Background:Although orthodontic treatment is an effective way to correct malocclusions, it often creates
unfavorable oral conditions such as enamel demineralization, white spot lesions, plaque retention, and
gingivitis. These may all contribute to treatment duration, less successful treatment, and patient
dissatisfaction. Numerous adjunctive therapeutic options have been investigated to combat these challenges:
vitamin D, 3 percent of sodium fluoride, chlorhexidine mouthrinse, among others. Effect has been studied
separately in most instances, and few direct comparisons have been made among orthodontic patients.
Materials and Methods:Forty orthodontic fixed appliance (age range 15–25) patients were randomly
allocated into four groups: oral Vitamin D daily, Sodium fluoride varnish monthly, %0.12 chlorhexidine
mouthwash twice a day vs control. Twelve-week follow-up examinations were conducted at 0, 4, 8 and 12
weeks to the evaluation tooth movement, enamel status and gingival health.
Results:This preliminary clinical trial showed that adjuvant treatments could be effective to enhance
orthodontic treatment compared with controls. Vitamin D accelerated tooth movement and alveolar bone
remodeling, sodium fluoride provided a remedy for protecting enamel from being demineralized as well as
developing white spot lesions, chlorhexidine maintained healthy gingivae with effective plaque control.
These results demonstrate the adjunctive therapeutic potential of these agents in patients undergoing fixed
orthodontic treatment and indicate that larger clinical trials may be required to develop evidence based
adjunct protocols in orthodontics.
Conclusion:This clinical experimental study shows that Vitamin D, sodium fluoride and chlorhexidine have
specific therapeutic values in orthodontic patients. Vitamin D drives teeth movement and alveolar
remodeling, sodium fluoride protects enamel and mitigates white spot lesions, while chlorhexidine improves
plaque management and health of the gingiva. These results demonstrate the necessity to integrate adjunctive
therapiesto fixed orthodontics, and indicated that further large-scale randomized controlled trials would be
required to validate their long-term efficacy, thereby obtaining best overall orthodontic outcome.
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