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Advisory Committee Chair

Chung H Kau

Advisory Committee Members

Clark Browne

Amjad Javed

Jose Paiva

Document Type

Thesis

Date of Award

2015

Degree Name by School

Master of Dentistry (MDent) School of Dentistry

Abstract

Introduction:. During the course of orthodontic treatment, enamel decalcification is a common problem. Demineralized enamel, the precursor to caries formation, can be attributed to fixed orthodontic appliances and prolonged exposure to bacterial plaque. Progression to clinically detectable white spot lesions may occur as early as one month following the placement of orthodontic appliances. Such problems have influenced clinicians to search for a solution. Because fluoride treatment immediately upon debonding is not advocated, clinicians have proposed fluoride treatment and fluoride-releasing materials at the commencement of the therapy. The two new anti-cavity toothpastes, ClinproTM 5000 with 1.1% Sodium Fluoride and ClinproTM Tooth Crème with 0.21% Sodium Fluoride have been shown to be useful in reduction of white spot lesions. Both the Clinpro TM products (3M ESPE) contain fluoride as well as tri-calcium phosphate, which are components naturally found in saliva. The aim of this study is to determine if ClinproTM 5000, ClinproTM Tooth Crème, or MI-Paste Plus has an effect on the formation and resolution of white spot lesions for patients undergoing orthodontic treatment. Methods: Three prospective groups of 40 patients undertaking routine orthodontic treatment were evaluated (total recruitment of 120 subjects). Patients must have their permanent dentition, be 12 years or older, and have not used extensive fluoride regimes before. Patients were chosen if they appear that they would be compliant as judged by the investigator. The selected product was brushed on the teeth by the patient for two minutes, twice daily for a total of 4 months. After brushing, the patients were instructed to expectorate only, not rinse t, t eat or drink anything for at least 30 minutes. The subjects were observed every 4 weeks. At each visit, 3 intraoral photos were taken (frontal and buccal views) and measurements based on the Enamel Decalcification Index (EDI) will be recorded. The Enamel Decalcification Index was used to determine the number of white spot lesions and caries risk detected in these photographic records. Also, a brushing diary was reviewed. A trained member of the 3M ESPE Clinical Research group did monitor the study by means of visits to the clinic to evaluate patient charts, study data, and study photographs. Results: Altogether, the results provided strong support with regard for ClinproTM 5000 providing superior enamel protection against decalcification when compared to ClinproTM Crème, and MI Paste. Conclusions: The use of ClinproTM 5000, ClinproTM Crème, and MI paste demonstrated less formation of white spot lesions when compared to data in the literature. ClinproTM 5000 had a marginally better affect compared to the other two products.

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