Clinical Evaluation of Dental Fluororsis Treatment Modalities
Condition: Dental Fluorosis
MeSH terms: Fluorosis, Dental; Fluoride Poisoning
Study type: Interventional

Summary: 
      Background: Various treatment modalities are available to improve esthetics of fluorosed
      teeth based on its severity.

      Aim: evaluate the clinical performance of different minimal invasive treatment protocols on
      mild to moderate fluorosed teeth.

      Materials and Methods: Participants were randomly allocated in eight treatment protocols with
      twenty teeth (n=20) included in each protocol. (P1) Opalescence boost PF 40%. (P2) Opalustre.
      (P3) MI-Paste Plus. In (P4) teeth were treated with Opalustre + Opalescence boost PF 40%. In
      (P5) Opalescence boost PF 40% + MI-Paste Plus, while in (P6) Opalustre +MI-Paste Plus.
      Whereas (P7) Opalustre + Opalescence boost PF 40% + MI-Paste Plus. (P8) control. All teeth
      were evaluated for color change (∆E) immediately after treatment (T1), after 14 days (T2),
      after 3 months (T3) and after 6 months (T4).

      Statistical analysis: Two-way ANOVA was applied to test the interaction between different
      variables. ANOVA repeated measures were followed by Duncan multiple range tests (DMRTs) to
      compare between groups.
    

Detailed description: 
      This study was conducted for clinical evaluation of the quality of different minimal-invasive
      treatment modalities and combination treatments in esthetics improvement of mild to moderate
      fluorosed teeth using two different evaluation methods.

      Materials and Methods:

      Materials used in this study were Opalustre™ (microabrasion paste of 6.6% hydrochloric acid
      and Silicon Carbide), Opalescence™ Boost™ PF 40% (in-office bleaching of 40% hydrogen
      peroxide) and MI-Paste Plus® (topical remineralizing tooth crème of casein phosphopeptide
      amorphous calcium fluoride phosphate).

      One hundred and sixty fluorosed teeth were included in this study. Prior to the
      interventions, tooth color coordinates were clinically recorded by VITA Easyshade V based on
      CIE Lab color system as baseline records. After that teeth were randomly allocated in eight
      treatment protocols with twenty teeth (n=20) included in each protocol. Protocol one (P1)
      Opalescence™ boost™ PF 40%. Protocol two (P2) Opalustre™. Protocol three (P3) MI-Paste Plus®.
      In protocol four (P4) teeth were treated with Opalustre™ followed by Opalescence™ boost™ PF
      40%. In protocol five (P5) Opalescence™ boost™ PF 40% was applied followed by MI-Paste Plus®,
      while in protocol six (P6) Opalustre™ was applied followed by MI-Paste Plus®. Whereas
      protocol seven (P7) teeth were treated with Opalustre™ followed by Opalescence™ boost™ PF 40%
      and lastly MI-Paste Plus®. Protocol eight (P8) control.

      All teeth were evaluated immediately after treatment (T1), after 14 days (T2), after 3 months
      (T3) and after 6 months (T4). Color change was calculated from the formula
      ∆E=√((∆〖L)〗^2+(∆〖a)〗^2+〖(∆b)〗^2 ) , where ∆L, ∆a and ∆b were the difference between readings
      mean values at different evaluating times from the baseline readings. Photographs were taken;
      immediately after application (T1), after 14 days (T2), after 3 months (T3) and after 6
      months (T4).

      Data were collected, checked, revised and organized in tables and figures using Microsoft
      Excel 2016. Data were checked for normality using Kolmogorov-Smirnov at 0.05. ∆L, ∆a, ∆b, and
      ∆E were normally distributed (p>0.05) i.e. parametric data, two-way ANOVA was applied to test
      the interaction between different variables. ANOVA repeated measures were followed by Duncan
      multiple range tests (DMRTs) to compare between groups.
    

Intervention name(s): Opalescence™ boost™ PF 40%; Opalustre™; MI-Paste Plus®
Intervention type(s): Other; Other; Other
Intervention description(s): 40% hydrogen peroxide in-office bleaching; 6.6% hydrochloric acid and silicon carbide microparticles microabrasion paste; casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) remineralizing tooth crème
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Bleaching, microabrasion, CPP-ACFP, color change, ∆E