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CompletedNCT03446690Updated Jun 26, 2023Results posted

MI Varnish for the Prevention of White Spot Lesions

A Phase 4 interventional study of MI Varnish and Control group in White Spot Lesion and Orthodontic Treatment, sponsored by University of Alabama at Birmingham. Completed. Open to participants aged 10 Years to 50 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-06-26.

Sponsored by University of Alabama at Birmingham · Phase 4, Interventional, and Prevention

Phase
Phase 4
Study type
Interventional
Enrollment
62
Allocation
Non-randomized
Ages
10 Years to 50 Years
Sex
All
01

Study summary

The current study aimed to determine if MI Varnish has an effect in preventing the formation of white spot lesions for patients undergoing orthodontic treatment. 33 subjects were prospectively recruited for the project as the MI Varnish group, with a control group of 29 orthodontically treated subjects who received routine treatment and oral hygiene regimes.Difference in prevention of white spot formation between the control and the study groups were evaluated through photographic records and clinical examination by using the Enamel Decalcification Index (EDI) scores.

Read the detailed description

Orthodontists face two common iatrogenic treatment side effects, root resorption and enamel decalcification, with the latter occurring at a much higher frequency. While the processes that lead to enamel demineralization are understood, methods to diminish or perhaps eliminate degradation of enamel surfaces are being searched for. A new product, MI Varnish, is current available and has been shown in some initial case reports to be useful in reducing white spot lesions. It contains a special milk-derived protein RECALDENT TM (CPP-ACP) in which the casein phosphopeptides (CPP) bind to teeth, dentin, and oral mucosa while the amorphous calcium phosphate (ACP) releases calcium and phosphate. The current study aimed to determine if MI Varnish has an effect in preventing the formation of white spot lesions for patients undergoing orthodontic treatment. 33 subjects were prospectively recruited for the project as the MI Varnish group, with a control group of 29 orthodontically treated subjects who received routine treatment and oral hygiene regimes. The study group received the MI Varnish on the day of bracket bonding. Subjects were recalled initially for 4 weeks (twice) and then at 3 monthly intervals. Difference in prevention of white spot formation between the control and the study groups were evaluated through photographic records and clinical examination by using the Enamel Decalcification Index (EDI) scores.

02

Conditions studied

  • White Spot Lesion
  • Orthodontic Treatment

Keywords

  • Enamel decalcification
03

Who can participate

Ages eligible
10 Years to 50 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Patients seeking orthodontic treatment and receiving routine treatment and oral hygiene regimes.

Exclusion criteria

Exclusion Criteria:

  • Any medical or dental condition that in the opinion of the investigator could impact study results during the expected length of the study;
  • Patient is currently using any investigational drug or any other investigational device;
  • Patient plans to relocate or move within six months of enrollment.
04

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
62 participants (actual)

Study arms

  • Experimental
    MI Varnish Group

    33 subjects were prospectively recruited for the project in the MI Varnish group. All subjects will be patients seeking orthodontic treatment at the Department of Orthodontics, UAB. MI Varnish were applied on their teeth initially for 4 weeks (twice) and then 3 monthly intervals.

    Drug: MI Varnish

  • Other
    Control group

    A control group was comprised of 29 orthodontically treated subjects who received routine treatment and oral hygiene regimes. All subjects will be patients seeking orthodontic treatment at the Department of Orthodontics, School of Dentistry, University of Alabama at Birmingham. No intervention for this group.

    Other: Control group

Interventions

  • DrugMI Varnish

    MI Varnish with RECALDENT™ (CPP-ACP) enhances enamel acid resistance and boosts salivary fluoride levels. This product remains on the teeth longer than other fluoride varnishes and contains high levels of fluoride and calcium released in the oral cavity. The difference is in the RECALDENT™ (CPP-ACP), which makes MI Varnish a natural and unique choice for your patients. Casein phosphopeptides (CPP) naturally occurs in milk casein; Amorphous Calcium Phosphate (ACP), which is found in the RECALDENT™, is also the source of calcium and phosphate. In the oral cavity, CPP binds to oral surfaces such as teeth, dentin, oral mucosa and biofilm. Calcium and phosphate ions are the building blocks for healthy teeth and MI Varnish delivers bioavailable calcium and phosphate ions into the saliva.

  • OtherControl group

    Participants received routine treatment and oral hygiene regimes. No intervention for this group.

