The effect of fluoride varnish application on colour change due to paediatric drug usage in polyacid-modified composite resin: an in vitro study.

OBJECTIVE: Colour stability is important in the long-term aesthetic success of restorative materials and is affected by both internal and external factors. Internal discolourations are due to the properties of the restorative materials. External discolourations can be associated with frequent consumption of food and beverages and the use of suspensions or syrups containing colourants/additives. Fluoride varnish application has an important place in preventive dentistry. The purpose of the research was to examine the protective effect of fluoride varnish application on the colour change on polyacid-modified composite resin restorative materials caused by the use of various paediatric drugs. METHODS: Two hundred ten discs were prepared from polyacid-modified composite resin material and divided into two groups: flouride varnish was applied to one group and flouride varnish was not applied to the other group. The groups were further divided into seven subgroups and the samples were kept in artificial saliva, amoxicillin + clavulanic acid, cefuroxime axetil, clarithromycin, paracetamol, ibuprofen, and iron supplement drug solutions. The colour change values of the discs were measured using a spectrophotometer device before immersion in the drug solutions and on the 7th, 14th, 21st, and 28th days after the immersion. The obtained data were calculated and statistically evaluated using IBM SPSS V23 software. RESULTS: It was found that the application of fluoride varnish in the iron supplement drug group prevented the colour change of the polyacid-modified composite resins for 28 days. In the amoxicillin + clavulanic acid, cefuroxime axetil, and paracetamol groups, the fluoride varnish did not prevent colour change in the polyacid-modified composite resin restorative materials at the end of the 14th day. CONCLUSION: It is thought that fluoride varnish application may be beneficial as a preservative in the colour change of polyacid-modified composite resins due to the use of various paediatric drugs, and this protective feature may be effective for a specific period of time.

A cost-effectiveness analysis of fluoride varnish application in preventing Root caries in elderly persons: a Markov simulation study.

BACKGROUND: Root caries are prevalent issues that affect dental health, particularly among elderly individuals with exposed root surfaces. Fluoride therapy has shown effectiveness in preventing root caries, but limited studies have addressed its cost-effectiveness in elderly persons population. This study aimed to evaluate the cost-effectiveness of a fluoride treatment program for preventing root caries in elderly persons within the context of Chinese public healthcare. METHODS: A Markov simulation model was adopted for the cost-effectiveness analysis in a hypothetical scenario from a healthcare system perspective. A 60-year-old subject with 23 teeth was simulated for 20 years. A 5% sodium fluoride varnish treatment was compared with no preventive intervention in terms of effectiveness and cost. Tooth years free of root caries were set as the effect. Transition probabilities were estimated from the data of a community-based cohort and published studies, and costs were based on documents published by the government. The incremental cost-effectiveness ratio (ICER) was calculated to evaluate cost-effectiveness. Univariate and probabilistic sensitivity analyses were performed to evaluate the influence of data uncertainty. RESULTS: Fluoride treatment was more effective (with a difference of 10.20 root caries-free tooth years) but also more costly (with a difference of ¥1636.22). The ICER was ¥160.35 per root caries-free tooth year gained. One-way sensitivity analysis showed that the risk ratio of root caries in the fluoride treatment group influenced the result most. In the probabilistic sensitivity analysis, fluoride treatment was cost-effective in 70.5% of the simulated cases. CONCLUSIONS: Regular 5% sodium fluoride varnish application was cost-effective for preventing root caries in the elderly persons in most scenarios with the consideration of data uncertainty, but to a limited extent. Improved public dental health awareness may reduce the incremental cost and make the intervention more cost-effective. Overall, the study shed light on the economic viability and impact of such preventive interventions, providing a scientific basis for dental care policies and healthcare resource allocation.

Fluoride-amorphous calcium phosphate and biomimetic nano-hydroxyapatite for enamel remineralization: An in-vitro study of surface microhardness and composition.

