Sodium Fluoride Varnish in Management of Dentin Hypersensitivity Associated with Gingival Recession

ABSTRACT@#Using laser for treatment of dentin hypersensitivity (DH) have recently shown promising results and better immediate reduction in pain scores. However, its efficacy and mechanism of action is controversial. Thus, this study aimed to evaluate the effectiveness of diode laser compared with sodium fluoride varnish in treating DH in patients with gingival recession. Eighteen patients with Miller’s class I and class II gingival recession and hypersensitivity in at least two non-adjacent teeth were included in the study. Test surfaces (n = 25) were treated with diode laser, whilst control surfaces (n = 23) were treated with 5% sodium fluoride varnish. Visual Analogue Scale (VAS) scores were recorded for air and tactile stimulus for both groups at baseline, 15 min, 1 month and 3 months post-treatment. Results showed significant (p < 0.05) reduction in VAS scores at 15 min, 1 month and 3 months compared with baseline in both test and control surfaces, with no significant intergroup differences. However, the percentage reduction in DH was more in laser at all evaluation periods. The use of diode laser and sodium fluoride varnish showed good immediate and prolonged results. Further studies are needed to come up with more effective treatment methods.

Comparative evaluation of antimicrobial efficacy of silver diamine fluoride, chlorhexidine varnish with conventional fluoride varnish as a caries arresting agent. An in vivo sodium dodecyl sulfate-polyacrylamide gel electrophoresis study

Introduction: Silver diamine fluoride (SDF) is employed as an adjunct cariostatic agent in the management of dental caries in high-risk population. Other than fluorides, chlorhexidine (CHX) is the most potent antimicrobial and efficacious agent against Streptococcus mutans. Aim: The aim of this study is to evaluate and differentiate the efficacy of 38% silver diamine fluoride, CHX varnish, and fluoride varnish on carious primary teeth. Materials and Methods: Ninety children having a count of ?1 carious lesion were recruited. Thirty-eighty percent silver diamine fluoride or fluoride varnish and CHX varnish were topically applied on the lesion. The primary outcome measured was the arrest of carious lesion (lesion rendered inactive as per the Nyvad criteria) after a follow-up of 14–21 days. Dental biofilm sample was obtained from each child and subsequently assessed for microbial composition by colony-forming unit method before and after treatment followed by protein analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis method. Results: Average proportion of arrested caries lesions in the SDF group was higher followed by CHX and fluoride varnish groups. Decreased total protein amount was found in SDF group. This proves that there is decrease in microbial load posttreatment in SDF group. Conclusion: Thirty-eight percent SDF is more effective than CHX varnish and fluoride varnish in arresting dentin carious lesions in young children.

Infiltración de resina y barniz de flúor para el tratamiento de caries interproximales no cavitadas en dentición temporal / Resin infiltration plus fluoride varnish for non-cavitated proximal caries in primary dentition

RESUMEN: Introducción: Con el fin de prevenir la progresión de la caries interproximal no cavitada en dientes temporales, se ha generalizado el uso de estrategias mínimamente invasivas como la aplicación de sellantes, barniz de flúor o la resina infiltrante, ya sea combinadas o como monoterapia. Pese a lo anterior, hay incertidumbre con relación al efecto de la infiltración de resina en combinación con el barniz de flúor en dientes temporales. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metaanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Se identificaron nueve revisiones sistemáticas que en conjunto incluyeron tres estudios primarios que corresponden a ensayos clínicos aleatorizados. Se concluye que la infiltración de resina probablemente reduce el riesgo de la progresión de la caries interproximal no cavitada en dientes temporales. No se encontraron estudios que evaluaran los eventos adversos. Palabras claves: caries, infiltración de resina, caries interproximal, barniz de flúor, tratamiento mínimamente invasivo, Epistemonikos, GRADE.

ABSTRACT: Introduction: Minimally invasive techniques are widely used in non-cavitated interproximal caries treatment in primary dentition. Sealants, fluoride varnish, or resin infiltration can be applied in conjunction or as monotherapy. There is uncertainty regarding the effect of resin infiltration in conjunction with fluoride varnish in primary dentition. Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. Results and conclusions: We identified 9 systematic reviews including three studies overall, of which all were randomized trials. We conclude that resin infiltration plus fluoride varnish probably decreases the risk of progression of non-cavitated interproximal caries in primary dentition. No studies were found that looked at adverse effects.

