Effect of Acidulated Phosphate Fluoride Gel on the Prevention of White Spot Lesions in Patients Undergoing Active Orthodontic Treatment
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Introduction: The purpose of this study was to evaluate the effect of 1.23% acidulated phosphate fluoride (APF) gel on white spot lesion (WSL) formation utilizing a typical orthodontic treatment interval for the applications. Methods: In this double-blind, placebo controlled trial, 55 patients starting orthodontic treatment, either at Texas A&M University, Baylor College of Dentistry or at a private practice, were randomly divided into two groups (a treatment and placebo). Every eight weeks, the treatment group received an application of Nupro 1.23% APF gel (Dentsply®) for one minute, while the placebo group received a gel treatment for one minute that was exactly the same composition, but lacked fluoride. Patients were followed for 6 or 8 months depending on when their second set of brackets was placed. Pre and post treatment photographs and Fluorecam® readings were used to quantify the development of WSLs. Results: There was no statistically significant difference in the percentage of patients who developed WSLs, the number of new WSLs that developed on each tooth during treatment, or in the number of new WSLs developed per patient when using photographic analysis or Fluorecam® readings. Based on photographic assessments, 37.5% of patients in the fluoride group and 32.3% of patients in the placebo group developed new WSLs (p=0.685), while with Fluorecam assessments 37.5% of patients in the fluoride group and 58.1% of patients in the placebo group developed a new WSL (p=.130). Five patients had pre-existing WSLs (1 patient in the treatment group and 4 patients in the placebo group). Only patients in the placebo group demonstrated worsening of white spot lesions (p=.375). When using the Fluorecam® to quantify WSL development by measuring the size, intensity, and impact of each lesion, the only measurement which demonstrated a significant difference between the fluoride and placebo group was the intensity of the lower left first premolar (P<.05). The remaining readings on all of the other teeth were not statistically significant between the groups. Conclusion: Application of 1.23% APF gel for one minute every eight weeks does not have an effect in the prevention of WSL development.
Hutto Fretty, Corneil Kimberly (2014). Effect of Acidulated Phosphate Fluoride Gel on the Prevention of White Spot Lesions in Patients Undergoing Active Orthodontic Treatment. Master's thesis, Texas A & M University. Available electronically from