AIM: Fluoride-Amorphous Calcium Phosphate and Biomimetic Nano-Hydroxyapatite for Enamel Remineralization; An In-Vitro Study of Surface Microhardness and Composition. MATERIAL AND METHODS: Ninety-six extracted human premolars with sound buccal surface were divided using a randomization computer-generating software into four groups; Group I (control) sound untreated enamel, Group II (demineralized) demineralized to create white spot lesions, Group III (biom-n-HA) demineralized and then treated with biomimetic nanohydroxyapatite cream, and Group IV (F-ACP) demineralized and then treated using Fluoride-Amorphous Calcium Phosphate varnish. Each group was divided into two subgroups; subgroup "A" evaluated for mineral content using energy dispersive x-ray spectroscopy (EDX) and for surface microhardness using the Vickers microhardness test and Subgroup "B" evaluated for white spot lesion depth using a polarized light microscope (PLM). RESULTS: The highest microhardness (VHN) was found in the (F-ACP) group (mean=428.61±54.43) and then in the (Biom-n-HA) group (mean=408.11±70.16) followed by the (Control) group (mean=402.13±53.40) with no significant difference between them and finally in the significantly different (Demineralized) group (mean=256.99±45.83). The weight percentage of Ca (30.29±1.04 and 33.44±1.07) and Ca/P ratio (1.87±0.06 and 2.03±0.05) were significantly different between Group III and Group IV respectively. PLM measurements in Group II (198.83µm), Group III (60.17µm), and Group IV (26.33µm) were significantly different. CONCLUSIONS: Both the (Biom-n-HA) cream and the (F-ACP) varnish showed promising results for enamel remineralization. The increased enamel surface microhardness was consistent with the mineral content and the changes in the birefringence.

Dental Hygiene Students' Knowledge, Understanding and Intended Use of Caries Preventive Regimens and Community Water Fluoridation.

Purpose The purpose of this study was to determine dental hygiene students' perspectives regarding their knowledge and understanding about caries prevention strategies and their intention to use these regimens in clinical practice. Dental hygienists' knowledge and understanding of caries prevention is critical because they are the primary providers of these regimens and the relevant education.Methods This 2019 national cross-sectional online survey was designed by the University of Maryland (UMD), structured by the ADA staff for online administration, distributed and collected by the American Dental Hygienists' Association (ADHA) to 9533 email addresses, and de-identified response data were analyzed by UMD. The survey included questions on three caries preventive regimens: fluoride varnish, dental sealants, and silver diamine fluoride (SDF), and items on community water fluoridation (CWF), respondent's demographics and intent to use the regimens. Statistical analyses included descriptive statistics and analysis of variance. Significance was set at p<0.05.Results Of the 235 surveys returned (response rate 2.5%) the majority were female, White and born in the United States. Over half were in associate degree programs; nearly a third were in baccalaureate programs. Respondents reported greater knowledge/understanding and intention to use fluoride varnish and dental sealants than SDF. Less than half (44.7%) reported knowledge/understanding of SDF and only 22.6% had a high level of confidence regarding applying it. Additionally, only 31.1% indicated they were extremely likely to use SDF upon graduation.Conclusions To reduce the prevalence of caries, dental hygiene graduates must be well-versed with the latest science-based preventive procedures, including non-invasive caries prevention and control therapies. The results of this survey, albeit non representative of the general population of dental hygiene students, suggest a need for a more extensive review of the caries preventive regimen content, especially for silver diamine fluoride, of dental hygiene curricular programs.

Effect of adhesive components in experimental fluoride varnish on fluoride release within 30 days in vitro study.

We aimed to determine whether adhesive components could increase the release time of effective fluoride concentration from an experimental fluoride varnish applied to bovine teeth. An experimental fluoride varnish containing 5% sodium fluoride (EX1) was prepared and combined with 35% hydroxyethyl methacrylate (HEMA) (EX2), 5% glutaraldehyde (EX3), or 35% HEMA/5% glutaraldehyde mixture (EX4). Two commercially available fluoride varnishes were used for comparison. Each group was applied to bovine incisors, and the fluoride release and pH were monitored for 30 days. Cell viability analysis, scanning electron microscopy, and energy-dispersive spectroscopy were performed. EX4 released the highest and most effective concentration of fluoride for the longest period and reached neutral pH at the earliest; the release was maintained for up to 30 days without cytotoxicity. In conclusion, EX4 is considered to be the most effective varnish to prevent dental caries.

Effects of Propolis-Based Herbal Toothpaste on Dentine Hypersensitivity.

