Efficacy of fluoride varnish for prevention of white spot lesions during orthodontic treatment with fixed appliances: A systematic review study
DOI:
https://doi.org/10.15419/bmrat.v4i08.222Keywords:
Chlorhexidine, Fluoride varnish, Orthodontic treatment, White spot lesionsAbstract
Background: White spot lesions (WSLs) are a problem commonly found in patients who use orthodontic devices. Fluoride varnish can reduce WSLs during orthodontic treatment with fixed appliances. The aim of this systematic review was to evaluate the efficacy of fluoride varnish compared with other agents for preventing WSLs during orthodontic treatment.
Methods: Studies were searched from four databases- PubMed, Scopus, Web of Science and Cochrane Library- from January 1980 to May 2017; only studies with English abstracts were included.
Results: Out of 432 studies searched from the databases, 33 studies were evaluated for eligibility. Of the 33 studies, 19 were excluded with reasons and 14 studies were included in the systematic review. Parameters of WSLs (decalcification score, prevalence, incidence, progression score, ΔQ and ΔZ and DiagnoDent (DD) pen score) were compared for the various treatments.
Conclusions: Although there were some limitations for this systematic review study, the review showed that fluoride varnish combined with chlorhexidine (CHX) may be a good treatment for WSLs after orthodontic treatment, especially for a 6-month period, and that resin infiltration might also be effective for preventing WSLs. More studies are needed to further investigate these observations.
References
<ol>
<li class="show">Adriaens, M., Dermaut, L., and Verbeeck, R. (1990). The use of 'Fluor Protector®', a fluoride varnish, as a caries prevention method under orthodontic molar bands. The European Journal of Orthodontics 12, 316-319. <a href="https://doi.org/10.1093/ejo/12.3.316">https://doi.org/10.1093/ejo/12.3.316</a></li>
<li class="show">de Leeuw, N.H. (2004). Resisting the onset of hydroxyapatite dissolution through the incorporation of fluoride. The Journal of Physical Chemistry B 108, 1809-1811. <a href="https://doi.org/10.1021/jp036784v">https://doi.org/10.1021/jp036784v</a></li>
<li class="show">Demito, C., Vivaldi‐Rodrigues, G., Ramos, A., and Bowman, S. (2004). The efficacy of a fluoride varnish in reducing enamel demineralization adjacent to orthodontic brackets: an in vitro study. Orthodontics & craniofacial research 7, 205-210. <a href="https://doi.org/10.1111/j.1601-6343.2004.00305.x">https://doi.org/10.1111/j.1601-6343.2004.00305.x</a></li>
<li class="show">Derks, A., Katsaros, C., Frencken, J., Van't Hof, M., and Kuijpers-Jagtman, A. (2004). Caries-inhibiting effect of preventive measures during orthodontic treatment with fixed appliances. Caries research 38, 413-420. <a href="https://doi.org/10.1159/000079621">https://doi.org/10.1159/000079621</a></li>
<li class="show">Ekstrand, K., Bakhshandeh, A., and Martignon, S. (2010). Treatment of proximal superficial caries lesions on primary molar teeth with resin infiltration and fluoride varnish versus fluoride varnish only: efficacy after 1 year. Caries research 44, 41-46. <a href="https://doi.org/10.1159/000275573">https://doi.org/10.1159/000275573</a></li>
<li class="show">Farhadian, N., Miresmaeili, A., Eslami, B., and Mehrabi, S. (2008). Effect of fluoride varnish on enamel demineralization around brackets: an in-vivo study. American Journal of Orthodontics and Dentofacial Orthopedics 133, S95-S98. <a href="https://doi.org/10.1016/j.ajodo.2006.09.050">https://doi.org/10.1016/j.ajodo.2006.09.050</a></li>
