| Title |
Fluoride-Releasing Primers Do Not Reduce Risk of White Spot Lesions Compared to Conventional Primers During Orthodontic Treatment |
| Clinical Question |
In a patient undergoing orthodontic care, do fluoride releasing primers reduce risk of white spot lesions compared to conventional primers? |
| Clinical Bottom Line |
In patients that have fixed orthodontic appliances, fluoride-releasing primers do not reduce significantly the rate of white spot lesions compared to conventional primers. This is based on a clinical study of the limited available evidence. |
| Best Evidence |
|
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| 31901283 | Comert / 2020 | 60 patients divided in 2 groups | Clinical study | | Key results | Although fluoride decreases tooth demineralization, the study has shown that when incorporated into a primer for orthodontic treatment, there was no significant difference between fluoride-releasing primers compared to conventional primers to reduce white spot lesion rate. The WSL rate 26.9% for fluoride-releasing primers groups and 29% for conventional primers. It was concluded by the authors that the fluoride-releasing primer had no significant advantage in reducing demineralization over conventional primer during orthodontic treatment. | |
| Evidence Search |
PUBMED: ("demineralization"[All Fields] OR "white spot lesion"[All Fields] OR “WSL”[All fields] OR “decalcification”) AND ("primer"[All Fields] OR "adhesives"[All Fields]) AND ("orthodontic"[All Fields]) AND (“fluoride”[All fields]) |
Comments on
The Evidence |
This was a clinical study (prospective) comparing the rate of white spot lesions in patients who were treated with fluoride-releasing primers with that of conventional primers during orthodontic treatment. The study was comprised of an experimental group (30 patients) and a control group (30 patients), and special care was taken to include in both groups patients with similar characteristics (age, sex distribution, duration of treatment, crowding amount, buffer capacity, salivary flow, number of patients who needed extractions for the treatment). The two subject groups were selected according to several criteria: no visible enamel demineralization or restoration on the labial surfaces of the teeth, no morphologic crown anomalies, full permanent dentition and no physical disability that could prevent an adequate tooth brushing. Both groups were treated the same, except for the choice of primer, and had adequate follow up (patients were recalled every 4 weeks). After the orthodontic treatment, digital images of each tooth were taken in order to score and measure the WSLs with software. The DIAGNOdent pen was used as well to assess the WSLs. Two patients in each group did not attend regularly their appointments and were excluded from the final data analysis. There was no statement provided regarding competing interests. |
| Applicability |
White spot lesions have always been a concern for Orthodontists, as fixed orthodontic appliances make it harder to have good plaque control and thus increase the risk of enamel demineralization. White spot lesions are, in the majority of cases, irreversible and they carry an esthetic impact. Knowing that there is no clinically significance difference in the rate of white spot lesions whether using a fluoride-releasing primer compared to a conventional one, it would be more judicious for the clinician to pick a primer based on other factors, such as bonding strength. |
| Specialty |
(General Dentistry) (Orthodontics) |
| Keywords |
White spot lesion, WSL, demineralization, fluoride, primer, orthodontics
|
| ID# |
3469 |
| Date of submission |
11/22/2021 |
| E-mail |
foucher@livemail.uthscsa.edu |
| Author |
Anne-Isabelle Foucher |
| Co-author(s) |
Timothy Glesener |
| Co-author(s) e-mail |
Glesener@livemail.uthscsa.edu |
| Faculty mentor |
Ravikumar Anthony, BDS, MDS, MS |
| Faculty mentor e-mail |
Anthonyr@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?) |
| None available | |
 |
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
| None available | |