Effect of fluoride varnish on primary teeth in children aged 3-6 years in Huangpu District of Shanghai / 上海预防医学

Objective To evaluate the implementation process, and cost-effectiveness of fluoride varnish in preventing primary caries project for children aged 3-6 years in Huangpu District.This would provide the basis for the popularization of fluoride varnish project in preschool children as a basic measure of caries prevention in community health service. Methods From 2016 to 2017, children aged 3-6 years old from 12 kindergartens in Huangpu District were varnished by fluoride twice a year.Three-years-old children in 12 kindergartens were divided into intervention group and control group according to the baseline survey results.The intervention group was implemented according to the established norms, while the control group was implemented according to the routine requirements.Follow-up examinations were conducted after 4 interventions to monitor primary caries increment among these children. Results Caries rate, average caries index and SiC in children aged 3, 4, 5 and 6 years were all dropped after fluorination in year of 2018.The caries rate of 5-year-old deciduous teeth decreased from 58.8% in 2015 to 45.0% in 2018.The dental caries rate in the intervention group was lower than that in the control group, and the frequency of fluoride application per capita was higher than that in the control group, showing a statistically significant difference (P < 0.05), but there was no significant difference in the rate of fluoride application and average caries index between the two groups (P > 0.05).The direct input-output ratio of the project is 1 : 5.16. Conclusion Fluorinated caries prevention project using fluoride varnish for preschool children can effectively reduce the incidence of dental caries in deciduous teeth and has good economic benefits.The application of standard fluorine coating on preschool children′s deciduous teeth can affect caries prevention.

The effect of chlorhexidine-thymol and fluoride varnishes on the levels of Streptococcus mutans in saliva in children aged 6–8 years

Background: Streptococcus mutans is considered as the main pathogenic factor for initiation and progression of dental caries. Fluoride is one of the most effective agents used to control caries. Chlorhexidine (CHX) is the most antimicrobial agent against S. mutans and dental caries. Aims: The study aimed to compare the effectiveness of antimicrobial activity of CHX-thymol (CHX/T) and fluoride varnishes on S. mutans levels in children's saliva aged from 6 to 8 years old. Materials and Methods: The total number of children involved in this study is sixty, ages 6 and 8 years old. The participants were divided into three groups by block randomization: Group 1 CHX/T varnish, Group 2 fluoride varnish (f varnish, and Group 3 control group. Varnish was applied onto all tooth surfaces of the participants. At the baseline conditions, saliva samples were collected from the participants for bacterial examination test. This procedure was repeated in week 1, 4, and 12. Bacterial quantitative test was performed, and the number of S. mutans was estimated. Results: The results revealed the significant efficacy of the two groups (fluoride and CHX/T varnishes) in reducing salivary S. mutans numbers when compared to the control group (P < 0.05). In terms of salivary colony-forming unit counts reduction of S. mutans, no significant difference was observed between the fluoride and CHX/T varnish groups (P > 0.05). Conclusion: The outcomes showed that there was a significant reduction in S. mutans counts in children's saliva following the application of fluoride and CHX/T varnishes.

In vitro fluoride release from five different fluoride varnishes / 대한구강보건학회지

OBJECTIVES: This study aims to compare the fluoride-release between different fluorine varnish under in vitro experimental conditions.METHODS: In this study, 5 fluoride varnish products distributed in Korea were selected. V-varnish™ (Vericom, Korea: VV), CavityShield™ (3M ESPE, USA: CS), Clinpro™ White varnish™ (3M ESPE, USA: CP), MI Varnish™ (GC, Japan: MI), and Fluor Protector (Ivoclar Vivadent, Liechtenstein: FP). For the in vitro study, 10 mg of each fluoride varnish was thinly applied to the same area of the specimen. The specimen was then immersed in 3 ml of distilled water at consistent intervals to confirm fluoride release. Nine specimens per group were used. Fluoride ion electrodes were used to measure the fluoride concentration of the solution. The Kruskal-Wallis nonparametric test was performed to compare between each experimental group, and the Wilcoxon signed-rank nonparametric test was performed to compare experimental groups over time. The significance level for a Type I error was set at 0.05. All statistical analyses were performed using SPSS 25.0 (IBM Co., Armonk, NY, USA).RESULTS: In vitro experiments showed that the amount of fluoride released from MI was higher than the other groups during the first 12 hours after application. However, the amount of fluoride released from CP and CS was higher than MI as the immersion time increased over 12 and 20 hours, respectively. The fluoride release from FP was the lowest at all measurement points.CONCLUSIONS: The results of this study showed that the remaining fluoride effect from rosin type fluoride varnishes was higher than liquid type fluoride varnishes. There were differences in the residual fluoride concentrations despite each fluoride varnish having the same fluoride content.

