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. 2023 Oct;27(10):5957-5968.
doi: 10.1007/s00784-023-05209-6. Epub 2023 Aug 21.

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

Qiqiu Wang  1   2 , Yang Zhou  1   2 , Tianqiang Cui  3 , Jianbo Li  4 , E C M Lo  5 , Gaofeng Hao  6 , Qinghui Zhi  7   8
Affiliations

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

Qiqiu Wang et al. Clin Oral Investig. 2023 Oct.

Abstract

Objectives: 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).

Materials and methods: 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 6 months, respectively. A toothpaste containing 1400 ppm 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.

Results: 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).

Conclusions: 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 12 months, resin infiltration group showed much better results than other groups.

Trial registration: Clinical Trials Registration Number: ChiCTR2000032516.

Clinical significance: 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.

Keywords: Casein phosphopeptide-amorphous calcium phosphate; Fluoride toothpaste; Fluoride varnish; Remineralization; Resin infiltration; White spot lesions.

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