{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T19:26:59Z","timestamp":1787081219644,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["3\/1\/2(14)\/Oral\/2019\u2010NCD\u2010II"],"award-info":[{"award-number":["3\/1\/2(14)\/Oral\/2019\u2010NCD\u2010II"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthod Craniofacial Res"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>White spot lesions (WSL) may appear on teeth during fixed orthodontic treatment. Professionally administered topical fluorides play a key role in preventing such lesions. However, the evidence for their long\u2010term efficacy and patient\u2010reported outcomes is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The primary objective was to evaluate the efficacy of topical fluorides (varnish vs. adhesive) in reducing the incidence of white spot lesions (WSLs) during and after 1 year of fixed orthodontic treatment. The secondary objectives were patient\u2010related outcomes, including perception of WSLs and adverse effects of the two agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Design<\/jats:title>\n                    <jats:p>Three\u2010arm, double\u2010blind, placebo\u2010controlled, single\u2010centre, single\u2010operator randomised controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      One hundred and fifty patients in the age group 14\u201320\u2009years (mean age 17.98\u2009\u00b1\u20094.97) seeking fixed orthodontic treatment were randomly allocated into three groups. Group I \u2010fluoride varnish (\n                      <jats:italic>Fluor\u2010Protector)<\/jats:italic>\n                      , Group II\u2010 fluoride adhesive (Reliance Light bond TM), and Group III\u2010 Placebo. Patients were screened for WSLs at T0 (pre\u2010treatment), T1 (at debond), and T2 (one\u2010year follow\u2010up) using three methods: (i) laser\u2010induced fluorescence device (DIAGNOdent Pen), (ii) visual, and (iii) photographic methods. A 5\u2010point scale was used at T1 and T2 to evaluate the patient's perception.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fluoride varnish showed the least number of new WSLs and the least progression of WSLs (Group I\u20138.95%; Group II\u201320.82%; and Group III\u201320%). Most of the lesions developed in the anterior teeth. There was more than a 50% spontaneous reduction (remineralization) in WSLs, 1 year post debond (T1 vs. T2), signifying the tendency of remineralization irrespective of the fluoride prophylaxis given during treatment. Most patients (61.8%) did not notice the lesions at debonding, and the scores increased to 95.1% of patients not noticing these lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>95% of patients do not notice WSLs after 1 year of debonding. Fluoride varnish was significantly more effective in preventing WSLs and could be considered during fixed orthodontic treatment, especially in patients with poor oral hygiene. There was no difference in remineralization in the three groups in the 1\u2009year follow\u2010up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      The protocol was published in the clinical trial registry prior to the trial commencement (Clinical Trials Registry, Trial CTRI\/2021\/11\/037918, URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/ctri.nic.in\/Clinicaltrials\/pmaindet2.php?EncHid=Mzc4OTA=&amp;Enc=&amp;userName=\">https:\/\/ctri.nic.in\/Clinicaltrials\/pmaindet2.php?EncHid=Mzc4OTA=&amp;Enc=&amp;userName=<\/jats:ext-link>\n                      [Registered on: 10\/11\/2021] \u2010 Trial Registered Prospectively)\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ocr.70105","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T04:16:50Z","timestamp":1771561010000},"page":"624-630","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the Effectiveness of Fluoride Varnish and Fluoride\u2010Releasing Adhesives in Preventing and Managing White Spot Lesions During Fixed Orthodontic Treatment, and Evaluation of Patient\u2010Reported Outcomes: A Randomised Controlled Trial 1 Year After Debonding"],"prefix":"10.1111","volume":"29","author":[{"given":"Arisha","family":"Izhar","sequence":"first","affiliation":[{"name":"Department of Orthodontics, Faculty of Dentistry Jamia Millia Islamia  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panchali","family":"Batra","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Faculty of Dentistry Jamia Millia Islamia  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Miglani","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry &amp; Endodontics, Faculty of Dentistry Jamia Millia Islamia  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitika","family":"Monga","sequence":"additional","affiliation":[{"name":"Division of Development Research ICMR Headquarters  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakshi","family":"Katyal","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Faculty of Dentistry Jamia Millia Islamia  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.2174\/1874210601105010158"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-263X.2007.00879.x"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0722.2010.00780.x"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9290.80001"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ortho.2013.02.014"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1834-7819.2006.tb00445.x"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.2341\/11-070-L"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2010.12.016"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9416(82)90032-X"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1179\/bjo.19.3.199"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.2319\/051710\u2010262.1"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.5958\/2394-2800.2016.00024.9"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/18.4.373"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/cjm008"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2010.04.001"},{"key":"e_1_2_13_17_1","first-page":"489","article-title":"Fluorides for Preventing Early Tooth Decay (Demineralised Lesions) During Fixed Brace Treatment","volume":"11","author":"Benson P. 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