RSUSSH 2020
IN20-192 Effect of Fluoride Varnish with ACP on Caries Progression of Partially Erupted First Permanent Molar in Grade 1 Student at Wat Nawong School
Presenter: Prat Hatsadaloi
Rangsit University, Thailand
Abstract
The objective of this study is to determine the effectiveness in the clinical use of 5% fluoride varnish with amorphous calcium phosphate (ACP) as an intervention to decrease dental caries progression on partially erupted first permanent molars among children with high caries risk. Forty-two Grade 1 students with partially erupted first permanent molars were participated in this 6-month clinical trials with split-mouth design. They were randomly divided into a fluoride varnish (Enamel ProÒ) group and a control group (each group consisted of 42 partially erupted first molars). The Chi-square test was used for statistical analysis with 95% level of confidence (p<0.05). Thirty-seven participants (88%) of the study group had no caries progression, while 5 participants (12%) had caries progression. In the control group, 21 participants (50%) had no caries progression and 21 participants (50%) had caries progression. There was a significant difference in caries progression between the two groups. Fluoride varnish group also resulted in 76% caries reduction in partially erupted first permanent molars at 6 months. In conclusion, 5% Sodium fluoride varnish with ACP (Enamel Pro®) is effective in reducing caries progression in study group. Fluoride varnish can be used as an alternative intervention for reducing caries progression in partially erupted first permanent molar among high caries risk children.
Citation format:
Sumethchotimetha, A., Poonsuk, S., Chiampichitr, C., Hatsadaloi, P., Iawprasert, S., Kanokmaneeporn, N., Painupong, T., & Khempitak, W.. (2020). Effect of Fluoride Varnish with ACP on Caries Progression of Partially Erupted First Permanent Molar in Grade 1 Student at Wat Nawong School. Proceeding in RSU International Research Conference, May 1, 2020. Pathum Thani, Thailand.QUESTIONS & ANSWERS
Dear Researchers,
First of all, I really enjoy reading your well-literate article. Good jobs!
One curiosity I had was about the randomization technique for determining the control and the treated teeth in this study. Which technique was used?
Another question is related to ACP, the interesting agent that make this study very distinctive. Could you please discuss more about this agent? For example: Is there other calcium-phosphate agents in the market? Is this agent promise better results comparing to others?
Sincerely,
Yada Anantawat, DDS, MSc.
Dear Dr.Yada
Thank you for the compliments and questions.
Simple Randomization was used for choosing between the control tooth and the study tooth. We used white and orange table tennis balls to random. White indicated the control tooth while orange indicates the study tooth.
Fluoride varnish with ACP was used in our research because we want to continue a further study from Dr. Ratanapongpisarn and his contributing authors which focused on the surface hardness of the tooth that was applied by fluoride varnish with ACP. The result stated that it can significantly increases the tooth surface hardness. We chose Enamel Pro® because it is used in the Pedodontic department at the college of Dental Medicine, Rangsit University.
The mechanism of CPP-ACP on enamel erosion may involve the incorporation of nano-complexes on the enamel surface. CPP-ACP nano-complexes located on the enamel surface have been purported to buffer the activity of free calcium and phosphate ions, thereby maintaining a state of supersaturation with respect to tooth enamel, preventing enamel demineralization, and promoting remineralization. The treatment of CPP-ACP was also found to facilitate the formation of a crystal layer, filling the interprism, and partially covering the prisms, thus preventing acid attack.
(Ref : Bayrak S, Tuloglu N, Bicer H, Sen Tunc E. Effect of fluoride varnish containing CPP-ACP on preventing enamel erosion. Scanning 2017;2017:1897825.)
Here are other calcium-phosphate agents in the market.
Enamel Pro® - 5% sodium fluoride plus amorphous calcium phosphate varnish (5%NaF+ACP)
MI VarnishTM - 5% sodium fluoride plus casein phospho peptide-amorphous calcium phosphate varnish (5%NaF+CPP-ACP) ClinproTM White - 5% sodium fluoride plus tricalcium phosphate varnish (5%NaF+TCP)
The study’s findings indicate that Clinpro White varnish offers greater protection against the challenge of enamel erosion than Duraphat varnish (5% sodium fluoride varnish); however it reveals less protection than MI varnish. It may be explained by the high release of calcium and inorganic phosphate ions from MI varnish or by the low solubility of tricalcium phosphate from Clinpro White varnish. However, there are no reports comparing Enamel Pro®, MI VarnishTM, and ClinproTM White.
(Ref : C. Poggio, M. Lombardini, A. Dagna, M. Chiesa, and S. Bianchi, “Protective effect on enamel demineralization of a CPP- ACP paste: an AFM in vitro study,” Journal of Dentistry, vol. 37, no. 12, pp. 949–954, 2009. )
Regards,
Researcher team