OBJECTIVES: To evaluate the efficacy of intensive application of Curodont Repair Fluoride Plus (CRFP), MI varnish or Duraphat in treating white spot lesions (WSLs) of primary teeth over 12-months follow-up. METHODS: Sixty-six high-caries-risk preschooler children with active WSLs in their primary anterior teeth, were randomly allocated to receive intensive application of CRFP, MI varnish, or Duraphat. Lesions were assessed using ICDAS-II criteria and DIAGNOdent laser fluorescence at baseline and after 3, 6, 9, and 12 months. lesion size changes were evaluated using standardized photographs after 3, 6, and 12 months. Visual analogue scale was used for assessing esthetic improvement after 6 and 12 months. RESULTS: Multivariable logistic regression models addressing caries arrest (using ICDAS-II severity scores) and reducing lesion activity revealed that CRFP achieved significantly higher odds of caries arrest (AOR=6.46, P = .011) and decreasing number of active lesions (AOR=19.86, P = .003) when compared to Duraphat. No significant difference was found between MI varnish and Duraphat regarding caries arrest (AOR=2.07, P = .242) or reducing lesion activity (AOR=4.11, P = .064). All study materials resulted in significant percent reduction in DIAGNOdent readings across time (P < .001). CRFP reduced DIAGNOdent readings significantly when compared to Duraphat at all time intervals while a significant difference appeared between CRFP and MI varnish groups only after 9 and 12 months. All the materials reduced lesion size significantly, with the greatest reduction achieved by CRFP, resulting in moderate to exceptional esthetic improvement. CONCLUSION: Intensive application of CRFP exhibited superior remineralization and esthetic improvement of WSLs compared to MI varnish or Duraphat.
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