Caries limited to enamel
Conditions
Interventions
This study investigated the effectiveness of fluoride varnishes in preventing and remineralizing white spot lesions (WSLs) and their impact on the oral microbiome in orthodontic patients. To compare t
Sponsors
Faculdade de Odontologia de Bauru - Universidade de São Paulo
Faculdade de Odontologia de Bauru - Universidade de São Paulo
Eligibility
Age
11 Years to 18 Years
Inclusion criteria
Inclusion criteria: Age between 11-18 years; both sexes; complete permanent dentition; having at least one active white spot lesion on the smooth surfaces of the permanent dentition (Nyvad index score 1); being under orthodontic treatment with a fixed appliance initiated between 6-18 months
Exclusion criteria
Exclusion criteria: Patients with cavitated caries lesions; who have undergone topical fluoride application in the past 6 months
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Expected outcome 1: After professional prophylaxis, the analysis of the vestibular surfaces and around the brackets will be made using the Nyvad index, which will be the primary outcome, clinical evolution or not of the white spot lesion. In this index we will define the activity of the white spot lesion, being considered active (lesion progression) when the active white spot lesion - initial non-cavitated (score 1) turns into cavitated enamel (score 3) or when a healthy surface (score 0) turns into an active white spot lesion - not cavitated (score 1) or cavitated (score 3). The regression will be considered when the active white spot lesion - initial cavitation (score 1) turns into inactive caries lesion - non-cavitated (score 2) or healthy surface (score 0). The appearance of new lesions will be considered when a healthy tooth becomes an active white spot lesion (score 1). In summary, the participants will be considered caries-inactive, when they have no cavities and no active cavities lesion. Volunteers who present cavities or cavities with active caries will be considered caries-active;Expected outcome 2: In addition, the ICDAS index (International Caries Detection and Assessment System) will be applied in T0, T1 (6 months), T2 (12 months), T3 (18 months) and T4 (24 months). ICDAS is an international caries detection and evaluation system that classifies the stages of the caries process. In this ICDAS index, we will define the progression or regression of the white spot lesion. The progression of the white spot lesion will be considered when the visible white spot lesion after drying (score 1) turns into visible white spot lesion in moisture (score 2) or localized cavitation (score 3). Or the progression will be when score 2 turns to 3. Regression will be considered when the visible white spot lesion in moisture (score 2) turns into score 1 or when score 1 turns into score 0. The appearance of new injuries will be considered when a healthy tooth becomes a white | — |
Secondary
| Measure | Time frame |
|---|---|
| Expected outocome 3: Two parameters will be measured by examining the surfaces by QLF (equipment applied to measure changes in enamel fluorescence of white spot lesions and to quantify the reversion or progression of lesions), lesion area (mm2) and change in fluorescence (delta F,%). For the storage and analysis of images, the QLF 2.00f software (Inspektor Research System BV) will be used. Thus, the lesion area (mm2), the loss of fluorescence in% (the detection threshold is 5%) and the loss of integrated fluorescence (delta Q, mm2 *%) will be determined. The procedures will be repeated, using plugs in the same position as the initial lesions and the new white spot lesions, at the end of 6, 12, 18 and 24 months. The total evaluation will be carried out by subtracting the images and quantification will be done later by another examiner who is blind to the treatment group. The reproducibility of QLF image analysis will be accessed by calculating intra-examiner reliability (10% repetition of analyzes);Outcome found 3: Increase or decrease in the lesion area (mm2) of pre-existing lesions during the study. In group G1, the white spot lesions maintained a consistent size throughout the observation period. In contrast, in the fluoride varnish groups, a reduction in lesion size was observed after 6 months. In group G2, this reduction was maintained until the end of the follow-up, while in group G3, a new reduction was observed after 12 months that was maintained until T3. Over time, we could observe a statistically significant difference between the groups only after 12 and 18 months, in which group G3 presented a smaller white spot lesion area than groups G1 and G2 (p 5.0% in the biofilm samples. These include Prevotella, Corynebacterium, Veillonella, Fusobacterium, Leptotrichia, Capnocytophaga, and Streptococcus. In G2, this percentage increases to 66%, with predominant genera (>5.0%) such as Veillonella, Neisseria, Streptococcus, Prevotella, Corynebacterium, Haemophilus, | — |
Countries
Brazil
Contacts
Public ContactSamanta Moraes
Faculdade de Odontologia de Bauru - Universidade de São Paulo
Outcome results
None listed