Masking-efficacy and caries arrestment after resin infiltration or fluoridation of initial caries lesions in adolescents during orthodontic treatment-A randomised controlled trial

Abstract

Objectives: The aim of this randomised, controlled, split-mouth trial was to assess the masking results in initial caries lesions (ICL) that were either resin infiltrated or fluoridated during treatment with fixed orthodontic appliances.

Methods: Adolescent patients (age range:12-18years) with fixed orthodontic appliances who had developed ICL [ICDAS 1 or 2 (International Caries Detection and Assessment System)] during orthodontic treatment were consecutively recruited and randomly assigned to either resin infiltration with up to 3 etching procedures (Group:Inf) or to 3-monthly application of a fluoride varnish (Group:FV). Both interventions were performed according to the manufacturer's recommendations. Primary and secondary outcomes (ΔE, ICDAS, DIAGNOdent) included the evaluation of the appearance of the ICL before (T₀), 1 week after (T₁) treatment and at the last appointment before debonding (T₂).

Results: Fifteen patients (8females, 7males) with 57ICL were included. Mean (SD) observation time at the last appointment before debonding was 0.5 (0.3) years. At T₀ FV and Inf did not differ significantly in ΔE (median ΔE_0,FV(25th/75th percentiles):11.6 (8.7/20.3): ΔE_0,Inf:15.1 (11.4/19.5); p_T0 = 0.135), ICDAS (p_T0 = 0.920) and DD (p_T0 = 0.367). At T₁ and T₂ ΔE values (p_T1<0.001, p_T2<0.001), ICDAS scores (p_T1<0.001, p_T2<0.001) and DIAGNOdent values (p_T1 = <0.001, p_T2 = <0.001) for Inf were significantly reduced whereas ΔE values (p_T1 = 0.382, p_T2 = 0.072) and ICDAS scores (p_T1 = 0.268, p_T2<0.001) for FV remained unchanged.

Conclusions: Resin infiltration effectively masked ICL during treatment with fixed orthodontic appliances both immediately after application and at the last appointment before debonding. Furthermore, the visual appearance of fluoridated lesions was not as satisfactory as that of the infiltrated ones at both T₁ and T₂.

Clinical significance: Resin infiltration effectively masked ICL during treatment with fixed orthodontic appliances both immediately after application and at the last appointment before debonding. Furthermore, the visual appearance of fluoridated lesions was not as satisfactory as that of the infiltrated ones immediately after first application as well as half a year after application.

Trial registration: German Clinical Trials Register (DRKS-ID: DRKS00011797).

Keywords: Aesthetics; Caries infiltration; Enamel lesions; Initial caries lesion; Micro-invasive treatment; Orthodontic treatment; White spot lesion.