The Effect of Fluoride Varnish on White Spot Lesion in Clear Aligner Orthodontic Patients
The Effect of Fluoride Varnish on White Spot Lesion in Clear Aligner Orthodontic Patients: Prospective Randomized Controlled Clinical Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Irbid, Jordan, 22110
- Postgraduate Teaching Clinics/JUST
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Healthy subjects form both sexes
- Mild to moderate crowding
- Optimum oral hygiene
- Maximum of three restored teeth
Exclusion Criteria:
- Presence of enamel hypoplasia or hypocalcification,
- Any salivary gland disease or medication use that affect the salivary flow
- Subjects using fluoride other than 1450 ppm fluoride toothpaste.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Fluoride varnish group
Patients received a layer of fluoride varnish on their teeth before the start of orthodontic clear aligner therapy
|
Fluoride varnish was applied to the teeth surfaces before aligner therapy
|
|
Placebo Comparator: Control group
Patients received a layer of normal saline on their teeth before the start of orthodontic clear aligner therapy
|
Normal saline was applied to the teeth surfaces before aligner therapy
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Average lesion fluorescence loss (∆F%)
Time Frame: 4 months
|
It reflects amount of mineral loss
|
4 months
|
|
Maximum lesion fluorescence loss (∆F-max%)
Time Frame: 4 months
|
It measures the deepest point of the lesion (in relation to sound enamel) using QLF system in percent
|
4 months
|
|
Lesion area
Time Frame: 4 months
|
It measures white spot lesion area in pixels
|
4 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Plaque measurement
Time Frame: 4 months
|
It measures the amount of plaque on teeth surfaces in percent using QLF system
|
4 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Susan Al-Khateeb, Jordan University of Science and Technology
Publications and helpful links
General Publications
- GREENE JC, VERMILLION JR. THE SIMPLIFIED ORAL HYGIENE INDEX. J Am Dent Assoc. 1964 Jan;68:7-13. doi: 10.14219/jada.archive.1964.0034. No abstract available.
- van der Veen MH, de Josselin de Jong E. Application of quantitative light-induced fluorescence for assessing early caries lesions. Monogr Oral Sci. 2000;17:144-62. doi: 10.1159/000061639.
- Al-Khateeb S, Forsberg CM, de Josselin de Jong E, Angmar-Mansson B. A longitudinal laser fluorescence study of white spot lesions in orthodontic patients. Am J Orthod Dentofacial Orthop. 1998 Jun;113(6):595-602. doi: 10.1016/s0889-5406(98)70218-5.
- Gorelick L, Geiger AM, Gwinnett AJ. Incidence of white spot formation after bonding and banding. Am J Orthod. 1982 Feb;81(2):93-8. doi: 10.1016/0002-9416(82)90032-x.
- Albhaisi Z, Al-Khateeb SN, Abu Alhaija ES. Enamel demineralization during clear aligner orthodontic treatment compared with fixed appliance therapy, evaluated with quantitative light-induced fluorescence: A randomized clinical trial. Am J Orthod Dentofacial Orthop. 2020 May;157(5):594-601. doi: 10.1016/j.ajodo.2020.01.004.
- Houston WJ. The analysis of errors in orthodontic measurements. Am J Orthod. 1983 May;83(5):382-90. doi: 10.1016/0002-9416(83)90322-6.
- Boersma JG, van der Veen MH, Lagerweij MD, Bokhout B, Prahl-Andersen B. Caries prevalence measured with QLF after treatment with fixed orthodontic appliances: influencing factors. Caries Res. 2005 Jan-Feb;39(1):41-7. doi: 10.1159/000081655.
- Tufekci E, Dixon JS, Gunsolley JC, Lindauer SJ. Prevalence of white spot lesions during orthodontic treatment with fixed appliances. Angle Orthod. 2011 Mar;81(2):206-10. doi: 10.2319/051710-262.1.
- van Loveren C, Duggal MS. Experts' opinions on the role of diet in caries prevention. Caries Res. 2004;38 Suppl 1:16-23. doi: 10.1159/000074358.
