Clinical evaluation of the effect of colorless preventive varnish with amino fluoride on children's constant teeth fissure enamel mineralization

A.Zh. Garifullina *, PhD, assistant
G.I.Skripkina *, MD, ass. professor, head of cathedra
A.P.Solonenko **, PhD, head of laboratory
D.O.Kolobova *, clinical intern
E.R.Timirbaeva *, clinical intern

* Cathedra of pediatric dentistry, Omsk state medical university
** Scientific laboratory of Dental faculty, Omsk state medical university

«Pediatric Dentistry and Prophylaxis», № 1, 2016

Abstract

Among modern caries preventive medicines there is a big variety of fluoride-containing varnishes. We have set the task: to study the effect of national preventive varnish "DentaFluor" (StomaDent) on constant teeth fissure mineralization in the period after teething. 45 children aged 6-7 years living in Omsk city with first constant molars have participated in the evaluation, all having sub-compensatory form of caries. The first group (Group 1) (22 persons, 45 teeth) was regarded as the control group, in the second group (23 persons, 45 teeth) preventive treatment has been made with the use of fluoride-containing varnish "DentaFluor".

The results obtained testify that the use of fluoride-containing varnish "DentaFluor" precipitates the process of enamel ripening in children's first constant molars during first 6 months after teething. On the basis of this established fact the varnish is recommended for wide clinical use with the purpose of speeding up fissure ripening and caries prevention with children.

Keywords: children, constant teeth, teeth caries prevention, teeth fissures, fluoride-containing varnish "DentaFluor".

Relevance. Preventive fluoride-containing varnishes are being widely used in modern dental practice with the aim of increasing resistance of hard tissues of emerging constant teeth. The laying of varnish leads to formation of fluoride calcium which is preserved for a long time in the micro-structures of teeth enamel and acts as additional depot of fluoride ions by later remineralization. Covering teeth by fluoride-containing varnish has been invented with the aim of prolonging contact between fluoride and teeth enamel, as a result the fluorapatite is being formed during much longer time period [3].

Among modern caries-preventive medicines there is a big variety of fluoride-containing varnishes. We have set the task to study the effect of national preventive varnish "DentaFluor" ("StomaDent") on constant teeth fissures mineralization in the period after teething.

Material and methods of the study

The dental study has been carried in accordance with the generally accepted methods [8-10]. The prevalence of teeth caries in percent and intensity as per DMF index have been determined. The condition of mouth hygiene has been determined with the use of hygiene index (HI) of Fedorov-Volodkina. The level of mouth hygiene experience among preschool children has been identified through questionnaires and discussion with children, through special observation of fulfilling elements in everyday life and through the timing of teeth cleaning [1, 2, 5].

The clinical study has been carried out on the basis of Pediatric dentistry affiliate of Omsk state medical university. 45 children aged 6 to 7 years have taken part in the study, all living in Omsk city, having sub-compensatory form of caries, having first constant molars. The first group (22 children, 45 teeth) was the control group, in the second group (23 children, 45 teeth) the preventive treatment was carried out with the use of fluoride-containing varnish "DentaFluor".

"DentaFluor" represents transparent low-viscosity composition with peculiar odor. It has been created on the basis of synthetic acryl polymer with high adhesion to the teeth enamel, contains amino fluoride, fluoride natrium and light antiseptic timol. Amino fluoride, forming part of the varnish, increases effect of the strengthening of teeth enamel structure, prevents caries and stimulates remineralization features of the saliva.

The dental inspection showed that 94% of the patients had unsatisfactory mouth hygiene at the time of first inspection with the Hygiene Index (HI) at 2.3.

While surveying the dental status we have analyzed the intensity of teeth caries by children. The average DMF index in the group of 6-7 years old children amounted to 3,5 ± 0,4 which corresponds to the average caries intensity level as per criteria of World health organization.

On the basis of the Scientific laboratory of Dental faculty, Omsk state medical university, the quantity of free ionized fluoride in saliva has been measured - before the start of the preventive treatment, after the start, in 1, 3 and 6 months thereafter. The degree of enamel maturity of first constant molars was determined through measurement of electrical conductivity of teeth enamel (ECTE) with the use of apparatus "DenTest" at the same intervals (before, after, in 1, 3 and 6 months thereafter).

The preventive treatment was carried out in accordance with instructions for use. First constant molars were covered by fluoride-containing varnish "DentaFluor" (applications were repeated 3 times during a week with 1-day interval).

After preventive treatment the measurements were done again: the dynamic indexes, the quantity of free fluoride in saliva and degree of enamel maturity (in 1 week, in 1, 3 and 6 months).

Statistical processing of the data was carried out with the use of SPSS Statistics 17.0, SPSS Statistics 20.0 programs. Statistical significance of the data was assessed through Paired - Samples T test [11, 18].

Results of the study and their discussion

The results of the study are presented in tables 1,2 and on Fig.1.

In the control group where the preventive treatment was not done, the analysis showed statistically insignificant decrease of ECTE indicator in fissures of first constant molars - in 1 month it amounted to 1,79 ± 0,18. In 6 months ECTE indicator increased and amounted to 2,29 ± 0,10. The dental inspection made in 6 months discovered carious cavities in 9 teeth out of 30 in the fissure area.

It was established that in the group where the preventive treatment was done with the use of "DentaFluor" fluoride containing varnish, statistically significant decrease of ECTE indicator in fissures of first constant molars took place - in 1 month it amounted to1,04 ± 0,21. Later ECTE decreased even more and in 6 months it amounted to 0,41 ± 0,12.

Therefore, the results testify, that the use of "DentaFluor" fluoride containing varnish speeds up the process of enamel ripening in fissures of children's first constant molars even when the period of use of the varnish is not long (Table 1, Fig. 1).

Tests on the content of fluoride-ions in the saliva of preschool children of Omsk city before the start of preventive treatment, after start and in 1, 3. 6 months thereafter, have shown that content of ionized fluoride in the mouth liquid does not exceed 3,1 ± 0,5 micromol/L at all stages of examinations (Table 2). There are no statistically significant differences in the quantity of F- in the biological medium before and after preventive treatment. On this basis one may assume that teeth hard tissues, by the chosen way of use of fluoride-containing preventive varnish, play the role of fluoride depot; and this fluoride very feebly is transferred to the saliva, thus making teeth enamel becoming more resistant to caries development.

Conclusion

Clinical tests and analysis of results of use of preventive varnish "DentaFluor" have shown its high efficiency in pediatric dentistry. Even short-term use of this remedy significantly decreases caries development by children in the period of occlusion change, which is explained by its unique composition. This study has shown that introduction of the program of controlled use of "DentaFluor" fluoride-containing varnish leads to the speed-up of unripe teeth fissures mineralization and to the decrease of caries development in the period of constant occlusion formation. This established fact serves as basis for recommending to widely use the varnish in clinics with the purpose of speeding up fissure ripening and caries prevention by children.

Fig. 1. Influence of fluoride-containing varnish "DentaFluor" on the speed of enamel mineralization in teeth fissures of preschool children (ECTE, mcА)

Table 1. Influence of fluoride-containing varnish "DentaFluor" on the speed of enamel mineralization in teeth fissures of preschool children (ECTE, mcА)

Table 2. Content of fluoride-ions in saliva of preschool children (С(F-), micromol/L)

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