White Spot Lesions After Orthodontic Treatment

2008 ◽  
Vol 14 (3) ◽  
pp. 209-219 ◽  
Author(s):  
Derrick Willmot
2019 ◽  
Vol 9 (2) ◽  
pp. 40-42
Author(s):  
Md Ali Kawsar ◽  
Md Nurul Islam ◽  
Moutithi Sen ◽  
Subodh Chandra Chakraborty ◽  
Muhammad Tanvir Siddiqui

Background: White spot lesions (enamel demineralization) is one of the most common and a significant risk associated with orthodontic treatment. Objective: To determine the prevalence of white spot lesion during fixed orthodontic treatment. Method: This prospective observational study and was conducted in the Department of Orthodontics and Dentofacial Orthopedics from January 2016 to December 2017 over a period of two years. Patients with fixed orthodontic appliance age between 12-30 years of both sex attended for follow up were included in this study. After taking written consent, a questionnaire included socio-demographic data, clinical and outcome variables including routine clinical photographs to examine WSL were filled up for each patient. Routine clinical photographs to examine WSL were taken after 6 months and 12 months of fixing orthodontics appliance. Qualitative data were expressed as frequency distribution and percentage. Results: Maximum patients were in age group 12 – 16 years and prevalence of WSL was also sought maximum in this group. Out of 36 cases with WSL, 14 (38.9%) were male and 22 (61.1%) were female. Prevalence of WSL after six month of fixing orthodontic appliance was 21.8% and 26.1% after 12 months. Prevalence of WSL after six month of fixing orthodontic appliance in male was 26.4% & in female was 19.6% and after 12 month of fixing orthodontic appliance it was 30.2% in male and 24.1% in female. After six months of fixing orthodontic appliance 1-3 WSLs was found in 17.0% cases and ≥ 4 WSLs in 4.8% cases. After twelve months of fixing orthodontic appliance 1-3 WSLs was found in 19.4% cases and ≥ 4 WSLs in 6.7% cases. Maximum WSL was found in maxillary incisors. Conclusion: This study showed that 21.8% of the study subjects developed white spot lesions during orthodontic procedure and incisors were the most common affected teeth. Update Dent. Coll. j: 2019; 9 (2): 40-42


2019 ◽  
Vol 42 (3) ◽  
pp. 326-330 ◽  
Author(s):  
Mikael Sonesson ◽  
Anna Brechter ◽  
Salem Abdulraheem ◽  
Rolf Lindman ◽  
Svante Twetman

Summary Background Self-applied and professional fluorides are key elements to limit caries-related side-effects during orthodontic treatment with fixed appliances. Objective To evaluate the effectiveness of a new fluoride varnish formula containing 1.5% ammonium fluoride in preventing white spot lesions (WSLs) in adolescents undergoing multi-bracket orthodontic treatment. Subjects and methods The study employed a randomized controlled triple-blinded design with two parallel arms. One hundred eighty-two healthy adolescents (12–18 years) referred to three orthodontic specialist clinics were eligible and consecutively enrolled. Informed consent was obtained from 166 patients and they were randomly allocated to a test or a placebo group (with aid of a computer program, generating sequence numbers in blocks of 15). In the test group, fluoride varnish was applied in a thin layer around the bracket base every sixth week during the orthodontic treatment, while patients in the placebo group received a varnish without fluoride. The intervention started at onset of the fixed appliances and continued until debonding. The endpoint was prevalence and severity of WSLs on the labial surfaces of the maxillary incisors, canines, and premolars as scored from high-resolution pre- and post-treatment digital photos with aid of a four-level score. Results One hundred forty-eight patients completed the trial, 75 in the test group and 73 in the placebo group (dropout rate 10.8%). The total prevalence of WSL’s on subject level after debonding was 41.8% in the test group and 43.8% in the placebo group. The number of patients exhibiting more severe lesions (score 3 + 4) was higher in the placebo group (P < 0.05); the absolute risk reduction was 14% and the number needed to treat was 7.1. Limitations The multicentre design with somewhat diverging routines at the different clinics may have increased risk for performance bias. No health-economic evaluation was carried out. Conclusions Regular applications of an ammonium fluoride varnish reduced the prevalence of advanced WSL during treatment with fixed orthodontic appliances. Clinical trial registration ClinicalTrials.gov (NCT03725020). Protocol The protocol was not published before trial commencement.


2016 ◽  
Vol 3 (2) ◽  
pp. 85
Author(s):  
Ashish Dabas ◽  
Nupur Dabas ◽  
Maninder Singh Sidhu ◽  
Mona Prabhakar ◽  
Seema Grover ◽  
...  

2021 ◽  
Vol 15 (1) ◽  
pp. 151-159
Author(s):  
Aravinthrajkumar Govindaraj ◽  
S.P. Saravana Dinesh

Aim: The aim of this study is to critically review the studies that studied the effect of Chlorhexidine varnish and fluoride varnish on White Spot Lesion (WSL) in patients undergoing orthodontic treatment. Materials and Methods: The electronic database PubMed, The Cochrane Library, Medline, Embase, Google Scholar, Web of Knowledge along with a complimentary manual search of all orthodontic journals till the first week of December 2019 was searched. English language study performed on humans, randomized or nonrandomized clinical trials, comparing the effect of fluoride and chlorhexidine varnish on WSL was included in the review. Quality assessment of included studies was performed. Clinical Significance: The need for an adjunct oral hygiene aid to reduce the incidence and prevalence of white spot lesions in orthodontic patients is necessary. The use of these varnishes will aid in the same and thus make the adverse effects of fixed orthodontic treatment negligible. Review of Literature: Enamel demineralization is a significant risk associated with orthodontic treatment when oral hygiene is poor. Prevention of demineralization during orthodontic treatment is one of the greatest challenges faced by clinicians despite modern advances in caries prevention. The development of White Spot Lesions (WSLs) is attributed to prolonged plaque accumulation around the brackets. Results: The search identified a total of 3 studies that were included in this review. One study had Low risk of bias and the remaining 2 studies had moderate overall risk. Results showed that there was a reduction in the incidence of white spot lesions in orthodontic patients after application of chlorhexidine and Fluoride varnish. Conclusion: Low level evidence is available to conclude that the use of chlorhexidine varnishes and fluoride varnishes reduces the prevalence of white spot lesions in patients undergoing fixed orthodontic treatment. Due to its limitations, the results of this systematic review should be handled with caution and further well-planned Randomized Clinical Trial (RCT) are needed to provide a discrete conclusion.


2020 ◽  
Vol 90 (3) ◽  
pp. 405-410
Author(s):  
Iyad Al-Omari ