EFFICACY OF A REMINERALIZATION AGENT CONTAINING AMMONIUM FLUORIDE SOLUTION AND NANO SOL CALCIUM FLUORIDE FOR TREATMENT OF INITIAL BUCCAL CARIES LESIONS: A SPLIT-MOUTH RANDOMIZED CONTROLLED CLINICAL TRIAL.

OBJECTIVE: The aim of the study was to investigate the efficacy of ammonium fluoride solution (AFS) combined with nano sol calcium fluoride (nano-CaF(2)) for the treatment of active buccal white spot lesions (WSLs) in permanent dentition. MATERIALS AND METHODS: Participants with at least 2 WSLs in different quadrants were included in the splitmouth randomized clinical trial. The WSLs meeting the inclusion criteria (n = 60) were randomly assigned into test and control groups. The WSLs in test group (n = 30) received AFS (25,000 ppmF(-)) and nano-CaF(2) (41,400 ppmF(-)) as a 2-step treatment (Experimental product, Ivoclar Vivadent AG, Schaan, Liechtenstein), while the WSLs in control group (n = 30) received 1-step ammonium fluoride varnish (AFV, 7700 ppmF(-), Fluor Protector S, Ivoclar Vivadent AG) treatment. The WSLs were quantitatively assessed using QLF (QrayCam, AIOBIO, Seoul, Republic of Korea) and qualitatively assessed using International Caries Detection and Assessment System (ICDAS-II) and Nyvad criteria at baseline, 1, 6 and 12-months follow-ups. The difference in QLF parameters within each group (Friedman test) and between groups (Wilcoxon test) was analyzed. Binary logistic regression model was used to compare the odds of the WSLs showed regression between the groups based on qualitative assessment. RESULTS: Overall, 56 WSLs in 21 participants (ages ranged from 14 to 40 years) could be evaluated. Quantitatively, mineral loss (DeltaF average and DeltaF max), lesion size (WS area) and volume (DeltaQ) decreased significantly in test group (P = .001) at 6 and 12 months compared to baseline, whereas no significant difference was found in control group (P > .05). Intergroup comparison showed greater reduction in DeltaF average and DeltaF max values in the test group compared to control group at 6-month;s follow-up (P = .05). Qualitatively assessed regression rate was higher in test group compared to control group at 6 and 12-months (P < .05). CONCLUSION: Caries preventive efficacy of AFS + nano-CF2 was found to be superior to AFV based on both quantitative and qualitative assessment in high caries risk adolescents and young adults. CLINICAL RELEVANCE: Two-step treatment with high level of AFS and nano sol CaF(2) might be a better option compared to 1-step AFV treatment for the management of WSLs.