INTRODUCTION: The objective of this in vitro study was to compare the effectiveness of a propolis-based herbal toothpaste with 5% sodium fluoride varnishin obstructing human dentinal tubules; Scanning electron microscopy was utilised to obtain quantitative and qulitative data on tubular obstruction. METHODS: Thirty-nine extracted human premolar teeth were collected. The cementum layer was removed using a water-cooled diamond bur and the smear layer using ethylenediaminetetraacetic acid (EDTA) 17%. Then, the samples were randomly divided into 3 groups (n = 13 each), as follows: group 1: dentin discs exposed to the propolis-based herbal toothpaste (Herbex); group 2: dentin discs exposed to 5% sodium fluoride varnish; and group 3: control. Then, all discs were observed and imaged in 4 non-overlapping fields by an electron microscope at 2000× magnification. The topography and number of open, closed, and semi-closed tubules were counted in all images. The data were analysed using Kruskal-Wallis test, Mann-Whitney U test, and Friedman test. The statistical analysis was performed with SPSS statistic 22.0 software, with a significance level of α = 0.05. RESULTS: In pairwise comparisons of the groups considering the percentage of open, closed, and semi-closed tubules, the difference was not statistically significant between the 5% sodium fluoride varnish and propolis groups in the closed and semi-closed tubules, but it was statistically significant with the control group. Additionally, the percentage of open tubules in the propolis-based herbal toothpaste group was significantly lower than in the 5% sodium fluoride varnish and control group. CONCLUSIONS: Both propolis-based herbal toothpaste and 5% sodium fluoride varnish is effective in blocking human dentin tubules to various extents.

Development and psychometric analysis: Fluoride varnish parent attitude, belief scale.

OBJECTIVE: To develop a scale to determine parents' attitudes and beliefs regarding fluoride varnish. DESIGN AND METHODS: This study had a cross-sectional design and was conducted between 2019 and 2021. A total of 810 parents were included in the study sample. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), discriminant validity, and convergent validity methods were used to estimate the scale validity. For reliability, the Cronbach alpha coefficient, item-total correlation coefficients, and test-retest method were used. RESULTS: As a result of psychometric analysis, the scale was found to have a three-factor structure. The factor loads of the items were between 0.838 and 0.715. The three-factor construct showed a good fit in confirmatory factor analysis (X2 (41): 110.06, p <.001; RMSEA: 0.065; RMSR, 0.02; GFI, 0.95; and NFI, 0.94). Cronbach's α coefficient on the scale was 0.85. The item-total correlation of the scale was found to be between 0.355 and 0.626. The test-retest intra-class correlation coefficient of the scale was 0.72. CONCLUSIONS: This study suggests that the developed scale is a reliable tool to evaluate the attitudes and beliefs of parents toward fluoride varnish. It is thought that the scale will make a contribution to public health.

Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial.

BACKGROUND: Early childhood caries (ECC) is the most prevalent chronic health problem in young children, and it can be arrested using professionally applied fluoride such as Sodium fluoride (NaF) varnish and Silver Diamine Fluoride (SDF). This trial compared two interventions to arrest ECC lesions: 38% SDF combined with 5% NaF varnish versus 38% SDF and assessed whether the arrest rate was affected by baseline lesion severity measured by ICDAS. METHODS: Children aged ≤ 4 years from 4 nurseries in a rural area in Alexandria, Egypt joined the study in March 2022. They were included if they had at least one active carious lesion with ICDAS codes ≥ 3. They were randomized to receive either 38% SDF with 5% NaF varnish or 38% SDF alone. In both groups, the agents were applied at baseline and after 6 months on the caries lesions. NaF was additionally applied on all teeth in the oral cavity, and it was also applied after three months. The primary outcome was lesion arrest status after six months. Parents' satisfaction with their children's appearance was the secondary outcome. Pearson Chi-Square test was used for bivariate comparison and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest controlling for confounders. The interaction between the intervention and baseline lesion severity (categorized into moderate and severe lesions) was assessed and the p value was calculated. RESULTS: The study included 1606 lesions in 220 children, median (IQR) age = 48(9) months. The percentages of arrested lesions after the application of SDF + NaF and SDF only were 77.7% and 73.2% (p = 0.035). In multivariable analysis, SDF + NaF had significantly greater caries arrest effect than SDF alone (AOR = 2.12, p = 0.03) with significant difference (p = 0.03) between moderate (AOR = 4.10, p = 0.005) and advanced (AOR = 1.92, p = 0.08) lesions. Most parents were satisfied with their children's appearance with no significant difference between groups (SDF + NaF = 84.5%, SDF = 78.18%, p = 0.23). CONCLUSION: SDF + NaF had a higher arrest rate than SDF alone and this difference was significant in moderate but not advanced lesions. The findings have implications for the non-invasive management of ECC. TRIAL REGISTRATION: This trial was registered in the clinicaltrials.gov registry (#NCT05642494).