Minimum inhibitory concentration and minimum bactericidal concentration of antibacterial fluoride varnish / 대한치과재료학회지

The aim of this study was to investigate the antibacterial effect of fluoride varnish with antibacterial agents on Streptococcus mutans (S. mutans). Experimental fluoride varnish (EFV) with 5% NaF was fabricated. Five antibacterial agents were tested with 1 mM and 10 mM concentrations, respectively: Bakuchiol (BAK), Bavachalcone (BCC), Isobavachromene (IBC), and Bavachromene (BCM). MIC and MBC test was performed by antibacterial agents with and without EFV using 1.1 × 10¹⁰ CFU/ml of S. mutans. Cell viability test were performed using MTT test. Statistical analysis was done with ANOVA and Duncan's multiple range test at α=0.05. In the antibacterial agents without EFV, the MIC of BAK, BCC, and IBC was the lowest (0.015 mM), and the MBC of BAK was the lowest (0.031 mM). For the antibacterial agents with EFV, the MIC (0.031 mM) and MBC (0.062 mM) of BAK was the lowest, respectively. In MTT test, 1 mM BCM showed the highest cell viability (P < 0.05). This study suggest that BAK can be applied the fluoride varnish under the control of the concentration to develop antibacterial fluoride varnish.

An in vitro study of Duraphat fluoride varnish on the remineralization of demineralized permanent enamel / 实用口腔医学杂志

Objective: To study Duraphat fluoride varnish on the remineralization of demineralized permanent enamel by carbonated beverages. Methods: 30 permanent premolar teeth from 12 to 25 years old young people were collected from orthodontic extraction. Enamel blocks were prepared from each tooth and randomly divided into group A (Coco cola), B(deionized water), C(Coco cola + Duraphat), D(Coco cola + 2％ NaF) and E(Coco cola + artificial saliva) (n = 15), the specinens were respectively treated for 7 d. The enamel surface were observed by scanning electron microscope(SEM). The Ca2 + and P3 + content(weight percentage) were detected by energy spectrum analyzer. Results: The surface of permanent enamel of group A showed a characteristic honeycomb-like appearance, that of group B were smooth. Group C showed irregular large globule deposits on the surface, group D showed some globule structures on the surface, group E showed a little deposits on the surface. Ca2 + and P3 + content of group A was lower than that of group B, in group C was higher than in group E(P＜ 0. 05). Ca2 + content in group D was higher than that in group E(P＜ 0. 05). Conclusion: Duraphat fluoride varnish can promote the remineralization of demineralized permanent enamel by carbonated beverage.

Evaluación clínica de barniz de flúor en el manejo de la hipersensibilidad dentinaria / Clinical evaluation fluoride varnish in the management of dentin hypersensitivity

La Hipersensibilidad Dentinaria (HD) se define como un corto y fuerte dolor generado por la exposición de dentina, que surge de un estímulo químico, térmico, táctil u osmótico, el cual no puede catalogarse como una patología dental propiamente tal. La teoría hidrodinámica de Brännström es la más aceptada en la actualidad para explicar la etiopatogenia de esta afección. Muchos productos han sido elaborados con el fin de combatir la HD, pero no todos constan de la efectividad deseada para atenuarla. El objetivo del presente estudio es evaluar la efectividad inmediata y mediata (posterior a 2 semanas), de un barniz de flúor (Flúor Protector®) utilizado en la problemática. El estudio es un ensayo clínico no controlado. La muestra consistió de 30 pacientes, sin distinción de género, de entre 20 a 60 años, atendidos en las clínicas de la Facultad de Odontología de la Universidad Andrés Bello, cuyo diagnóstico fue HD, en al menos un diente, con recesión gingival de al menos 2 mm, la cual presento dentina expuesta desde la unión amelocementaria, y además que respondieron a 3 o más puntos en la Escala Numérica (EN), cuando fue aplicado el estímulo evaporativo. Los datos fueron recogidos, en una ficha diseñada para el estudio, la cual incluyo datos del paciente y 9 EN, con las cuales se cuantifico la percepción de dolor de los pacientes frente a 3 estímulos: evaporativo, táctil y térmico. Estadísticamente se utilizó análisis de tipo descriptivo y de varianza de Friedman. Se obtuvieron resultados estadísticamente significativos (p<0.05) en la disminución casi completa de la HD frente al tratamiento inmediato (mediana< 3), además de la mantenida reducción de la misma en el control posterior a 2 semanas de aplicada la terapia. En conclusión, la terapia con flúor barniz es efectiva en el tratamiento inmediato y mediato de la HD.

