Resin infiltration technique and fluoride varnish on white spot lesions in children: Preliminary findings of a randomized clinical trial

Giray, Figen Eren; Ma, Dan; Haznedaroğlu, Eda; Durmuş, Başak; Kalyoncu, IO; Tanboğa, İlknur

doi:10.4103/njcp.njcp_209_18

Cited by 23 publications

(15 citation statements)

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“…Table 1 , shows the primary characteristics of the 20 studies selected for this systematic review. Most of the studies selected are RCT [ 18 – 20 , 22 , 23 , 25 – 27 , 29 , 35 – 37 ]. There are also cross-sectional studies [ 21 , 28 , 30 , 32 , 33 ], longitudinal studies [ 24 , 34 ] and only one case report [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

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White spot lesions: diagnosis and treatment – a systematic review

Lopes,

Carvalho,

Gomes

et al. 2024

BMC Oral Health

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Background White spot lesions represent the first stage of caries and their prevalence has been increasing in recent years, particularly in patients undergoing orthodontic treatment. DIferential diagnosis and lesion activity are essential to decide on the clinical approaches to treatment. The aim of this study is to understand if the new diagnostic tools such as fluorescence, microradiography and computed microtomography have the potential to change the conventional treatment of white spots”. Methods A systematic search of available studies in the literature was carried out, using PRISMA guidelines, in Pubmed and Scopus electronic databases and manually to identify relevant articles to answer the PICO question: “Do the new diagnostic tools have the potential to change the conventional treatment of white spots?”. This systematic review included randomized controlled trials (RCT), cross-sectional and longitudinal studies complying with the following inclusion criteria: (i) studies in humans, (ii) studies about white spot lesions, (iii) studies published between 2012 and 2023, (iv) studies having both diagnosis and treatment and (v) studies with full text available. In this review we excluded other systematic reviews of clinical trials and in vitro studies. The RoB tool was used to assess the risk of bias. Results The systematic literature search identified 143 potentially relevant references, which after applying the exclusion criteria, resulted in 20 articles. Regarding diagnostic methods, most articles found were based on conventional methods of visual examination (n:10) or fluorescence (n:7). The least referenced diagnostic techniques were based on the use of clinical photographs (n:2), cross-sectional microradiography (n:1) and computed microtomography (n:1). The use of DIAGNOdent was reported by 3 in vitro studies. With regard to therapies, most studies reported the use of infiltrating resin (n:7) and fluoride-based products (n:5). Other studies have reported the use of self-assembling peptide P11-4 (n:1), home care (n:1), casein phosphopeptide-amorphous calcium phosphate (n:2) and hydrochloric acid (n:1). Combination therapies were also considered. Conclusion Diagnostic tool does not have the potential to change the form of treatment, whether it is a conventional method or a more differentiated one.

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Section: Resultsmentioning

confidence: 99%

“…Visual and fluorescence are the most frequent diagnostic techniques, but other techniques such as clinical photographs [ 18 , 19 ] and DIAGNOdent [ 35 – 37 ] are also used. Interestingly, one studie reported the use of two techniques: visual and fluorescence and fluorescence and transverse microradiography [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

White spot lesions: diagnosis and treatment – a systematic review

Lopes,

Carvalho,

Gomes

et al. 2024

BMC Oral Health

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“…When 2033 non-RCT records were removed, 349 articles were included in the final eligible assessment. Subsequently, 42 studies fulfilled the requirements of the systematic review [ 1 , 2 , 6 , 12 , 15 , 22 , 26 , 30 – 32 , 34 , 36 , 37 , 67 – 95 ]. Eleven studies were excluded from the NMA because the format of the results or the quantity of interventions is not appropriate for use in NMA [ 22 , 26 , 34 , 67 , 71 – 73 , 76 , 81 , 83 , 86 ].…”

Section: Resultsmentioning

confidence: 99%

“…Unlike remineralization therapy, resin infiltration, as a minimally invasive etch-adhesive system, can penetrate deep into caries and significantly improve the aesthetic effect of the surface of caries [ 50 , 106 , 107 ]. This means that resin infiltration therapy did not cause regeneration of the enamel, although the effectiveness of resin infiltration has been favored by many clinical studies and meta-analyses [ 37 , 40 , 50 , 108 ]. Visual indicators such as visual analog scale (VAS) may introduce a potential bias, which also questions the accuracy of optical indicators [ 50 , 58 ].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of therapies of white spot lesions: a systematic review and network meta-analysis