Professional oral health care prevents mouth-lung infection in long-term care homes: a systematic review.

Background: Nursing home-acquired pneumonia (NHAP) is the leading cause of mortality among residents in long-term care (LTC) homes. Aspiration pneumonia (AP) is one cause of NHAP. Professional oral health care (POHC) and daily mouth care can be effective in decreasing AP risk. Aim: To identify, appraise, synthesize, analyze, and interpret results on the effectiveness of onsite POHC interventions/programs delivered to LTC home residents in reducing oral disease and NHAP. To summarize the findings and provide recommendations for clinical work and future research. Methods: The PICO question addressed was, "In LTC home residents with oral health needs (P), is onsite POHC (I), compared to usual care (C), clinically effective in reducing dental disease and pneumonia/AP (O)?" Databases searched were PubMed, EMBASE (Ovid), CINAHL (Ebsco), Cochrane Library (Wiley), Web of Science, and the databases of the Centre for Reviews and Dissemination. Included were randomized controlled trials (RCTs), non-RCTs, and cross-sectional studies. PRISMA guidelines were followed and GRADE was used to assess the quality of studies. Results: Thirteen clinical effectiveness studies were included: 10 RCTs, 1 non-RCT, and 2 cross-sectional studies. Discussion: Better oral health and respiratory infection outcomes were found in the experimental groups who received an onsite POHC intervention compared to the control groups. Conclusion: There is moderate-to-strong evidence that onsite POHC in LTC homes, provided mostly by dental hygienists, is effective in preventing bacterial mouth infection, pneumonia, and AP.

Contexte : La pneumonie nosocomiale des foyers de soins est la principale cause de mortalité chez les résidents des foyers de soins de longue durée (SLD). La pneumonie par aspiration (PA) est l'une des causes de la pneumonie nosocomiale des foyers de soins. Les soins buccodentaires professionnels et les soins quotidiens d'hygiène buccale peuvent permettre de réduire efficacement le risque de PA. Objectif: Définir, évaluer, résumer, analyser et interpréter les résultats relatifs à l'efficacité des interventions et des programmes de soins buccodentaires professionnels offerts sur place aux résidents des foyers de SLD pour réduire l'incidence des affections buccales et de la pneumonie nosocomiale des foyers de soins. Résumer les constatations et formuler des recommandations pour les travaux cliniques et les études à venir. Méthodes: La question relative aux patients, aux interventions, aux comparaisons et aux résultats était la suivante : « Chez les résidents des foyers de SLD ayant des besoins en santé buccodentaire (patients), les soins buccodentaires professionnels sur place (interventions) sont-ils cliniquement efficaces par rapport aux soins ordinaires (comparaisons) pour réduire l'incidence des affections dentaires et de la pneumonie/de la PA (résultats)? ¼ Les bases de données concernées par les recherches étaient PubMed, EMBASE (Ovid), CINAHL (Ebsco), la Bibliothèque Cochrane (Wiley), la plateforme Web of Science et les bases de données du Centre for Reviews and Dissemination (« Centre des examens et de la dissémination ¼). Des essais cliniques randomisés (ECR), des essais cliniques non randomisés et des études transversales étaient inclus. On a suivi les lignes directrices PRISMA et on s'est appuyé sur le cadre GRADE pour évaluer la qualité des études. Résultats: On a inclus 13 études sur l'efficacité clinique : 10 ECR, 1 étude clinique non randomisée et 2 études transversales. Les membres des groupes expérimentaux qui bénéficiaient d'interventions de soins buccodentaires professionnels sur place avaient de meilleurs résultats en matière de santé buccodentaire et d'incidence des infections respiratoires que ceux des groupes témoins. Conclusion: On constate l'existence de preuves modérées à solides que les soins buccodentaires professionnels offerts sur place dans les foyers de SLD, assurés principalement par des hygiénistes dentaires, sont efficaces pour prévenir les infections bactériennes buccales, la pneumonie et la PA.

Barriers and Facilitators to Optimal Fluoride Varnish Application.

