Effectiveness of MI Paste Plus and PreviDent fluoride varnish for treatment of white spot lesions: A randomized controlled trial

• Published in: American journal of orthodontics and dentofacial orthopedics Vol. 143; no. 1; pp. 31 - 41
• Main Authors: Huang, Greg J, Roloff-Chiang, Brie, Mills, Brian E, Shalchi, Salma, Spiekerman, Charles, Korpak, Anna M, Starrett, Jeri L, Greenlee, Geoffrey M, Drangsholt, Ross J, Matunas, Jack C
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 2013
• Subjects: Adolescent; Cariostatic Agents - therapeutic use; Caseins - administration & dosage; Child, Preschool; Dental Caries - drug therapy; Dental Caries - etiology; Dentistry; Drug Synergism; Female; Fluorides, Topical - therapeutic use; Fluorine - administration & dosage; Humans; Male; Ointments; Oral Hygiene; Orthodontic Appliances - adverse effects; Single-Blind Method; Treatment Outcome; Young Adult
• ISSN: 0889-5406; 1097-6752
• DOI: 10.1016/j.ajodo.2012.09.007

Introduction White spot lesions are a common sequela of orthodontic therapy. In this parallel-group randomized trial, we assessed the effectiveness of 2 agents commonly used to ameliorate white spot lesions compared with a normal home-care regimen. Methods Patients aged 12 to 20 years were recruited from the offices of orthodontists and dentists who belonged to the Practice-based Research Collaborative in Evidence-based Dentistry network. The patients had their orthodontic appliances removed within the past 2 months and had at least 1 white spot lesion affecting their maxillary incisors. The subjects were randomized to 1 of 3 arms: (1) an 8-week regimen of MI Paste Plus (GC America, Alsip, Ill), (2) a single application of PreviDent fluoride varnish (Colgate Oral Pharmaceuticals, New York, NY), and (3) usual home care (control). Photographs were taken at enrollment and 8 weeks later. Two panels consisting of 5 dental professionals and 5 laypersons assessed the before-and-after pairs of photographs in a blinded fashion. Objective assessments and self-assessments were also performed. Results One hundred fifteen subjects completed the study; 34 were assigned to the MI Paste Plus group, 40 to the fluoride varnish group, and 41 to the control group. The mean improvements assessed by the professional panel were 21%, 29%, and 27% in the MI Paste Plus, fluoride varnish, and control groups, respectively.The results from the lay panel were 29%, 31%, and 25%, respectively. Objective improvements in the surface affected were 16%, 25%, and 17%, respectively; self-assessments of improvement were 37% in all 3 groups. No assessments indicated significant differences between subjects in the active arms compared with the control arm. Conclusions MI Paste Plus and PreviDent fluoride varnish do not appear to be more effective than normal home care for improving the appearance of white spot lesions over an 8-week period.