Effects of the Dental Caries Preventive Procedure on the White Spot Lesions during Orthodontic Treatment-An Open Label Randomized Controlled Trial

Abstract

(1) Background: The aim of this study was to assess the preventive effect of tooth surface disinfection treatment, in addition to fluoride application, during fixed orthodontic treatment. (2) Methods: An open label randomized control trial for the evaluation of the dental caries preventive procedure was performed for the patients with high caries risk who had been visited at Department of Orthodontics, Tsurumi University Dental Hospital for orthodontics treatment. The follow-up period was six months. White spot lesions (WSLs) were evaluated by quantitative light-induced fluorescence (QLF). Cariogenic bacteria were monitored and evaluated by bacterial culture. In addition, the oral microbiome was evaluated by a next-generation sequence (NGS). (3) Results: By the mixed effect modeling, tooth surface disinfection treatment significantly reduced cariogenic bacteria and all parameters obtained by QLF. (4) Conclusions: Tooth surface disinfection treatment, in addition to PMTC and fluoride application, were effective for dental caries prevention and keeping a healthy microbiome during orthodontic treatment.

Keywords: fixed orthodontic treatment; mixed effect model; oral microbiome; quantitative light-induced fluorescence; tooth surface disinfection.

Figure 1

Changes of salivary levels of proportion of mutans streptococci in total streptococci during study periods. p-values were calculated by mixed effect model. Changes of cariogenic bacteria were all statistically significant. The results of mixed effect models were shown in Table S2. Time-points: TS, screening; T0, at the start of study (baseline); T1: after 1 month; T2: after 2 months; T3: after 3 months; T4: after 4 months; T5: after 5 months; T6: after 6 months.

Figure 2

Changes of ΔQ value evaluated by QLF. (A) Heatmap by segmentation of nine areas in each tooth. (B) Histogram of white spot parameters.

Figure 3

Oral microbiome structure before and after treatment. Data are presented separately phylum, and genus level. (A) Tooth surface disinfection group at phylum level. (B) Fluoride application group at phylum level. (C) Tooth surface disinfection group at genius level. (D) Fluoride application group at genus level.

Figure 4

Correlation heatmap of ΔQ value and species. The order of tooth surface in legend is maxillary to mandibular, right to left, distal to mesial. Detailed correlations are shown in the Table S8. Sky blue area indicate positive correlations. Some of the sky-blue area contains site specific species: Aggregatibacter, Alloprevotella, Anaerococcus, Bifidobacterium, Porphyromonas, Prevotella, Treponemma, Vagococcus, Veillonella, and Streptococci. (A–E): Cluster of highly positive correlation between WSLs and species.