OBJECTIVE: National guidelines recommend that all children under age six receive fluoride varnish (FV) in medical settings. However, application rates remain low. This study aimed to update understanding of barriers and facilitators to guideline concordant FV application. METHODS: We conducted virtual semi-structured interviews with a purposive sample (eg, FV application rates, geographic location, practice size and type) of pediatric primary care clinicians and medical assistants in Massachusetts between February 1 and June 30, 2022. The Consolidated Framework for Implementation Research (CFIR) served as the study's theoretical framework and data were analyzed using a modified grounded theory approach. RESULTS: Of the 31 participants, 90% identified as White and 81% as female. Major themes, which linked to four CFIR domains, included: variation in perceived adequacy of reimbursement; differences in FV application across practice types; variation in processes, protocols, and priorities; external accountability for quality of care; and potential levers for change. Important subthemes included challenges for small practices; role of quality measures in delivering guideline-concordant preventive oral health care; and desire for preventive care coordination with dentists. CONCLUSIONS: This study suggests that potential barriers and facilitators to guideline concordant FV application exist at multiple levels that may warrant further study. Examples include testing the effectiveness of quality measures for FV application and testing strategies for implementing consistent processes and protocols for improving FV application rates.

The Effects of a Novel Nanohydroxyapatite Gel and Er: YAG Laser Treatment on Dentin Hypersensitivity.

PURPOSE: This study evaluates the effects of a novel nanohydroxyapatite gel and Er: YAG laser on the surface roughness, surface morphology, and elemental content after dentin hypersensitivity treatments. METHODS: Dentin discs (2 × 3 × 3 mm3) were prepared from 75 human molars. Out of 75 human molars, 50 were used to evaluate surface roughness and randomly divided into five groups: Group ID (intact dentin), Group DD (demineralized dentin), Group BF (fluoride varnish/Bifluorid 10), Group Lsr (Er: YAG laser-50 mJ, 0.50 W, 10 Hz), and Group NHA (nanohydroxyapatite-containing gel). Dentin hypersensitivity was stimulated by 35% phosphoric acid for 1 min (except Group ID). The surface roughness (Ra, µm) was measured via contact profilometry (n = 10). Out of the 75 sound human molars, 25 were used to evaluate the surface morphology and elemental content using scanning electron microscopy and energy-dispersive X-ray spectroscopy (n = 5). The data were statistically analyzed using Welsch ANOVA, Games-Howell, Kruskal-Wallis, and Dunn tests (p < 0.05). RESULTS: Group Lsr showed significantly lower surface roughness than Group NHA and Group BF (p < 0.05). The SEM analysis indicated that most of the dentinal tubules were obliterated for Group NHA. Precipitant plugs with partially occluded dentinal tubules were observed for Group BF, while partially or completely occluded tubules with a melting appearance were detected for Group Lsr. The EDS analysis revealed that Group NHA and Group Lsr presented similar calcium and phosphorus amounts to Group ID. All dentin hypersensitivity treatment methods could provide promising results in terms of tubular occlusion efficiency. However, laser treatment resulted in smoother surfaces, which could help prevent dental plaque accumulation.

Comparative Evaluation of the Remineralizing Potential of Silver Diamine Fluoride, Casein Phosphopeptide-amorphous Calcium Phosphate, and Fluoride Varnish on the Enamel Surface of Primary and Permanent Teeth: An In Vitro Study.

Introduction: With the paradigm shift in the management of dental caries, the focus is now laid on remineralization therapies that can arrest the progression of the disease and remineralize the subsurface lesions. Objectives: The purpose of this study was to determine and compare the remineralizing potential of silver diamine fluoride (SDF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and fluoride varnish (FV) on enamel surfaces in primary and permanent teeth. Materials and methods: A total of 120 primary anterior teeth and 120 premolars were used to prepare enamel blocks in acrylic resin. The mean baseline surface microhardness (SMH) for each sample was determined using a microvickers hardness testing machine. Thereafter, the samples were randomly and equally distributed into groups and subgroups based on the materials used, that is, SDF, CPP-ACP, FV, and distilled water (control). After subjecting the samples to a pH cycling regime, SMH was determined again and the percentage change in SMH was calculated. Results: The data were tabulated and subjected to statistical analysis using an independent t-test and one-way analysis of variance (ANOVA). In primary teeth, the least mean percentage reduction in SMH was observed after the application of FV followed by SDF, CPP-ACP, and control. In permanent teeth, both SDF and FV showed the least percentage reduction of enamel SMH followed by CPP-ACP and control. Conclusion: Silver diamine fluoride (SDF), FV, and CPP-ACP showed remineralizing potential in both primary and permanent teeth. How to cite this article: Kaur S, Bhola M, Bajaj N, et al. Comparative Evaluation of the Remineralizing Potential of Silver Diamine Fluoride, Casein Phosphopeptide-amorphous Calcium Phosphate, and Fluoride Varnish on the Enamel Surface of Primary and Permanent Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-1):S91-S96.