<li class="show">Geiger, A.M., Gorelick, L., Gwinnett, A.J., and Benson, B.J. (1992). Reducing white spot lesions in orthodontic populations with fluoride rinsing. American Journal of Orthodontics and Dentofacial Orthopedics 101, 403-407. <a href="https://doi.org/10.1016/0889-5406(92)70112-N">https://doi.org/10.1016/0889-5406(92)70112-N</a></li>
<li class="show">Hammad, S.M., El Banna, M., El Zayat, I., and Mohsen, M.A. (2012). Effect of resin infiltration on white spot lesions after debonding orthodontic brackets. Am J Dent 25, 3-8.</li>
<li class="show">He, T., Li, X., Dong, Y., Zhang, N., Zhong, Y., Yin, W., and Hu, D. (2016). Comparative assessment of fluoride varnish and fluoride film for remineralization of postorthodontic white spot lesions in adolescents and adults over a 6-month period: A single-center, randomized controlled clinical trial. American Journal of Orthodontics and Dentofacial Orthopedics 149, 810-819.<a href=" https://doi.org/10.1016/j.ajodo.2015.12.010"> https://doi.org/10.1016/j.ajodo.2015.12.010</a></li>
<li class="show">Huang, G.J., Roloff-Chiang, B., Mills, B.E., Shalchi, S., Spiekerman, C., Korpak, A.M., Starrett, J.L., Greenlee, G.M., Drangsholt, R.J., and Matunas, J.C. (2013). Effectiveness of MI Paste Plus and PreviDent fluoride varnish for treatment of white spot lesions: a randomized controlled trial. American Journal of Orthodontics and Dentofacial Orthopedics 143, 31-41. <a href="https://doi.org/10.1016/j.ajodo.2012.09.007">https://doi.org/10.1016/j.ajodo.2012.09.007</a></li>
<li class="show">Huizinga, E., Ruben, J., and Arends, J. (1991). Chlorhexidine and thymol release from a varnish system. Journal de biologie buccale 19, 343-348.</li>
<li class="show">Jumanca, D., Galuscan, A., Podariu, A.C., Ardelean, L., and Rusu, L.C. (2012). Infiltration Therapy-an Alternative to Fluoride Varnish Application for Treatment of White Spot Lesion After Fixed Orthodontic Treatment. Revista de Chimie 63, 783-786.</li>
<li class="show">Kronenberg, O., Lussi, A., and Ruf, S. (2009). Preventive effect of ozone on the development of white spot lesions during multibracket appliance therapy. The Angle orthodontist 79, 64-69. <a href="https://doi.org/10.2319/100107-468.1">https://doi.org/10.2319/100107-468.1</a></li>
<li class="show">Llena-Puy, C. (2013). MI Paste Plus and PreviDent fluoride varnish appear No more effective than normal home care for improving the appearance of white spot lesions. Journal of Evidence Based Dental Practice 13, 114-116. <a href="https://doi.org/10.1016/j.jebdp.2013.07.012">https://doi.org/10.1016/j.jebdp.2013.07.012</a></li>
<li class="show">Lucchese, A., and Gherlone, E. (2012). Prevalence of white-spot lesions before and during orthodontic treatment with fixed appliances. European Journal of Orthodontics 35, 664-668. <a href="https://doi.org/10.1093/ejo/cjs070">https://doi.org/10.1093/ejo/cjs070</a></li>
<li class="show">McNeill, C.J., Wiltshire, W.A., Dawes, C., and Lavelle, C.L. (2001). Fluoride release from new light-cured orthodontic bonding agents. American Journal of Orthodontics and Dentofacial Orthopedics 120, 392-397. <a href="https://doi.org/10.1067/mod.2001.118103">https://doi.org/10.1067/mod.2001.118103</a></li>
