title: Efficacy of fluoride varnish for preventing white spot lesions and gingivitis during orthodontic treatment with fixed appliances-a prospective randomized controlled trial.
abstract: OBJECTIVE
  The development of white spot lesions around orthodontic brackets and gingivitis is a common problem during orthodontic treatment with fixed appliances. This prospective randomized double-blind controlled clinical trial investigated the preventive efficacy of a one-time application of two commonly used fluoride varnishes in patients with low to moderate caries risk.
  
  
  METHODS
  Ninety adolescent orthodontic patients with a low to moderate caries risk were prospectively randomized to three groups of 30 patients each: (1) standardized dental hygiene with fluoride toothpaste and one-time application of placebo varnish (control) or (2) of elmex® fluid or (3) of Fluor Protector S on all dental surfaces at the start of fixed therapy. The extent of enamel demineralization and gingivitis was determined with the ICDAS and the gingivitis index (GI) at baseline and after 4, 12, and 20 weeks.
  
  
  RESULTS
  Each treatment group showed a significant increase of the ICDAS index, but not of the GI over the course of time with no significant intergroup differences detectable.
  
  
  CONCLUSIONS
  A one-time application of fluoride varnish at the start of orthodontic treatment did not provide any additional preventive advantage over sufficient dental hygiene with fluoride toothpaste with regard to formation of white spots and gingivitis in patients with a low to moderate caries risk.
  
  
  CONCLUSIONS
  In dental practice, patients often receive an application of fluoride varnish at the start of orthodontic treatment with fixed appliances. However, the efficacy of this procedure is still unclear.
authors.affiliation: Department of Orthodontics, University Medical Centre of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany. christian.kirschneck@ukr.de.
authors.forename: Christian
authors.identifier: http://orcid.org/0000-0001-9473-8724
authors.initials: C
authors.lastname: Kirschneck
authors.affiliation: Department of Orthodontics, University Medical Centre of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
authors.forename: Jan-Joachim
authors.initials: JJ
authors.lastname: Christl
authors.affiliation: Department of Orthodontics, University Medical Centre of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Reicheneder
authors.affiliation: Department of Orthodontics, University Medical Centre of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Proff
mesh_terms: D000293:Adolescent; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002648:Child; D003731:Dental Caries / Q000517:prevention & control*; D003959:Diamines; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005459:Fluorides; D005460:Fluorides, Topical / Q000627:therapeutic use*; D005858:Germany; D005891:Gingivitis / Q000517:prevention & control*; D006801:Humans; D008297:Male; D016910:Orthodontic Brackets / Q000009:adverse effects*; D011140:Polyurethanes; D011446:Prospective Studies; D012821:Silanes; D013499:Surface Properties; D017001:Tooth Demineralization / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D002327:Cariostatic Agents; D003959:Diamines; D004338:Drug Combinations; D005460:Fluorides, Topical; D011140:Polyurethanes; D012821:Silanes; C022599:Fluor Protector; C495399:Olaflur; D005459:Fluorides
keywords: Fluorides, Topical, White Spots, Gingivitis, Orthodontics.
references.citation: Community Dent Oral Epidemiol. 2007 Jun;35(3):170-8
references.pmid: 17518963
references.citation: J Mich Dent Assoc. 2011 May;93(5):42-8
references.pmid: 21675658
references.citation: Quintessence Int. 2011 Oct;42(9):753-60
references.pmid: 21909500
references.citation: Am J Orthod Dentofacial Orthop. 1992 May;101(5):403-7
references.pmid: 1590288
references.citation: Dent Today. 2008 Jan;27(1):64-7; quiz 67, 58
references.pmid: 18240633
references.citation: Am J Dent. 2001 Feb;14(1):8-12
references.pmid: 11806483
references.citation: Am J Orthod Dentofacial Orthop. 2011 Jul;140(1):e17-24
references.pmid: 21724067
references.citation: Am J Orthod Dentofacial Orthop. 1994 Jan;105(1):35-41
references.pmid: 8291491
references.citation: Angle Orthod. 1993 Spring;63(1):25-30
references.pmid: 8507027
references.citation: J Periodontol. 2008 Nov;79(11):2087-92
references.pmid: 18980517
references.citation: World J Orthod. 2006 Summer;7(2):138-44
references.pmid: 16779972
references.citation: Eur J Orthod. 1991 Apr;13(2):129-33
references.pmid: 2055251
references.citation: Caries Res. 2007;41(6):455-9
references.pmid: 17827963
references.citation: Eur Arch Paediatr Dent. 2009 Sep;10(3):183-91
references.pmid: 19772849
references.citation: Eur J Orthod. 2013 Oct;35(5):664-8
references.pmid: 23045306
references.citation: J Periodontol. 1965 May-Jun;36:177-87
references.pmid: 14296927
references.citation: Acta Odontol Scand. 2003 Feb;61(1):29-33
references.pmid: 12635778
references.citation: Eur J Orthod. 1990 Aug;12(3):316-9
references.pmid: 2401340
references.citation: Minerva Stomatol. 2006 Jul-Aug;55(7-8):449-63
references.pmid: 17041545
references.citation: Am J Orthod Dentofacial Orthop. 1987 Jul;92(1):33-40
references.pmid: 3300270
references.citation: Acta Med Acad. 2013 Nov;42(2):179-88
references.pmid: 24308397
references.citation: Am J Orthod Dentofacial Orthop. 2002 Aug;122(2):125-34
references.pmid: 12165766
references.citation: Angle Orthod. 2013 Jul;83(4):641-7
references.pmid: 23289733
references.citation: J Am Dent Assoc. 2006 Sep;137(9):1231-9
references.pmid: 16946427
references.citation: Am J Orthod Dentofacial Orthop. 1989 Nov;96(5):423-7
references.pmid: 2816842
references.citation: Behav Res Methods. 2007 May;39(2):175-91
references.pmid: 17695343
references.citation: Evid Based Dent. 2008;9(3):81
references.pmid: 18927569
references.citation: Rev Belge Med Dent (1984). 1998;53(1):337-48
references.pmid: 10432832
references.citation: Am J Orthod. 1982 Feb;81(2):93-8
references.pmid: 6758594
references.citation: Orthod Craniofac Res. 2004 Nov;7(4):205-10
references.pmid: 15562583