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Efficacy evaluation of an anti-caries varnish: protocol for a phase II randomised controlled trial.
Milgrom, P, Tut, O, Rothen, M, Mancl, L, Gallen, M, Tanzer, JM
BMJ open. 2017;(6):e017866
Abstract
INTRODUCTION Dental caries (tooth decay) is a common disease in which the products of sugar metabolism by certain bacteria that populate the tooth surface induce the development and progression of lesions (cavities). This is a phase II single-centre randomised, double-blind, active-controlled, parallel-group trial to assess the efficacy of a combination povidone iodine and sodium fluoride dental varnish to determine if it is superior to a varnish containing only sodium fluoride in the prevention of new caries lesions. The objective of this report is to describe the rationale and protocol for the trial. METHODS AND ANALYSIS The study site is Pohnpei State, Federated States of Micronesia. The study population is 284 children 48-84 months old. The primary outcome will be the surface-level primary molar caries increment (d2-3mfs/DMFS) at 2 years post baseline. The incremental dental caries at 1 year will also be compared between the two interventions. The secondary outcome is the Facial Image Scale after the initial treatment and after the fifth treatment at 1 year that gauges the child's response to the treatment. ETHICS AND DISSEMINATION The Western Institutional Review Board (designated IRB) and the Institutional Review Board of the College of Micronesia-FSM approved all study procedures. The US Food and Drug Administration (FDA) has issued IND 128835 covering this study. The study results will be published and submitted to the FDA in support of a new drug application. TRIALREGISTRATION NUMBER NCT03082196.
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2.
Evaluation of fluoride varnish and its comparison with pumice prophylaxis using self-etching primer in orthodontic bonding--an in vivo study.
Grover, S, Sidhu, MS, Prabhakar, M, Jena, S, Soni, S
European journal of orthodontics. 2012;(2):198-201
Abstract
The aim of this study was to evaluate the use of fluoride varnish as a prophylaxis method with self etching primer (SEP) and its comparison with pumice before orthodontic bonding. Thirty seven orthodontic patients participated in a prospective clinical trial. A split mouth technique was used in each patient, one quadrant was assigned to fluoride varnish and the contralateral quadrant to pumice prophylaxis. A total of 684 teeth were bonded with SEP (Transbond plus; 3M Unitek) and monitored for 6 months for bond failures. A total of 42 (6.1%) failures were recorded, 9 (2.6%) in the pumice group and 33 (9.6%) in the fluoride varnish group. Chi-square analysis was used to compare the number of bracket failures between the pumice and fluoride varnish groups and the number of patients in each group experiencing at least one bond failure. Statistically significant differences were found both in total number of bond failures (P < 0.001) and in the number of patients with bond failures (P < 0.05) between both groups. A significantly lower and clinically acceptable bond failure rate was observed with Transbond Plus self etching primer after pumice prophylaxis.
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3.
A clinical trial to evaluate the effects of prophylactic fluoride agents on the superelastic properties of nickel-titanium wires.
Vo, J, Chudasama, DN, Rinchuse, DJ, Day, R
World journal of orthodontics. 2010;(2):135-41
Abstract
AIM: To study the effects of a prophylactic fluoride regimen on the mechanical properties of nickel-titanium (Ni-Ti) archwires under clinical conditions. METHOD The unloading properties of 100 Ni-Ti wires were tested using a three-point bending test at five deflections (0.5 mm, 1.0 mm, 2.0 mm. 3.0 mm, and 3.1 mm). Sixty-six 0.016 3 0.022-inch Ni-Ti wires were tested after being used intraorally for 6 weeks using two protocols. Thirty-three wires were evaluated after the use of fluoride-containing Crest toothpaste (sodium fluoride 0.243%, 0.15% w/v fluoride ion) and Equate fluoride rinse (sodium fluoride 0.05%, fluoride ion 0.0226%). Another 33 wires were examined after a nonfluoridated natural toothpaste (Tom's of Maine; calcium carbonate, xylitol, myrrh, propolis, sodium lauryl sulfate, carrageenan, spearmint and peppermint oils, glycerin, and water) was used. Another 34 Ni-Ti wires served as a control; they were tested as received. Statistical analyses were carried out with a linear-mixed model (analysis of variance [ANOVA]). RESULTS Force degradation occurred within both groups of intraorally used wires but not in the unused archwires. When compared to unexposed wires, those with fluoride exposure exhibited slightly higher force degradation at 3.1 and 3.0 mm deflection, but they displayed less force degradation at 0.5 and 1.0 mm deflection. CONCLUSIONS Topical fluoride regimens decreased the unloading property of Ni-Ti wires at higher deflections but increased it at lower deflections.
