The comparison of the efficacy of remineralization agents on white spot lesions

The aim of this in vivo study is to evaluate remineralization effects of fluoride varnish which contains tricalcium phosphate (TCP) and sodium fluoride (Clinpro White varnish), self assembling P 11-4 peptides (CurodontTM Repair) and combined application of these products on white spot lesions. 48 subjects, between 10-18 (13,91±2,92) ages with white spot lesions on their teeth are included in this study. Subjects are divided into 4 groups including 12 individuals as control group, fluoride varnish which contains tricalcium phosphate (TCP) and sodium fluoride (Clinpro White varnish) group, self assembling P 11-4 peptides (CurodontTM Repair) group and combined application of these products. At the beginning, each sbjects' caries risk profile is revealed by assessing diet cariogenicity, DMFS index, plaque index, gingival bleeding index, salivary flow rate, S. mutans and lactobacillus levels in saliva. At first, white spot lesions' activity and depth levels are evaluated with Nyvad caries diagnostic scale and ICDAS II respectively. Before doing any applications, white spot lesions' baseline demineralization values are determined numerically with DIAGNOdent that uses laser fluorescence principle and quantitative light induced fluorescence (QLF, InspektorTM Pro) device. Since another goal was esthetic improvements in the recovery of these lesions, baseline color assessments have been done with spectrophotometer device (Vita EasyShade). Oral health education is given to all the subjects and they are provided to brush their teeth twice daily with toothpaste that contains 1450 ppm sodium fluoride. Color (L and ΔE) and remineralization (ΔF, ΔQ ve lesion area) datas have been obtained in 6 weeks, 3 and 6 months. Obtained data was analyzed statistically. No statistically significant difference has been detected between groups in terms of criteria which shows the caries risk profile of the subjects and DIAGNOdent data (p>0,05). In all groups S. mutans levels in saliva and plaque index score decreased significantly in the 6th month. After remineralization, there was a statistically significant increase in ΔF only in Clinpro White varnish group in the 6th month, in ΔQ values in Clinpro White varnish group in the 6th month, in CurodontTM Repair and Clinpro White varnish combined application group in the 3th month and the lesion area showed a decrease in Clinpro White varnish group in the 6th month, in CurodontTM Repair group in the 3th month and in combined application group in the 3th and the 6th months (p<0,05) within groups. If we compare groups with each other ΔF, ΔQ and lesion area values are only seen statistically different in Clinpro White varnish group in the 6th month (p<0,05) when compared with the other groups. While L values statistically have decreased in all groups in the 6th month, the statistically difference was seen in ΔE values only for control group between the 3th and the 6th months. As a result remineralization has been affected positively with fluoride varnish that contains tricalcium phosphate (TCP) and sodium fluoride (Clinpro White varnish) in the 6th month, with self-assembling P 11-4 peptides (CurodontTM Repair) and the combination usage of them in the 3th month short term.