Correlation of quantitative light-induced fluorescence and qualitative visual rating in infiltrated post-orthodontic white spot lesions

Abstract

Summary Objectives The aim of this prospective, clinical single-centre study was to evaluate the masking efficacy of post-orthodontic resin infiltration after 12-month follow-up and correlate quantitative and qualitative outcome measures. Methods Patients with completed fixed orthodontic treatment and the presence of one or more vestibular active non-cavitated white spot lesion/s (WSL) [ICDAS 1 or 2 (International Caries Detection and Assessment System)] were provided with resin infiltration 3–12 months after bracket removal. All patients (n = 31) participating before (t0) intervention were invited again and examined after 12 months (t2). Enamel demineralization was scored using quantitative light-induced fluorescence [QLF (DeltaF[flourescence], DeltaQ[lesion volume], White Spot Area)] and qualitative visual rating [11-point Likert-scale from 0 (no lesions visible on any tooth) to 10 (all teeth affected on the entire vestibular surface)]. Results In 17 patients (7 female and 10 male) 112 WSL (ICDAS 1: n = 1; ICDAS 2: n = 111) in 112 teeth were (re)examined. Before treatment (t0) a significant, weak (DeltaF), and moderate (DeltaQ, White Spot Area) correlation was observed between the quantitative and the qualitative rating (P < 0.002) [median DeltaF: −7.31 (−10.4/−6.58)%; DeltaQ:−2.25 (−10.8/−0.41)% mm2; White Spot Area: 0.34 (0.05/1.16) mm2; visual rating:3.7 ± 1.2]. Resin infiltration led to significantly increased fluorescence and decreased visual scores (P < 0.001) 7 days (t1) and 12 months (t2) after treatment. No significant changes based on DeltaF [−6.55 (−7.29/−6.08)%] and on visual ratings [1.0 ± 1.0] were observed between t1 and t2 (P = 1.000). After 7 days (t1) the correlation between the quantitative and the qualitative ratings remained significant, weak to moderate (P < 0.002). After 12 months (t2) the correlation was (non-)significant and weak for DeltaF, DeltaQ, and White Spot Area (P ≤ 0.097). Limitations Since the overall masking efficacy of resin infiltration has been shown previously, an untreated control group was omitted. Conclusions When assessing the masking efficacy of infiltrated post-orthodontic WSL only a weak to moderate correlation was found between QLF values and visual ratings. Furthermore, over time this correlation decreased. Thus, it remains unclear if QLF is a viable method to assess and quantify infiltrated post-orthodontic WSL over time. Trial registration German Clinical Trials Register (DRKS-ID:DRKS00005067).

Randomized in situ evaluation of surface polishing protocols on the caries-protective effect of resin Infiltrant

“…Although the present results showed that polishing neither influenced the caries-protective effect of resin infiltration nor the bacterial adhesion, from a clinical point of view and specially for labial white-spot lesions infiltrated for masking the whitish appearance, it is still probably more reasonable to polish then anyway. Data from previous clinical studies on this application showed that labial lesions may suffer from long-term staining, when not polished 41 – 43 . Moreover, contrary to the clinical studies on approximal lesions, which all did not report polishing procedures 29 , 44 – 47 , for labial lesions most of the clinical studies have been performed including polishing steps after light curing of the infiltrant 41 .…”

Randomized in situ evaluation of surface polishing protocols on the caries-protective effect of resin Infiltrant

“…Although the present results showed that polishing neither in uenced the caries-protective effect of resin in ltration nor the bacterial adhesion, from a clinical point of view and specially for labial white-spot lesions in ltrated for masking the whitish appearance, it is still probably more reasonable to polish then anyway. Data from previous clinical studies on this application showed that labial lesions may suffer from long-term staining, when not polished [37][38][39] . Moreover, contrary to the clinical studies on approximal lesions, which all did not report polishing procedures 29,40−43 , for labial lesions most of the clinical studies have been performed including polishing steps after light curing of the in ltrant 37 .…”

Evaluation of the masking efficacy of caries infiltration in post-orthodontic initial caries lesions: 1-year follow-up

“…Approval was given by the ethical committee of the RWTH Aachen (EK 110/13). The study design has previously been described in detail and a selection of data referring re-wetting, quantitative analysis of light-induced fluorescence, and qualitative visual rating have been formerly published [13,19]. Reporting follows the STROBE guideline for cohort studies [20].…”