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4.
Chemical exchange between glass-ionomer restorations and residual carious dentine in permanent molars: an in vivo study.
Ngo, HC, Mount, G, Mc Intyre, J, Tuisuva, J, Von Doussa, RJ
Journal of dentistry. 2006;(8):608-13
Abstract
OBJECTIVE To evaluate the remineralization of carious dentine following the restoration of an extensive lesion in a permanent molar with a high strength glass-ionomer cement (GIC). MATERIALS AND METHODS Thirteen first permanent molars, which were scheduled for extraction because of the presence of extensive caries lesions, were selected for this study. They were first restored, according to the ART technique, using encapsulated Fuji IX(GP), which contains a strontium glass rather than the traditional calcium glass. The cavities were prepared with a clean enamel margin and minimal removal of the carious dentine around the walls. After a period of 1-3 months they were harvested and subsequently sectioned and examined using an electron probe microanalysis (EPMA) and scanning electron microscopy (SEM). RESULTS EPMA demonstrated that both fluorine and strontium ions had penetrated deep into the underlying demineralized dentine. The only possible source of these ions was the GIC restoration. CONCLUSION The pattern of penetration of the fluorine and strontium ions into the dentine was consistent with a remineralization process.
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5.
Effect of fluoride varnish on the in vitro bond strength of orthodontic brackets using a self-etching primer system.
Kimura, T, Dunn, WJ, Taloumis, LJ
American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics. 2004;(3):351-6
Abstract
To reduce the number of steps involved with bonding procedures, manufacturers have simplified adhesive systems by combining the hydrophilic primer and the adhesive, or by combining the etchant, the primer, and the adhesive into 1 bottle and application. The purpose of this study was to investigate the relationship between the shear bond strength of orthodontic brackets to enamel, with or without fluoride varnish, by using either conventional or self-etching primer systems. Forty-eight extracted teeth were divided into 4 groups of 12 teeth each: group 1, fluoride varnish, conventional adhesive; group 2, fluoride varnish, self-etching primer system; group 3, no fluoride varnish, conventional adhesive; and group 4, no fluoride varnish, self-etching primer system. The bonding procedure followed the manufacturers' recommendations for the materials. Precoated adhesive orthodontic brackets were light-cured to the facial surfaces of the teeth and stored in whole human saliva at 37 degrees C for 24 hours. The specimens were subjected to a shear force in a testing machine until failure. The adhesive remnant index was used to score the teeth. Data were analyzed with a 2-way analysis of variance to test for differences in shear bond strength with respect to fluoride varnish and type of adhesive system used. The results showed no difference in bond strength among any of the experimental groups. Similarly, chi-square analysis determined that adhesive remnant index scores were not statistically different. The application of fluoride varnish does not affect the bond strength of orthodontic brackets to enamel with conventional or self-etching primer systems.
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6.
Effect of xylitol-containing chewing gums on lactic acid production in dental plaque from caries active pre-school children.