Dentin Hypersensitivity (DH) is defined as a short, sharp pain generated by exposure of dentin, which arises from a chemical stimuli, thermal, tactile or osmotic, which can't be categorized as a dental pathology as such. Brännström hydrodynamic theory is widely accepted today to explain the pathogenesis of this condition. Many products have been developed to combat DH, but not all consist of the desired effectiveness to attenuate. The aim of the present study is to evaluate the effectiveness immediate and mediate (after two weeks), a fluoride varnish (Fluor Protector), used in the management of patients with this problem. The present study is an uncontrolled clinical trial. The sample consisted of 30 patients, regardless of gender, aged 20 to 60, treated at the clinics of the Faculty of Dentistry at the "Universidad Andres Bello", whose diagnosis was DH, in a least one tooth with gingival recession at least 2 mm, which exposed dentin present from the CEJ, and also responding to three of more points on the Numeric Scale (NS), when the stimulus was applied evaporative. Data were collected after approval and written informed consent, in a form designed for the study, which included data from the patient and 9 NS, which was quantified with pain perception of patients versus 3 stimuli: evaporative, touch and heat. For statistical analysis we used descriptive analysis and variance of Friedman. Regarding the 3 stimuli under study results were statistically significant (p< 0.05) decrease in the almost complete DH versus immediate treatment (median < 3), besides the maintained reduction thereof in the inspection after 2 weeks of therapy applied. In conclusion, treatment with fluoride varnish is effective in treating the immediate and mediate DH.

Clinical evaluation of the preventing effect of 4 anti-caries preparations on enamel decalcification in orthodontic treatment with fixed appliance / 实用口腔医学杂志

Objective:To evaluate the preventing effects of 4 anti-caries preparations on enamel demineralization in fixed appliance orthodontic treatment.Methods:200 patients treated with fixed appliance were included and randomly divided into 4 groups (n =50),the teeth were treated with fluoride-containing toothpaste,fluoride varnish,fluoride free toothpaste and casein phosphopeptide-amorphous calcium phoaphate(CPP-ACP) respectively.The enamel decalcification incidence was calculated after orthodontic treatment.Results:The incidence of enamel decalcification calculated by tooth number was 16.3％ in fluoride-containing toothpaste group,9.3％ in fluoride varnish group,21.9％ in fluoride free toothpaste and 8.5％ in CPP-ACP group(among groups,P ＜0.05;between CPP-ACP and fluoride varnish,P ＞ 0.05).Conclusion:Fluoride containing preparation can prevent the enamel demineralization during the fixed appliance orthodontic treatment,CPP-ACP and fluoride varnish are more effective.

Remineralization ability of fluoride varnish containing tricalcium phosphate by time / 대한구강보건학회지

OBJECTIVES: The aim of this study was to evaluate the degree of remineralization over time after application of fluoride varnish with and without tricalcium phosphate (TCP). METHODS: This in vitro study used extracted bovine lateral incisors without dental caries. Artificial lesions were created in the enamel specimens. The amount of mineral loss (ΔF(before)) was measured using quantitative light-induced fluorescence (QLF). Test fluoride varnishes (10 mg) were applied to the enamel surface of the specimen and dried for 4 min. No fluoride varnish was applied to the specimens in the control group. Each group was randomly assigned 12 specimens, and remineralization was allowed to occur to different time points (0.5, 1, 3, 6, 12, and 24 h) in each group. Specimens were washed with distilled water and dried with compressed air for 3 s. ΔF(after) was determined using QLF. RESULTS: When fluoride varnish containing TCP was applied for up to 6 h, the amount of mineral loss significantly increased, and when non-TCP fluoride varnish was applied for up to 12 hours, the amount of mineral loss significantly increased (P<0.05). However, the amount of mineral loss was higher in the control group. The difference between ΔF(before) and ΔF(after) (ΔΔF) increased over time. There was a significant difference between the TCP group and the control group after 6 h. The non-TCP group showed a significant difference after 24 h compared to the control group. After 12 h, significant differences were observed in the TCP group compared to both the non-TCP and control groups. CONCLUSIONS: This study showed that the degree of remineralization increased gradually over time after fluoride varnish application compared to the control group. In particular, fluoride varnish containing TCP showed better remineralization capability than varnish without TCP.