Fluoride Varnish in Dentistry: A Bibliometric Analysis of the 100 Most-Cited Papers.

A highly cited paper is a milestone and might impact research and clinical practice. The present study analyzed the 100 most-cited papers on fluoride varnishes in dentistry. A search was performed on July 20, 2022, on the Web of Science Core Collection. Two independent researchers extracted the following data: number and citation density; year and journal of publication; study design; main topic; authors; institutions; keywords; countries and continents. Scopus and Google Scholar were consulted to compare the number of citations. Bibliometric networks were generated in the VOSviewer. The number of citations ranged from 36 to 351, and thirteen papers were cited more than 100 times. The papers were published between 1977 and 2018, most of which were published after 2008 (48%). The most prevalent journal was Caries Research (17%). Intervention studies were the most common design (41%). The most discussed topics were dental caries prevention (48%) and dental remineralization (31%). Europe was the continent with the highest number of publications (46%), mainly from Sweden (14%), and Umea University had the most substantial number of studies (8%). Petersson L.G. was the author with more papers in the top 100 (6%). The most used keywords were "dental caries" (34%) and "fluoride varnish" (31%). It can be concluded that the top 100 cited papers on fluoride varnish primarily originated from Europe, with the majority consisting of intervention studies focusing on the utilization of fluoride varnish for the prevention of dental caries.

Immediate and Sustained Root Caries Prevention of Fluoride Varnish Combined with Toothpastes.

The aim of this study was to determine the immediate and sustained effect of a fluoride varnish and its combinations with toothpastes in preventing root caries development using a salivary microcosm in vitro model. Human root dentin specimens (n = 150) were randomly divided into 5 experimental protocols (n = 30): (1) Fluoride Varnish (V); (2) V followed by Paste One (V + PO); (3) V followed by Paste Plus (V + PP); (4) V followed by PO and PP (V + PO + PP); and (5) No treatment (control). One varnish layer was applied on the specimens (except for the control group) and kept for 18 h. Then, the varnish was removed and toothpaste treatments were initiated according to experimental groups. For the short-term incubation model (n = 15), the specimens were also immediately subjected to 7-day cariogenic challenge. For that, human saliva was used as bacterial inoculum and McBain artificial saliva containing 2% sucrose as growth medium. The other half of the specimens (n = 15) were used to study the varnish's sustained effect by long-term incubation (8 weeks) before cariogenic challenge. The protocols' anti-caries properties were evaluated by dentin porosity (rhodamine intensity; RI) and mineral density, while their anti-biofilm effects were evaluated using biofilm's biomass and viability assays. For short- and long-term incubation models, all experimental regimens resulted in statistically significant decreases (p < 0.05) in the RI (up to 180 µm and 120 µm, respectively) as well as higher mineral density compared to No treatment (p < 0.001). V + PO + PP and/or V + PO resulted in statistically lower RI compared to V for some depths (p < 0.05) in both models. There were changes in RI and mineral density within groups over time. All experimental treatments exhibited anti-biofilm effects. All prevention protocols exhibited immediate and sustained anti-caries effect against root caries development. The combination of a fluoride varnish with PO resulted in superior additional anti-caries effects.

Evaluation of the Cytocompatibility of Fluoride Varnish and Its Effect on Human Gingival Fibroblasts (hGFs): An In Vitro Study.

Introduction Untreated dental decay poses a significant oral health challenge, leading to pain, tooth loss, and infections. Fluoride varnishes are in prolonged contact with the tooth surface and this prevents dental decay. However, limited research has been conducted regarding the cytotoxicity and cytocompatibility of varnishes on oral cells. Recent studies have shed light on the cytotoxic effect of these varnishes on human fibroblast cells. Material and Methods The fibroblasts were isolated and cultured in 0.00001, 0.0001, 0.001, 0.01, 0.1, and 1 % fluoride concentration The cells were incubated for 72 hours at a temperature of 37°C and cell viability after the application of varnish was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide (MTT) assay. Results This study observed that fluoride varnish had a concentration dependant cytotoxic effect on human gingival fibroblasts (hGFs). As the concentration of fluoride increased, the cell viability decreased. At 1% concentration, there was maximum cell cytotoxicity. At the lowest concentration (0.00001), more than 78% of the cells were found to be viable. Conclusion Further research is necessary to develop safer and more biocompatible fluoride varnish formulations to ensure their efficacy in preventing dental caries without causing harm to oral tissues.

