ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Opalustre More Effective For The Removal Of Enamel Fluorosis Stains Than PREMA
Clinical Question For a patient with enamel fluorosis stains, which micro-abrasion material, PREMA or Opalustre, is more effective in reducing the presence of staining?
Clinical Bottom Line Opalustre compound shows more rapid results and a higher mean rating for appearance improvement. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18051001Loguercia/200736 participants, 19 male and 17 female, 10-12 years, each having at least four maxillary incisors with fluorosisRTC-Split Mouth Design
Key resultsAfter the first clinical appointment, the Opalustre compound showed a statistically higher mean rating for improvement in appearance (3.4 +/- 0.7) than the PREMA compound (2.4 +/- 0.5) (Wilcoxon test, p=0.002).
Evidence Search "Fluorosis, Dental"[Mesh] AND "Enamel Microabrasion"[Mesh] ...view in PubMed
Comments on
The Evidence
The study design was a split mouth trial. There was a completion rate greater than 90% and all patients were treated with the both compounds, Opalustre and PREMA. There was adequate followup with the same questions being asked of all groups following treatment. This was not a double-blind study type and compliance was adequate. It was unclear whether recall bias would be unlikely, and there were no relevant competing interests. Overall, this study revealed a highly feasible treatment for patients diagnosed with dental fluorosis that could easily be implemented in a private practice setting. While both compounds seemed to reach the same results, the Opalustre worked a bit more quickly and efficiently than the PREMA compound within this group of 36 participants all with very similar condition characteristics.
Applicability These subjects with questionable to mild dental fluorosis are highly likely to be seen in private practice and this treatment shows to be highly feasible within this setting. Potential harms include the roughening of the tooth surface that follows microabrasion, but I believe the benefits outweigh the harms as the roughening will lessen over time. This microabrasion technique seems to be very effective and met patient’s expectations with a 97% degree of satisfaction.
Specialty/Discipline (General Dentistry)
Keywords dental fluorosis, enamel microabrasion
ID# 542
Date of submission: 03/26/2010spacer Revised: 09/20/2011
E-mail salinasa5@livemail.uthscsa.edu
Author Ana A. Salinas
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Mary Norma Partida, DDS, MPH
Faculty mentor/Co-author e-mail PARTIDAM@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Shachi Khatri (San Antonio, TX) on 04/16/2012
I conducted a PubMed search on this topic April 2012 and found a more recent publication: PubMed: 19057750. Using the CIE L*a*b* system in this in vitro study, no statistical differences between the two material were detected.
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