Effectiveness of different preventive agents on initial occlusal and proximal caries lesions: A follow-up study

Abstract

Background/purpose Monitoring the effects of different caries-preventive agents on initial caries lesions in orthodontic patients is important. Therefore, the purpose of this study is to investigate the efficacy of different preventive methods in preventing occlusal and proximal incipient lesions (ILs) during fixed orthodontic treatment. Materials and methods Forty-eight subjects at the beginning of fixed orthodontic treatment were included. All subjects were well educated and motivated to use the fluoride toothpaste (Colgate Total, 1450 ppm F) three times a day during the study period. Four different groups were created with a split-mouth design: placebo, fluoride gel, fluoride varnish, and chlorhexidine varnish. The occlusal surfaces of the second molar teeth were assessed with DIAGNOdent pen (DD) during the first 12 months (6th and 12th), and the proximal surfaces of each quadrant were monitored using bitewing radiographs until the 24th month (baseline and 24th month). Results The mean DD values increased in each group during the first 6 months compared to the baseline, but a significant increment was only obtained in the control and fluoride gel groups (p < 0.05). Fluoride and chlorhexidine varnish had significantly more preventive effects than the control and the fluoride gel for occlusal surfaces at the 6th and 12th month and for intact proximal surfaces at the 24th month, but no significant differences were found between the two varnish groups (p > 0.05). No significant differences were found between the four methods in terms of caries progression for proximal ILs after 24 months. Conclusion Effective toothbrushing with 1450 ppm fluoridated toothpaste and topical fluoride gel application seems to be inadequate for prevention of new proximal ILs during fixed orthodontic treatment. Fluoride and chlorhexidine varnish showed more protection in relation to occlusal surfaces.

Randomized Clinical Trial investigating Self-Assembling Peptide P11-4 for Treatment of Early Occlusal Caries

“…For the first time, such a guided enamel regeneration enables the tooth to get closer to its healthy state and further from the disease state 3,26 . Arresting a lesion with fluoride stops the imminent clinical issue at hand, but does little to alleviate the thread of a lesion becoming active again and progressing to a cavity 27 .…”

Biochemical and Mechanical Analysis of Occlusal and Proximal Carious Lesions

“…The biochemical characterization of proximal carious lesions is scarce in the literature. The susceptibility of different tooth surfaces for caries development and progression is markedly differed in occlusal versus smooth surfaces [ 21 ], added to differences in the inflammatory pulp response in proximal lesions as compared to occlusal lesions [ 22 ]. This might necessitate an assessment of the structural changes in proximal carious lesions in comparison to occlusal in the same tooth model.…”

Efficacy of Topical Strategies to Prevent the Onset of Root Caries Lesions, In vitro.

“…Consistent with these findings, the evidence has reported that 1% CHX gel significantly reduces root caries lesions [45, 46]. Moreover, it has even been recommended for root caries in patients requiring special care [44], such as institutionalized elderly people, as it can control established root lesions and reduce the incidence of new lesions [45].…”

“…Another noninvasive product for topical use as a preventive method for root caries is 1% chlorhexidine gel (CHX). Evidence shows that CHX can inhibit the growth of cariogenic bacteria on the root surface [39][40][41][42][43], specifically on S. mutans [44], reducing root caries lesions [45,46], and even as a tertiary preventive method, showing favorable results [45,47,48].…”