In Vitro Evaluation of the Effect of Fluoride Varnish Application Frequency on Initial Enamel Lesions

Year 2022, Volume: 49 Issue: 3, 96 - 100, 31.12.2022

Elif Şenay , Zeynep Ökte

https://doi.org/10.52037/eads.2022.0034

Cited By: 1

Abstract

Purpose: The aim of this study is the in vitro evaluation of the effect of fluoride varnish application at different frequencies on initial enamel lesions by surface microhardness (SMH) measurements.
Material and Methods: This in vitro experimental study was performed on 80 extracted unerupted third molar teeth. The teeth were divided randomly into 4 groups: Group 1: Fluoride varnish application once a year, Group 2: Fluoride varnish application 4 times at 1 week intervals, Group 3: Fluoride varnish application 4 times a year with an interval of 3 months, Group 4: Application of fluoride varnish twice a year at 6-month intervals. Artificial enamel carious lesions were created by inserting the specimens in demineralization solution for 96 hours. The Vicker’s microhardness number (VHN) was measured at baseline, after demineralization and after fluor varnish application and 1 year after fluoride treatments of each group. The percent change in surface microhardness (% SMH change) was also calculated. Anova and Kruskall-Wallis H test, t-test and/or Wilcoxen sign test were used with 95% confidence levels to compare differences.
Results: The surface microhardness values and recovery of surface hardness values of the groups were found as follows: Group 3> Group 2>Group 4> Group 1. VHN of Group 3 was statistically significantly higher than other groups (p<0.05).
Conclusion: Fluoride varnish application 4 times a year with an interval of 3 months showed significantly higher enamel SMH than that of the other groups (p<0.05).

