Efficacy of 1.23% acidulated phosphate fluoride gel on non-cavitated enamel lesions: a randomized clinical trial.

A randomized controlled parallel clinical trial was conducted to evaluate the efficacy of the association of 1.23% topical professional acidulated phosphate fluoride (APF) gel with oral hygiene and dietary instructions on the arrest of active non-cavitated lesions in permanent, mixed, and temporary dentition in children between 3 and 12 years of age. Ninety-eight caries-active children were randomly divided into two groups: a fluoride gel group (n = 49) and a non-fluoridated gel group (n = 49). Each group received up to eight weekly applications of gel, weekly professional toothbrushing with oral hygiene instructions and dietary counselling. Caries lesions were assessed qualitatively through visual-tactile criteria performed in three stages: initial, intermediate, and final. Regression models were applied to identify risk indicators for caries control. Between-group comparison regarding the time taken to arrest the lesions was performed using Chi-squared and Fisher's exact tests. Seventeen children did not receive the allocated intervention, and one was lost to follow-up (n = 80). There was no difference between the control and placebo groups regarding the time to the arrest of the lesion (p >.05). The treatments showed similar results without significant statistical difference (p = 0.33; 95%CI: 0.32-1.48). No adverse effects were observed. It can be concluded that no additional effect of the association of 1.23% APF gel with oral hygiene using fluoride dentifrice and dietary instructions on the arrest of active non-cavitated lesions could be established. We can also confirm the importance of toothbrushing frequency and, consequently, the visible plaque reduction in the control of caries activity. RBR-37V5S3.

Estudo retrospectivo da efetividade de uma abordagem de tratamento não invasiva para inativação de lesões de cárie dentária não cavitadas em pacientes infantis / Effectiveness of a non-invasive treatment protocol for incipient enamel carious lesions in a child population: a retrospective study

Objetivo: Avaliar a efetividade de uma abordagem de tratamento não invasiva para a inativação de lesões não cavitadas de dentes decíduos e permanentes realizada na Clínica Infanto-Juvenil (CIJ) da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul (FO-UFRGS), identificando os fatores clínicos do paciente e associando-os ao sucesso clínico do tratamento. Métodos: Foram incluídos 55 prontuários de pacientes que receberam instruções de higiene bucal, controle de dieta e aplicações tópicas de flúor (ATF) na CIJ da FO-UFRGS entre 2016 e 2018. Foram coletados dados demográficos e clínicos referentes a avaliação da atividade de cárie dentária na consulta inicial e após o tratamento realizado: índice de placa visível (IPV), índice de sangramento gengival (ISG) e o número médio de dentes permanentes cariados, perdidos e restaurados (CPO-D) e/ou número médio de dentes decíduos cariados, extraídos ou com indicação de extração e restaurados (ceo-d). Na análise estatística foram utilizados os testes Qui-quadrado de Pearson, Exato de Fisher e Wilcoxon, nível de significância: p < 0,05. Resultados: Não houve diferença estatisticamente significativa quando se comparou as variáveis idade, sexo, IPV, ISG e ceo-d/CPO-D com o sucesso do tratamento. Houve diferença estatisticamente significativa comparando o IPV inicial com o final (p = 0,016) e número de lesões não cavitadas ativas inicial e final (p < 0,001), mas não houve diferença para o ISG inicial e final (p = 0,324). Conclusão: Baseado nos achados da redução do IPV e da redução no número de lesões não cavitadas ativas ao final do tratamento, sugere-se que a abordagem de tratamento não invasiva para inativação de lesões de cárie dentária não cavitadas aplicada na CIJ da FO-UFRGS é efetiva.

Aim: To evaluate the effectiveness of a non-invasive treatment on the arrest of non-cavitated caries lesions of primary and permanent teeth performed at the Pediatric Clinic (PC) at the Dental Teaching Hospital of the Federal University of Rio Grande do Sul (DT-UFRGS), identifying the patient's clinical factors and associating them with the clinical success of the treatment. Methods: This study included 55 patient's medical records who received oral hygiene instructions, diet control, and topical fluoride applications (TFA) at the PC of DT-UFRGS between 2016 and 2018. Demographic and clinical data regarding the evaluation of caries activity in the initial visit and after the performed treatment were collected: visible plaque index (VPI), gingival bleeding index (GBI), and DMF-T caries index (average number of decayed, missing, and restored permanent teeth), and/or dmf-t (average number of decayed, extracted or with recommendation for extraction, and restored deciduous teeth). Pearson's Chi-square, Fisher's Exact, and Wilcoxon tests were used for statistical analysis, significance level: p < 0.05. Results: No significant difference was observed when the variables of age, gender, VPI, CBI, DMF-T/dmf-t were compared with treatment success. A statistically significant difference was found when comparing the initial with the final VPI (p = 0.016), as well as the number of initial and final active non-cavitated carious lesions (p < 0.001), but no difference was identified for the initial and final GBI (p = 0.324). Conclusion: Based on the findings of VPI reduction and reduction in the number of active non-cavitated carious lesions upon completion of treatment, it is suggested that the non-invasive treatment for arrestment of non-cavitated carious lesions applied at the PC of DT-UFRGS is effective.