Penetration and durability of CPP-ACP paste and sodium fluoride varnish as desensitizing agents: An in vitro comparison.

Background: This study aimed to investigate and compare the penetration and durability of two dentin desensitizers, sodium fluoride varnish and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste, using electron microscopy. Methods: The study was performed on 60 dentin specimens prepared from extracted human premolars. After applying 17% EDTA to remove the smear layer, the specimens were divided into two groups. MI Paste and Bi-fluoride varnish were applied to the specimens. Microscopic images of 20 samples were obtained immediately. Twenty other samples were accessed after 15 days, and the other 20 were accessed after 30 days of toothbrushing and thermal cycling. Both surface and longitudinal cross-sectional images (after sample fracture) were studied. Data were analyzed with two-way ANOVA and Mann-Whitney U test at a significance level of P<0.05. Results: The mean depth of material penetration was significantly time-dependent and fluctuated in both groups. There was a significant difference between the mean level of plugs between 0, 15, and 30 days (P<0.001). Penetration increased with time for the MI Paste group, while in the Bi-fluoride group, the increase was significant at 15 and 30 days than immediately after application. The mean thickness of the plugs was significantly different at the three time periods, and MI Paste showed a sudden decrease in plug thickness after 15 days. Conclusion: Immediately after application, Bi-fluoride occluded dentinal tubules more effectively, and its durability after abrasion and thermal fatigue were higher than MI Paste.

Comparative evaluation of four treatments for postorthodontic white spot lesions: a randomized controlled trial.

OBJECTIVES: To evaluate the treatment efficacy of fluoride toothpaste alone and those of adjunctive use of resin infiltration, sodium fluoride varnish, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on white spot lesions (WSLs). MATERIALS AND METHODS: Seventy-nine patients (356 teeth) with WSLs after orthodontic treatment were randomly allocated into four groups. The WSLs of the participants received resin infiltration only at baseline, and the other groups received fluoride varnish, CPP-ACP mousse, and placebo treatment every 6 months, respectively. A toothpaste containing 1400 ppm fluoride and toothbrushes were distributed to all participants, and oral hygiene instructions were provided. Photos of the teeth with WSL were taken to compare the change between groups which was measured by ImageJ software. RESULTS: Twelve months later, different degrees of reduction in the area of WSLs were observed in all groups. The percentage of lesion area reduction in WSLs in the resin infiltration group was 46.6%, which was significantly higher than that in fluoride varnish group (26.6%), CPP-ACP group (28.6%), and control group (29.8%), and the differences were statistically significant (p < 0.001). CONCLUSIONS: This study shows that after 1-year follow-up, the use of fluoride toothpaste, with or without the use of fluoride varnish or CPP-ACP, can reduce the area of WSLs. While resin infiltration can immediately improve dental aesthetics and continuously improved in 12 months, resin infiltration group showed much better results than other groups. TRIAL REGISTRATION: Clinical Trials Registration Number: ChiCTR2000032516. CLINICAL SIGNIFICANCE: The use of fluoride toothpaste, with or without adjunctive use of fluoride varnish and CPP-ACP, can reduce the area of WSLs, while resin infiltration treatment has additional effect and can immediately improve dental aesthetics.

Long-term Effectiveness of Integrated Caries Preventive Programs in Thailand Among Preschool Children Using a System Dynamics Model.

OBJECTIVE: To compare the effect of three caries preventive interventions provided by Thailand's Ministry of Public Health (MOPH): supervised toothbrushing (STB), fluoride varnish (FV), and combined STB+FV from 0 to 5 years old to the base case using the System Dynamics Model (SDM). METHODS: The SDM was developed to compare the intervention scenarios: STB, FV, and combined STB+FV with the base case scenario. Meta-analyses determined the effective rates of the interventions included in the model. RESULTS: The model indicated that the population with no caries in deciduous teeth increased by 7.5%, 5.7%, and 4.2% at three years of age, and 12.8%, 9.9%, and 5.9% at five years of age, under STB+FV, STB, and FV respectively when compared to the base case. At three years old, the population with untreated caries in deciduous teeth decreased by 12.9% in STB+FV, 9.8% in STB, and 7.3% in FV, and by 10.9% in STB+FV, 8.5% in STB, and 4.9% in FV, at five years old. The increase in the population without caries is considered clinically significant compared to baseline. CONCLUSION: The model determined that an effective combination of STB and FV should be administered between 0 and 5 years of age to reduce caries in the primary dentition. The SDM could be applied as a "what-if" analysis in order to determine the most beneficial intervention or policy by comparing them.