- Lucchese A, Gherlone E. Prevalence of white-spot lesions before and during orthodontic treatment with fixed appliances. Eur J Orthod. 2013 Oct;35(5):664-8. doi: 10.1093/ejo/cjs070. Epub 2012 Oct 8.
- Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review. Angle Orthod. 2015 Sep;85(5):881-9. doi: 10.2319/061614-436.1. Epub 2014 Nov 20.
- Zabokova-Bilbilova E, Popovska L, Kapusevska B, Stefanovska E. White spot lesions: prevention and management during the orthodontic treatment. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2014;35(2):161-8. doi: 10.2478/prilozi-2014-0021.
- Ogaard B. [Cariologic aspects of orthodontic treatment]. Nor Tannlaegeforen Tid. 1989 Dec;99(20):802-5. Norwegian.
- Sharma S, Narkhede S, Sonawane S, Gangurde P. Evaluation of Patient's Personal Reasons and Experience with Orthodontic Treatment. J Int Oral Health. 2013 Dec;5(6):78-81. Epub 2013 Dec 26.
- Geiger AM, Gorelick L, Gwinnett AJ, Benson BJ. Reducing white spot lesions in orthodontic populations with fluoride rinsing. Am J Orthod Dentofacial Orthop. 1992 May;101(5):403-7. doi: 10.1016/0889-5406(92)70112-N.
- Todd MA, Staley RN, Kanellis MJ, Donly KJ, Wefel JS. Effect of a fluoride varnish on demineralization adjacent to orthodontic brackets. Am J Orthod Dentofacial Orthop. 1999 Aug;116(2):159-67. doi: 10.1016/s0889-5406(99)70213-1.
- Banks PA, Chadwick SM, Asher-McDade C, Wright JL. Fluoride-releasing elastomerics--a prospective controlled clinical trial. Eur J Orthod. 2000 Aug;22(4):401-7. doi: 10.1093/ejo/22.4.401.
- Benson PE, Douglas CW, Martin MV. Fluoridated elastomers: effect on the microbiology of plaque. Am J Orthod Dentofacial Orthop. 2004 Sep;126(3):325-30. doi: 10.1016/j.ajodo.2003.07.007.
- Gay G, Ravera S, Castroflorio T, Garino F, Rossini G, Parrini S, Cugliari G, Deregibus A. Root resorption during orthodontic treatment with Invisalign(R): a radiometric study. Prog Orthod. 2017 Dec;18(1):12. doi: 10.1186/s40510-017-0166-0. Epub 2017 May 15.
- Bisht S, Khera AK, Raghav P. White spot lesions during orthodontic clear aligner therapy: A scoping review. J Orthod Sci. 2022 May 4;11:9. doi: 10.4103/jos.jos_170_21. eCollection 2022.
- Sudjalim TR, Woods MG, Manton DJ. Prevention of white spot lesions in orthodontic practice: a contemporary review. Aust Dent J. 2006 Dec;51(4):284-9; quiz 347. doi: 10.1111/j.1834-7819.2006.tb00445.x.
- Horst JA, Tanzer JM, Milgrom PM. Fluorides and Other Preventive Strategies for Tooth Decay. Dent Clin North Am. 2018 Apr;62(2):207-234. doi: 10.1016/j.cden.2017.11.003.
- Benson PE, Parkin N, Dyer F, Millett DT, Germain P. Fluorides for preventing early tooth decay (demineralised lesions) during fixed brace treatment. Cochrane Database Syst Rev. 2019 Nov 17;2019(11):CD003809. doi: 10.1002/14651858.CD003809.pub4.
- Stecksen-Blicks C, Renfors G, Oscarson ND, Bergstrand F, Twetman S. Caries-preventive effectiveness of a fluoride varnish: a randomized controlled trial in adolescents with fixed orthodontic appliances. Caries Res. 2007;41(6):455-9. doi: 10.1159/000107932. Epub 2007 Sep 7.
- Sajjan PG, Nagesh L, Sajjanar M, Reddy SK, Venktesh UG. Comparative evaluation of chlorhexidine varnish and fluoride varnish on plaque Streptococcus mutans count--an in vivo study. Int J Dent Hyg. 2013 Aug;11(3):191-7. doi: 10.1111/idh.12028. Epub 2013 May 30.
