Authors' response

Abstract

made to identify demineralized lesions and the perception of how esthetics are compromised by them. Besides that, clinical records verified the number of first-time bond failures. We find it important to discuss 2 of the conclusions. The authors report in the first affirmation that "There was no difference in the incidence of new demineralized lesions (DLs) in patients who received fixed orthodontic appliances bonded with either a light-cured RM-GIC or LCC." However, there was no standard to follow in the methodology for the photographs, because they were taken with different digital cameras and different environmental and lighting conditions. Besides that, the examiners did not receive a standardized training to take the photographs. Therefore, it is possible for the examiners to identify and evaluate DLs in the sample, but not to make any statement about the incidence of DLs in it. It is known that to evaluate DLs, there is the need of a clinical evaluation with the tooth surface clean and dry, as recommended by the International Caries Detection and Assessment System. 2 As for the last conclusion, in which the authors reported "potential advantages to using RM-GIC, including reduced sensitivity to moisture, reduced cleanup time, as well as lower environmental and cytotoxic impacts," it is based on information described by previously published papers 3,4 and does not express an interpretation of the results of the study, because the chosen methodology was limited to evaluating failures after bonding orthodontic brackets with RM-GIC. Despite having used the methodology in a satisfactory manner to compare RM-GIC and LCC efficacy when bonding orthodontic brackets, the fact that there was no standard procedure to take the photographs allowed them to be used only to evaluate how white spot lesions compromise esthetics, but not to identify the clinical incidence of those lesions. This fact can influence future studies that refer to the literature in search of information about the incidence of DLs in an improper manner.