The effect of topical fluorides on decalcification in patients with fixed orthodontic appliances: A systematic review

Cardiff University Dental School, United Kingdom.
American Journal of Orthodontics and Dentofacial Orthopedics (Impact Factor: 1.38). 12/2005; 128(5):601-6; quiz 670. DOI: 10.1016/j.ajodo.2004.07.049
Source: PubMed


Decalcification is a significant problem during fixed orthodontic treatment. Topical Fluorides can reduce or eliminate the problem, but the relative effectiveness of different treatments or combinations of topical fluoride preparations is unknown. This systematic review was undertaken to determine the effectiveness of topical fluoride preparations in preventing decalcification during fixed orthodontic treatment.
A wide search of published and unpublished material in any language was undertaken by using general and specialist databases; key dental journals were searched by hand. Predefined inclusion criteria based on objective outcome measures of decalcification, duration of treatment, presence of a comparison group, and study design were applied to determine study selection. Included studies were double extracted onto pre-designed data extraction sheets.
By screening titles and abstracts, we identified 143 articles; after the inclusion criteria were applied, 7 reports (of 6 studies) remained. Differences in the methodologies and reporting made statistical analysis impossible. However, the use of topical fluorides in addition to fluoride toothpaste reduced the incidence of decalcification in populations with both fluoridated and non-fluoridated water supplies. Different preparations and formats appear to decrease decalcification, but there was no evidence that any 1 method was superior. There was some evidence that the potency of fluoride preparations might be important.

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    • "The increased amount of plaque adjacent to bands and brackets commonly results in poor oral hygiene and changes in the oral flora, including increased levels of Mutans streptococci (MS) and Lactobacilli (LB), increased plaque and bleeding scores, and reduced levels of buffe-ring capacity (3-5). Insufficient removal of supragingival plaque may cause development of white spot lesions and gingival diseases (3,6). "
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    ABSTRACT: Objective: To evaluate the effect of chlorhexidine-thymol varnish alone, its combination with chlorhexidine-fluoride containing dentifrice and fluoride varnish on oral hygiene and caries prevention in orthodontic patients. Study design: Sixty patients, aged 12-18, with orthodontic fixed appliances were randomly assigned into three groups as follows: Group 1 (n=20): 1% chlorhexidine and 1% thymol varnish (Cervitec®Plus); Group 2 (n=20): Cervitec®Plus+ 0.2% chlorhexidine and 0.2% sodium fluoride (900 ppm fluoride) (Cervitec®Gel)); and Group 3 (n=20): 0.1% fluoride varnish (Fluor Protector®). Mutans streptococci (MS), lactobacilli (LB) levels, buffering capacity (BC), visible plaque index (VPI), and gingival bleeding index (GBI) scores were evaluated at four stages: T0, before orthodontic bonding; T1, one week after orthodontic bonding; T2, one week; and T3, four weeks after the first application, respectively. Inter and intra group comparisons were made by the Kruskal-Wallis, Mann-Whitney U, Friedman and Wilcoxon Signed-Rank tests with Bonferroni step-down correction (P<0.017). Results: Significantly lower MS and LB levels were found in Group 2 than Group 1 (T2) and 3 (T2, T3) (P<0.017). Groups 1-2 (T2) showed significantly higher BC (P<0.017) and lower VPI and GBI (P<0.017) scores compared with Group 3. Decreased MS levels at T2 (P<0.017) and T3 (P>0.017) were found in Group1-2 compared with T0. Significantly lower LB levels were recorded in Group 2 at T2 compared with T0 (P<0.017) while no significant differences were seen in Group 1 and 3 (P>0.017). Conclusions: Addition of Cervitec®Plus+Cervitec®Gel combination to the standard oral hygiene regimen may be beneficial for orthodontic patients for maintaining oral health by reducing bacterial colonisation and gingivitis. Key words:Chlorhexidine, flouride, mutans streptococci, lactobacilli, antibacterial effect, plaque, gingivitis, orthodontic treatment.
    Medicina oral, patologia oral y cirugia bucal 02/2013; 18(2). DOI:10.4317/medoral.18261 · 1.17 Impact Factor
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    • "Prevention of enamel decalcification and remineralization of enamel through orthodontic treatments is a critical issue. Topical fluoride in various forms (toothpaste, mouthrinse, gels, varnishes, and fluoride-releasing cements) has been used extensively in the prevention of demineralization around orthodontic brackets.[123467814] The use of topical fluorides in addition to fluoride toothpaste appears to reduce the incidence of decalcification in patients undergoing orthodontic treatment with fixed appliances.[2] A systematic review examining 90 studies concluded that the optimum results were obtained when orthodontic patients with fixed appliances had used daily mouth rinsing with a 0.05% sodium fluoride mouthrinse.[1] "
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    ABSTRACT: Aim: To evaluate the effect of the application of either fluoride varnish (FV) or amorphous calcium phosphate (ACP) as preventive method on shear bond strength (SBS) at the same time of their bonding in vitro using self-etching primer (SEP) as an agent for enamel pre-treatment FV. Materials and Methods: Sixty human bicuspids were randomly divided into five groups: G1 was rubbed by SEP for 5 s, G2 for 5 s by SEP and ACP, G3 for 10 s by SEP and ACP, G4 for 5 s by SEP and FV, and G5 for 10 s by SEP and FV. Stainless steel metal brackets were bonded. A Zwick/Roell Z020 Universal Testing Machine (Zwick GmbH and Co, Germany) with a 500 N load cell was used to test SBS. SBS values were analyzed using one-way analysis of variance (ANOVA) and Tukey's post hoc tests (P≤0.05). Differences in adhesive remnant index (ARI) values between groups were calculated. Results: The mean SBS values were 10.00±4.48 MPa, 5.71±4.3 MPa, 7.47±4.44 MPa, 4.4±2.39 MPa, and 3.98±0.83 MPa for groups 1–5, respectively. Significant differences in SBS values between all groups were found. The mean SBS values of groups 2, 4, and 5 were significantly lower than that of the G1. No significant difference was found between G3 and G1. Significant difference in ARI between the groups was found (P<0.001) and G1 had a significantly higher ARI. Conclusion: The results suggested that the application of ACP at the same time of using SEP for 10 s has no effect on SBS.
    07/2012; 1(3):63-8. DOI:10.4103/2278-0203.103862
    • "However, non-extraction treatment involves a longer treatment time to correct and would increase the chance of adversely affecting the patient's profile by proclining the incisors. Non-extraction treatment also increases the chance of enamel demineralization due to the extended amount of time in appliances.[1516] Extraction treatment gives more stable result because arch form is maintained. "
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    ABSTRACT: Ectopic canine teeth develop displaced from their normal position. Any permanent tooth can be ectopic, and the cause may be both genetic and environmental. Orthodontic treatment is justified because ectopic canine teeth can migrate in the jaw bone and may damage the adjacent teeth roots and bone. Orthodontic treatment is also justifiable for aesthetic reasons. Diagnosis and treatment of ectopically erupting permanent maxillary canines requires timely management by the orthodontist. Internal or external root resorption of teeth adjacent to the ectopic canine is the most common sequel. Malocclusion with severe crowding is difficult to treat without extraction. Non-extraction treatment of ectopic canines can compromise the patient's profile. This article represents two cases of extraction treatment approach for buccally displaced or ectopic canine in a patient with severe crowding in the mandibular arch.
    04/2012; 3(1):123-8. DOI:10.4103/0976-237X.94563
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