Comparative Evaluation of Resin Infiltration and Bifluoride Varnish in White Spots in Children between the Ages of 8 and 15 Years

ORIGINAL ARTICLE
Blerta Krasniqi, Meri Pavlevska, Erejeta Deva Kurshumliu, Blerta Latifi Xhemajli, Teuta Kutllovci

 
For citation: Krasniqi B, Pavlevska M, Kurshumliu ED, Xhemajli BL, Kutllovci T. Comparative Evaluation of Resin Infiltration and Bifluoride Varnish in White Spots in Children between the Ages of 8 and 15 Years. International Journal of Biomedicine. 2024;14(2):329-334. doi:10.21103/Article14(2)_OA16
 
Originally published June 5, 2024
 

Abstract: 

The aim of this study was to compare the efficacy of resin infiltration and bifluoride varnish in white spot lesions (WSLs) in children between the ages of 8 and 15.
Methods and Results: This study was conducted at Alma Mater Europaea Campus College "Rezonanca" (Pristina, Kosovo) and enrolled 60 participants (34 females and 26 males) between the ages of 8 and 15 years with WSLs in the vestibular surface on permanent anterior teeth. The participants were randomly assigned to the resin infiltration (Icon®) group (Group 1, n=30) and the bifluoride varnish (F&A Biflu) group (Group 2, n=30). Both materials were applied on permanent anterior teeth with WSLs in enamel. WSLs were assessed using ICDAS-II (International Caries Detection and Assessment System) criteria by visual inspection, which were coded as 1 and 2. Lesions were evaluated before the material was applied (T0), just after application (T1), and at a 6-month follow-up (T2). A total of 173 teeth from 60 participants were included in our study. Group 1 showed a significant decrease in ICDAS-II scores throughout time intervals T0-T1 (P=0.001), T0-T2 (P=0.001), and T1-T2 (P=0.041). In Group 2, there was no visible difference between T0-T1 (P=1.00) but a significant decrease between T0-T2 (P=0.001) and T1-T2 (P=0.001). Comparisons between the two groups in relation to T0, T1, and T2 were analyzed using the independent samples t-test. Significant differences have been presented in two cases at T1 (P=0.001) and T2 (P=0.003). ICDAS-II scores decreased significantly in Group 1.
Conclusion: The application of RI in WSLs was found to be more effective than the application of BFV. While the effects of BFV in WSLs persisted over time, the effect of RI was evident as soon as WSLs were treated. Moving forward, we recommend considering RI as a favorable option for WSL treatment. Future studies with long-term follow-ups are necessary to corroborate these results.

