Abstract
Objectives
To assess the remineralization capacity of carious, non-carious, and combined white spot lesions (WSLs) using the ICDAS and SS-OCT.
Materials and methods
This clinical trial was based on a quasi-experimental design. Forty-two healthy subjects (median age 26.6 years), who visited university hospital and had at least one WSL with an ICDAS score of 2 or 1, were recruited. The subjects chewed a non-blind sugar-free gum containing bioavailable calcium and fluoride for 3 months. The remineralization capacities of carious and non-carious 121 WSLs were assessed using ICDAS by two calibrated non-blind examiners and optical boundary depth (BD) by SS-OCT at a monthly recall. The outcome variables, transitions of ICDAS score, mean BD, and mean BD recovery rate (RR%), were statistically analyzed using the chi-square test, two way-repeated measures ANOVA, and Wilcoxon rank sum test, respectively (alpha = 0.05).
Results
Based on the visual inspection, OCT images at the baseline, 72 WSLs were purely carious, 20 were non-carious (developmental) lesions, while 29 were combined (carious-developmental). The responses of WSLs over time showed to be highly variable. There was a significant difference in transitions of ICDAS scores after 3 months between carious and non-carious WSLs (p < 0.05) and non-carious and combined WSLs (p < 0.05). Carious and combined WSLs underwent significant changes in the mean BD between baseline (161.8 ± 56.8 μm) and 2 months (130.7 ± 57.4 μm) or 3 months (119.1 ± 57.5 μm) (p < 0.05), while there was no significant difference between baseline (132.2 ± 26.2 μm) and 2 months (122.8 ± 24.1 μm) or 3 months (119.8 ± 22.6 μm) in non-carious WSLs (p > 0.05). There was a significant difference in mean RR% after 2 and 3 months between carious and non-carious WSLs (p < 0.05).
Conclusions
The remineralization capacity of WSL was variable among the cases and subjects, and depended on the WSLs history, etiology (carious, non-carious, or combined lesion) and structure (histological pattern).
Clinical relevance
Carious WSLs showed the highest remineralization potential.
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Acknowledgements
The authors would like to thank all individual participants who took part in this study.
Funding
This study was funded by a Grant-in Aid for Scientific Research (grant number 16K11541) from the Japan Society for the Promotion of Science (JSPS).
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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.
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Informed consent was obtained from all individual participants included in the study.
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Kitasako, Y., Sadr, A., Shimada, Y. et al. Remineralization capacity of carious and non-carious white spot lesions: clinical evaluation using ICDAS and SS-OCT. Clin Oral Invest 23, 863–872 (2019). https://doi.org/10.1007/s00784-018-2503-1
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DOI: https://doi.org/10.1007/s00784-018-2503-1