Caries-Inhibiting Effect of Preventive Measures during Orthodontic Treatment with Fixed Appliances

Abstract

A systematic review was performed of published data on the caries-inhibiting effect of preventive measures during orthodontic treatment with fixed appliances. The purpose was to develop evidence-based recommendations about the most effective means of preventing white spot lesions in orthodontic patients. The 15 studies included were divided into four groups based on comparable preventive measures: fluoride, chlorhexidine, sealants and bonding materials. The caries-inhibiting effect of the preventive measures was expressed by the prevented fraction (PF). The overall PF of the fluoride-releasing bonding materials was 20% (SEM 0.09). This effect was, however, not statistically significant. It was impossible to calculate an overall PF for the other preventive measures, but the tendency of their caries-inhibiting effect has been described. The use of toothpaste and gel with a high fluoride concentration of 1,500–5,000 ppm or of complementary chlorhexidine during orthodontic treatment showed a demineralisation-inhibiting tendency. The use of a polymeric tooth coating on the tooth surface around the brackets showed almost no demineralisation-inhibiting effect. Many publications had to be excluded from this systematic review because of improper research designs. Future clinical trials are needed to give evidence- based advice on the optimal caries-prevention strategy.

Caries infiltrant combined with conventional adhesives for sealing sound enamel in vitro

“…1 This results in dissociation of calcium (Ca) and phosphate (PO 4 ) ions from enamel in an attempt to reach chemical equilibrium in the oral environment. 1,2 Thus, one possible inherent problem during the whole course of orthodontic treatment is the subsurface enamel demineralization around brackets, representing the primary phase of caries formation. 2 Prevalence of these acquired surface lesions due to orthodontic treatment, so-called white spot lesions (WSL), is relatively high, affecting more than 40% to 60% of the patients.…”

Eficacia Del Uso Del Enjuague De Clorhexidina Durante El Tratamiento De Ortodoncia

“…El alto riesgo se atribuye a la presencia de diversos tipos de aparatos básicos y otros elementos auxiliares ortodóncicos que dificultan las medidas convencionales de higiene oral. 3,4 La literatura ha demostrado que los tratamientos de ortodoncia incrementan la acumulación de placa y la colonización bacteriana por lo que resultan afectados los tejidos periodontales y dentarios. [21][22][23][24][25] Si se permite el crecimiento de esta placa aparecerán algunos cambios cuyos resultados dan lugar al establecimiento de la gingivitis tras dos a tres semanas.…”

“…El alto riesgo es atribuido a la presencia de los alambres, arcos, ligaduras y otros elementos auxiliares ortodóncicos que dificultan las medidas convencionales de higiene oral. 3,4 Si se permite el crecimiento de la placa bacteriana sin interferencia de medidas de higiene oral, aparecerán algunos cambios cuyos resultados dan lugar al establecimiento de la gingivitis tras dos a tres semanas. En consecuencia, la prevención de la gingivitis, la forma inicial de la enfermedad periodontal, está ampliamente gobernada por la limitación del desarrollo de la placa bacteriana.…”

Bond Strength of an Amorphous Calcium Phosphate–Containing Orthodontic Adhesive

“…Derks et al 24 concluded that the most effective means of preventing white spots is through the use of a high fluoride (1500-5000 ppm) gel and toothpaste used daily during orthodontic treatment. Another study indicated daily brushing with a fluoridated dentifrice along with daily rinsing with fluoride will help prevent demineralization.…”