Demineralized white spot lesions: An unmet challenge for orthodontists

Miller, Matthew J.; Bernstein, Shira; Colaiacovo, Stephanie L.; Nicolay, Olivier; Cisneros, George J.

doi:10.1053/j.sodo.2016.05.006

Cited by 11 publications

(8 citation statements)

References 22 publications

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“…Enamel WSLs are an unmet challenge for dental profession. 30 As these lesions are caused by acidic attacks from bacterial biofilms and the resultant demineralization, numerous efforts have been made to treat WSLs with remineralization, which means the regain of mineral content by precipitating calcium and phosphate from external sources into small pores on top of enamel prisms and the inter-prism gaps resulted from demineralization.…”

Section: Discussionmentioning

confidence: 99%

In vitro remineralization of enamel white spot lesions with a carrier-based amorphous calcium phosphate delivery system

et al. 2019

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Objectives: To achieve in vitro remineralization of enamel white spot lesions (WSLs) via a mesoporous delivery system of amorphous calcium phosphate (ACP) precursors.Materials and methods：Amine-functionalized expanded pore mesoporous silica (aMSN) was loaded with polyacrylic acid-stabilized amorphous calcium phosphate (PAA-ACP) to develop a carrier-based delivery system (PAA-ACP@aMSN). Thirty-six artificial WSLs samples were created and randomly assigned to three treatments: artificial saliva solution (negative control, n = 12), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) slurry (n = 12), and PAA-ACP@aMSN slurry (n = 12). Surface microhardness, Raman intensity, and color were measured before/after artificial demineralization and after remineralization treatments to evaluate the remineralization level of each sample. SEM images were taken on the surface and cross-section of samples to observe microstructure changes.Results：The surface microhardness recovery ratio (%SMHRR), Raman intensity change ratio (%ICR), and color recovery ratio (%CRR) were not significantly different between CPP-ACP and PAA-ACP@aMSN groups (P > 0.05), but both of them had significantly higher %SMHRR, %ICR, and %CRR values than negative control (P < 0.01). SEM images showed that apparent enamel prism imprints and inter-prism gaps in negative control were masked by mineral deposition in the PAA-ACP@aMSN and CPP-ACP groups.Conclusions: PAA-ACP@aMSN has an ability to remineralize enamel WSLs.Clinical relevance: The carrier-based amorphous calcium phosphate delivery system has great potential to serve as a remineralizing agent for the treatment of WSLs.

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Section: Discussionmentioning

confidence: 99%

In vitro remineralization of enamel white spot lesions with a carrier-based amorphous calcium phosphate delivery system

et al. 2019

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“…In contrast, Frazier et al demonstrated that tooth surfaces sealed with a fissure sealant developed 80% fewer occurrences of demineralization than the control group without sealant, and this difference was significant [20]. It has been reported that the use of fluoride-releasing materials around the bracket environment is beneficial to reducing white spot lesions in patients undergoing fixed appliance therapy [21,22]. To prevent white spot lesions, fluoride release should be prolonged [23].…”

Section: Discussionmentioning

confidence: 99%

Fluoride Ion Release Characteristics of Fluoride-Containing Varnishes—An In Vitro Study

et al. 2021

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Despite the latest advances in orthodontic treatment, white spot lesions remain a common side effect of fixed appliance therapy. An effective treatment for the prevention of white spot lesions is the use of fluoride-containing products. The aim of the present in vitro study was to check the durability of the tested products for their fluoride release into the surrounding solution. Three varnishes (Protecto CaF2 Nano one-step seal, Bifluorid 12 single dose, and Fluor Protector S) were applied to hydroxyapatite discs and kept in diluted Total Ionic Strength Adjustment Buffer III (TISAB III) solution for fluoride ion release measurement. A group of clear hydroxyapatite discs served as the control group. The carrier discs (N = 40) underwent three thermal cycling runs for 20 days. Before the first run and after each run, the fluoride ion concentration in the solution was measured at appointed times (T) T0, T1, T2, and T3. Fluoride ion release was highest at T1 for all products (median values for Protecto CaF2 Nano one-step seal: 0.09 ppm, Bifluorid 12 single dose: 37.67 ppm, and Fluor Protector S: 3.36 ppm) except for the control group, showing its peak at T0 (0.04 ppm). There was a significant difference between the tested fluoride varnishes at all measurement times. Bifluorid 12 achieved significantly higher fluoride release values than the other products (p < 0.05 at all measurement times). A solitary product application of only once or twice per year, as stated by the manufacturers, cannot be supported.

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“…During fixed orthodontic treatment, it is very hard for the patient to maintain excellent oral hygiene as the brackets, bands, wires, elastics, and other appliances and attachments worn intra-orally provide a platform for food retention, plaque formation, and then colonization by acidogenic bacteria like Streptococcus mutans and Lactobacillus . [ 3 4 5 6 ] Moreover, the process of etching of the enamel done using phosphoric acid before bonding the brackets to the tooth surface using composite resins causes some amount of superficial demineralization. [ 4 ]…”

Section: Factors Associated With Wslmentioning

confidence: 99%

White spot lesions in fixed orthodontic treatment: Etiology, pathophysiology, diagnosis, treatment, and future research perspectives

Shankarappa,

Burk,

Subbaiah

et al. 2024

Journal of Orthodontic Science

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White spot lesions (WSLs) refer to localized areas of hypo-mineralization limited to the enamel of the teeth surface, which is noticeable clinically to the naked eye on drying of the teeth. During fixed orthodontic treatment, it is very hard for the patient to maintain excellent oral hygiene as the brackets, bands, wires, elastics, and other appliances and attachments worn intra-orally provide a platform for food retention, plaque formation, and then colonization by acidogenic bacteria like Streptococcus mutans and Lactobacillus. This review aims to elaborate and focus on etiology, pathophysiology, diagnosis, treatment aspect, and future scope for research about the WSLs occurring due to fixed orthodontic treatment.

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Demineralized white spot lesions: An unmet challenge for orthodontists

Cited by 11 publications

References 22 publications

In vitro remineralization of enamel white spot lesions with a carrier-based amorphous calcium phosphate delivery system

In vitro remineralization of enamel white spot lesions with a carrier-based amorphous calcium phosphate delivery system

Fluoride Ion Release Characteristics of Fluoride-Containing Varnishes—An In Vitro Study

White spot lesions in fixed orthodontic treatment: Etiology, pathophysiology, diagnosis, treatment, and future research perspectives

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