Aim The aim of the present randomized, controlled trial was to compare the impact of the regular use of a fluoride‐free microcrystalline hydroxyapatite (HAP) dentifrice and a 1400 ppm fluoride control dentifrice on caries progression in 150 highly caries‐active orthodontic patients. Methods The primary outcome was the occurrence of lesions with International Caries Detection and Assessment System (ICDAS) ≥code 1 on the vestibular surfaces of teeth 15‐25 within 168 days after fixation of orthodontic brackets. Secondary outcomes were lesion development ICDAS ≥code 2, the plaque index, and the gingival index. Results In total, 147 patients were included in the intent‐to‐treat (ITT) analysis; 133 finished the study per protocol (PP). An increase in enamel caries ICDAS ≥code 1 was observed in 56.8% (ITT) and 54.7% (PP) of the HAP group participants compared with 60.9% (ITT) and 61.6% (PP) of the fluoride control group. Non‐inferiority testing (ITT and PP) demonstrated the absence of a significant difference between the groups. No significant differences in secondary outcomes were observed between the groups. Conclusion In highly caries‐active patients, the impact of the regular use of a microcrystalline HAP dentifrice on caries progression is not significantly different from the use of a 1400 ppm fluoride toothpaste (ClinicalTrials.gov: NCT02705456).

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Survival of denture teeth may be influenced by material, oral position, and bearing situation.

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