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Prevention and remineralization of white spot lesions in orthodontics: comparison of sodium fluoride varnish and titanium tetrafluoride varnish (TiF4)

Grant number: 19/09847-2
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): July 01, 2019
Effective date (End): June 30, 2021
Field of knowledge:Health Sciences - Dentistry - Orthodontics
Principal researcher:Marília Afonso Rabelo Buzalaf
Grantee:Larissa Ayumi Koshino
Home Institution: Faculdade de Odontologia de Bauru (FOB). Universidade de São Paulo (USP). Bauru , SP, Brazil


Considering the orthodontic appliance promotes the accumulation of bacterial plaque and makes hygiene difficult, its presence may increase the risk of the patient developing caries. Among the several preventive methods, the varnish containing sodium fluoride is a strategy widely used in dentistry for the purpose of controlling caries. Nowadays, attention has been directed to fluorides containing polyvalent metals, such as stannous fluoride (SnF2) and titanium tetrafluoride (TiF4), since they have been shown to be more effective against dental demineralization than NaF. Even with promising results with the use of TiF4 in the protection against dental demineralization in vitro and in situ, clinical studies have not yet been performed. In addition, there are no studies on the efficacy of TiF4 varnish in patients with orthodontic appliances in the prevention of white spot. Therefore, the objective of this study is to evaluate, by means of a randomized clinical study, the efficacy of TiF4 varnish compared to conventional fluoride varnish in the prevention of white spot lesions in patients undergoing orthodontic treatment. To do this, 66 volunteers aged between 11 and 18 years old who have orthodontic appliances will be selected and divided into 3 groups of 22 individuals according to the varnish that will be applied: G1- professional prophylaxis and non-fluoridated varnish, G2- professional prophylaxis and fluoride varnish (NaF) and G3- professional prophylaxis and TiF4 varnish. The volunteers will receive 4 applications of the varnish, at the beginning. Clinical examination by the ICDAS index, Nyvad index, plaque index and surface reading by the QLF system will be performed by two examiners previously calibrated at the first visit and after 6 months of treatment. The ICDAS, Nyvad and plaque index will be applied to all teeth, only on the vestibular face. Fluorescence evaluation will be done on the buccal surfaces. For selection of the appropriate statistical test, normality (Kolmogorov and Smirnov test) and homogeneity (Bartlett's test) of the data will be checked. The level of significance will be 5%.

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