Efficacy of Resin Infiltration and Fluoride Casein Phosphopeptide Amorphous Calcium Phosphate Varnish on Non-cavitated Active White Spot Lesions in Children: A Randomized Clinical Trial

Mohit Dhamija; Rish Tyagi; Namita Kalra; Amit Khatri

Authors

Mohit Dhamija
Rish Tyagi
Namita Kalra
Amit Khatri

Keywords:

Dental Caries, Tooth, Deciduous, Fluorides, Preventive Dentistry

Abstract

Objective: To compare the efficacy of resin infiltration and fluoride casein phosphopeptide amorphous calcium phosphate varnish on non-cavitated active white spot lesions in 5-8 years old children. Material and Methods: 60 non-cavitated active white spot lesions in 60 patients with ICDAS II score 2 from both genders in the age range of 5 to 8 years were taken. Thirty lesions were treated by resin infiltration (Group 1) and 30 by Fluoride CPP-ACP varnish (Group 2). Resin infiltration was performed on the same day, while Fluoride CPP-ACP varnish was applied once a week for 4 weeks. The follow-up was done at 3, 6 months, and 12 months. Results: At 3, 6, and 12 months change in mean ICDAS II Score in group 1 was 1.5±0.5,1.13±0.73 and 0.9±0.88, respectively, while in group 2, it was observed to be 0.30±0.59, 0.4±0.89 and 0.06±0.82, respectively (p<0.001). Conclusion: Resin infiltration was more successful than Fluoride CCP-ACP varnish in active non-cavitated white spot lesions.

References

Giray FE, Durhan MA, Haznedaroglu E, Durmus B, Kalyoncu IO, Tanboga I. Resin infiltration technique and fluoride varnish on white spot lesions in children: preliminary findings of a randomized clinical trial. Niger J Clin Pract 2018; 21(12):1564-9. https://doi.org/10.4103/njcp.njcp_209_18

Gugnani N, Pandit IK, Gupta M, Josan R. Caries infiltration of noncavitated white spot lesion: a novel approach for immediate esthetic improvement. Contemp Clin Dent 2012; 3(Suppl 2):199-202. https://doi.org/10.4103/0976-237X.101092

Munjal D, Garg S, Dhindsa A, Sidhu GK, Sethi HS. Assessment of white spot lesions and in-vivo evaluation of the effect of cpp-acp on white spot lesions in permanent molars of children. J Clin Diagn Res 2016; 10(5):149-54. https://doi.org/10.7860/JCDR/2016/19458.7896

Fejerskov O, Kidd E. Dental Caries: The Disease and its Clinical Management. 2nd. ed. New Jersey: John Wiley and Sons; 2009.

Meligy OAESE, Ibrahim STE, Alamoudi NM. Resin infiltration of non-cavitated proximal caries lesions: a literature review. J Oral Hyg Health 2018; 6(1):234. https://doi.org/10.4172/2332-0702.1000234

Son JH, Hur B, Kim HC, Park JK. Management of white spots: resin infiltration technique and microabrasion. J KorAcad Cons Dent 2011; 36(1):66-71. https://doi.org/10.5395/JKACD.2011.36.1.66

Weisrock G, Terrer E, Couderc G, Koubi S, Levallois B, Manton D, et al. Naturally aesthetic restorations and minimally invasive dentistry. J Minim Interv Dent 2011; 4(2):23-30.

Meyer-Lueckel H, Paris S. Progression of artificial enamel caries lesions after infiltration with experimental light curing resins. Caries Res 2008; 42(2):117-24. https://doi.org/10.1159/000118631

Ten Cate JM, Featherstone JD. Mechanistic aspects of the interactions between fluoride and dental enamel. Crit Rev Oral Biol Med 1991; 2(3):283-96. https://doi.org/10.1177/10454411910020030101

Azarpazhooh A, Main PA. Fluoride varnish in the prevention of dental caries in children and adolescents: a systematic review. J Can Dent Assoc 2008; 74(1):73-9.

Reynolds ECNB. Anticariogenic phosphopeptides. U.S. Patent No 5,015,628, 1991.

Taher NM, Alkhamis HA, Dowaidi SM. The influence of resin infiltration system on the enamel microhardness and surface roughness: an in vitro study. Saudi Dent J 2012; 24(2):79-84.

