clear benefit of any of the varnishes used during orthodontic treatment, in terms of the magnitude of DIAGNOdent readings, could not be identified in the present study.