Xie

et al. 2023

BMC Oral Health

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Objective White spot lesions (WSLs), the earliest evidence of enamel demineralization, are considered amenable to intervention to achieve a remineralized or arrested state of caries. The management of WSLs is quite challenging, and there is no definitive cure as yet. We performed a network meta-analysis to assess the efficacy of seven therapies for WSLs and gave a hierarchy of them. Materials and methods We systematically searched the PubMed, EMBASE, Cochrane, and Web of Science databases (last search: July 2022) to identify all relevant studies. We limited our search to studies published in English. Randomized controlled designed in vitro/clinical trials related to the efficacy of the seven therapies for WSLs were included. Data extraction was performed independently by two reviewers. The risk of bias (ROB) 2.0 tool from Cochrane and a previous in vitro methodological tool will be used for the quality assessment. Variations in quantitative light-induced fluorescence (QLF), laser fluorescence (LF), and lesions area were the primary outcome measures. Standard mean difference (SMD) was used as the effect size for the Network meta-analysis (NMA). Consistency and inconsistency tests were conducted. The hierarchy of 7 treatment effects was evaluated using surface probabilities under cumulative ranking (SUCRA). Publication bias was evaluated using a bias plot. Results Forty-two articles were included in the systematic review. Thirty-one of them, with a total of 1906 participants, were included in the network meta-analysis. The studies owned a low and moderate risk of bias. This analysis does not suffer from significant inconsistency. The difference between 4 groups ‘self-assembled peptide (SAP) P11-4’, ‘P11-4 + Fluoride Varnish (FV)’, ‘Resin Infiltration (RI)’, ‘casein phosphor peptides-amorphous calcium fluoride phosphate (CPP-ACFP)’ and the 'Control' group was found to be statistically significant. Compared to the ‘FV’ and ‘casein phosphor peptides-amorphous calcium phosphate (CPP-ACP)’ groups, the ‘P11-4 + FV” group and ‘RI” group made a significant difference. The hierarchy was evident in the SUCRA values of 7 therapies. P11-4 + FV and RI were considered effective therapies compared to the control group or the FV group (gold standard group). Conclusions The available evidence suggests that resin infiltration and P11-4 in combination with fluoride varnish had advantages over gold standard (FV). The effect of tricalcium phosphate-based drugs and fluoride is not very noticeable. Overall, drugs based on P11-4 and resin infiltration will be better therapies. Using more than two drugs in combination also would increase efficacy.

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

et al. 2021

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Objective The present review systematically analyzed clinical studies investigating the efficacy of resin infiltration on post-orthodontic or non-post-orthodontic, white spot lesions (WSL), or fluorosis. Materials Five electronic databases (Central, PubMed, Ovid MEDLINE, Ovid EMBASE, LILACS) were screened. Article selection and data abstraction were done in duplicate. No language or time restrictions were applied. Outcomes were visual-tactile or DIAGNOdent measurements. Results Eleven studies with 1834 teeth being affected in 413 patients were included. Nine studies were randomized control trials, one a prospective cohort study, and one had an unclear study design. Meta-analysis could be performed for “resin infiltration vs. untreated control,” “resin infiltration vs. fluoride varnish,” and “resin infiltration without bleaching vs. resin infiltration with bleaching.” WSL being treated with resin infiltration showed a significantly higher optical improvement than WSL without any treatment (standard mean difference (SMD) [95% CI] = 1.24 [0.59, 1.88], moderate level of evidence [visual-tactile assessment]) and with fluoride varnish application (mean difference (MD) [95% CI] = 4.76 [0.74, 8.78], moderate level of evidence [DIAGNOdent reading]). In patients with fluorosis, bleaching prior to resin infiltration showed no difference in the masking effect compared to infiltration alone (MD [95% CI] = − 0.30 [− 0.98, 0.39], moderate level of evidence). Conclusion Resin infiltration has a significantly higher masking effect than natural remineralization or regular application of fluoride varnishes. However, although the evidence was graded as moderate, this conclusion is based on only very few well-conducted RCTs. Clinical relevance Resin infiltration seems to be a viable option to esthetically mask enamel white spot lesions and fluorosis.

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Resin infiltration technique and fluoride varnish on white spot lesions in children: Preliminary findings of a randomized clinical trial

Cited by 23 publications

References 0 publications

White spot lesions: diagnosis and treatment – a systematic review

White spot lesions: diagnosis and treatment – a systematic review

Comparison of therapies of white spot lesions: a systematic review and network meta-analysis

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

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