Comparative evaluation of application of different fluoride varnishes on artificial early enamel lesion: An in vitro study

Introduction: In an attempt to manage noncavitated carious lesions noninvasively through remineralization, a range of novel fluoride varnishes with additional remineralizing agents have been made available for clinical application. Aim and Objectives: The aim of this study was to compare and evaluate the remineralization potential of three commercially available varnishes on artificial enamel lesions. Materials and Methods: This in vitro study involves eighty intact enamel specimens prepared from premolars extracted for orthodontic purposes. After specimen preparation, the eighty samples were divided randomly into two groups (n = 40) for measurement of baseline surface Vickers microhardness and baseline calcium/phosphorus ratio (% weight) through EDAX testing. Thereafter, the specimens were subjected to demineralization for 96 h to induce initial enamel lesions and the measurements were repeated. Following demineralization, each of the two groups was divided randomly into four subgroups (n = 10) from which one was used as the control group and the others three were allotted to each of the three test varnishes. After varnish application, all the specimens were subjected to a pH cycling regimen that included alternative demineralization (3 h) and remineralization (21 h) daily, for 5 consecutive days. The Vickers microhardness and EDAX measurements were then repeated. Results: One-way ANOVA and post hoc Tukey's tests were conducted for multiple group comparison. All the three commercially available varnishes were capable of remineralizing initial enamel lesions that were induced artificially. No difference was noted in the remineralizing efficacy of the varnishes despite their different compositions. MI Varnish™ (casein phosphopeptide-amorphous calcium phosphate fluoride varnish) showed slightly better recovery in surface microhardness as compared to the other two varnishes. Conclusion: All the varnishes used in this in vitro study are capable of reversing early enamel lesions.

Clinical Application of Duraphat Fluoride Varnish / 昆明医科大学学报

Duraphat fluoride varnish is a topical coating material applied to tooth surfaces composed of fluoride compound,film-forming material and volatile solvent and containing 5％ sodium fluoride (22,600 ppm Fluoride).Many studies have shown the effectiveness of Duraphat fluoride varnishes in inhibiting caries,reducing tooth mineralization and releasing hypersensitive dentine.This article aims to review the research on clinical application of Duraphat fluoride varnish

Clinical effect of fluoride agents in prevention of caries in preschool children / 中国基层医药

Objective To evaluate the clinical effect of fluoride agents in prevention of caries in preschool 4 to 5 years old children.Methods 700 kindergartens 4 -5 years old children were selected to conduct prevention study with the agree of guardian.The children were randomly divided into observation group and control group. 350 preschool children in the control group received regular oral health measures and fluoride foam treatment every six months.350 preschool children in the observation group received fluoride products every six months on the basis of the control group.After two years study,the deciduous caries and caries rate of the two groups were analyzed.Results After prevention of dental caries 24 months,the prevalence of dental caries and caries of deciduous teeth surface in the observation group significantly reduced,and were significantly lower than the control group ( observation group:caries prevalence 11.3%,caries mean 0.85;control group:caries prevalence 36.1%,caries mean 1.77),the deciduous caries rate and the number of surface caries between the two groups had statistically significant differences (χ2 =4.339 1,3.016 8,all P<0.05).Conclusion Child deciduous dental caries in China is still at a relatively high inci-dence of disease,regular use of fluoride foam and fluoride products namely fluor protector can significantly prevent dental caries,oral health measures than on a regular basis is more effective,and significantly reduce deciduous caries among children,protection of children's oral health,and it is worth further clinical application.