Keywords: 
white spot lesion • ICDAS-II criteria • bifluoride varnish • resin infiltration
References: 
  1. Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet. 2007 Jan 6;369(9555):51-9. doi: 10.1016/S0140-6736(07)60031-2. PMID: 17208642.
  2. Pitts NB, Zero DT, Marsh PD, Ekstrand K, Weintraub JA, Ramos-Gomez F, Tagami J, Twetman S, Tsakos G, Ismail A. Dental caries. Nat Rev Dis Primers. 2017 May 25;3:17030. doi: 10.1038/nrdp.2017.30. PMID: 28540937.
  3. Mathur VP, Dhillon JK. Dental Caries: A Disease Which Needs Attention. Indian J Pediatr. 2018 Mar;85(3):202-206. doi: 10.1007/s12098-017-2381-6. Epub 2017 Jun 23. PMID: 28643162.
  4. Ferreira MA, Mendes NS. Factors associated with active white enamel lesions. Int J Paediatr Dent. 2005 Sep;15(5):327-34. doi: 10.1111/j.1365-263X.2005.00641.x. PMID: 16128996.
  5. Cazzolla AP, De Franco AR, Lacaita M, Lacarbonara V. Efficacy of 4-year treatment of icon infiltration resin on postorthodontic white spot lesions. BMJ Case Rep. 2018 Jul 18;2018:bcr2018225639. doi: 10.1136/bcr-2018-225639. PMID: 30021744; PMCID: PMC6058148.
  6. Dhamija M, Tyagi R, Kalra N, Khatri A. Efficacy of resin infiltration and fluoride casein phosphopeptide amorphous calcium phosphate varnish on non-cavitated active white spot lesions in children: a randomized clinical trial. Pesqui Bras Odontopediatria Clín Integr. 2022; 22:e210094. doi: 10.1590/pboci.2022.059.
  7. Temel SS, Kaya B. Diagnosis, Prevention and Treatment of White Spot Lesions Related to Orthodontics. Int J Oral Dent Health.2019;5:085. doi: 10.23937/2469-5734/1510085.
  8. Bishara SE, Ostby AW. White spot lesions: Formation, prevention, and treatment. Semin Orthod.2008;14:174-182.
  9. Abbas BA, Marzouk ES, Zaher AR. Treatment of various degrees of white spot lesions using resin infiltration-in vitro study. Prog Orthod. 2018 Aug 6;19(1):27. doi: 10.1186/s40510-018-0223-3. PMID: 30079435; PMCID: PMC6081872.
  10. Ogaard B, Rølla G, Arends J. Orthodontic appliances and enamel demineralization. Part 1. Lesion development. Am J Orthod Dentofacial Orthop. 1988 Jul;94(1):68-73. doi: 10.1016/0889-5406(88)90453-2. PMID: 3164585.
  11. Borges BC, de Souza Borges J, de Araujo LS, Machado CT, Dos Santos AJ, de Assunçao Pinheiro IV. Update on nonsurgical, ultraconservative approaches to treat effectively non-cavitated caries lesions in permanent teeth. Eur J Dent. 2011 Apr;5(2):229-36. PMID: 21494394; PMCID: PMC3075999.
  12. Sonesson M, Bergstrand F, Gizani S, Twetman S. Management of post-orthodontic white spot lesions: an updated systematic review. Eur J Orthod. 2017 Apr 1;39(2):116-121. doi: 10.1093/ejo/cjw023. PMID: 27030284.
  13. Ferreira JM, Aragão AK, Rosa AD, Sampaio FC, Menezes VA. Therapeutic effect of two fluoride varnishes on white spot lesions: a randomized clinical trial. Braz Oral Res. 2009 Oct-Dec;23(4):446-51. doi: 10.1590/s1806-83242009000400015. PMID: 20027453.
  14. Paris S, Hopfenmuller W, Meyer-Lueckel H. Resin infiltration of caries lesions: an efficacy randomized trial. J Dent Res. 2010 Aug;89(8):823-6. doi: 10.1177/0022034510369289. Epub 2010 May 26. PMID: 20505049.
  15. Senestraro SV, Crowe JJ, Wang M, Vo A, Huang G, Ferracane J, Covell DA Jr. Minimally invasive resin infiltration of arrested white-spot lesions: a randomized clinical trial. J Am Dent Assoc. 2013 Sep;144(9):997-1005. doi: 10.14219/jada.archive.2013.0225. PMID: 23989837.
  16. Bagher SM, Hegazi FM, Finkelman M, Ramesh A, Gowharji N, Swee G, Felemban O, Loo CY. Radiographic Effectiveness of Resin Infiltration in Arresting Incipient Proximal Enamel Lesions in Primary Molars. Pediatr Dent. 2018 May 15;40(3):195-200. PMID: 29793566.
  17. Lee JH, Kim DG, Park CJ, Cho LR. Minimally invasive treatment for esthetic enhancement of white spot lesion in adjacent tooth. J Adv Prosthodont. 2013 Aug;5(3):359-63. doi: 10.4047/jap.2013.5.3.359. Epub 2013 Aug 31. PMID: 24049579; PMCID: PMC3774952.
  18. Paris S, Meyer-Lueckel H, Cölfen H, Kielbassa AM. Resin infiltration of artificial enamel caries lesions with experimental light curing resins. Dent Mater J. 2007 Jul;26(4):582-8. doi: 10.4012/dmj.26.582. PMID: 17886464.
  19. Paris S, Meyer-Lueckel H, Kielbassa AM. Resin infiltration of natural caries lesions. J Dent Res. 2007 Jul;86(7):662-6. doi: 10.1177/154405910708600715. PMID: 17586715.
  20. Meyer-Lueckel H, Paris S. Improved resin infiltration of natural caries lesions. J Dent Res. 2008 Dec;87(12):1112-6. doi: 10.1177/154405910808701201. PMID: 19029077.