Keywords

Demineralization, Fluoride varnish, Remineralization, Surface microhardness

Supporting Institution

Ankara University Scientific Research Projects Coordinatorship

Project Number

18L0234005

References

• 1- Arends J, Christoffersen J. The nature of early caries lesions in enamel. J Dent Res. 1986 Jan 65(1):2-11.
• 2- Ferreira MA, Mendes NS. Factors associated with active white enamel lesions. Int J Paediatr Dent 2005 Sep 15;(5):327-34.
• 3- Machiulskiene V, Campus G, Carvalho JC, Dige I, Ekstrand KR, Jablonski-Momeni A, et al. Terminology of Dental Caries and Dental Caries Management: Consensus Report of a workshop organized by ORCA and cariology research group of IADR. Caries Res. 2020 54(1):7-14.
• 4- Cury JA, Tenuta LM. Enamel remineralization: controlling the caries disease or treating early caries lesions? Braz Oral Res. 2009 23 Suppl 1:23-30.
• 5- Reynolds EC. Calcium phosphate‐based remineralization systems: scientific evidence? Aust Dent J 2008 Sep 53(3); 268-73.
• 6- Amaechi B T. Remineralization therapies for initial caries lesions. Curr Oral Health Rep 2015 2; 95–101.
• 7- Featherstone J, Glena R, Shariati M, Shields C. Dependence of in vitro demineralization of apatite and remineralization of dental enamel on fluoride concentration. J Dent Res 1990 Feb 69; (2): 620-5.
• 8- Featherstone JD. The science and practice of caries prevention. J Am Dent Assoc 2000 Jul 1;131(7):887-99.
• 9- Llena C, Leyda AM, Forner L. CPP-ACP and CPP-ACFP versus fluoride varnish in remineralisation of early caries lesions. A prospective study. Eur J Paediatr Dent. 2015 Sep 1;16(3):181-6.
• 10- Zero DT. Dentifrices, mouthwashes, and remineralization/caries arrestment strategies. InBMC Oral Health 2006 Jun 6;1.1-13.
• 11- Abreu-Placeres N, Garrido LE, Castillo Jáquez I, Féliz-Matos LE. Does applying fluoride varnish every three months better prevent caries lesions in erupting first permanent molars? A randomised clinical trial. Oral Health Prev Dent. 2019 Jan 1;17(6):541-6.
• 12- Ferreira JM, Aragão AK, Rosa AD, Sampaio FC, Menezes VA. Therapeutic effect of two fluoride varnishes on white spot lesions: a randomized clinical trial. Braz Oral Res 2009 23:446-51.
• 13- Toumba KJ, Twetman S, Splieth C, Parnell C, Van Loveren C, Lygidakis NΑ. Guidelines on the use of fluoride for caries prevention in children: an updated EAPD policy document. Eur Arc Paediatr Dent 2019 Dec;20(6):507-16.
• 14- Tenuta LM, Cury JA. Fluoride: its role in dentistry. Braz Oral Res 2010;24:9-17.
• 15- American Academy of Pediatric Dentistry. Fluoride therapy. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2021:302-5.
• 16- Buzalaf MAR. Review of Fluoride Intake and Appropriateness of Current Guidelines. Adv Dent Res. 2018 Mar;29(2):157-166.
• 17- Rana R, Itthagarun A, King NM. Effects of dentifrices on artificial caries like lesions: an in vitro pH cycling study. Int Dent J 2007 Aug 1;57(4):243-8.
• 18- Ten Cate JM, Duijsters PP. Alternating demineralization and remineralization of artificial enamel lesions. Caries Res1982;16(3):201-10.
• 19- Pashley DH, Tay FR, Yiu C, Hashimoto M, Breschi L, Carvalho RM, Ito S. Collagen degradation by host-derived enzymes during aging. J Dent Res. 2004 Mar;83(3):216-21.
• 20- Mohd Said SN, Ekambaram M, Yiu CK. Effect of different fluoride varnishes on remineralization of artificial enamel carious lesions. Int J Paediatr Dent. 2017 May;27(3):163-173.
• 21- Mount GJ. Defining, classifying, and placing incipient caries lesions in perspective. Dent Clin North Am. 2005 Oct;49(4):701-23.
• 22- Usha C, Sathyanarayanan R. Dental caries-A complete changeover (Part I). J Conserv Dent 2009 Apr;12(2):46.
• 23- Modéer T, Twetman S, Bergstrand F. Three‐year study of the effect of fluoride varnish (Duraphat) on proximal caries progression in teenagers. Eur J Oral Sci 1984 Oct;92(5):400-7.
• 24- Sköld UM, Petersson LG, Lith A, Birkhed D. Effect of school-based fluoride varnish programmes on approximal caries in adolescents from different caries risk areas. Caries Res 2005;39(4):273-9.
• 25- Weintraub JA, Ramos-Gomez F, Jue B, Shain S, Hoover CI, Featherstone JD, Gansky SA. Fluoride varnish efficacy in preventing early childhood caries. J Dent Res 2006 Feb;85(2):172-6.
• 26- Jabbarifar SE, Salavati S, Akhavan A, Khosravi K, Tavakoli N, Nilchian F. Effect of fluoridated dentifrices on surface microhardness of the enamel of deciduous teeth. Dent Res J 2011;8(3):113.
• 27- Neto FR, Maeda FA, Turssi CP, Serra MC. Potential agents to control enamel caries-like lesions. J Dent 2009 Oct 1;37(10):786-90.
• 28- Rirattanapong P, Vongsavan K, Suratit R, Tanaiutchawoot N, Charoenchokdilok V, Jeansuwannagorn S, Yoddee M. Effect of various forms of calcium in dental products on human enamel microhardness in vitro. Southeast Asian J Trop Med Public Health. 2012 Jul 1;43(4):1053-8.
• 29- Yesilyurt CE, Sezer U, Ayar MK, Alp CK, Tasdemir T. The effect of a new calcium‐based agent, Pro‐Argin, on the microhardness of bleached enamel surface. Aust Dent J 2013 Jun;58(2):207-12.
• 30- Oliveira MR, Oliveira PH, Oliveira LH, Horliana AC, Cesar PF, Moura SK, Bussadori SK. Microhardness of bovine enamel after different fluoride application protocols. Dent Mater J 2018 Nov 29:2017-399.
• 31- Elkassas D, Arafa A. Remineralizing efficacy of different calcium-phosphate and fluoride based delivery vehicles on artificial caries like enamel lesions. J Dent 2014 Apr 1;42(4):466-74.
• 32- Kooshki F, Pajoohan S, Kamareh S. Effects of treatment with three types of varnish remineralizing agents on the microhardness of demineralized enamel surface. J Clin Exp Dent 2019 Jul;11(7):e630.
• 33- Delbem AC, Danelon M, Sassaki KT, Vieira AE, Takeshita EM, Brighenti FL, Rodrigues E. Effect of rinsing with water immediately after neutral gel and foam fluoride topical application on enamel remineralization: an in situ study. Arch Oral Biol 2010 Nov 1;55(11):913-8.
• 34- Cardoso CA, De Castilho AR, Salomão PM, Costa EN, Magalhães AC, Buzalaf MA. Effect of xylitol varnishes on remineralization of artificial enamel caries lesions in vitro. J Dent 2014 Nov 1;42(11):1495-501.
• 35- Manarelli MM, Delbem AC, Lima TM, Castilho FC, Pessan JP. In vitro remineralizing effect of fluoride varnishes containing sodium trimetaphosphate. Caries Res 2014;48(4):299-305.
• 36- Mohd Said SN, Ekambaram M, Yiu CK. Effect of different fluoride varnishes on remineralization of artificial enamel carious lesions. Int J Paediat Dent 2017 May;27(3):163-73.
• 37- Seppä L, Tolonen T. Caries preventive effect of fluoride varnish applications performed two or four times a year. Eur J Oral Sci 1990 Apr;98(2):102-5.
• 38- Newbrun E. Current treatment modalities of oral problems of patients with Sjögren's syndrome: caries prevention. Adv Dent Res 1996 Apr;10(1):29-34.
• 39- Ripa LW. A critique of topical fluoride methods (dentifrices, mouthrinses, operator‐, and self‐applied gels) in an era of decreased caries and increased fluorosis prevalence. J Public Health Dent 1991 Mar;51(1):23-41.
• 40- Arends J, Schuthof J. Fluoride content in human enamel after fluoride application and washing - an in vitro study. Caries Res 1975;9(5):363-72.