8/28/2023 0 Comments Buy mi paste plusWith that in mind, we conducted this randomized trial of 2 commercially available products, MI Paste Plus and PreviDent fluoride varnish (Colgate Oral Pharmaceuticals, New York, NY), to assess their clinical effectiveness over an 8-week period. 25, 33– 37 A newer product, MI Paste Plus (GC America), containing 900 ppm fluoride and casein phosphopeptide-amorphous calcium phosphate, is now commercially available.įew in-vivo studies have investigated the effectiveness of remineralization products to address the appearance of WSLs after orthodontic treatment. 23– 32 Recent studies have investigated the remineralization potential of casein phosphopeptide-amorphous calcium phosphate combined with fluoride and have found a synergistic effect when these are administered together. 22 A number of in-vitro and in-situ studies have demonstrated the remineralizing potential of casein phosphopeptide-amorphous calcium phosphate. The active agent, casein phosphopeptide-amorphous calcium phosphate, is thought to stabilize and localize calcium, fluoride, and phosphate at the tooth surface in a slow-release amorphous form, thus enhancing deeper remineralization of WSLs. In recent years, MI Paste (GC America, Alsip, Ill) has often been prescribed for remineralization of WSLs. 19, 20 Thus, the most ideal concentrations and delivery vehicles for fluoride remain controversial. 15– 18 This superficial layer might prevent calcium and phosphate from penetrating to the deeper layers of the enamel, thus inhibiting deeper remineralization and limiting the cosmetic improvement of the WSLs. 10– 14 However, some authors warn against the use of high concentrations of fluoride because they believe this will cause remineralization mainly in the superficial part of the WSLs. This should cause an increase in remineralization of the outer enamel and a decrease in demineralization of the inner enamel, resulting in a significant mineral gain. 9 High doses of fluoride have been recommended during and after orthodontic treatment for arresting areas of decalcification and preventingWSLs from progressing to carious lesions. 6– 8 Fluoride has been shown to increase the initial rate of remineralization. 4, 5 The pattern of remineralization follows a time trend, with greater remineralization during the first few months and then continuing at a slower rate. Saliva can remineralize WSLs to some degree, but this process is slow and rarely results in complete resolution of the lesions. 2, 3 Once formed, WSLs compromise esthetics and can be extremely difficult or even impossible to reverse. 1 Although prevention of these lesions is the goal of every orthodontist, the prevalence of WSLs after orthodontic treatment has been reported to be 5% to 97%. White spot lesions (WSLs), clinically defined as opaque, white areas caused by the loss of minerals below the outermost enamel layer, can be an unfortunate sequela of orthodontic treatment.
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