Clinical Efficacy of Two Topical Agents for the Remineralization of Enamel White Spot Lesions in Primary Teeth

 

TAKE-HOME MESSAGE

  • This randomized controlled trial enrolled 130 children between age 3 and 7 years with at least one white spot lesion on a primary maxillary anterior tooth. Participants were randomized to topically use Colgate Total toothpaste (fluoride and triclosan), Remin Pro toothpaste (fluoride, hydroxyapatite, and xylitol), or MI Paste Plus (fluoride, CPP-ACPF, and xylitol) twice daily after toothbrushing. DIAGNOdent readings were taken after day 10 and day 21. It was found that all toothpastes used improved DIAGNOdent readings. Remin Pro and MI Paste Plus both showed statistically significantly better DIAGNOdent improvement than Colgate Total, but no difference was found between Remin Pro and MI Paste Plus.

  • All approaches showed remineralized white spot lesions within 21 days. Providers with young child patients should encourage toothbrushing with fluoride toothpaste. Providers can consider adjunctive remineralizing agents in children with a high caries risk, but longer studies are necessary to show a long-term benefit over fluoride toothpaste alone.
–  James Boynton, DDS, MS

PURPOSE

The purpose of this study was to compare the remineralizing clinical efficacy of fluoride plus hydroxyapatite (Remin Pro®; RP) and fluoride plus casein phosphopeptide-amorphous calcium phosphate fluoride (Mi Paste Plus®; MPP) for the treatment of white spot lesions (WSLs) in primary tooth enamel.

METHODS

This study was a randomized double-blind clinical trial. It included patients with at least one primary maxillary anterior tooth with a WSL on the enamel surface. They were randomly assigned to receive either the twice-daily at-home topical application of RP or MPP or fluoride (NaF) paste (Colgate Total®; CT). The remineralization degree was quantified by the change in the number of units of fluorescence (UF) measured with laser fluorescence pen device (DIAGNOdent™) from the baseline and at days 10 and 21.

RESULTS

UF decreased significantly in all groups (P<0.001). Both RP and MPP resulted in significantly higher standardized mean difference (SMD) UF than CT (P<0.05); however, the difference between RP and MPP was not statistically significant (P>0.05).

CONCLUSIONS

Topical application of Colgate Total®, Mi Paste Plus®, and Remin Pro® resulted in a remineralizing effect against white spot lesions on primary tooth enamel. Both MPP and RP were statistically superior to CT.

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