Effect of high-fluoride toothpaste and mouth rinse on the prevention of demineralized lesions during orthodontic treatment: a randomized controlled trial.

OBJECTIVE: To evaluate the effect of high-fluoride mouth rinse and high-fluoride toothpaste on the development of demineralized lesions (DLs) during orthodontic treatment. TRIAL DESIGN: Three-armed parallel-group randomized controlled trial. METHODS: The trial was performed with 270 adolescent orthodontic patients. Randomization was performed in blocks of 30, enrolling the patients into one of the following groups: the fluoride mouth rinse (FMR) group receiving 0.2% sodium fluoride (NaF) mouth rinse plus 1450 ppm fluoride (F) toothpaste; high-fluoride toothpaste (HFT) group receiving 5000 ppm F toothpaste; and the Control (CTR) group receiving 1450 ppm F toothpaste. Inclusion criteria were patients scheduled for treatment in both arches with fixed appliances and age between 12 and 20 years. The primary outcome variable was the proportion of participants with at least one new demineralized lesion as assessed on digital photos taken before and after treatment, analysed by a blinded clinician. The analysis included all teeth or teeth in the aesthetic zone, i.e. all central incisors, lateral incisors, and canines. A random sample of 30 participants was assessed to check intra- and inter-reliability. For pairwise comparison between groups, Fisher's non-parametric permutation test was used for continuous variables. Blinding was employed during the caries registration and data analysis. RECRUITMENT: October 2010 to December 2012. RESULTS: In total, 270 patients were randomized, of which 22 were excluded during treatment. Therefore, 248 participants were included in the study. The number of patients with an increase of ≥1 DL, including only central- and lateral incisors and canines, during orthodontic treatment, was significantly lower in the HFT group, 51/85 60%, compared to the CTR group, 64/82 78%, RR 0.77 (CI 0.62; 0.95), P = .01 and in the FMR group, 47/81 58%, compared to the CTR group, RR 0.74 (CI 0.60; 0.92), P < .01. CONCLUSIONS: To prevent demineralized lesions in the aesthetic zone, high-fluoride mouth rinse and high-fluoride toothpaste may be recommended. LIMITATIONS: The protocol was not registered, and the present study did not use a double-blinded design.

Dental age in children with impacted maxillary canines.

OBJECTIVE: The aim of this study was to evaluate if delayed dental development is a cause of postponed care for patients with impacted maxillary canine (IMC). MATERIALS AND METHODS: This case-control study was based on 403,355 children and adolescents in Region Västra Götaland, Sweden. The subjects, who were in the age range of 9-16 years during the period of 2011-2013, underwent surgical exposure or removal of a maxillary canine. Demirjian's dental age assessment was carried out on panoramic radiographs. RESULTS: In total, 1028 patients, 514 with IMC and 514 age- and gender-matched controls, were enrolled. The patients with IMC exhibited a dental development delay of 0.2 years compared to the control group. In the impaction sub-groups, the female patients, patients in the chronological age group of 12-13 years, and patients with palatally positioned IMC had a significantly lower dental age than their paired-control subjects. CONCLUSIONS: Overall, the difference in dental age between patients with or without IMC is significant but small, and as such is likely of minor clinical relevance. Therefore, the timing of preventive care and treatment for patients with IMC should be the same as that for patients with normally erupting canines.

Prevalence of impacted maxillary canines-an epidemiological study in a region with systematically implemented interceptive treatment.

BACKGROUND: In dentistry, epidemiological studies are important for establishing high-quality care for the individual patient as well as for socio-economic reasons. OBJECTIVE: The aim of this epidemiological study was to evaluate the prevalence of impacted maxillary canines in a geographical region in which interceptive treatment is implemented systematically. Furthermore, the aim was to study the age and gender of the patients, and the location and surgical technique used for the impacted maxillary canine. METHOD: The study was based on 54 716 adolescents in the Region Västra Götaland, Sweden who were born in the period 1996-98. All patients in the three cohorts who had impacted maxillary canines treated with surgical exposure or surgical removal were identified in the dental record system used in the region. RESULTS: The prevalence of impacted maxillary canines when interceptive treatment was systematically implemented was 1.1% (N = 601). Overall, the cohorts of patients with impacted canines comprised 65% girls and 35% boys. Most of the canines were palatally impacted and the most common surgical technique was closed exposure. CONCLUSION: The prevalence of impacted maxillary canines in a geographical area in which interceptive treatment is systematically implemented is lower than that reported previously. The distributions of impacted canines with respect to gender and location are in accordance with those reported previously in similar studies.