Twetman, S, Stecksén-Blicks, C
Oral health & preventive dentistry. 2003;(3):195-9
Abstract
PURPOSE The aim of this study was to evaluate the lactic acid concentration in supragingival plaque from caries-active pre-school children after a short-term use of either xylitol- or sorbitol-containing chewing gums. MATERIAL AND METHODS The investigation consisted of a prospective crossover design with 10 healthy children aged 2-4 years each with at least two caries lesions within the dentine (ds > or = 2). The children were instructed to chew 6 pieces of a test or a control gum every day for a 14-day period. The test gum contained 65% xylitol and the control gum was sweetened with sorbitol. At baseline and after 14 days, salivary mutans streptococci were enumerated with a chair-side test (Strip mutans) and dental plaque was collected from the upper maxillary incisors. After a washout period of 6 weeks, the same procedure was repeated with the corresponding test or control gum. Lactic acid was determined enzymatically in glucose-challenged plaque suspensions. RESULTS The lactic acid concentration was significantly reduced (p<0.05) by 22% compared with baseline following the xylitol gum regimen but was unaltered after the control gum. The levels of salivary mutans streptococci were mainly unaffected by both chewing gums. CONCLUSION A 14-day use of xylitol-containing chewing gums, corresponding to a daily amount of 5 grams of xylitol, could diminish glucose-initiated lactic acid formation in supragingival plaque in caries-active pre-school children.
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7.
A clinical trial of the anticaries efficacy of casein derivatives complexed with calcium phosphate in patients with salivary gland dysfunction.
Hay, KD, Thomson, WM
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2002;(3):271-5
Abstract
OBJECTIVE The purpose of this study was to compare the caries preventive efficacy of a mouthrinse solution containing casein derivatives coupled with calcium phosphate (CD-CP) with that of a 0.05% sodium fluoride mouthrinse among individuals with dry mouth. STUDY DESIGN A randomized control trial design was used. Participants included individuals who had had radiotherapy for head and neck cancer (n = 82) and others with Sjögren's syndrome (n = 56). Baseline data collection was followed by reexamination 12 months later. Posterior bite-wing radiographs were taken on both occasions. RESULTS A total of 124 participants, 61 (49.2%) in the sodium fluoride group and 63 (50.8%) in the CD-CP group, completed the 12-month examination. The baseline characteristics of the 2 groups did not differ. Coronal caries incidence was higher in the sodium fluoride group than in the CD-CP group (34.4% and 27%, respectively), but the difference was not statistically significant. Similarly, the small difference in coronal caries increment between the 2 groups was not statistically significant (0.4 and 0.3 surfaces, respectively). There was insufficient root surface caries experience between the 2 groups observed for differences to be examined. Proportionately more of the CD-CP group lost 1 or more teeth, and the mean number of tooth loss was higher. The participants with the highest incidence and increment were those with Sjögren's syndrome in the CD-CP group. Some of that difference was accounted for by differences in baseline caries status. CONCLUSION It appears that CD-CP preparations hold promise as caries preventive agents for individuals with dry mouth, although confirmation of this study's findings in other settings is warranted before a definitive conclusion can be reached.
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8.
Effect of four dental varnishes on the colonization of cariogenic bacteria on exposed sound root surfaces.
Ekenbäck, SB, Linder, LE, Lönnies, H
Caries research. 2000;(1):70-4
Abstract
The aim of this study was to evaluate the effect of four different dental varnishes on the colonization of mutans streptococci, total streptococci and lactobacilli on exposed sound root surfaces. Sixty-five individuals were randomly allotted to one of four groups for treatment with Cervitec((R) ) varnish containing 1% chlorhexidine and 1% thymol, a thymol varnish or one of two different fluoride varnishes, Fluor Protector and Duraphat. The varnish was applied to three buccal root surfaces in each patient at baseline and after 1 week. Dental plaque from the root surfaces was collected and analysed on four different occasions: at baseline, after 1 week, 1 month and 6 months. The Cervitec varnish caused a statistically significant reduction in the number of mutans streptococci over time. The reduction was significant at 1 week and 1 month relative to baseline. The numbers of total streptococci and lactobacilli were not significantly affected by treatment with Cervitec. No statistically significant difference over time was found for mutans streptococci, lactobacilli or total streptococci after treatment with the fluoride varnishes or the thymol varnish.