Effect of Fluoride Varnish Combined with Er:YAG Laser on the Permeability of Eroded Dentin: An In Situ Study

This study evaluated the combined effect of fluoride varnish and Er:YAG laser on the permeability of eroded bovine root dentin. After initial erosive challenge followed by a remineralization period, the specimens were divided in two groups according to the treatment - fluoride varnish and non-fluoride varnish - and were subdivided according to the irradiation protocol: Er:YAG laser (100 mJ, 3 Hz, 12.8 J/cm2per pulse, non-contact and defocus mode) and non-irradiated. After a lead-in period, 7 volunteers wore a palatal device containing 4 specimens that were subjected to erosive challenges. At the first experimental phase, 4 volunteers used specimens treated with fluoride varnish and fluoride varnish+Er:YAG laser and 3 volunteers used specimens treated with non-fluoride varnish and non-fluoride varnish+Er:YAG laser. After a washout period, volunteers were crossed to treatments, characterizing a 2x2 crossover experiment. At the end of the experimental phase, the quantitative response variable was obtained by permeability analysis and the qualitative response by scanning electron microscopy (SEM). Two-way ANOVA and Tukey-Kramer's test revealed that specimens treated with fluoride varnish+Er:YAG laser showed the lowest permeability and a significant difference was found between this group and the others. When varnish (fluoride/non-fluoride) was applied in the absence of Er:YAG laser, higher permeability was found when compared to the laser-treated groups. SEM evaluations showed partially or completely obliterated dentinal tubules when specimens were treated with fluoride varnish+Er:YAG laser. It may be concluded that Er:YAG laser was able to control the permeability of eroded root dentin and the combination with fluoride varnish increased laser action.

Resumo Esse estudo avaliou o feito combinado do verniz fluoretado ao laser de Er:YAG na permeabilidade da dentina radicular erodida. Fragmentos de dentina radicular bovina, foram submetidos a um desafio erosivo inicial com ácido cítrico, que foi seguido por um período de remineralização. Posteriormente, os espécimes foram divididos em relação aos tratamentos: verniz (fluoretado e não fluoretado) e subdivididos de acordo com a irradiação: laser de Er:YAG (100 mJ, 3 Hz, 12.8 J/cm2 por pulso, sem contato e modo não focado) e não irradiado. Após um período de lead in, 7 voluntários utilizaram um dispositivo palatino contendo 4 espécimes que foram submetidos a desafios erosivos. Na primeira fase do experimento, 4 voluntários utilizaram dispositivos com fragmentos tratados com verniz fluoretado e verniz fluoretado+laser de Er:YAG e 3 voluntários utilizaram espécimes tratados com verniz não fluoretado e verniz não fluoretado+laser de Er:YAG. Depois de um período de wash-out, os voluntários foram cruzados em relação aos tratamentos, caracterizando um experimento cross-over 2x2. Ao final de cada fase experimental, a variável resposta quantitativa foi obtida através da análise de permeabilidade e a qualitativa por microscopia eletrônica de varredura (MEV). A ANOVA dois critérios e teste de Tukey-Kramer revelou que as amostras tratadas com verniz fluoretado+laser de Er:YAG mostraram menor permeabilidade e uma diferença significativa foi encontrada entre este grupo, quando comparado aos demais grupos. Quando o verniz (fluoretado/não fluoretado) foram aplicados na ausência do laser de Er:YAG maiores valores de permeabilidade foram encontrados quando comparados com os grupos irradiados com o laser. A MEV demostrou túbulos dentinários parcialmente ou completamente ocluídos quando as amostras foram tratadas com verniz fluoretado+laser de Er: YAG. Pode-se concluir que o laser de Er:YAG foi capaz de controlar a permeabilidade da dentina radicular erodida e essa ação é aumentada quando o laser está associado ao verniz fluoretado.

The effects of fluoride toothpaste and fluoride varnish on enamel remineralization and acid resistance:An in vitro study / 实用口腔医学杂志

Objective:To investigate the ability of fluoride toothpaste and fluoride varnish on enamel remineralization and acid resist-ance.Methods:Enamel specimens were prepared from bovine incisors,and were randomly divided into 4 groups(n=3)after acid-etching by 37%phosphoric acid.Specimens in group A(control)was processed daily with normal saline;those in group B and C were treated once with Duraphat varnish and Fluor Protector varnish respectively;in group D was daily processed with fluoride toothpaste. All specimens were incubated in artificial saliva for 2 weeks.Then all specimens received acid-etching again.Micro-hardness test, SEM observation and image analysis were performed before and after each step.Results:After 2 weeks of processing,no remineraliza-tion was found in group A.Varnish layers were observed on the surface of specimens in group B and C.In group D remineralization was detected on the enamel surface.After re-etching,micro-hardness decreased in group A and D.Fluoride varnish layers in group B and C showed strong resistance to acid-etching.After re-etching,area of micro-holes in group A and D increased(P<0.05 ),but that in group D was smaller than in the control(P<0.05).No micro-hole was observed in group B and group C.Conclusion:Protec-tive layer formed on the enamel surface by fluoride varnish is resistant to acid-etching and promotes enamel remineralization.Fluoride toothpaste application can promote enamel remineralization,but with less resistance to acid.

