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Efficacy of fluoride varnish for preventing white spot lesions and gingivitis during orthodontic treatment with fixed appliances—a prospective randomized controlled trial

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Abstract

Objectives

The development of white spot lesions around orthodontic brackets and gingivitis is a common problem during orthodontic treatment with fixed appliances. This prospective randomized double-blind controlled clinical trial investigated the preventive efficacy of a one-time application of two commonly used fluoride varnishes in patients with low to moderate caries risk.

Materials and methods

Ninety adolescent orthodontic patients with a low to moderate caries risk were prospectively randomized to three groups of 30 patients each: (1) standardized dental hygiene with fluoride toothpaste and one-time application of placebo varnish (control) or (2) of elmex® fluid or (3) of Fluor Protector S on all dental surfaces at the start of fixed therapy. The extent of enamel demineralization and gingivitis was determined with the ICDAS and the gingivitis index (GI) at baseline and after 4, 12, and 20 weeks.

Results

Each treatment group showed a significant increase of the ICDAS index, but not of the GI over the course of time with no significant intergroup differences detectable.

Conclusions

A one-time application of fluoride varnish at the start of orthodontic treatment did not provide any additional preventive advantage over sufficient dental hygiene with fluoride toothpaste with regard to formation of white spots and gingivitis in patients with a low to moderate caries risk.

Clinical relevance

In dental practice, patients often receive an application of fluoride varnish at the start of orthodontic treatment with fixed appliances. However, the efficacy of this procedure is still unclear.

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Authors and Affiliations

  1. Department of Orthodontics, University Medical Centre of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany

    Christian Kirschneck, Jan-Joachim Christl, Claudia Reicheneder & Peter Proff

Authors
  1. Christian Kirschneck
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  2. Jan-Joachim Christl
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  3. Claudia Reicheneder
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  4. Peter Proff
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Corresponding author

Correspondence to Christian Kirschneck.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals.

Conflict of interest

The authors report no financial or other conflict of interest relevant to this article, which is the intellectual property of the authors. Furthermore, no part of this article has been published before or is considered for publication elsewhere. It has been approved by all authors and the affiliated institution.

Funding

No funding was received for this study.

Informed consent

Informed consent was obtained from all individual participants included in the study and in addition - if under age - from their legal guardians.

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Kirschneck, C., Christl, JJ., Reicheneder, C. et al. Efficacy of fluoride varnish for preventing white spot lesions and gingivitis during orthodontic treatment with fixed appliances—a prospective randomized controlled trial. Clin Oral Invest 20, 2371–2378 (2016). https://doi.org/10.1007/s00784-016-1730-6

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  • DOI: https://doi.org/10.1007/s00784-016-1730-6

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