Comparative Evaluation of the Remineralizing Efficacy of Fluoride Varnish and its Combination Varnishes on White Spot Lesions in Children with ECC: A Randomized Clinical Trial

Association of Breastfeeding and Early Childhood Caries: A Systematic Review and Meta-Analysis

Early childhood caries (ECC) is a growing public health concern worldwide. Although numerous systematic reviews have been published regarding the association between breastfeeding and early childhood caries (ECC), the results remain inconclusive and equivocal. This systematic review synthesises the evidence on the association between breastfeeding and ECC. Five electronic databases and backward citation chasing were performed from inception until May 2023. A total of 31 studies (22 cohort studies and 9 case-control studies) were included in this review. The meta-analysis of the case-control studies showed statistically significant fewer dental caries in children who were breastfed for < 6 months compared to those who were breastfed for ≥6 months (OR = 0.53, 95% CI 0.41-0.67, p < 0.001). There was a statistically significant difference in dental caries between children who were breastfed for <12 months and those who were breastfed for ≥12 months (RR = 0.65, 95% CI 0.50-0.86, p < 0.002). Similarly, there was a statistically significant difference in dental caries in children who were breastfed for < 18 months compared to those who were breastfed for ≥18 months (RR = 0.41, 95% CI 0.18-0.92, p = 0.030). Nocturnal breastfeeding increases the risk of ECC compared with no nocturnal breastfeeding (RR = 2.35, 95% CI 1.42-3.89, p < 0.001). The findings suggest breastfeeding for more than 12 months and nocturnal breastfeeding increase the risk of ECC.

Evaluation of Remineralization Efficacy of Nanoparticle-based Materials on White Spot Lesions in Children: A Comparative Clinical Study

Background

Despite the introduction of several anticaries products, dental caries continues to be a global problem. In recent years, there has been a rise in interest in noninvasive treatment for noncavitated caries lesions by employing remineralization concepts. Each remineralizing agent has its own drawbacks. Therefore, it is desirable to seek new agents that offer the advantages of earlier counterparts with lower detrimental reactions.

Aim

The purpose of this research is to evaluate the remineralization efficacy of nanoparticle-based materials on white spot lesion (WSL) in children.

Materials and methods

A total of 45 children between the age-group of 4 and 8 years with WSLs were selected and randomly divided into three groups. At baseline, the teeth with WSLs were confirmed and identified using International Caries Detection and Assessment System II (ICDAS II) criteria, and the dimensions of the lesions were measured using photographic methods. Then, they were randomly placed into three groups of 15 samples each-group I nanosilver fluoride (NSF), group II nanohydroxyapatite (nano-HAP) serum, and group III MI varnish. Following that, the varnish was applied, and follow-up was done in the 2nd, 4th, 12th, and 24th week.

Results

By the 4th week, all three groups had a statistically significant difference (p < 0.05). Baseline measurements for groups I, II, and III showed that their respective mean WSL dimensions were 4.9 ± 0.66, 4.27 ± 0.69, and 5.44 ± 2.95. The dimensions of each group were reduced by the 24th week to 1.22 ± 0.46, 0.93 ± 0.41, and 2.19 ± 1.40, respectively. Overall, group II (nano-HAP serum) showed a statistically significant decrease in the dimension of the lesion at the end of the 24th week, followed by groups I and III.

Conclusion

The remineralization of enamel was induced by all three agents. Nano-HAP serum is more successful than MI Varnish and NSF.

How to cite this article

Annadurai T, Vundela RR, Chowdhary N, et al. Evaluation of Remineralization Efficacy of Nanoparticle-based Materials on White Spot Lesions in Children: A Comparative Clinical Study. Int J Clin Pediatr Dent 2024;17(4):425-432.

Effectiveness of Clinpro Tooth Crème in comparison with MI Varnish with RECALDENT™ for treatment of white spot lesions: a randomized controlled trial

BACKGROUND

Unsightly opaque white impaired enamel may ruin a great aesthetic orthodontic outcome. This study aims to evaluate effectiveness of Clinpro Tooth Crème (0.21% w/w NaF anti-caries dentifrice with 950 ppm fluoride and f-TCP) and MI Varnish with RECALDENT™ (CPP-ACP) for treatment of white spot lesions (WSLs).

MATERIALS AND METHODS

This was a randomized (1:1:1), single-blind, 3-armed, active-controlled, parallel-group trial. The study comprised three groups of 35 patients randomly assigned in blocks of 3 or 6 to one of the three following arms of the study- Group I: Clinpro™ Tooth Crème 0.21% Sodium Fluoride Anti-Cavity Paste with functional-Tri Calcium Phosphate(f-TCP) group. Group II: Fluoride varnish group (MI Varnish with RECALDENT™). Group III: Home-care group (control). For the subjective assessment, a blinded panel of 4 dental experts rated the improvement in WSLs over the eight weeks using a visual analog scale (VAS).