- Sonesson M, Brechter A, Abdulraheem S, Lindman R, Twetman S. Fluoride varnish for the prevention of white spot lesions during orthodontic treatment with fixed appliances: a randomized controlled trial. Eur J Orthod. 2020 Jun 23;42(3):326-330. doi: 10.1093/ejo/cjz045.
- Restrepo M, Bussaneli DG, Jeremias F, Cordeiro RC, Magalhaes AC, Palomari Spolidorio DM, Santos-Pinto L. Control of white spot lesion adjacent to orthodontic bracket with use of fluoride varnish or chlorhexidine gel. ScientificWorldJournal. 2015;2015:218452. doi: 10.1155/2015/218452. Epub 2015 Apr 20.
- Paula AB, Fernandes AR, Coelho AS, Marto CM, Ferreira MM, Caramelo F, do Vale F, Carrilho E. Therapies for White Spot Lesions-A Systematic Review. J Evid Based Dent Pract. 2017 Mar;17(1):23-38. doi: 10.1016/j.jebdp.2016.10.003. Epub 2016 Nov 1.
- Azarpazhooh A, Limeback H. Clinical efficacy of casein derivatives: a systematic review of the literature. J Am Dent Assoc. 2008 Jul;139(7):915-24; quiz 994-5. doi: 10.14219/jada.archive.2008.0278.
- Xie Z, Yu L, Li S, Li J, Liu Y. Comparison of therapies of white spot lesions: a systematic review and network meta-analysis. BMC Oral Health. 2023 Jun 1;23(1):346. doi: 10.1186/s12903-023-03076-x.
- Yassir YA, Nabbat SA, McIntyre GT, Bearn DR. Clinical effectiveness of clear aligner treatment compared to fixed appliance treatment: an overview of systematic reviews. Clin Oral Investig. 2022 Mar;26(3):2353-2370. doi: 10.1007/s00784-021-04361-1. Epub 2022 Jan 6.
- Raghavan S, Abu Alhaija ES, Duggal MS, Narasimhan S, Al-Maweri SA. White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed orthodontic treatment. A systematic review and meta- analysis. BMC Oral Health. 2023 Aug 27;23(1):599. doi: 10.1186/s12903-023-03257-8.
- Al Saffan AD. Current Approaches to Diagnosis of Early Proximal Carious Lesion: A Literature Review. Cureus. 2023 Aug 14;15(8):e43489. doi: 10.7759/cureus.43489. eCollection 2023 Aug.
- Sardana D, Ekambaram M, Yang Y, McGrath CP, Yiu CKY. Caries-preventive effectiveness of two different fluoride varnishes: A randomised clinical trial in patients with multi-bracketed fixed orthodontic appliances. Int J Paediatr Dent. 2023 Jan;33(1):50-62. doi: 10.1111/ipd.13013. Epub 2022 Jul 10.
- Benson PE, Parkin N, Dyer F, Millett DT, Furness S, Germain P. Fluorides for the prevention of early tooth decay (demineralised white lesions) during fixed brace treatment. Cochrane Database Syst Rev. 2013 Dec 12;(12):CD003809. doi: 10.1002/14651858.CD003809.pub3.
- Baik A, Alamoudi N, El-Housseiny A, Altuwirqi A. Fluoride Varnishes for Preventing Occlusal Dental Caries: A Review. Dent J (Basel). 2021 Jun 3;9(6):64. doi: 10.3390/dj9060064.
- Quock RL, Warren-Morris DP. Fluoride varnish: the top choice for professionally applied fluoride. Tex Dent J. 2010 Aug;127(8):749-59.
- Sonesson M, Twetman S. Prevention of white spot lesions with fluoride varnish during orthodontic treatment with fixed appliances: a systematic review. Eur J Orthod. 2023 Sep 18;45(5):485-490. doi: 10.1093/ejo/cjad013.
- Moshiri M, Eckhart JE, McShane P, German DS. Consequences of poor oral hygiene during aligner therapy. J Clin Orthod. 2013 Aug;47(8):494-8. No abstract available.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- JUST20230273
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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