A Comparison of the Fluoride ‘Paint- On’ vs Tray Application Techniques for Enamel Remineralisation

• Published in: International dental journal 2024-10, Vol.74 (5), p.1006-1015
• Main Authors: Keratibumrungpong, Keratiporn, Trairatvorakul, Chutima, Jirakran, Ketsupar, Govitvattana, Nattanan
• Format: Article
• Language: English
• Subjects: Acidulated Phosphate Fluoride - therapeutic use; APF gel; Artificial carious lesion; Cariostatic Agents - therapeutic use; Child; Child, Preschool; Cross-Over Studies; Dental Caries; Dental Enamel - drug effects; Female; Fluorides - therapeutic use; Fluorides, Topical - therapeutic use; Gels; Humans; Hydrogen-Ion Concentration; Male; Paint-on; QLF-D; Remineralisation; Scientific Research Report; Tooth Remineralization - methods
• ISSN: 0020-6539; 1875-595X; 1875-595X
• DOI: 10.1016/j.identj.2024.03.003

Fluoride gel treatment is not recommended for children < 6 years old due to its potential toxicity. Hence the aim of this study was to compare the effect of 1.23% acidulated-phosphate fluoride (APF) gel paint-on and the conventional tray application techniques on artificial, deciduous enamel carious lesions embedded on wearable appliances. In a randomised crossover study, the volunteer children (n = 29) wore mandibular removable appliances containing embedded tooth specimens with artificial carious lesions. The volunteers had 3 different treatment protocols: (I) 0.4 mL non-fluoride (control) gel, (II) 0.4 mL paint-on 1.23% APF gel or (III) 5 mL 1.23% APF gel, 4 minutes tray application. After 1 hour, the appliances were removed and the specimens underwent an in vitro, 14 days of pH-cycling. The mean percentage reduction in fluorescence (ΔF, %) at baseline (ΔF0) and after the pH-cycling (ΔF1) were determined using quantitative light-induced fluorescence-digital analysis. The mean ΔΔF (ΔF1-ΔF0) was calculated to compare the differences between groups. The mean ΔΔF of groups I to III were −1.42 ± 1.49, 1.06 ± 2.11, and 1.12 ± 3.57 and −1.25 ± 1.44, 1.13 ± 1.84 and 1.44 ± 3.62 for the smooth surface and proximal surface lesions, respectively. The mean ΔΔF in the 2 treatment groups were significantly greater compared with the control group (P < .001). There was no significant difference in ΔΔF between the APF gel tray and paint-on groups either in the smooth surfaces, or the proximal surfaces (P = .629 and P = .613, respectively). Our study, for the first time, indicates that the paint-on application of APF gel or the tray application of APF had a similar enamel remineralisation effect. Clinically, this implies that, particularly in younger children, the paint-on application of fluoride is less cumbersome, and possibly more tolerable with a lesser likelihood of fluoride ingestion than the tray application technique. Thai Clinical Trial Registry (https://www.thaiclinicaltrials.org/show/TCTR20190724001).