Comparative efficacy of ClinproTM clear fluoride treatment and DuraphatTM varnish as remineralizing agents for white spot lesions around orthodontic brackets: an in vitro study

Introduction Fixed orthodontic appliances increase plaque accumulation and the risk of enamel white spot lesions (WSLs). Although Duraphat™ Varnish (22,600 ppm fluoride) is widely used for WSLs management, limited evidence exists regarding the remineralization efficacy of the newer Clinpro™ Clear Fluoride Treatment (9,500 ppm fluoride). Objective To compare the remineralization efficacy of Duraphat™ Varnish, single-application Clinpro™ Clear, double-application Clinpro™ Clear, and a no-treatment control on artificial WSLs adjacent to orthodontic brackets. Methods Sixty-eight extracted human premolars were randomly allocated to four groups ( n = 17 each). Following artificial lesion formation, specimens received the assigned fluoride treatment and underwent a 7-day pH-cycling regimen. Remineralization was assessed using Vickers surface microhardness, polarized light microscope (PLM), scanning electron microscope (SEM), and energy-dispersive x-ray spectroscopy (EDS). Data were analyzed using Welch ANOVA and the Games-Howell post hoc test (α = 0.05). Results Duraphat™ Varnish demonstrated significantly greater hardness recovery than single-application Clinpro™ Clear ( p < 0.001) and the no-treatment control ( p < 0.001). Double-application Clinpro™ Clear produced significantly greater remineralization than a single application ( p < 0.05) and achieved outcomes approaching those of Duraphat™ Varnish ( p < 0.05). These findings were supported by percentage hardness recovery and remineralization potential. Qualitative PLM, SEM, and EDS analyses consistently demonstrated greater remineralization in all fluoride-treated groups than in the untreated control. Conclusion Under the present in vitro conditions, Duraphat™ Varnish produced the greatest remineralization, while a double application of Clinpro™ Clear significantly enhanced its remineralization efficacy compared with a single application. These findings suggest that repeated application may improve the performance of Clinpro™ Clear; however, further in vivo and clinical studies are required to confirm its clinical effectiveness.