Clinical Effect Of Two Fluoride Varnish In Inhibiting Enamel Demineralization In Fixed Appliance Therapy

Objective To compare the clinical efficacy of Doroflu sodium fluoride tooth protector?hereinafter referred to as Dole Fluoride?and ClinproTM White Varnish fluorine protective paint in inhibiting enamel demineralization in orthodontic fixed treatment.Methods?1?42 cases of 12-26 years old orthodontic patients treated with fixed appliance from October 2017 to March 2018 in the Department of Stomatology,Affiliated Hospital of Youjiang Medical College for the treatment of patients with fixed appliance therapy were randomly divided into group A?control group?,15 patients,238 teeth,group B?Duraphat intervention?,15 patients,280 teeth,and group C(Clinpro^TM White Varnish?3M ESPE?intervention),12 patients,192 teeth.The maxillary and mandibular central incisors to the first molars of each fixed appliance therapy patient were selected as the subjects of study?those with severe malposition or incomplete eruption were not included in the study?.?2?The demineralization scores and demineralization rate of the four quadrants around the bracket before and after treatment for 3 months,6 months,and 12 months were recorded and the demineralization index was calculated.?3?The demineralization indexes and demineralization rate were analyzed by SPSS23.0 statistical software.Rank sum test was used to the measurement data and chi-square test was used to the counting data.The difference was statistically significant with P<0.05.Results?1?Enamel demineralization of maxillary teeth in groups A,B and C:?1?Comparison of enamel demineralization index:The baseline values of enamel demineralization index of three groups of maxillary teeth were P>0.05,there was no significant difference and comparability;The demineralization index of enamel in group B and group C was lower than that in group A at 3,6 and 12 months after fixed appliance therapy?P<0.05?,but there was no significant difference between group C and group B?P>0.05?;?2?Comparison of enamel demineralization rates:The baseline values of enamel demineralization rate in three groups were P>0.05,with no significant difference and comparability;The demineralization rate of group B and C was lower than that of group A at 3,6 and 12 months after fixed appliance therapy?P<0.017?,but there was no significant difference between group B and C at 3 and 6months?P>0.017?,and the demineralization rate of group C at 12 months was lower than that of group B?P<0.017?,the difference was statistically significant.?3?Comparison of the trend of enamel demineralization with time:During 3,6 and 12 months of fixed appliance therapy,the demineralization rate of enamel showed an increasing trend.There was a significant difference between group A and group B(P_{trend A}<0.01;P_{trend B}<0.05),but there was no significant difference between group C(P _{trend C}>0.05).?2?Enamel demineralization of mandibular teeth in groups A,B and C:?1?Comparison of enamel demineralization index:The baseline values of the enamel demineralization index of the three groups of mandibular teeth were compared with P=0.096>0.05.The difference was not statistically significant and comparable;There was no significant difference in enamel demineralization index between group A,B and C at 3 months and 6 months after fixed appliance therapy?P>0.05?.Group B and group C were lower than group A at 12 months after treatment.The significance of learning?P<0.05?,there was no significant difference between group B and group C?P>0.05?;?2?Comparison of enamel demineralization rate:The baseline values of enamel demineralization rate of the three groups of mandibular teeth were compared with P>0.05.The difference was not statistically significant and comparable.There was no significant difference in enamel demineralization rate between the groups at 3 months and 6 months.P>0.05),the enamel demineralization rate of group B and group C was lower than that of group A at 12 months,the difference was statistically significant?P<0.017?,but there was no statistical difference in enamel demineralization rate between group B and group C.Academic significance?P>0.017?;?3?Comparison of enamel demineralization rate over time:During the 3 months,6 months and12 months of fixed appliance therapy,the demineralization rate of enamel increased.The difference of demineralization rate between group A and group B was statistically significant(P_{trend A}<0.01);P_{trend B}<0.05),the difference between the C group was not statistically significant(P _{trend C}>0.05);?3?Comparison of total enamel demineralization rates of upper and lower jaw teeth during fixed appliance therapy:There was no significant difference in the baseline value of demineralization rate between the upper and lower teeth before fixed appliance therapy?P>0.05?.It was comparable.The maxillary teeth demineralization rate was higher than that of the lower jaw when treated at 3 months,6 months and 12 months.The demineralization rate of teeth was statistically significant?P<0.05?.Conclusion?1?Enamel demineralization was visible to the naked eye in the third month during fixed appliance therapy,and the incidence and degree of demineralization increased with time.?2?The enamel demineralization rate of maxillary teeth is significantly higher than that of mandibular teeth in patients undergoing fixed appliance therapy.Therefore,we orthodontic doctors should pay more attention to the enamel demineralization of maxillary teeth in clinical work and take preventive measures as soon as possible.?3?Duraphat and Clinpro^TM White Varnish can effectively prevent enamel demineralization around brackets and reduce the occurrence of white spot lesion on enamel surface during fixed appliance therapy.?4?Regular application of Clinpro^TM White Varnish has certain advantages in terms of aesthetics,convenience and comfort for orthodontic fixed appliance therapy patients with high risk of enamel demineralization.It is worth promoting in clinic.