<li class="show">Mount, G.J., Hume, W.R., Ngo, H.C., and Wolff, M.S. (2016). Preservation and restoration of tooth structure (John Wiley & Sons).</li>
<li class="show">Mueller, J., Meyer-Lueckel, H., Paris, S., Hopfenmuller, W., and Kielbassa, A. (2006). Inhibition of lesion progression by the penetration of resins in vitro: influence of the application procedure. Operative dentistry 31, 338-345. <a href="https://doi.org/10.2341/05-39">https://doi.org/10.2341/05-39</a></li>
<li class="show">Øgaard, B., Duschner, H., Ruben, J., and Arends, J. (1996). Microradiography and confocal laser scanning microscopy applied to enamel lesions formed in vivo with and without fluoride varnish treatment. European journal of oral sciences 104, 378-383. <a href="https://doi.org/10.1111/j.1600-0722.1996.tb00095.x">https://doi.org/10.1111/j.1600-0722.1996.tb00095.x</a></li>
<li class="show">Øgaard, B., Larsson, E., Henriksson, T., Birkhed, D., and Bishara, S.E. (2001). Effects of combined application of antimicrobial and fluoride varnishes in orthodontic patients. American Journal of Orthodontics and Dentofacial Orthopedics 120, 28-35. <a href="https://doi.org/10.1067/mod.2001.114644">https://doi.org/10.1067/mod.2001.114644</a></li>
<li class="show">Palamara, J.E., Tyas, M., and Burrow, M.F. (2010). Resin infiltrated artificial caries lesions examined by polarized light microscopy and micro-hardness tests (Hamburg, Germany: DMG). Paris, S., and Meyer-Lueckel, H. (2010). Inhibition of caries progression by resin infiltration in situ. Caries research 44, 47-54. <a href="https://doi.org/10.1159/000275917">https://doi.org/10.1159/000275917</a></li>
<li class="show">Restrepo, M., Bussaneli, D., Jeremias, F., Cordeiro, R., Raveli, D., Magalhães, A., Candolo, C., and Santos-Pinto, L. (2016). Control of white spot lesions with use of fluoride varnish or chlorhexidine gel during orthodontic treatment a randomized clinical trial. Journal of Clinical Pediatric Dentistry 40, 274-280. <a href="https://doi.org/10.17796/1053-4628-40.4.274">https://doi.org/10.17796/1053-4628-40.4.274</a></li>
<li class="show">Restrepo, M., Bussaneli, D.G., Jeremias, F., Cordeiro, R.C., Magalhães, A.C., Palomari Spolidorio, D.M., and Santos-Pinto, L. (2015). Control of white spot lesion adjacent to orthodontic bracket with use of fluoride varnish or chlorhexidine gel. The Scientific World Journal 2015. <a href="https://doi.org/10.1155/2015/218452">https://doi.org/10.1155/2015/218452</a></li>
<li class="show">Reynolds, E., Cai, F., Shen, P., and Walker, G. (2003). Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugar-free chewing gum. Journal of dental research 82, 206-211. <a href="https://doi.org/10.1177/154405910308200311">https://doi.org/10.1177/154405910308200311</a></li>
<li class="show">Sari, E., and Birinci, I. (2007). Microbiological evaluation of 0.2% chlorhexidine gluconate mouth rinse in orthodontic patients. The Angle Orthodontist 77, 881-884. <a href="https://doi.org/10.2319/080506-320.1">https://doi.org/10.2319/080506-320.1</a></li>
<li class="show">Seppä, L. (1983). Effect of dental plaque on fluoride uptake by enamel from a sodium fluoride varnish in vivo. Caries research 17, 71-75. <a href="https://doi.org/10.1159/000260651">https://doi.org/10.1159/000260651</a></li>
<li class="show">Shinaishin, S.F., Ghobashy, S.A., and EL-Bialy, T.H. (2011). Efficacy of light-activated sealant on enamel demineralization in orthodontic patients: an atomic force microscope evaluation. The open dentistry journal 5, 179. <a href="https://doi.org/10.2174/1874210601105010179">https://doi.org/10.2174/1874210601105010179</a></li>
