Effect of Three Types of Fluoride Varnish in Preventing Early Childhood Caries

Sponsor
The University of Hong Kong (Other)
Overall Status
Enrolling by invitation
CT.gov ID
NCT04274569
Collaborator
Research Grants Council, Hong Kong (Other)
570
1
3
42.6
13.4

Study Details

Study Description

Brief Summary

This study evaluates and compares the effect of two types of calcium- and phosphate-containing fluoride varnishes to conventional fluoride varnishes in preventing early childhood caries.

Condition or Disease Intervention/Treatment Phase
  • Other: NaF vanish
  • Other: NaF-TCP
  • Other: NaF-CPP-ACP
N/A

Detailed Description

Fluoride vanish is the most commonly used professionally applied topical agent. Traditional fluoride vanish application has been reported to exhibit significant caries inhibiting effect in both permanent teeth and primary teeth. The greatest advantage of fluoride vanish is its ability to adhere to tooth tissues for a longer period of time that enables improved fluoride uptake. It allows continuous release of fluoride ions into enamel, dentine, plaque, and saliva.The main action of topical fluoride is to retard demineralization and promote remineralization of enamel by the uptake of calcium and phosphates from saliva. The proposed mechanism of action of topical fluoride is the formation of intraoral calcium fluoride reservoirs, which are retained on enamel and slowly released to inhibit mineral loss during demineralization.

However, the formation of the intraoral calcium fluoride reservoirs is limited by the availability of intraoral calcium and fluoride ions. Low concentration of salivary calcium and phosphate ions leads to mineral deposition only at the surface of enamel as a result of low ion concentration gradient. Deposition of minerals at the surface of enamel alone may not improve the structural properties of the deep part of the incipient carious lesions. Hence, many manufacturers have modified fluoride vanish to include calcium and phosphate ions in an attempt to further improve efficacy of fluoride varnishes.

The in vitro remineralizing effects of calcium- and phosphate-containing fluoride vanishes are encouraging and scientifically sound, a longitudinal, high quality clinical study is needed to verify the laboratory findings.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
570 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Triple (Participant, Investigator, Outcomes Assessor)
Primary Purpose:
Prevention
Official Title:
Are Calcium- and Phosphate-containing Fluoride Varnishes More Effective Than Conventional Fluoride Varnish in Preventing Early Childhood Caries? A Randomized Clinical Trial.
Actual Study Start Date :
Mar 13, 2019
Anticipated Primary Completion Date :
Jul 15, 2021
Anticipated Study Completion Date :
Oct 1, 2022

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: Sodium fluoride (NaF)

Group 1: Quarterly application of a 5% NaF varnish (Duraphat® Varnish, Colgate-Palmolive Ltd, (UK) Ltd., Guildford, Surrey, UK)

Other: NaF vanish
A disposable micro-brush will be used to apply the varnishes to all tooth surfaces. The fluoride varnish will be applied every 3 months, from baseline to 24-months follow-up.

Experimental: NaF plus tricalcium phosphate (TCP )

Group 2: Quarterly application of 5% NaF-TCP (ClinproTM White Varnish; 3M ESPE, St Paul, MN, USA)

Other: NaF-TCP
A disposable micro-brush will be used to apply the varnishes to all tooth surfaces. The fluoride varnish will be applied every 3 months, from baseline to 24-months follow-up.

Experimental: NaF plus CPP-ACP

Group 3: Quarterly application of a 5% NaF plus casein phosphopeptide-stabilized amorphous calcium phosphate complexes (CPP-ACP) (MI Varnish TM; GC corporation, Itabashi-Ku, Tokyo, Japan)

Other: NaF-CPP-ACP
A disposable micro-brush will be used to apply the varnishes to all tooth surfaces. The fluoride varnish will be applied every 3 months, from baseline to 24-months follow-up.

Outcome Measures

Primary Outcome Measures

  1. Proportion of children with new caries and new dmfs. [24 months]

Secondary Outcome Measures

  1. MS growth [12 months and 24 months]

    Quantity of mutans streptococcus (MS) measured by quantitative polymerase chain reaction (qPCR)

Eligibility Criteria

Criteria

Ages Eligible for Study:
3 Years to 4 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Generally healthy children age between 3-4 of age with unremarkable medical history and at high caries risk with at least one carious lesion (precavitated or cavitated) (Agouropoulos et al 2014). The high caries risk children are chosen because it is anticipated that they will benefit more from the topical fluoride varnish application than the low caries risk children.
Exclusion Criteria:
  • Patients who had received professional fluoride application in the past 6 months

  • Patients with underlying medical history or special health care needs

  • Patient who are uncooperative or refuse the treatment

  • Patient who are allergic to milk protein (as MI VarnishTM contains "casein, a milk protein)

  • Patient with contraindication for fluoride varnish e.g. hypersensitivity to colophony and/or any other constituents

  • Patient who have primary teeth with enamel hypoplasia

Contacts and Locations

Locations

Site City State Country Postal Code
1 The University of Hong Kong Hong Kong Hong Kong 999077

Sponsors and Collaborators

  • The University of Hong Kong
  • Research Grants Council, Hong Kong

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Professor Cynthia Kar-Yung Yiu, Clinical Professor in Paediatric Dentistry, The University of Hong Kong
ClinicalTrials.gov Identifier:
NCT04274569
Other Study ID Numbers:
  • GRF Project HKU17106318
First Posted:
Feb 18, 2020
Last Update Posted:
Feb 18, 2020
Last Verified:
Feb 1, 2020
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Keywords provided by Professor Cynthia Kar-Yung Yiu, Clinical Professor in Paediatric Dentistry, The University of Hong Kong

Study Results

No Results Posted as of Feb 18, 2020