Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT06178042 |
Other study ID # |
SPEYNIRCI |
Secondary ID |
|
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
February 1, 2020 |
Est. completion date |
May 25, 2022 |
Study information
Verified date |
December 2023 |
Source |
Izmir Katip Celebi University |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
One of the most undesired side effects of fixed orthodontic treatment is white spot lesions
(WSLs), that appear on the buccal surface of teeth and cause aesthetic problems. The aim of
this prospective study was to quantitively evaluate the remineralization effect of casein
phosphopeptide-amorphous calcium fluorophosphate (CPP-ACFP) containing (MI Paste Plus®) and
hydroxyapatite, xylitol and fluoride containing (Remin Pro®) agents in remineralizing post
orthodontics white spots using Quantitive Light-Induced Fluorescence Method (QLF) and ICDAS
II criteria, compared to a control group in whom just a routine home care was instructed.
Thirty-nine individuals who had recently completed orthodontic treatment, had at least one
WSL on upper anterior teeth and aged between 12-25 years were included. The participants were
randomly assigned into three groups of 13 each; (1) MI Paste Plus + routine home care; (2)
Remin Pro + routine home care; and (3) routine home care (control). The treatment/
observation period was 12 weeks after bracket debonding. Fluorescence loss (∆F, %), lesion
area (LA, mm2), lesion volume (∆Q, % × mm2), maximum fluorescence loss (∆Fmax), ICDAS II
criteria of WSLs were measured at beginning (T0) and 4 (T1), 8 (T2), and 12 (T3) weeks later.
Statistical significance was set at p<0.05.
Description:
This randomized controlled trial was a parallel arm 1-1 allocations. The study carried out in
the Orthodontics Department, Izmir Katip Celebi University, Turkey. The protocol of the trial
was approved by the Izmir Katip Celebi University Research Ethics Committee. A power analysis
was carried out to provide that there was enough power to apply a statistical test of the
research hypothesis to compare caries regression of Remin Pro to MI Paste Plus comparing with
a control group in the remineralization of postorthodontic WSLs. Patients who finished their
fixed appliance treatment in the clinic of the Department of Orthodontics, Faculty of
Dentistry, Izmir Katip Celebi University who were found to comply with the study criteria
were informed. Patients and parents who agreed to participate in the study signed an informed
consent. A total of 39 people, 22 women and 17 men, aged between 14 and 23, were included in
the study, with 13 people in each group. Gender distribution and average age of the groups
are similar. Patients who are 12 to 25 years of age, at least had 12 months of orthodontic
treatment with braces, at least had one upper anterior tooth with WSL included in the study.
Patient who are smoking, with enamel hypoplasia or fluorosis, with active periodontal
disease, with dentin caries, with allergy to casein, with previous bleaching excluded. Simple
randomization was performed at the start of the study using a random number table prepared
using SPSS software (version 26.0; New York, USA) for the allocation of patients who
fulfilled all criteria and were willing to participate in this study. Group I: Patients were
instructed to use MI Paste Plus (GC Europe, Leuven, Belgium) according to manufacturers
instructions. Group II: Patients were instructed to use (Remin Pro, VOCO , Cuxhaven, Germany)
a pea-sized amount of the cream. Group III. Patients (control group) used a 1450 ppm
fluoridated tooth paste (Colgate Sensitive Pro-Relief, Colgate-Palmolive, Swidnica, Poland)
for conventional tooth brushing and instructed to follow a routine home care. The patients
were evaluated at baseline (T0) and every 30 days intervals for 3 months. The primary outcome
measures were assessment of mineral loss based on fluorescence loss measurements using QLF.
Lesions that scored 1 and 2 according to ICDAS II at debonding were included in the study.
The buccal surfaces of the teeth were examined and evaluated by light induced fluorescence
intraoral camera QLF-D Biluminator,™ (Inspektor-Pro, Amsterdam, Holland) for capturing
fluorescent photographs in accordance with the manufacturer's instructions. Fluorescent
images of the patient were evaluated in the 'White Spot Lesion' option of the analysis
program (QA2.v.1.27). Following five QLF measurements were performed;
1. Depth of lesion (∆F, %) shows the percentage of loss in fluorescence.
2. Lesion area (LA, mm2) refers to the area covered by the demineralized area on the tooth.
3. Lesion volume (∆Q, % × mm2) is derived from the combination of lesion area and lesion
depth and represents the volume of the affected enamel.
4. Maximum fluorescence loss (∆Fmax)is related to depth of lesion and mineral loss.
Statistical analysis was performed with IBM® SPSS® (version 26. SPSS Inc., IBM
Corporation, NewYork, USA). Descriptive statistics are expressed as number of units (n),
percent (%), mean ± standard deviation (x ̅±ss), median (M), minimum (min), maximum
(max), and interquartile range (IQR) values. The normal distribution of the data was
evaluated with the Shapiro Wilk test of normality. Homogenicity of variances was
evaluated with Levene's test.The concordance and differences in the first measurements
and the second measurements were evaluated with the intra-class correlation coefficient
and the paired samples t test. The ages of the groups were compared with one-way
analysis of variance. The ΔF, lesion area and ΔFmax values of the groups in T0, T1, T2
and T3 were compared with two-way analysis of variance in repeated measurements.
Bonferroni correction was applied in multiple comparisons. ΔQ, ICDAS II score, and
difference values from baseline were compared between groups by Kruskal-Wallis analysis.
In case of difference with Kruskal-Wallis analysis, Dunn-Bonferroni test was used for
multiple comparisons. For ΔQ, ICDAS II score, Friedman analysis was performed for
intragroup timepoint comparisons. Bonferroni correction was applied in multiple
comparisons for Friedman analysis. Fisher Exact test was used to compare groups with
categorical variables. If the chi-square test result was found to be significant,
subgroup analyzes were performed with Bonferroni-corrected two-ratio z-test. Statistical
significance level was set at p<0.05.