Qualitative and Quantitative Profiling of Enamel Remineralizing Potential of Fluoride Varnishes Incorporating Bioactive Glass, Dicalcium Phosphate Dihydrate, and Modified MTA: A Raman Spectroscopic Study.

Aim: To evaluate and compare for remineralization potential of enamel at three different time intervals using commercially available MI Varnish and Duraflor Halo varnish [5% sodium fluoride (NaF) varnish] incorporating bioactive glass, dicalcium phosphate dihydrate (DCPD), and biomimetically modified mineral trioxide aggregate (MTA). Materials and methods: For the study, a buccolingual division into equal halves was done for 64 decoronated premolar crowns. Among these 64 crowns, we mounted 32 in acrylic discs to be used for microhardness and induced white spot lesions (WSLs) measuring 5 × 5 mm on the exposed enamel surface. These samples were divided into four groups of 24 each depending upon the varnish used. Varnish application was done, followed by immersion of these samples for 24 hours in artificial saliva, followed by peeling off of varnish. A pH cycling of 28 days was done after the varnish application before assessing the remineralization of the samples. Evaluation of all these samples was done at three different time intervals, baseline, after demineralization, and post remineralization for microhardness on the enamel surface. Raman spectroscopy was utilized for the measurement of phosphate (P) ion release. Sectioning of these samples to a thickness of 100 µm approximately was done to be viewed under a polarized light microscope. Results: Bioactive glass incorporated varnish showed the highest microhardness values, mineral content levels, and least depth of lesion posttreatment. Conclusion: All the experimental varnish showed significant remineralizing potential with the best potency seen with bioactive glass incorporated varnish. Clinical significance: The nonfluoride agents can be appropriately used in 2 wt% amount to augment the benefits of fluoride. How to cite this article: Hardikar AS, Gaonkar NN, Devendrappa SN, et al. Qualitative and Quantitative Profiling of Enamel Remineralizing Potential of Fluoride Varnishes incorporating Bioactive Glass, Dicalcium Phosphate Dihydrate, and modified MTA: A Raman Spectroscopic Study. Int J Clin Pediatr Dent 2023;16(2):363-370.

Evaluation of the antibacterial activity of Enamelast® and Fluor defender® fluoride varnishes against Streptococcus mutans biofilm: an in vitro study in primary teeth.

PURPOSE: The aim of the current work was to compare the antibacterial activity of Enamelast® and Fluor defender® fluoride varnish on biofilm generation by Streptococcus mutans on extracted primary teeth. METHODS: Thirty-six primary molars were collected and sliced into seventy-two test model disks. All specimens were examined, and the cracked or broken ones were discarded. A total number of specimens (n = 54) were divided into two experimental analyses viz; biofilm formation (n = 27) and microscopic examination (n = 27). Specimens of each analysis were tested under different experimental conditions: a negative control group (n = 9), Fluor defender group (n = 9), and Enamelast group (n = 9). Following treatment, biofilms were generated by adherent Streptococcus mutans on the test model disks on three time intervals: 24 h (n = 3), 48 h (n = 3), and 72 h (n = 3) for each analysis. Then, for biofilm formation analysis, the biofilm was detected spectrophotometrically at 620 nm after being stained by crystal violet. For microscopical analysis, the surfaces of the test model disks were visualized by scanning electron microscopy (SEM), and each image was processed and analyzed using ImageJ software. RESULTS: At 48 and 72 h, Enamelast® and Fluor defender®-treated group showed significantly (p < 0.001) slight adhered bacterial cells when compared with the negative control group as revealed by the absorbance and SEM. Compared with the Fluor defender®-treated group, the absorbance of the Enamelast®-treated group showed a significant (p < 0.001) increase by approximately 7- and 16.5-fold at 48 and 72 h, respectively. Similarly, SEM showed that the number of bacterial cells adhered to enamel surfaces in the Fluor defender®-treated group was significantly (p < 0.001) fewer than the Enamelast®-treated group by approximately 36.55% and 20.62% at 48 and 72 h after exposure, respectively. CONCLUSION: We conclude that the anti-biofilm activity of Fluor defender® against Streptococcus mutans was significantly (p < 0.001) greater than Enamelast® fluoride varnish. The use of Fluor defender® is encouraged as a preventive measure in children with the high risk of developing dental caries.