Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis — a systematic review and meta-analysis

Bourouni, Sotiria; Dritsas, Konstantinos; Kloukos, Dimitrios; Wierichs, Richard Johannes

doi:10.1007/s00784-021-03931-7

Cited by 65 publications

(69 citation statements)

References 51 publications

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“…Therefore, the remineralization agents can reduce the lesion by potentially inducing enamel staining [ 41 ]. Resin infiltration is an alternative not only to arrest the enamel lesions but also as a minimally invasive method to improve the esthetic outcomes after multibracket therapy [ 42 – 46 ]. However, in Germany, resin infiltration is not included in the standard care coverage by the health insurance companies.…”

Section: Discussionmentioning

confidence: 99%

Management of white spot lesions induced during orthodontic treatment with multibracket appliance: a national-based survey

2022

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Objectives The study aimed to survey current strategies against enamel demineralization during multibracket therapy (MBT) and guide a prevention concept based on existing scientific evidence. Materials and methods The survey comprised questions on the prevention and management of white spot lesions (WSL). The questionnaire was sent via email to orthodontists working in practices and universities throughout Germany. The analysis involved descriptive statistics using the chi-square test (p < 0.05). Results A prevention protocol was used before MBT by 80.6% of the participants. Less than a quarter of the participants regularly applied topical fluoride (gel or varnish) during MBT. According to the respondents’ assessment, the prevalence of WSL during MBT is 11.6%, mainly observed in 12- to 15-year-old male patients. Orthodontists graduating after 2000 tended to recommend and apply fluoride-containing materials more often than their senior colleagues (p = 0.039). Participants from private practices applied fluoride varnish or gel more frequently than those from university clinics (p = 0.013). Fluoridation was the most common (70.7%) treatment for WSL after MBT, followed by resin infiltration (21.2%). The majority (80.9%) of the participants favor a guideline for preventing WSL. Conclusions WSL prevention during MBT is challenging. Males in puberty are predominantly affected. Younger orthodontists are more concerned about the prevention of WSL during MBT. Clinical relevance. The non-negligible prevalence of individuals with WSL emphasizes the need for dental education and health care reform. This would help to implement standardized procedures and establish innovative applications.

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Section: Discussionmentioning

confidence: 99%

Management of white spot lesions induced during orthodontic treatment with multibracket appliance: a national-based survey

2022

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“…However, the aesthetic appearance in most cases may remain impaired 15 , 16 . Although micro-invasive treatment options can successfully recover the aesthetic appearance by masking these lesions 17 , 18 , various preventive strategies during treatment with fixed appliances have been employed to prevent the initiation of WSL. Patients were instructed to use fluoride-, chlorhexidine- or CPP-ACP-containing products 19 , 20 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a systematic review and meta-analysis

Kamber

Meyer-Lueckel

Kloukos

et al. 2021

Sci Rep

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To analyse clinical studies investigating coating agents such as sealants and other bonding materials to prevent the initiation or inhibit the progress of white spot lesions (WSL) during orthodontic treatment with fixed appliances. Electronic databases (Pubmed, CENTRAL, EMBASE) were screened for studies. No language restrictions were applied. Study selection, data extraction and quality assessment were done in duplicate. Primary outcome included assessment of WSL with visual-tactile assessment and/or laser fluorescence measurements. Twenty-four studies with 1117 patients (age: 11–40 years) and 12,809 teeth were included. Overall, 34 different sealants or bonding materials were analysed. Fourteen studies analysed fluoride and 14 studies non-fluoride releasing materials. Meta-analysis for visual tactile assessment revealed that sealants significantly decreased the initiation of WSL compared to untreated control (RR [95%CI] = 0.70 [0.53; 0.93]; very low level of evidence). Materials releasing fluoride did not decrease initiation of WSL compared to those with no fluoride release (RR [95%CI] = 0.84 [0.70; 1.01]; very low level of evidence). For laser fluorescence measurements no meta-analysis could be performed. The use of sealants seems to be effective in preventing the initiation of post-orthodontic WSL. Furthermore, there is no evidence supporting that fluoride-releasing sealants or bonding materials are more effective than those without fluoride release. No gold standard prevention strategy to prevent WSL during treatment with fixed orthodontic appliances has been established yet. However, based on only a limited number of studies the use of sealants seems to be effective in preventing the initiation of post-orthodontic WSL.

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“…Certain treatments require the use of orthodontic bands due to the stability these provide to appliances, despite the disadvantages of hindering oral hygiene, causing the accumulation of dentobacterial plaque and giving rise to white lesions [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Mechanical Properties and Antibacterial Effect on Mono-Strain of Streptococcus mutans of Orthodontic Cements Reinforced with Chlorhexidine-Modified Nanotubes

et al. 2022

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Recently, several studies have introduced nanotechnology into the area of dental materials with the aim of improving their properties. The objective of this study is to determine the antibacterial and mechanical properties of type I glass ionomers reinforced with halloysite nanotubes modified with 2% chlorhexidine at concentrations of 5% and 10% relative to the total weight of the powder used to construct each sample. Regarding antibacterial effect, 200 samples were established and distributed into four experimental groups and six control groups (4 +ve and 2 −ve), with 20 samples each. The mechanical properties were evaluated in 270 samples, assessing microhardness (30 samples), compressive strength (120 samples), and setting time (120 samples). The groups were characterized by scanning electron microscopy and Fourier transform infrared spectroscopy, and the antibacterial activity of the ionomers was evaluated on Streptococcus mutans for 24 h. The control and positive control groups showed no antibacterial effect, while the experimental group with 5% concentration showed a zone of growth inhibition between 11.35 mm and 11.45 mm, and the group with 10% concentration showed a zone of growth inhibition between 12.50 mm and 13.20 mm. Statistical differences were observed between the experimental groups with 5% and 10% nanotubes. Regarding the mechanical properties, microhardness, and setting time, no statistical difference was found when compared with control groups, while compressive strength showed higher significant values, with ionomers modified with 10% concentration of nanotubes resulting in better compressive strength values. The incorporation of nanotubes at concentrations of 5% and 10% effectively inhibited the presence of S. mutans, particularly when the dose–response relationship was taken into account, with the advantage of maintaining and improving their mechanical properties.

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Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis — a systematic review and meta-analysis

Cited by 65 publications

References 51 publications

Management of white spot lesions induced during orthodontic treatment with multibracket appliance: a national-based survey

Management of white spot lesions induced during orthodontic treatment with multibracket appliance: a national-based survey

Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a systematic review and meta-analysis

Mechanical Properties and Antibacterial Effect on Mono-Strain of Streptococcus mutans of Orthodontic Cements Reinforced with Chlorhexidine-Modified Nanotubes

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