Estudo retrospectivo da efetividade de uma abordagem de tratamento não invasiva para inativação de lesões de cárie dentária não cavitadas em pacientes infantis / Effectiveness of a non-invasive treatment protocol for incipient enamel carious lesions in a child population: a retrospective study

Objetivo: Avaliar a efetividade de uma abordagem de tratamento não invasiva para a inativação de lesões não cavitadas de dentes decíduos e permanentes realizada na Clínica Infanto-Juvenil (CIJ) da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul (FO-UFRGS), identificando os fatores clínicos do paciente e associando-os ao sucesso clínico do tratamento. Métodos: Foram incluídos 55 prontuários de pacientes que receberam instruções de higiene bucal, controle de dieta e aplicações tópicas de flúor (ATF) na CIJ da FO-UFRGS entre 2016 e 2018. Foram coletados dados demográficos e clínicos referentes a avaliação da atividade de cárie dentária na consulta inicial e após o tratamento realizado: índice de placa visível (IPV), índice de sangramento gengival (ISG) e o número médio de dentes permanentes cariados, perdidos e restaurados (CPO-D) e/ou número médio de dentes decíduos cariados, extraídos ou com indicação de extração e restaurados (ceo-d). Na análise estatística foram utilizados os testes Qui-quadrado de Pearson, Exato de Fisher e Wilcoxon, nível de significância: p < 0,05. Resultados: Não houve diferença estatisticamente significativa quando se comparou as variáveis idade, sexo, IPV, ISG e ceo-d/CPO-D com o sucesso do tratamento. Houve diferença estatisticamente significativa comparando o IPV inicial com o final (p = 0,016) e número de lesões não cavitadas ativas inicial e final (p < 0,001), mas não houve diferença para o ISG inicial e final (p = 0,324). Conclusão:Baseado nos achados da redução do IPV e da redução no número de lesões não cavitadas ativas ao final do tratamento, sugere-se que a abordagem de tratamento não invasiva para inativação de lesões de cárie dentária não cavitadas aplicada na CIJ da FO-UFRGS é efetiva.

Aim: To evaluate the effectiveness of a non-invasive treatment on the arrest of non-cavitated caries lesions of primary and permanent teeth performed at the Pediatric Clinic (PC) at the Dental Teaching Hospital of the Federal University of Rio Grande do Sul (DT-UFRGS), identifying the patient's clinical factors and associating them with the clinical success of the treatment. Methods: This study included 55 patient's medical records who received oral hygiene instructions, diet control, and topical fluoride applications (TFA) at the PC of DT-UFRGS between 2016 and 2018. Demographic and clinical data regarding the evaluation of caries activity in the initial visit and after the performed treatment were collected: visible plaque index (VPI), gingival bleeding index (GBI), and DMF-T caries index (average number of decayed, missing, and restored permanent teeth), and/or dmf-t (average number of decayed, extracted or with recommendation for extraction, and restored deciduous teeth). Pearson's Chi-square, Fisher's Exact, and Wilcoxon tests were used for statistical analysis, significance level: p < 0.05. Results: No significant difference was observed when the variables of age, gender, VPI, CBI, DMF-T/dmf-t were compared with treatment success. A statistically significant difference was found when comparing the initial with the final VPI (p = 0.016), as well as the number of initial and final active non-cavitated carious lesions (p < 0.001), but no difference was identified for the initial and final GBI (p = 0.324). Conclusion: Based on the findings of VPI reduction and reduction in the number of active non-cavitated carious lesions upon completion of treatment, it is suggested that the non-invasive treatment for arrestment of non-cavitated carious lesions applied at the PC of DT-UFRGS is effective.