  21. Taher NM, Alkhamis HA, Dowaidi SM. The influence of resin infiltration system on enamel microhardness and surface roughness: An in vitro study. Saudi Dent J. 2012 Apr;24(2):79-84. doi: 10.1016/j.sdentj.2011.10.003. Epub 2011 Nov 16. PMID: 23960533; PMCID: PMC3723288.
  22. Paris S, Meyer-Lueckel H. Inhibition of caries progression by resin infiltration in situ. Caries Res. 2010;44(1):47-54. doi: 10.1159/000275917. Epub 2010 Jan 16. PMID: 20090328.
  23. Paris S, Meyer-Lueckel H. Masking of labial enamel white spot lesions by resin infiltration--a clinical report. Quintessence Int. 2009 Oct;40(9):713-8. PMID: 19862396.
  24. Kielbassa AM, Muller J, Gernhardt CR. Closing the gap between oral hygiene and minimally invasive dentistry: a review on the resin infiltration technique of incipient (proximal) enamel lesions. Quintessence Int. 2009 Sep;40(8):663-81. PMID: 19639091.
  25. Hiremath SS. Textbook of Preventive and Community Dentistry. 2nd. ed. New Delhi: Elsevier India; 2011.
  26. Enaia M, Bock N, Ruf S. White-spot lesions during multibracket appliance treatment: A challenge for clinical excellence. Am J Orthod Dentofacial Orthop. 2011 Jul;140(1):e17-24. doi: 10.1016/j.ajodo.2010.12.016. PMID: 21724067.
  27. Petersson LG. Fluoride mouthrinses and fluoride varnishes. Caries Res. 1993;27 Suppl 1:35-42. doi: 10.1159/000261600. PMID: 8500123.
  28. Tranaeus S, Al-Khateeb S, Björkman S, Twetman S, Angmar-Månsson B. Application of quantitative light-induced fluorescence to monitor incipient lesions in caries-active children. A comparative study of remineralisation by fluoride varnish and professional cleaning. Eur J Oral Sci. 2001 Apr;109(2):71-5. doi: 10.1034/j.1600-0722.2001.00997.x. PMID: 11347658.
  29. Mohd Said SN, Ekambaram M, Yiu CK. Effect of different fluoride varnishes on remineralization of artificial enamel carious lesions. Int J Paediatr Dent. 2017 May;27(3):163-173. doi: 10.1111/ipd.12243. Epub 2016 Jun 27. PMID: 27348852.
  30. Güçlü ZA, Alaçam A, Coleman NJ. Corrigendum to "A 12-Week Assessment of the Treatment of White Spot Lesions with CPP-ACP Paste and/or Fluoride Varnish". Biomed Res Int. 2018 Dec 24;2018:1816959. doi: 10.1155/2018/1816959. Erratum for: Biomed Res Int. 2016;2016:8357621. PMID: 30671446; PMCID: PMC6323475.
  31. Girish Babu KL, Subramaniam P, Tele S. Remineralization potential of varnish containing casein phosphopeptides- amorphous calcium phosphate with fluoride and varnish containing only fluoride: comparative study. Saudi J Oral Sci 2018; 5(1):35-40. doi: 10.4103/sjos.SJOralSci_44_17.
  32. Autio-Gold JT, Courts F. Assessing the effect of fluoride varnish on early enamel carious lesions in the primary dentition. J Am Dent Assoc. 2001 Sep;132(9):1247-53; quiz 1317-8. doi: 10.14219/jada.archive.2001.0367. PMID: 11665349.
  33. Ciftci ZZ, Hanimeli S, Karayilmaz H, Gungor OE. The efficacy of resin infiltrate on the treatment of white spot lesions and developmental opacities. Niger J Clin Pract. 2018 Nov;21(11):1444-1449. doi: 10.4103/njcp.njcp_235_18. PMID: 30417842.
  34. Meyer-Lueckel H, Paris S. Progression of artificial enamel caries lesions after infiltration with experimental light curing resins. Caries Res. 2008;42(2):117-24. doi: 10.1159/000118631. Epub 2008 Feb 28. PMID: 18305389.
  35. Gözetici B, Öztürk-Bozkurt F, Toz-Akalın T. Comparative Evaluation of Resin Infiltration and Remineralisation of Noncavitated Smooth Surface Caries Lesions: 6-month Results. Oral Health Prev Dent. 2019;17(2):99-106. doi: 10.3290/j.ohpd.a42203. PMID: 30874252.
  36. Dhamija M, Tyagi R, Kalra N, Khatri A. Efficacy of Resin Infiltration and Fluoride Casein Phosphopeptide Amorphous Calcium Phosphate Varnish on Non-cavitated Active White Spot Lesions in Children: A Randomized Clinical Trial. Pesqui Bras Odontopediatria Clín Integr [Internet]. 2022;22:e210094. Available from:  https://doi.org/10.1590/pboci.2022.059
  37. Giray FE, Durhan MA, Haznedaroglu E, Durmus B, Kalyoncu IO, Tanboga I. Resin infiltration technique and fluoride varnish on white spot lesions in children: Preliminary findings of a randomized clinical trial. Niger J Clin Pract. 2018 Dec;21(12):1564-1569. doi: 10.4103/njcp.njcp_209_18. PMID: 30560818.

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Received April 18, 2024.
Accepted May 26, 2024.
©2024 International Medical Research and Development Corporation.