Effect of light curable fluoride varnish and nanohydroxyapatite toothpaste in preventing whitespot lesions adjacent to orthodontic brackets: An in-vivo study
Jenifer Gnanasekar, Babukuttan pillai S, Koshi Philip
Objective: To evaluate the effect of light curable fluoride varnish and nanohydroxyapatite toothpaste in preventing enamel demineralization adjacent to orthodontic brackets. Methods: Forty-five patients whose orthodontic treatment involved extraction of first premolars were recruited. The patients were assigned into three groups each of fifteen through consecutive sampling. In each patient one first upper premolar was considered the test teeth, brackets were bonded in all the teeth and normal orthodontic procedure was continued as per the treatment protocol. In Group 1 (control) the subjects followed regular oral hygiene regimen, in Group 2 subjects were advised to brush twice daily using nanohydroxyapatite toothpaste whereas in Group 3 they received single application of light curable fluoride varnish on the test teeth alone, The study was carried out for a period of 4 months after which the test teeth (premolar) was extracted and buccolingual sections were made to analyse the mean depth of demineralization under polarized light microscope. The statistical analysis was done using Kruskal Wallis one-way ANOVA followed by Mann Whitney test for intergroup comparison. Results: Statistically significant difference in demineralization adjacent to orthodontic brackets were evident. The mean lesion depth were 175.18±58.4 µm in the control group, 88.75±22.5 µm in the nanohydroxyapatite toothpaste group and 37.86±16.3 µm in the light curable fluoride varnish group. The least demineralization was with light curable fluoride varnish followed by nanohydroxyapatite toothpaste group. Maximum demineralization occurred in control (untreated) group. Conclusion: Light curable fluoride varnish showed 80% reduction in lesion depth followed by nanohydroxyapatite toothpaste with 50% reduction indicating that both are effective in preventing enamel demineralization adjacent to orthodontic brackets during orthodontic treatment. Light curable fluoride varnish could be an effective alternative in preventing enamel demineralization during orthodontic treatment especially for non-compliant and high-risk patients.