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Randomized Controlled Trial
. 2024 May 11;28(6):308.
doi: 10.1007/s00784-024-05695-2.

Resin infiltration versus fluoride varnish for visual improvement of white spot lesions during multibracket treatment. A randomized-controlled clinical trial

Yamen Kashash  1 , Sascha Hein  2 , Gerd Göstemeyer  3 , Pervin Aslanalp  1 , Manon Isabelle Weyland  4 , Theodosia Bartzela  5
Affiliations
Randomized Controlled Trial

Resin infiltration versus fluoride varnish for visual improvement of white spot lesions during multibracket treatment. A randomized-controlled clinical trial

Yamen Kashash et al. Clin Oral Investig. .

Abstract

Aims: This study aimed to evaluate the visual improvement of resin infiltration of white spot lesions (WSL) during orthodontic treatment with the multibracket appliance (MBA) compared to fluoride varnish.

Methods: Patients aged 12-17 years with at least one WSL with an International Caries Detection and Assessment System (ICDAS) score of 1-2 during an active MBA treatment were included and randomized to receive either resin infiltration (Icon) or fluoride application (Flairesse). Standardized digital images were obtained before, one-day, one-week, one-month, three-months and six-months after treatment using a DSLR camera and a matching polarization filter. A grey reference card was used for color standardization. A Matlab routine was used to measure the color difference between adjacent healthy enamel and treated WSL. The independent-samples t-test was used for intergroup and paired-samples t-test for intragroup comparison.

Results: Images of 116 teeth from 36 patients were analyzed. The ΔE for the "Icon" treated WSL was smaller (T1ICON = 5.0 ± 1.4) than in the fluoride group (T1Fluoride = 8.4 ± 3.2). Caries infiltration significantly improved the aesthetic appearance of WSL (p < 0.001), which remained satisfactory at six months (T5ICON = 5.2 ± 1.6).

Conclusion: WSL infiltration management during orthodontic treatment was superior to topical fluoridation in not only arresting the enamel lesions but also significantly improving the aesthetic appearance of demineralized regions around the brackets.

Clinical relevance: WSL treatment in orthodontic patients is usually initiated after debonding. Research has shown that the earlier WSL is treated, the better the aesthetic outcome. There is limited data on the efficacy of resin infiltration of WSL during orthodontic treatment.

Keywords: Demineralization; Fluoride; Multibracket appliance; Orthodontics; Resin infiltration; White spot lesions.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Images of the two black and white masks; M1 and M2, representing affected and sound enamel, respectively. Gr. 1: Icon-group, Gr. 2: Fluoride-group, T0: baseline
Fig. 2
Fig. 2
Images of two subjects. Gr. 1: Icon-group, Gr. 2: Fluoride-group, T0: baseline, T1: 1st day of observation, T5: 6 months later
Fig. 3
Fig. 3
Flowchart of the participant. N number of subjects, n number of teeth, T1 1st day of observation, T2 1 week later, T3 1 month later, T4 3 months later
Fig. 4
Fig. 4
Summarized ∆E of white spot lesion (WSL) and sound adjacent enamel (SAE) before treatment (T0) and after six months (T5). In contrast to the resin infiltration group, no significant changes were observed in the fluoride varnish group
See this image and copyright information in PMC

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