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Introduction White spot lesions are a common sequela of orthodontic therapy. In this parallel-group randomized trial, we assessed the effectiveness of 2 agents commonly used to ameliorate white spot lesions compared with a normal home-care regimen. Methods Patients aged 12 to 20 years were recruited from the offices of orthodontists and dentists who belonged to the Practice-based Research Collaborative in Evidence-based Dentistry network. The patients had their orthodontic appliances removed within the past 2 months and had at least 1 white spot lesion affecting their maxillary incisors. The subjects were randomized to 1 of 3 arms: (1) an 8-week regimen of MI Paste Plus (GC America, Alsip, Ill), (2) a single application of PreviDent fluoride varnish (Colgate Oral Pharmaceuticals, New York, NY), and (3) usual home care (control). Photographs were taken at enrollment and 8 weeks later. Two panels consisting of 5 dental professionals and 5 laypersons assessed the before-and-after pairs of photographs in a blinded fashion. Objective assessments and self-assessments were also performed. Results One hundred fifteen subjects completed the study; 34 were assigned to the MI Paste Plus group, 40 to the fluoride varnish group, and 41 to the control group. The mean improvements assessed by the professional panel were 21%, 29%, and 27% in the MI Paste Plus, fluoride varnish, and control groups, respectively. The results from the lay panel were 29%, 31%, and 25%, respectively. Objective improvements in the surface affected were 16%, 25%, and 17%, respectively; self-assessments of improvement were 37% in all 3 groups. No assessments indicated significant differences between subjects in the active arms compared with the control arm. Conclusions MI Paste Plus and PreviDent fluoride varnish do not appear to be more effective than normal home care for improving the appearance of white spot lesions over an 8-week period.

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Objective (1) To determine which facial landmarks show the greatest movement during specific facial animations and (2) to determine the sensitivity of our instrument in using these landmarks to detect putatively abnormal facial movements. Design Movements of an array of skin-based landmarks on five healthy human subjects (2 men and 3 women; mean age, 27.6 years; range, 26 to 29 years) were observed during the execution of specific facial animations. To investigate the instrument sensitivity, we analyzed facial movements during maximal smile animations in six patients with different types of functional problems. In parallel, a panel was asked to view video recordings of the patients and to rate the degree of motor impairment. Comparisons were made between the panel scores and those of the measurement instrument. Results Specific regions of the face display movement that is representative of specific animations. During the smile animation, landmarks on the mid- and lower facial regions demonstrated the greatest movement. A similar pattern of movement was seen during the cheek puff animation, except that the infraorbital and chin regions demonstrated minimal movement. For the grimace and eye closure animations, the upper, mid-facial, and upper-lip regions exhibited the greatest movement. During eye opening, the upper and mid-facial regions, excluding the upper lip and cheek, moved the most, and during lip purse, markers on the mid- and lower face demonstrated the most movement. We used the smile-sensitive landmarks to evaluate individuals with functional impairment and found good agreement between instrument rankings based on the data from these landmarks and the panel rankings. Conclusion The present method of three-dimensional tracking has the potential to detect and characterize a range of clinically significant functional deficits.