<li class="show">Singh, S., Singh, S.P., Goyal, A., Utreja, A.K., and Jena, A.K. (2016). Effects of various remineralizing agents on the outcome of post-orthodontic white spot lesions (WSLs): a clinical trial. Progress in orthodontics 17, 25. <a href="https://doi.org/10.1186/s40510-016-0138-9">https://doi.org/10.1186/s40510-016-0138-9</a></li>
<li class="show">Stecksén-Blicks, C., Renfors, G., Oscarson, N., Bergstrand, F., and Twetman, S. (2007). Caries-preventive effectiveness of a fluoride varnish: a randomized controlled trial in adolescents with fixed orthodontic appliances. Caries research 41, 455-459. <a href="https://doi.org/10.1159/000107932">https://doi.org/10.1159/000107932</a></li>
<li class="show">Tufekci, E., Dixon, J.S., Gunsolley, J., and Lindauer, S.J. (2011). Prevalence of white spot lesions during orthodontic treatment with fixed appliances. The Angle orthodontist 81, 206-210. <a href="https://doi.org/10.2319/051710-262.1">https://doi.org/10.2319/051710-262.1</a></li>
<li class="show">Turska-Szybka, A., Gozdowski, D., Mierzwińska-Nastalska, E., and Olczak-Kowalczyk, D. (2016). Randomised Clinical Trial on Resin Infiltration and Fluoride Varnish vs Fluoride Varnish Treatment Only of Smooth-surface Early Caries Lesions in Deciduous Teeth. Oral health & preventive dentistry 14, 485-491.</li>
<li class="show">Twetman, S. (2004). Antimicrobials in future caries control? A review with special reference to chlorhexidine treatment. Caries Res 38, 223-229. <a href="https://doi.org/10.1159/000077758">https://doi.org/10.1159/000077758</a></li>
<li class="show">Ullsfoss, B.N., Ögaard, B., Arends, J., Ruben, J., Rölla, G., and Afseth, J. (1994). Effect of a combined chlorhexidine and NaF mouthrinse: an in vivo human caries model study. European Journal of Oral Sciences 102, 109-112. <a href="https://doi.org/10.1111/j.1600-0722.1994.tb01164.x">https://doi.org/10.1111/j.1600-0722.1994.tb01164.x</a></li>
<li class="show">Vivaldi-Rodrigues, G., Demito, C.F., Bowman, S.J., and Ramos, A.L. (2006). The effectiveness of a fluoride varnish in preventing the development of white spot lesions. World journal of orthodontics 7.</li>
</ol>
<li class="show">Adriaens, M., Dermaut, L., and Verbeeck, R. (1990). The use of 'Fluor Protector®', a fluoride varnish, as a caries prevention method under orthodontic molar bands. The European Journal of Orthodontics 12, 316-319. <a href="https://doi.org/10.1093/ejo/12.3.316">https://doi.org/10.1093/ejo/12.3.316</a></li>
<li class="show">de Leeuw, N.H. (2004). Resisting the onset of hydroxyapatite dissolution through the incorporation of fluoride. The Journal of Physical Chemistry B 108, 1809-1811. <a href="https://doi.org/10.1021/jp036784v">https://doi.org/10.1021/jp036784v</a></li>
<li class="show">Demito, C., Vivaldi‐Rodrigues, G., Ramos, A., and Bowman, S. (2004). The efficacy of a fluoride varnish in reducing enamel demineralization adjacent to orthodontic brackets: an in vitro study. Orthodontics & craniofacial research 7, 205-210. <a href="https://doi.org/10.1111/j.1601-6343.2004.00305.x">https://doi.org/10.1111/j.1601-6343.2004.00305.x</a></li>
