Ar. Biesbrock et al., Reversal of incipient and radiographic caries through the use of sodium and stannous fluoride dentifrices in a clinical trial, J CLIN DENT, 9(1), 1998, pp. 5-10
Experimental evidence has clearly demonstrated that the early stages of les
ion formation (enamel demineralization) are reversible following exposure t
o saliva and/or fluoride. Clinical evidence for remineralization has also b
een reported extensively in the literature. However, the literature is lack
ing with respect to data from well-controlled clinical studies regarding th
e quantitative contribution of remineralization to arrestment and reversal
of caries. Retrospective analysis of an existing clinical trial database pr
ovided an opportunity to examine the incidence of clinical lesion reversals
in a placebo-controlled, double-blinded caries clinical study. The clinica
l study examined three treatment groups: 1) 0.243% sodium fluoride/silica d
entifrice, 2) 0.4% stannous fluoride/calcium pyrophosphate (positive contro
l) dentifrice and 3) non-fluoridated placebo/calcium pyrophosphate (negativ
e control) dentifrice. Clinical measures in this study included both radiog
raphic and visual-tactile assessments of caries. Examination of all subject
s revealed a statistically greater frequency for caries reversals in the so
dium fluoride group as compared to the placebo group at Year 3, for both to
tal and radiographic caries, In contrast, while caries reversals in the sta
nnous fluoride group occurred with greater frequency than in the placebo gr
oup at Year 3, for both total and radiographic caries, the differences were
not statistically significant. When only subjects who were ''at risk" for
potential reversals (i.e., those with a mini mum of one carious lesion at b
aseline) were examined, a statistically greater frequency in caries reversa
ls was observed in both the sodium fluoride (total, incipient, and radiogra
phic caries) and stannous fluoride (total and radiographic caries) groups a
s compared to the placebo group at Year 3. Collectively, these data confirm
the ability of both 0.243% sodium fluoride/silica and 0.4% stannous fluori
de/calcium pyrophosphate dentifrices to clinically reverse caries. The resu
lts suggest that sodium fluoride may deliver a greater frequency of caries
reversals than stannous fluoride, although these treatments were not found
to be significantly different.