EFFICACY OF NOVEL BIOACTIVE GLASS IN THE TREATMENT OF ENAMEL WHITE SPOT LESIONS: A RANDOMIZED CONTROLLED TRIAL✰

Rania Salah; Rania R Afifi; Hany A Kehela; Nourhan M Aly; Maher Rashwan; Robert G Hill

doi:10.1016/j.jebdp.2022.101725

EFFICACY OF NOVEL BIOACTIVE GLASS IN THE TREATMENT OF ENAMEL WHITE SPOT LESIONS: A RANDOMIZED CONTROLLED TRIAL✰

J Evid Based Dent Pract. 2022 Dec;22(4):101725. doi: 10.1016/j.jebdp.2022.101725. Epub 2022 Mar 19.

Authors

Rania Salah¹, Rania R Afifi², Hany A Kehela², Nourhan M Aly², Maher Rashwan³, Robert G Hill⁴

Affiliations

¹ Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt. Electronic address: rania.salah@alexu.edu.eg.
² Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
³ Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt; Centre for Oral Bioengineering, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
⁴ Centre for Oral Bioengineering, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

PMID: 36494113
DOI: 10.1016/j.jebdp.2022.101725

Abstract

Objectives: to evaluate the efficacy of 2 types of bioactive glass (45S5) compared to casein-phosphopeptide stabilized-amorphous calcium phosphate (CPP-ACP) in the treatment of orthodontically-induced white spot lesions (WSLs).

Methods: Sixty post-orthodontic WSLs (ICDAS II score 2) were randomly allocated to a double blind randomized controlled trial with 3 parallel arms (n = 20). Test group I (Bio-BAG) received BiominF slurry and toothpaste, and test group II (N-BAG) received Novamin slurry and toothpaste. While the positive control group (CPP-ACP) received Recaldent paste. Products were applied daily in-office during week 1, and boosted by self-administered home application for 4 weeks (week 1-4). Standard oral hygiene care was performed by all participants twice daily during months 2-6. All patients were assessed for change in WSL dimensions using computer assisted analysis based on standardized digital intraoral photographs in addition to laser fluorescence DIAGNOdent assessment before treatment (T0) and at 1 week (T1), 1 month (T2), 3 months (T3,) and 6 months (T4) follow up periods.

Results: Kruskal Wallis test was used (P < .05 for all). At T4, a statistically significant (P < .001) regression of WSL was disclosed in all 3 groups compared to baseline, and a highly significant lesion size percent reduction in Bio-BAG group compared to the control group (P < .001). The mean area of the lesions decreased by 64.8%, 32.2%, and 31.6% for groups I, II and III respectively (P = .001). DIAGNOdent findings largely reflected the clinical scores (Mean scores at baseline/T4 for groups I, II, and III respectively; 16.57/3.62, 16.93/7.90, 21.95/19.27). No adverse effects were reported.

Conclusions: The combined in-office and home-application of BiominF paste for 4 weeks resulted in greater esthetic improvements of post-orthodontic WSLs compared to Novamin and CPP-ACP. In addition, BiominF showed a significant reduction in fluorescence intensity which indicates potential lesion remineralization.

Clinical relevance: Post-orthodontic WSLs can be diminished using bioactive glass remineralization therapy.

Keywords: Biominf; Cpp-acp; Diagnodent laser fluorescence; Novamin; Remineralization.

Publication types

Randomized Controlled Trial

MeSH terms

Cariostatic Agents / pharmacology
Cariostatic Agents / therapeutic use
Dental Caries* / therapy
Dental Enamel
Humans
Tooth Remineralization* / methods
Toothpastes / pharmacology
Toothpastes / therapeutic use

Substances

Cariostatic Agents
Toothpastes