Citation Information :
Nalawade VA, Jeri SY, Dash BP, Narayanamurthy S, Mohammed JS, Babu M. Effectiveness of Various Remineralizing Agents on White Spot Lesions after Orthodontic Treatment: A Comparative Study. J Contemp Dent Pract 2021; 22 (5):545-548.
Aim and objective: To evaluate and compare the ability of three commercially available remineralizing agents on the surface microhardness (SMH) of enamel after induction of white spot lesions (WSLs) by demineralization.
Materials and methods: About 80 sound mandibular human premolars that were later removed as a part of orthodontic treatment were employed in this research under the inclusion criteria. After cleaning and disinfecting the teeth, their crowns were mounted in acrylic resin and painted with nail varnish, not including a 3 mm × 3 mm window in the middle of the buccal surface. Each tooth was soaked in 15 mL of a demineralizing solution at a pH of 4.5 that was prepared for this study and left in a place for 10 subsequent days to permit the formation of WSLs after which the SMH was again assessed. The premolar teeth were then randomly allocated and equally divided into one of the four groups of 20 each depending on the treatment they received as Group 1: control group, Group 2: Colgate sensitive Pro-Relief toothpaste group, Group 3: Amflor group, and Group 4: Enafix group. After 15 days, the microhardness of all samples was estimated and alterations in the same were noted. Scanning electron microscopy (SEM) was used to evaluate the surface morphology.
Results: Enhanced and highest mean SMH was present in the Colgate sensitive Pro-Relief group (53.26 ± 0.10) followed by Enafix group (47.72 ± 0.21), Amflor group (44.84 ± 0.66), and control group (39.52 ± 0.32), respectively after application of remineralizing agents. Except for Group 3 vs Group 4, statistically significant differences (p < 0.05) were noted in all the groups.
Conclusion: All the three agents employed in this study, that is, Colgate sensitive Pro-Relief toothpaste, Amflor, and Enafix improved the SMH of teeth after the therapy given over 15 days compared to the microhardness following demineralization.
Clinical significance: White spot lesions often occur on labial surfaces of teeth after orthodontic treatment. Hence, these lesions pose esthetic challenges thereby affecting treatment satisfaction perceived by the patient. As esthetics and appearance are of foremost significance after orthodontic treatment, elimination protocols for remineralization of WSLs are of utmost importance employing economic means.
Heravi F, Ahrari F, Tanbakuchi B. Effectiveness of MI Paste Plus and Remin Pro on remineralization and color improvement of post-orthodontic white spot lesions. Dent Res J (Isfahan) 2018;15(2):95–103.
Temel SS, Kaya B. Diagnosis, prevention and treatment of white spot lesions related to orthodontics. Int J Oral Dent Health 2019;5:085. DOI: 10.23937/2469-5734/1510085.
Hu H, Feng C, Jiang Z, et al. Effectiveness of remineralising agents in prevention and treatment of orthodontically induced white spot lesions: a protocol for a systematic review incorporating network meta-analysis. Syst Rev 2019;8(1):339. DOI: 10.1186/s13643-019-1253-8.
Farzanegan F, Ameri H, Soleiman IM, et al. An in vitro study on the effect of amorphous calcium phosphate and fluoride solutions on color improvement of white spot lesions. Dent J (Basel) 2018;6(3):24. DOI: 10.3390/dj6030024.
Kakkar S, Singh G, Tandon P, et al. Comparison of various white spot lesion preventing medicaments: an in vitro study. J Indian Orthod Soc 2018;52(2):94–99. DOI: 10.1177/0974909820180203.
Lopatiene K, Borisovaite M, Lapenaite E. Prevention and treatment of white spot lesions during and after treatment with fixed orthodontic appliances: a systematic literature review. J Oral Maxillofac Res 2016;7(2):e1. DOI: 10.5037/jomr.2016.7201.
Mohanty P, Padmanabhan S, Chitharanjan AB. An in vitro evaluation of remineralization potential of novamin on artificial enamel sub-surface lesions around orthodontic brackets using energy dispersive X-ray analysis (EDX). J Clin Diagn Res 2014;8(11): ZC88–ZC91. DOI: 10.7860/JCDR/2014/9340.5177.
Rahimi F, Sadeghi M, Mozaffari HR. Efficacy of fluoride varnish for prevention of white spot lesions during orthodontic treatment with fixed appliances: a systematic review study. Biomed Res Ther 2017;4(8):1513–1526. DOI: 10.15419/bmrat.v4i08.222.
Sonesson M, Bergstrand F, Gizani S, et al. Management of post-orthodontic white spot lesions: an updated systematic review. Eur J Orthod 2017:39(2):116–121. DOI: 10.1093/ejo/cjw023.
Vinod D, Gopalakrishnan A, Subramani S, et al. A comparative evaluation of remineralizing potential of three commercially available remineralizing agents: an in vitro study. Int J Clin Pediatr Dent 2020;13(1):61–65. DOI: 10.5005/jp-journals-10005-1715.
Karad A, Dhole P, Juvvadi SR, et al. White spot lesions in orthodontic patients: an expert opinion. J Int Oral Health 2019;11:172–180. DOI: 10.4103/jioh.jioh_129_19.
Alsubhi H, Gabbani M, Alsolami A, et al. A comparison between two different remineralizing agents against white spot lesions: an in vitro study. Int J Dent 2021:1–5. DOI: 10.1155/2021/6644069.
Tahmasbi S, Adhami M, Valian A, et al. Effect of three different remineralizing agents on white spot lesions; an in vitro comparative study. J Islam Dent Assoc Iran (JIDAI) 2016;28(3):98–103. DOI: 10.30699/jidai.29.3.98.
Singh S, Singh SP, Goyal A, et al. Effects of various remineralizing agents on the outcome of post-orthodontic white spot lesions (WSLs): a clinical trial. Prog Orthod 2016;17(1):25. DOI: 10.1186/s40510-016-0138-9.
Khoroushi M, Kachuie M. Prevention and treatment of white spot lesions in orthodontic patients. Contemp Clin Dent 2017;8(1):11–19. DOI: 10.4103/ccd.ccd_216_17.