<li class="show">Derks, A., Katsaros, C., Frencken, J., Van't Hof, M., and Kuijpers-Jagtman, A. (2004). Caries-inhibiting effect of preventive measures during orthodontic treatment with fixed appliances. Caries research 38, 413-420. <a href="https://doi.org/10.1159/000079621">https://doi.org/10.1159/000079621</a></li>
<li class="show">Ekstrand, K., Bakhshandeh, A., and Martignon, S. (2010). Treatment of proximal superficial caries lesions on primary molar teeth with resin infiltration and fluoride varnish versus fluoride varnish only: efficacy after 1 year. Caries research 44, 41-46. <a href="https://doi.org/10.1159/000275573">https://doi.org/10.1159/000275573</a></li>
<li class="show">Farhadian, N., Miresmaeili, A., Eslami, B., and Mehrabi, S. (2008). Effect of fluoride varnish on enamel demineralization around brackets: an in-vivo study. American Journal of Orthodontics and Dentofacial Orthopedics 133, S95-S98. <a href="https://doi.org/10.1016/j.ajodo.2006.09.050">https://doi.org/10.1016/j.ajodo.2006.09.050</a></li>
<li class="show">Geiger, A.M., Gorelick, L., Gwinnett, A.J., and Benson, B.J. (1992). Reducing white spot lesions in orthodontic populations with fluoride rinsing. American Journal of Orthodontics and Dentofacial Orthopedics 101, 403-407. <a href="https://doi.org/10.1016/0889-5406(92)70112-N">https://doi.org/10.1016/0889-5406(92)70112-N</a></li>
<li class="show">Hammad, S.M., El Banna, M., El Zayat, I., and Mohsen, M.A. (2012). Effect of resin infiltration on white spot lesions after debonding orthodontic brackets. Am J Dent 25, 3-8.</li>
<li class="show">He, T., Li, X., Dong, Y., Zhang, N., Zhong, Y., Yin, W., and Hu, D. (2016). Comparative assessment of fluoride varnish and fluoride film for remineralization of postorthodontic white spot lesions in adolescents and adults over a 6-month period: A single-center, randomized controlled clinical trial. American Journal of Orthodontics and Dentofacial Orthopedics 149, 810-819.<a href=" https://doi.org/10.1016/j.ajodo.2015.12.010"> https://doi.org/10.1016/j.ajodo.2015.12.010</a></li>
<li class="show">Huang, G.J., Roloff-Chiang, B., Mills, B.E., Shalchi, S., Spiekerman, C., Korpak, A.M., Starrett, J.L., Greenlee, G.M., Drangsholt, R.J., and Matunas, J.C. (2013). Effectiveness of MI Paste Plus and PreviDent fluoride varnish for treatment of white spot lesions: a randomized controlled trial. American Journal of Orthodontics and Dentofacial Orthopedics 143, 31-41. <a href="https://doi.org/10.1016/j.ajodo.2012.09.007">https://doi.org/10.1016/j.ajodo.2012.09.007</a></li>
<li class="show">Huizinga, E., Ruben, J., and Arends, J. (1991). Chlorhexidine and thymol release from a varnish system. Journal de biologie buccale 19, 343-348.</li>
<li class="show">Jumanca, D., Galuscan, A., Podariu, A.C., Ardelean, L., and Rusu, L.C. (2012). Infiltration Therapy-an Alternative to Fluoride Varnish Application for Treatment of White Spot Lesion After Fixed Orthodontic Treatment. Revista de Chimie 63, 783-786.</li>
<li class="show">Kronenberg, O., Lussi, A., and Ruf, S. (2009). Preventive effect of ozone on the development of white spot lesions during multibracket appliance therapy. The Angle orthodontist 79, 64-69. <a href="https://doi.org/10.2319/100107-468.1">https://doi.org/10.2319/100107-468.1</a></li>
<li class="show">Llena-Puy, C. (2013). MI Paste Plus and PreviDent fluoride varnish appear No more effective than normal home care for improving the appearance of white spot lesions. Journal of Evidence Based Dental Practice 13, 114-116. <a href="https://doi.org/10.1016/j.jebdp.2013.07.012">https://doi.org/10.1016/j.jebdp.2013.07.012</a></li>
