Effectiveness of fluoride mouthrinse in prevention of demineralization during fixed orthodontic treatment: A systematic review and meta-analysis

Enamel demineralization is a very common occurrence around bonded brackets in an orthodontic practice. Fluoride (FLR) applications have been used to prevent decalcification and further progression of white spot lesions. The purpose of this systematic review and meta-analysis was to systematically appraise available literature on the effectiveness of fluoride mouthrinse in the prevention of demineralization around fixed orthodontic appliances. A search was conducted for randomized controlled clinical trials among four electronic databases (MEDLINE, Google Scholar, PubMed, and Cochrane Review) through MeSH terms and keywords. Studies were excluded if random allocation was not conducted, or if they were animal or in vitro studies. About 146 articles were screened and 5 studies were selected for the present review. Only two studies were selected for MA due to variations in the measurement of outcomes among studies. This review concluded that rinsing with FLR in the course of the fixed orthodontic treatment lessens demineralization around the bracket. Using FLR mouthrinse to inhibit the formation of white spot lesions or dental caries in patients with multiple cavities or restoration can be considered in clinical practice.

Improving Oral Health with Fluoride-Free Calcium-Phosphate-Based Biomimetic Toothpastes: An Update of the Clinical Evidence

As the demand for clinically effective fluoride-free oral care products for consumers increases, it is important to document which types of toothpastes have been shown in clinical studies to be effective in improving oral health. In this review, we included different indications, i.e., caries prevention, improving periodontal health, reducing dentin hypersensitivity, protecting against dental erosion, and safely improving tooth whitening in defining what constitutes improvement in oral health. While there are several professional and consumer fluoride-containing formulations fortified with calcium-phosphate-based ingredients, this review focuses on fluoride-free toothpastes containing biomimetic calcium-phosphate-based molecules as the primary active ingredients. Several databases were searched, and only clinical trials in human subjects were included; in vitro and animal studies were excluded. There were 62 oral health clinical trials on biomimetic hydroxyapatite (HAP), 57 on casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), 26 on calcium sodium phosphosilicate (CSPS, or so called Bioglass), and 2 on β-tricalcium phosphate (β-TCP). HAP formulations were tested the most in clinical trials for benefits in preventing caries, dentin hypersensitivity, improving periodontal health, and tooth whitening. Based on the current clinical evidence to date, fluoride-free HAP toothpaste formulations are the most versatile of the calcium phosphate active ingredients in toothpastes for improving oral health.

Effect of remineralization agents on white spot lesions: A systematic review

Objective:

The goal of this systematic review was to evaluate the therapeutic efficacy of Casein Phosphopeptide Amorphous Calcium Phosphate (CPP-ACP) remineralizing potential to that of other remineralizing treatments and placebo in both naturally occurring and postorthodontic white spot lesions (WSL) in vivo.

Materials and Methods:

From 2005 to 2020, the literature search used electronic databases PubMed, Embase, Science Direct, and Google Scholar to find studies published solely in English and randomized controlled trials (RCTs) employing CPP-ACP as an intervention. All eligible studies were reviewed by two independent reviewers.

Results:

Excluding duplications, 72 articles were identified. Abstracts of 58 articles were reviewed independently, 19 articles were excluded, 36 full text articles were retrieved; finally selecting 14 studies.

Conclusion:

The CPP-ACP was found to have efficacious remineralizing potential on naturally occurring and postorthodontic WSL compared to placebo or other preventive measures. Further well-performed RCTs are needed to determine the therapeutic significance of remineralizing medicines, and long-term follow-ups are required.