A prospective, randomized placebo-controlled clinical trial on the effects of a fluoride rinse on white spot lesion development and bleeding in orthodontic patients

Demineralizations around orthodontic brackets are a main disadvantage of orthodontic treatment. Several methods have been advocated to prevent their development, such as fluoride rinses or varnishes. In this randomized clinical trial, a fluoride rinse (a combination of sodium fluoride and amine fluoride) was compared with a placebo rinse, to be used every evening after toothbrushing. A total of 81 participants (mean age: 13.3 yr) completed the study (mean treatment period: 24.5 months). Demineralizations, measured using quantitative light‐induced fluorescence and the decayed, missing, and filled surfaces (DMFS) index, were assessed before treatment (baseline) and around 6 wk after debonding (post treatment). Bleeding scores were measured at baseline, and during and post treatment. The incidence rate ratio for demineralizations was 2.6 (95% CI: 1.1–6.3) in the placebo group vs. the fluoride group. In the fluoride group, 31% of participants developed at least one demineralization, compared with 47% in the placebo group. Relative to baseline, gingival bleeding increased significantly in the placebo group 1 yr after the start of treatment and onwards. For the fluoride group, bleeding scores during treatment were not different from those at baseline. In conclusion, using a fluoride rinse helps to maintain better oral health during fixed appliance treatment, resulting in fewer demineralizations.

The effects of in vitro fluoride mouth rinse on the antibacterial properties of orthodontic cements

OBJECTIVES

To investigate the ability of orthodontic cements to regain their antibacterial effect after aging for 1 month, followed by 2 weeks of fluoride 'recharging' through daily fluoride rinse.

MATERIALS AND METHODS

Four orthodontic cements were tested: composite resin-based materials (Transbond XT and Transbond Plus), a conventional glass ionomer cement (CX Plus) and dual-cured resin-reinforced glass ionomer cement (Fuji ORTHO LC) by direct contact test. After polymerization and a 30-day aging process, the samples were rinsed daily with 0.05% NaF solution for 14 days. Twenty-four hours after the last fluoride rinse, Streptococcus mutans cells (approximately 1 x 10(6) ) were placed on the surface of each sample for 1 h at 37°C to establish direct contact. Bacterial growth was monitored for 24 h by temperature-controlled spectrophotometry. Similar experiments were conducted after aging for 48 h and 72 h after the last fluoride rinse. One-way anova, two-way anova, and Tukey's multiple comparison test were applied to the data.

RESULTS

Twenty-four hours after the last fluoride rinse, the resin-modified glass ionomer and the glass ionomer showed potent antibacterial properties, whereas the composite-based material Transbond XT encouraged bacterial growth. After 72 h, only Fuji Ortho LC maintained its bacteriostatic properties while all the other tested materials showed no antibacterial activity.

CONCLUSIONS

Fourteen days daily fluoride rinse temporarily revives the antibacterial properties of the resin-modified glass ionomer cement and glass-ionomer-based cement.