05

What researchers measure

Primary outcomes

  1. Enamel Decalcification Index (EDI) Scores

    Photographic records will be used to determine the improvements in the white spot lesions. A standard intra-oral photographic camera will be utilized and the photographs will be taken in a light controlled environment and photographs will be captured in a pre-set photographic protocol. The Enamel decalcification index (EDI) will be used to determine the number of white spot lesions present at each time frame.Enamel decalcification index calculation: The facial surface of each tooth was divided into 4 areas (m, Mesial; g, gingival; d, distal; o, occlusal). A score was allocated for each area of each tooth: 0, no decalcification, to 3, decalcifications covering 100% of the area at each time period. Analysis was done at the tooth level, aggregating the enamel decalcification scores from all four areas, creating an EDI for each tooth ranging potentially from 0 to 12. Higher EDI scores indicate more decalcification of teeth and represent a worse outcome.

    Time frame: Photographs were taken for 4 times at monthly intervals. EDI scores were measured and assessed at 1, 2, 3 and 4 months, Month 4 reported. The duration of the observation is an average of 4 months.

06

Results

Posted Jun 12, 2018
Limitations and caveats
We attempt to overcome the compliance barrier giving the patients brushing technique instructions as a control of their actual compliance with the protocol. However it was observed plaque accumulation and gingival inflammation on some patients.

Participant flow

Participant flow — Overall Study
MilestoneMI Varnish GroupControl Group
Started3329
Completed2629
Not completed70

Outcome measures

PrimaryEnamel Decalcification Index (EDI) Scores

Photographic records will be used to determine the improvements in the white spot lesions. A standard intra-oral photographic camera will be utilized and the photographs will be taken in a light controlled environment and photographs will be captured in a pre-set photographic protocol. The Enamel decalcification index (EDI) will be used to determine the number of white spot lesions present at each time frame.Enamel decalcification index calculation: The facial surface of each tooth was divided into 4 areas (m, Mesial; g, gingival; d, distal; o, occlusal). A score was allocated for each area of each tooth: 0, no decalcification, to 3, decalcifications covering 100% of the area at each time period. Analysis was done at the tooth level, aggregating the enamel decalcification scores from all four areas, creating an EDI for each tooth ranging potentially from 0 to 12. Higher EDI scores indicate more decalcification of teeth and represent a worse outcome.

Time frame:
Photographs were taken for 4 times at monthly intervals. EDI scores were measured and assessed at 1, 2, 3 and 4 months, Month 4 reported. The duration of the observation is an average of 4 months.
Reported as:
Mean · scores on a scale
Enamel Decalcification Index (EDI) Scores
scores on a scaleMI Varnish GroupControl Group
Total EDI score of 1-month visit1.038 (0.268 to 1.809)1 (0.382 to 1.618)
Total EDI score of 2-month visit1.308 (0.138 to 2.477)2.724 (0.769 to 4.679)
Total EDI score of 3-month visit1.923 (0.382 to 3.464)3.966 (1.662 to 6.269)
Total EDI score of 4-month visit2.692 (0.778 to 4.607)5.897 (3.028 to 8.765)

Adverse events

Collected over During and within 6 months from the end of the treatment.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
MI Varnish Group0/33 (0%)0/33 (0%)0/33 (0%)
Control Group0/29 (0%)0/29 (0%)0/29 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)MI Varnish GroupControl GroupTotal
Mean29.5 ± 6.728.5 ± 5.229 ± 5.94
Sex: Female, Male
Sex: Female, Male(Participants)MI Varnish GroupControl GroupTotal
Female161632
Male101323
Region of Enrollment
Region of Enrollment(Participants)MI Varnish GroupControl GroupTotal
Central America182038
Africa6915
China202
07

Study locations

No study locations are listed for this record.

08

References and documents

Study documents

  • Study protocol · Jan 1, 2018
  • Statistical analysis plan · Jan 1, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Undecided

09

Registry details

Key details

Study ID
NCT03446690
Lead sponsor
University of Alabama at Birmingham
Responsible party
Chung How Kau (Professor and Chairman, University of Alabama at Birmingham) — Principal investigator
First posted
Feb 27, 2018
Start date
Jan 1, 2015
Primary completion
Nov 1, 2015
Completion
Jan 1, 2016
Results posted
Jun 12, 2018
Last update
Jun 26, 2023

Study contacts

Chung H Kau, BDS, PhD
principal investigator · University of Alabama at Birmingham

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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