Treatment of white spot lesions after fixed orthodontic appliance  (RCT)

Method: 83 patients were treated in this block randomized controlled trial (35 female, 48 male (p > 0,05)). The chair-side group was treated immediately after de-bonding of the appliances (Icon,  DMG, Germany), consisted of 41  patients, mean age 16.7 years . The home-side group applied the product for 12 weeks immediately after de-bonding (Topex ReNew, Sultan Healthcare, USA), consisted of 42 patients, mean age 15.6 years. The WSL were clinically diagnosed with the Gorelik index and metrically measured with a LASER fluorescence measurement (DiagnoDent, KaVo, Germany) before treatment and three months after intervention.

Results: The statistical comparison showed in both groups a statistically significant decrease in the severity of white spot lesions (p < 0.001). However, the mean difference after treatment was half a Gorelik class better in the remineralisation group. 12,2 % of the remineralisation group and 11,9 % of the infiltration group showed a complete disappearence of the WSL. The LASER fluorescence measurements improved from 9 to 4 in the infiltration group and from 6,5 to 3 in the remineralisation group.

Conclusion: Both treatment methods, infiltration and  remineralisation, led in the  present clinical trial to a significant reduction of the clinical appearance of white spot lesions after fixed orthodontic appliances. Within the limitations of this RCT both therapeutic approaches can be recommended.