<li class="show">Lucchese, A., and Gherlone, E. (2012). Prevalence of white-spot lesions before and during orthodontic treatment with fixed appliances. European Journal of Orthodontics 35, 664-668. <a href="https://doi.org/10.1093/ejo/cjs070">https://doi.org/10.1093/ejo/cjs070</a></li>
<li class="show">McNeill, C.J., Wiltshire, W.A., Dawes, C., and Lavelle, C.L. (2001). Fluoride release from new light-cured orthodontic bonding agents. American Journal of Orthodontics and Dentofacial Orthopedics 120, 392-397. <a href="https://doi.org/10.1067/mod.2001.118103">https://doi.org/10.1067/mod.2001.118103</a></li>
<li class="show">Mount, G.J., Hume, W.R., Ngo, H.C., and Wolff, M.S. (2016). Preservation and restoration of tooth structure (John Wiley & Sons).</li>
<li class="show">Mueller, J., Meyer-Lueckel, H., Paris, S., Hopfenmuller, W., and Kielbassa, A. (2006). Inhibition of lesion progression by the penetration of resins in vitro: influence of the application procedure. Operative dentistry 31, 338-345. <a href="https://doi.org/10.2341/05-39">https://doi.org/10.2341/05-39</a></li>
<li class="show">Øgaard, B., Duschner, H., Ruben, J., and Arends, J. (1996). Microradiography and confocal laser scanning microscopy applied to enamel lesions formed in vivo with and without fluoride varnish treatment. European journal of oral sciences 104, 378-383. <a href="https://doi.org/10.1111/j.1600-0722.1996.tb00095.x">https://doi.org/10.1111/j.1600-0722.1996.tb00095.x</a></li>
<li class="show">Øgaard, B., Larsson, E., Henriksson, T., Birkhed, D., and Bishara, S.E. (2001). Effects of combined application of antimicrobial and fluoride varnishes in orthodontic patients. American Journal of Orthodontics and Dentofacial Orthopedics 120, 28-35. <a href="https://doi.org/10.1067/mod.2001.114644">https://doi.org/10.1067/mod.2001.114644</a></li>
<li class="show">Palamara, J.E., Tyas, M., and Burrow, M.F. (2010). Resin infiltrated artificial caries lesions examined by polarized light microscopy and micro-hardness tests (Hamburg, Germany: DMG). Paris, S., and Meyer-Lueckel, H. (2010). Inhibition of caries progression by resin infiltration in situ. Caries research 44, 47-54. <a href="https://doi.org/10.1159/000275917">https://doi.org/10.1159/000275917</a></li>
<li class="show">Restrepo, M., Bussaneli, D., Jeremias, F., Cordeiro, R., Raveli, D., Magalhães, A., Candolo, C., and Santos-Pinto, L. (2016). Control of white spot lesions with use of fluoride varnish or chlorhexidine gel during orthodontic treatment a randomized clinical trial. Journal of Clinical Pediatric Dentistry 40, 274-280. <a href="https://doi.org/10.17796/1053-4628-40.4.274">https://doi.org/10.17796/1053-4628-40.4.274</a></li>
<li class="show">Restrepo, M., Bussaneli, D.G., Jeremias, F., Cordeiro, R.C., Magalhães, A.C., Palomari Spolidorio, D.M., and Santos-Pinto, L. (2015). Control of white spot lesion adjacent to orthodontic bracket with use of fluoride varnish or chlorhexidine gel. The Scientific World Journal 2015. <a href="https://doi.org/10.1155/2015/218452">https://doi.org/10.1155/2015/218452</a></li>
<li class="show">Reynolds, E., Cai, F., Shen, P., and Walker, G. (2003). Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugar-free chewing gum. Journal of dental research 82, 206-211. <a href="https://doi.org/10.1177/154405910308200311">https://doi.org/10.1177/154405910308200311</a></li>