Evaluation of release of fluoride from dental varnishes marketed in Korea / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to compare the amount and rate of cumulative fluoride released over a period of 4 h from several varnishes marketed in Korea. METHODS: The following six commercial products were studied: cavity shield (CS, 22,600 ppm F), V varnish (VV, 22,600 ppm F), enamel pro varnish (EP, 22,600 ppm F), MI varnish (MI, 22600 ppm F), fluorine care (FC, 22600 ppm F), and fluor protector N (FP, 7700 ppm F). Five samples were collected from each varnish. Further, 10 mg of each varnish were applied onto an acrylic surface (diameter, 5 mm) and then immersed in 20 mL of distilled water at 37degrees C. The fluoride concentration in each sample was then analyzed after 30 min, 1, 2, 3, and 4 h, and after 4 days of exposure. RESULTS: The cumulative amount of fluoride released by FC (5.64+/-1.10 ppm) was significantly higher than that released by other products after 30 min. FC (8.55+/-1.85 ppm) and MI (8.21+/-0.81 ppm) released a significantly higher cumulative amount of fluoride after 4 h. The cumulative rate of fluoride released by FC (47.80+/-9.35%) was significantly higher than that of other products after 30 min. FC (72.44+/-15.68%) and MI (69.54+/-6.88%) showed a higher cumulative fluoride release rate after 4 h. MI sustainably released fluoride after 4 h and demonstrated a high fluoride release rate of 95.76%. CONCLUSIONS: The cumulative amount and rate of fluoride released by several varnishes were statistically significant at each time point. This data can be used by clinicians prior to selection of dental products.

Remineralização de lesões de mancha branca adjacentes aos bráquetes ortodônticos / Remineralization of white spot enamel lesions adjacent to fixed orthodontic appliance

Avaliar e quantificar, in vitro e in vivo, o efeito remineralizador de produtos fluoretados e antimicrobianos sobre lesões de mancha branca adjacentes ao bráquete ortodôntico. Materiais e métodos: Para o estudo in vitro, bráquetes ortodônticos metálicos foram colados em 30 pré-molares hígidos que foram submetidos a indução artificial de mancha branca e divididos aleatoriamente em 3 grupos (n=10): controle (GC), verniz fluoretado (VF) e clorexidina gel 2% (CHX). O processo de des-remineralização dos dentes foi quantificado por QLF (Quantitative Light-Induced Fluorescence) utilizando-se os valores de Delta F, %. Para o estudo in vivo foram selecionados trinta pacientes adolescentes (n=56 lesões) com idade media de 17.2 ± 2.3 anos, alocados aleatoriamente em três grupos: verniz fluoretado (VF), clorexidina gel 2% (CHX) ou pasta dental fluoretada – controle (CO). O processo de des-remineralização dos dentes foi avaliado e quantificado pelo exame visual com critérios Nyvad (NY) e DIAGNOdent Pen 2190 (DDpen). Tanto para o estudo in vitro quanto para o in vivo, os respectivos produtos foram aplicados sobre as lesões de mancha branca duas vezes, com intervalo de uma semana. Resultados: No estudo in vitro observou-se um aumento nos valores de fluorescência (Delta F, %) nos três grupos, sendo que as lesões tratadas com verniz fluoretado apresentaram uma resposta mais favorável à remineralização. No in vivo, os resultados evidenciaram uma diminuição nos valores de fluorescência nos três grupos durante todo o período experimental, e assim como no in vitro, as lesões tratadas com verniz fluoretado apresentaram uma resposta mais rápida e favorável à remineralização (teste t, p<0.0001). Após 3 meses, o grupo CHX foi semelhante ao CO e ambos diferentes de VF (ANOVA, p<0.05). Concluiu-se que duas aplicações de verniz fluoretado são suficientes para remineralização de lesões de mancha branca com controle de 3 meses, sempre que complementadas com adequada higiene oral