Paris S, Meyer-Lueckel H. Inhibition of caries progression by resin infiltration in situ. Caries Res 2010; 44(1):47-54. https://doi.org/10.1159/000275917

Paris S, Hopfenmuller W, Meyer-Lueckel H. Resin Infiltration of caries lesions: an efficacy randomized trial. J Dent Res 2010; 89(8):823-6. https://doi.org/10.1177/002203451036928

Paris S, Meyer-Lueckel H. Masking of labial enamel white spot lesions by resin infiltration—a clinical report. Quintessence Int 2009; 40(9):713-8.

Kielbassa AM, Muller J, Gernhardt CR. Closing the gap between oral hygiene and minimally invasive dentistry: a review on the resin infiltration technique of incipient (proximal) enamel lesions. Quintessence Int 2009; 40(8):663-81.

Hiremath SS. Textbook of Preventive and Community Dentistry. 2nd. ed. New Delhi: Elsevier India; 2011.

Featherstone JD. The caries balance: The basis for caries management by risk assessment. Oral Health Prev Dent 2004; 2(Suppl 1):259‐64.

Enaia M, Bock N, Ruf S. White‐spot lesions during multibracket appliance treatment: a challenge for clinical excellence. Am J Orthod Dentofacial Orthop 2011; 140(1):e17‐24. https://doi.org/10.1016/j.ajodo.2010.12.016

Paris S, Bitter K, Naumann M, Dorfer CE, Meyer-Lueckel H. Resin infiltration of proximal caries lesions differing in ICDAS codes. Eur J Oral Sci 2011; 119(2):182-6. https://doi.org/10.1111/j.1600-0722.2011.00807.x

Meyer-Lueckel H, Bitter K, Paris S. Randomized controlled clinical trial on proximal caries infiltration: three-year follow-up. Caries Res 2012; 46(6):544-8. https://doi.org/10.1159/000341807

Martignon S, Ekstrand KR, Gomez J, Lara JS, Cortes A. Infiltrating/sealing proximal caries lesions: a 3-year randomized clinical trial. J Dent Res 2012; 91(3):288-92. https://doi.org/10.1177/0022034511435328

Ekstrand KR, Bakhshandeh A, Martignon S. Treatment of proximal superficial caries lesions on primary molar teeth with resin infiltration and fluoride varnish versus fluoride varnish only: efficacy after 1 year. Caries Res 2010; 44(1):41-6. https://doi.org/10.1159/000275573

Turska-Szybka A, Gozdowski D, Mierzwińska-Nastalska E, Dorota Olczak-Kowalczyk D. Randomised clinical trial on resin infiltration and fluoride varnish vs fluoride varnish treatment only of smooth-surface early caries lesions in deciduous teeth. Oral Health Prev Dent 2017; 15(2):122.

Shen P, Bagheri R, Walker GD, Yuan Y, Stanton DP, Reynolds C, et al. Effect of calcium phosphate addition to fluoride containing dental varnishes on enamel demineralization. Aust Dent J 2016; 61(3):357-65. https://doi.org/10.1111/adj.12385

Oliveira GM, Ritter AV, Heymann HO, Swift E Jr, Donovan T, Brock G, et al. Remineralization effect of CPP-ACP and fluoride for white spot lesions in vitro. Dent 2014; 42(12):1592-602. https://doi.org/10.1016/j.jdent.2014.09.004

Tuloglu N, Bayrak S, Tunc ES, Ozer F. Effect of fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate on the acid resistance of the primary enamel. BMC Oral Health 2016; 16:1-7. https://doi.org/10.1186/s12903-016-0299-4

Güçlü ZA, Alaçam A, Coleman NJ. Corrigendum to "A 12-week assessment of the treatment of white spot lesions with CPP-ACP paste and/or fluoride varnish". Biomed Res Int 2018; 2018:1816959. https://doi.org/10.1155/2018/1816959.

Girish Babu KL, Subramaniam P, Tele S. Remineralization potential of varnish containing casein phosphopeptides-amorphous calcium phosphate with fluoride and varnish containing only fluoride: a comparative study. Saudi J Oral Sci 2018; 5(1):35-40. https://doi.org/10.4103/sjos.SJOralSci_44_17

Çiftçi ZZ, Hanimeli S, Karayilmaz H, Güngör ÖE. The efficacy of resin infiltrate on the treatment of white spot lesions and developmental opacities. Niger J Clin Pract 2018; 21(11):1444-9. https://doi.org/10.4103/njcp.njcp_235_18