White Spot Lesions: Prevention and Management During the Orthodontic Treatment

Zabokova-Bilbilova, Efka; Popovska, Lidija; Kapuševska, Biljana; Stefanovska, Emilija Sukarova

doi:10.2478/prilozi-2014-0021

Cited by 24 publications

(20 citation statements)

References 37 publications

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“…[22324] The use of a dentifrice with a high fluoride concentration (5000 ppm), twice daily, by patients at high risk for WSL is more effective than conventional formulations;[252627] however, such a toothpaste (Duraphat) cannot be prescribed for patients under 16 years of age. Heymann and Grauer[5] recommend this toothpaste for brushing in the evenings only.…”

Section: Prevention and Management Of White Spot Lesionsmentioning

confidence: 99%

“…Detection of WSLs after the removal of orthodontic appliances is absolutely discouraging. [2] This article reviews the frequency, distribution, and initiation of WSLs during and subsequent to orthodontic treatment and evaluates the current methods used to manage enamel demineralization resulting from orthodontic treatment, in addition to risk factors and preventive measures involved.…”

Section: Introductionmentioning

confidence: 99%

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Prevention and treatment of white spot lesions in orthodontic patients

2017

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Decalcification of enamel, appearing as white spot lesions (WSLs), around fixed orthodontic appliances is a major challenge during and after fixed orthodontic treatment by considering the fact that the goal of orthodontic treatment is to enhance facial and dental esthetic appearance. Banded or bonded teeth exhibit a significantly higher rate of WSLs compared to the controls with no braces as fixed appliances and the bonding materials promote retention of biofilms. These lesions are managed in the first step by establishing good oral hygiene habits and prophylaxis with topical fluorides, including high-fluoride toothpastes, fluoride mouthwashes, gels, varnishes, fluoride-containing bonding materials, and elastic ligatures. Recently, other materials and methods have been recommended, including the application of casein phosphopeptides-amorphous calcium phosphate, antiseptics, probiotics, polyols, sealants, laser, tooth bleaching agents, resin infiltration, and microabrasion. This article reviews the currently used methods to manage enamel demineralization during and after orthodontic treatment and the risk factors and preventive measures based on the latest evidence.

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Section: Prevention and Management Of White Spot Lesionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevention and treatment of white spot lesions in orthodontic patients

2017

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“…(8). Apart from the daily use of toothpastes and/or mouth rinses containing fluorides effective to prevent WSL development, these approaches have the disadvantage of depending on patient compliance and their results can be disappointing when solely these strategies of caries prevention are used in high-risk patients, such as those using orthodontic appliances (9).…”

Section: Introductionmentioning

confidence: 99%

“…Fluoride can be added to the cement itself, to the adhesive, and to the sealants or varnishes used to protect the bonding interface. Besides the advantage of not depending on patient collaboration, these treatments are usually implemented in a single dental office visit (6,9). Prior reviews have sought to assess the preventive effectiveness of this strategy, however, little evidence is available to support it (10-13).…”

Section: Introductionmentioning

confidence: 99%

Fluoride-Releasing Materials to Prevent White Spot Lesions around Orthodontic Brackets: A Systematic Review

et al. 2016

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The relation between orthodontic fixed appliances use and enamel demineralization is well established. Different preventive approaches have been suggested to this problem, but controversy remains about which is the best. The aim of this study was to perform a systematic review of clinical trials that investigated the effectiveness of materials containing fluorides to lute brackets or cover the bonding interface in order to inhibit the development and progression of white spot lesions. The null hypothesis was that fluoride materials do not affect the incidence of white spot lesions around brackets. A MEDLINE search was conducted for randomized clinical trials evaluating the development of white spot lesions in patients using fixed orthodontic appliances, followed by meta-analysis comparing the results for patients for whom dental materials containing fluorides were used (experimental group) to those for whom these materials were not used (control group). The pooled relative risk of developing white spot lesions for the experimental group was 0.42 (95% confidence interval: 0.25 to 0.72); hence, when fluoride-releasing materials are used, the patient has 58% less risk of white spot lesion development. Regarding white spot lesion extent, the pooled mean difference between the experimental and control groups was not statistically significant (-0.12; 95% confidence interval: -0.29 to 0.04).In conclusion, the results of the present systematic review suggest that fluoride-releasing materials can reduce the risk of white spot lesions around brackets. However, when white spot lesions had already occurred, there is no evidence that fluoride-releasing materials reduce the extent of these lesions.

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“…Removable orthodontic appliances used either as a retention appliance or as an active device, increase plaque accumulation on teeth surfaces, clasps, springs and acrylic base. 6 Zabokova-Bilbilova et al 7 reported high occurrence of enamel demineralization white spots in 50 percent of patients undergoing orthodontic treatments for 2 years.…”

mentioning

confidence: 99%

The Effect of Time and Three Different Storage Environments on the Dimensional Stability of Acrylic Removable Orthodontic Appliances

Mousavi¹,

Ghorani²,

Javidi³

et al. 2015

Biosci., Biotech. Res. Asia

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Acrylic resin is widely used in manufacturing removable orthodontic appliances. Nevertheless water sorption and dimensional changes are some of the drawbacks of this material that can affect the accuracy of the appliance. The aim of this study was to evaluate the effects of Corega® solution on dimensional changes of orthodontic appliances in comparison with two conditions including dry and water environment. Sixty six acrylic resin specimens were made in quadrangular metal mold. Then the length, width and diameter of each specimen were measured with digital caliper with measurement accuracy of 0.01 mm. Specimens were randomly divided into three groups. The samples in these three groups were kept in dry environment, water and Corega® solution respectively. Different dimensions of the specimens were blindly measured after 18 hours, 48 hours and 1 week by two independent evaluators. Dry environment had the highest amount of dimensional change and was significantly different from water and Corega® solution over those three evaluated periods of time. No significant difference was seen between dimensional changes in water and Corega® solution. Also data analysis showed that acrylic resin's dimensional change in dry environment over different periods of time is not statistically significant. Orthodontic appliances should be kept in water or Corega® solution and Corega® solution is the superior choice due to its antibacterial effects.

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White Spot Lesions: Prevention and Management During the Orthodontic Treatment

Cited by 24 publications

References 37 publications

Prevention and treatment of white spot lesions in orthodontic patients

Prevention and treatment of white spot lesions in orthodontic patients

Fluoride-Releasing Materials to Prevent White Spot Lesions around Orthodontic Brackets: A Systematic Review

The Effect of Time and Three Different Storage Environments on the Dimensional Stability of Acrylic Removable Orthodontic Appliances

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