RESULTS

In total, 240 WSLs were identified, with maxillary lateral incisors and canines showing the highest incidence. Group I achieved the highest success rate of 67.61 (%) followed by group II (60.59%). There were no significant differences between the success rates of treatment in groups I and II. A minimum decline in WSLs was found in the control group, with a success rate of only 32.43%, significantly less than the first two groups (P < .001).

CONCLUSION

Both the test agents in consideration were comparable in their remineralization potential. Clinpro Tooth Crème provides additional protection against decalcification of enamel compared to MI Varnish with RECALDENT™ (CPP-ACP). TRIAL/PROJECT REGISTRATION NO.

AND DATE

4857/2017 on 21 June 2017.

Effectiveness-of Calcium Phosphate derivative agents on the prevention and remineralization of caries among children- A systematic review & meta-analysis of randomized controlled trials

OBJECTIVES

Dental caries among children is a highly prevalent yet easily preventable oral health issue among children. Various calcium phosphate (CaP) derivatives are implicated to exhibit caries preventive potential; however, no study has summarized the anti-caries effectiveness of these agents. This systematic review and meta-analysis sought to assess the caries-preventive and tooth-remineralizing effect of various (CaP) derivative agents compared to no-intervention/placebo or Fluoride (F) use alone among children.

MATERIALS AND METHODS

EMBASE, Ovid, PubMed, Scopus, Web of Science, Cochrane central register of controlled trials (CENTRAL), and grey literature were searched for relevant articles up to April 2021. Only English-language articles were included. Total 2636 articles were searched through different databases; out of the 2161 articles were screened after duplicate removal. 26 studies fulfilling the eligibility criteria were included in this systematic review. Methodological quality assessment and quantitative analysis were done using RevMan. GRADE was used to evaluate the certainty of evidence.

RESULTS

A total of 26 trials fulfilling the eligibility criteria were included. The meta-analysis of 10 studies revealed that complete white spot lesions (WSLs) regression (RR=1.56; 95% CI, 1.27 to 1.91; P < .0001, I2=0%), post intervention active WSLs (RR=0.80; 95% CI, 0.70 to 0.90; P = .0004, I2=0%) and post intervention Salivary S. mutans count (RR= 0.69; 95% CI, 0.48 to 0.99; P = .47, I2=0%) significantly favored the CaP+F combined therapy as compared to F alone. No significant differences in the lesion area, Delta F, and DIAGNOdent values were observed between the 2 groups. Low certainty of the evidence was found in the present systematic review due to the high/unclear risk of bias, imprecision, and indirectness of included trials.

CONCLUSIONS

Topical treatment using CaP+F group showed superior remineralization potential as well as the antibacterial effect on dental caries among children as compared to no intervention and/or placebo or F alone. Apart from CPP-ACP, other CaP derivatives like TCP and fTCP seem to have promising effects in remineralizing early lesions, however, very few trials exist on these potential agents. To provide definitive recommendations in this area, more clinical trials on caries preventive effectiveness of various CaP agents are warranted.

The Effectiveness of Early Childhood Caries Treatment with MI Varnish Fluor in Obese Subjects: A Study from Vietnam

Objective: We conducted this work to evaluate the effectiveness of treatment for early childhood caries (ECC) using MI Varnish Fluor in obese children aged from 36 to 71 months. Methods: This study was conducted on 300 carious teeth of obese children and normal-weight children in Hanoi, Vietnam, over the period 2019–2020. Diagnodent KaVo 2190 laser equipment was used to diagnose ECC. The children in each group were selected on the basis of similarities in age, gender, and study location, and the teeth in the two groups were selected on the basis of similarities in damage level and jaw position. ECC treatment was performed once a week for four consecutive weeks with MI Varnish Fluor. The child, the child’s family, and the child’s teacher were consulted on diet and oral hygiene during the treatment. Children were examined and monitored throughout the treatment period. Children were re-examined after 3 and 6 months from the start time of treatment. The Mann–Whitney U test and Kruskal–Wallis tests were used, with statistical significance indicated at p < 0.05. Results: After six months of treatment with MI Varnish Fluor, the number of cases of code 0 damage recovery (D0) increased in both groups. The result showed that MI Varnish fluor was effective in ECC treatment. D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children were observed after six months of treatment, but there was no statistically significant difference between the two groups. Furthermore, there was no statistically significant difference between the two groups according to age, tooth position, or tooth surface position in D0 damage recovery. Conclusions: MI Varnish Fluor was effective in ECC treatment, with D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children after six months of treatment.