Comparative evaluation of Icon® resin infiltration and Clinpro™ XT varnish on colour and fluorescence changes of white spot lesions: a randomized controlled trial

Abstract

Background The aim of this trial was to comparatively evaluate Icon® resin infiltration and Clinpro™ XT varnish in restoring aesthetics of white spot lesions (WSLs) present post-orthodontic treatment. Materials and methods Two hundred forty WSLs were detected in 193 teeth of 12 patients. The participants were analysed—before intervention (T 0 ), immediately after intervention (T 1 ), 3 months later (T 2 ) and 6 months later (T 3 ), with a 1:1 allocation ratio for the application of Icon® resin infiltration and Clinpro™ XT varnish. Using a computer-generated allocation sequence, block randomization was done. A spectrophotometer was used to assess the colour of WSLs and the adjacent enamel, while a DIAGNOdent® was used to assess the fluorescence loss. Results Immediately after the intervention, Icon® resin infiltration showed statistically significant better improvement than Clinpro™ XT varnish in restoring the colour ( p = 0.000); however, at 3 ( p = 0.001) and 6 months ( p = 0.000), this was reversed. Except at 3 months, the fluorescence loss sequentially reduced more for Icon® resin infiltration (4.48 ± 1.42 at T 0 to 1.48 ± 0.81 at T 3 ) and was not statistically significant. Conclusions Clinpro™ XT varnish showed significantly better improvement than Icon® resin infiltration in restoring the colour and lightness of the WSLs at 3 and 6 months. The fluorescence loss significantly recovered with both intervention methods between immediate application and at 6 months. However, Clinpro™ XT varnish-treated WSLs showed a statistically significant difference compared to the adjacent sound enamel at 6 months.

Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis — a systematic review and meta-analysis

“…Regardless of the used outcome, resin infiltration showed a significantly higher optical improvement of WSL than remineralization alone (untreated WSL) as well as significantly higher optical improvement than the regular application of fluoride varnishes. Only in one study, fluoride varnish provided optical results comparable to resin infiltration [42]. However, in this study, inconsistencies of the inclusion criteria of the lesions were reported.…”

“…Nine studies were randomized control trials [34][35][36][37][38][39][40][41][42], one a prospective cohort study [43], and one did not report if it was a randomized or non-randomized study [44], all of which investigated the efficacy of resin infiltration on post-orthodontic [34,37,39,[41][42][43] or non-post-orthodontic [35,36] white spot lesions or fluorosis [38,40,44]. Resin infiltration was compared to fluoride varnish [35,36,42,43], untreated control [34,36,39,41], microabrasion [37,44], or bleaching [38,40]. The outcomes were described using DIAGNOdent values [35,36,42,43], spectroscopy [37,39,42,44], colorimetric values [40], ICDAS II [41,43] /LAA-ICDAS scores [36], or a modified enamel decalcification score…”

“…Resin infiltration was compared to fluoride varnish [35,36,42,43], untreated control [34,36,39,41], microabrasion [37,44], or bleaching [38,40]. The outcomes were described using DIAGNOdent values [35,36,42,43], spectroscopy [37,39,42,44], colorimetric values [40], ICDAS II [41,43] /LAA-ICDAS scores [36], or a modified enamel decalcification score [34]. Furthermore, visual analog scales (VAS) were used to evaluate the change/improvement in esthetics [38,41] or patients' oral health-related quality of life [40].…”

“…Meta-analyses were performed for studies with similar interventions and outcome measures investigated in more than one study. Although analysis showed that a meta-analysis could be performed for resin infiltration vs. untreated control [34,36,39,41] and for resin infiltration vs. fluoride varnish [35,36,42,43], one study in each comparison had to be excluded since not all information required for recalculation was reported [36] or the inclusion criteria of the lesions were inconsistent [42]. Even if not differentiating between untreated controls and fluoride varnish controls, no further study could have been included in meta-analysis.…”

“…Even if not differentiating between untreated controls and fluoride varnish controls, no further study could have been included in meta-analysis. Either data were not reported for recalculation (e.g., color difference (ΔE values) [42]) or data were presented insufficientlye.g., reporting an ordinally scaled outcome (ICDAS II score) by using values for continuous outcome [43].…”