<li class="show">Sari, E., and Birinci, I. (2007). Microbiological evaluation of 0.2% chlorhexidine gluconate mouth rinse in orthodontic patients. The Angle Orthodontist 77, 881-884. <a href="https://doi.org/10.2319/080506-320.1">https://doi.org/10.2319/080506-320.1</a></li>
<li class="show">Seppä, L. (1983). Effect of dental plaque on fluoride uptake by enamel from a sodium fluoride varnish in vivo. Caries research 17, 71-75. <a href="https://doi.org/10.1159/000260651">https://doi.org/10.1159/000260651</a></li>
<li class="show">Shinaishin, S.F., Ghobashy, S.A., and EL-Bialy, T.H. (2011). Efficacy of light-activated sealant on enamel demineralization in orthodontic patients: an atomic force microscope evaluation. The open dentistry journal 5, 179. <a href="https://doi.org/10.2174/1874210601105010179">https://doi.org/10.2174/1874210601105010179</a></li>
<li class="show">Singh, S., Singh, S.P., Goyal, A., Utreja, A.K., and Jena, A.K. (2016). Effects of various remineralizing agents on the outcome of post-orthodontic white spot lesions (WSLs): a clinical trial. Progress in orthodontics 17, 25. <a href="https://doi.org/10.1186/s40510-016-0138-9">https://doi.org/10.1186/s40510-016-0138-9</a></li>
<li class="show">Stecksén-Blicks, C., Renfors, G., Oscarson, N., Bergstrand, F., and Twetman, S. (2007). Caries-preventive effectiveness of a fluoride varnish: a randomized controlled trial in adolescents with fixed orthodontic appliances. Caries research 41, 455-459. <a href="https://doi.org/10.1159/000107932">https://doi.org/10.1159/000107932</a></li>
<li class="show">Tufekci, E., Dixon, J.S., Gunsolley, J., and Lindauer, S.J. (2011). Prevalence of white spot lesions during orthodontic treatment with fixed appliances. The Angle orthodontist 81, 206-210. <a href="https://doi.org/10.2319/051710-262.1">https://doi.org/10.2319/051710-262.1</a></li>
<li class="show">Turska-Szybka, A., Gozdowski, D., Mierzwińska-Nastalska, E., and Olczak-Kowalczyk, D. (2016). Randomised Clinical Trial on Resin Infiltration and Fluoride Varnish vs Fluoride Varnish Treatment Only of Smooth-surface Early Caries Lesions in Deciduous Teeth. Oral health & preventive dentistry 14, 485-491.</li>
<li class="show">Twetman, S. (2004). Antimicrobials in future caries control? A review with special reference to chlorhexidine treatment. Caries Res 38, 223-229. <a href="https://doi.org/10.1159/000077758">https://doi.org/10.1159/000077758</a></li>
<li class="show">Ullsfoss, B.N., Ögaard, B., Arends, J., Ruben, J., Rölla, G., and Afseth, J. (1994). Effect of a combined chlorhexidine and NaF mouthrinse: an in vivo human caries model study. European Journal of Oral Sciences 102, 109-112. <a href="https://doi.org/10.1111/j.1600-0722.1994.tb01164.x">https://doi.org/10.1111/j.1600-0722.1994.tb01164.x</a></li>
<li class="show">Vivaldi-Rodrigues, G., Demito, C.F., Bowman, S.J., and Ramos, A.L. (2006). The effectiveness of a fluoride varnish in preventing the development of white spot lesions. World journal of orthodontics 7.</li>
</ol>
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2017-08-25
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Efficacy of fluoride varnish for prevention of white spot lesions during orthodontic treatment with fixed appliances: A systematic review study. (2017). Biomedical Research and Therapy, 4(08), 1513-1526. https://doi.org/10.15419/bmrat.v4i08.222