The aim of this study was to evaluate and quantify the remineralization process on white spot enamel lesions adjacent to orthodontic braces. In the in vitro study, orthodontic braces were bonded in 30 extracted premolars that remained in a special solution for artificial enamel lesion development. Teeth were divided into three gropus (n=10), control (CO), varnish fluoride (VF) and chlorehexidine gel 2% (CHX). The demineralization process was assessed by Quantitative Light-Induced Fluorescence (QLF). In the vivo study, 30 healthy adolescents (mean age ± standard deviation: 17.2 ± 2.3 years) (n=56 lesions) undergoing orthodontic treatment with fixed appliances were enrolled in a double blind, randomized, longitudinal trial lasting three months. The subjects were randomly divided into three groups, using varnish fluoride (n=20), chlorexidine gel 2% (n=17) or fluoride toothpaste (n=19). The remineralization process was evaluated and quantified by Nyvad criteria (NY) and DIAGNOdent pen (DDpen). In both studies, the products were applied twice with one-week interval. All groups in the in vitro study, showed an increase in fluorescence (Delta F, %), whereas lesions treated with varnish fluoride had a quicker and more favorable response to remineralization. In the vivo study, fluorescence decreased during the experimental period, and lesions in the VF group had a quicker and more favorable response to remineralization. The correlation between DDpen and NY was 0.67 (Sperman, p<0.05). Two applications of varnish fluoride supplementated with oral hygiene and fluoride tooth paste, are effective in reversing WSLs during orthodontic treatment

Efficiency of resin infiltration versus fluride varnish for treatment of post-orthodontic white spot lesions / 中国组织工程研究

BACKGROUND:White spot lesions caused by enamel demineralization are a common side effect of orthodontic treatment. Resin infiltration treatment for white spot lesions has obtained favorable effects, but there is no report on the difference between resin infiltration and fluoride varnish treatment for post-orthodontic white spot lesions. OBJECTIVE:To compare the efficiency of resin infiltration and fluride varnish for treatment of post-orthodontic white spot lesions. METHODS:Twenty-nine patients with post-orthodontic white spot lesions were randomly divided into two groups:one group accepted the resin infiltration treatment and the other group accepted fluoride varnish treatment. Frontal intraoral photos before treatment and 6 months after treatment were col ected for study. The difference in efficiency of resin infiltration and fluride varnish for treatment of post-orthodontic white spot lesion was analyzed and evaluated by both dentists and College students who were not engaged in oral medicine. RESULTS AND CONCLUSION:Except one patient treated with fluride varnish, al the patients completed the referral on schedule. There was significant improvement in the two groups after treatment (P<0.05). Resin infiltration treatment was better than fluoride varnish treatment in post-orthodontic white spot lesions. Thus, resin infiltration that requires fewer referrals and has better effects is an ideal therapy for post-orthodontic white spot lesions.

Comparative evaluation of two commercially available desensitizing agents for the treatment of dentinal hypersensitivity.

Aims: A randomized clinical trail was designed to compare the efficacy of two commercially available desensitizing agents (fluoride varnish containing 6% sodium fluoride and 6% calcium fluoride and a gel containing 6% potassium nitrate and 0.11% fluoride ions) in the treatment of dentinal hypersensitivity. Settings and Design: Randomized clinical trial. Materials and Methods: Twenty-one patients were selected. Subjects were evaluated using three different stimuli, i.e., tactile test, air blast test and cold water test. They were then randomly divided into two groups. Patients in group I were treated with fluoride varnish and group II patients were treated with gel containing 6% potassium nitrate and 0.11% fluoride ions. The patients were examined at baseline, immediately after application of the agent, at 1 week, 1 month and 3 months interval. Statistical Analysis: Statistical analysis was done using unpaired "t" test, paired "t" test and Chi-square test with Yate's correction. Results: The results were analyzed; it was seen that patients treated in group I showed significantly better results compared to group II patients at 1 month and 3 months interval. Teeth which required repeat dose and those which did not require repeat dose were comparable in number. Conclusions: Both the agents showed significant reduction in sensitivity at all time intervals compared to baseline. A comparatively significant reduction in sensitivity score was seen in patients treated with fluoride varnish and it appeared to be more effective in providing long-term relief against all the three test stimuli. Teeth with initial high sensitivity score required repeat doses, which was comparable for both the groups.