Efficacy of fluoride varnish and casein phosphopeptide-amorphous calcium phosphate for remineralization of primary teeth: a randomized clinical trial

ABSTRACT

We aimed to evaluate the efficacy of oral hygiene instruction, fluoride varnish and casein phosphopeptide-amorphous calcium phosphate [CPP-ACP] for remineralizing white spot lesions [WSL], and the effect of these on the dmft index in primary teeth.Subjects and In this 1-year, randomized clinical trial, 140 children aged 12-36 months with WSL in the anterior maxillary teeth were selected and randomly divided into 4 groups of 35 children each. Group 1 [control] received no preventive intervention. In group 2, there was oral hygiene and dietary counseling. In group 3, there was oral hygiene and the application of fluoride varnish at 4, 8 and 12 months after baseline. In group 4, there was oral hygiene and tooth mousse was applied by the parents twice a day over a 12-month period. At baseline and 4, 8 and 12 months after the intervention, the size of WSL in millimeters and the dmft index were recorded. One hundred and twenty-two children completed the study. Data were analyzed using the repeated-measures ANOVA test. In group 1, the mean percent WSL area and dmft index values had increased significantly at 12 months after baseline [p < 0.001]. The interventions led to significant decreases in the size of the WSL; the greatest reduction was in group 4 [63%] followed by group 3 [51%] and group 2 [10%] after 12 months. The smallest increase in the dmft index was in group 4 [0.17], followed by groups 3 [0.3] and 2 [0.42]. However, there were no significant differences between the groups [p < 0.001]. Oral hygiene along with four fluoride varnish applications or constant CPP-ACP during the 12- month period reduced the size of WSL in the anterior primary teeth and caused a small increase in dmft index values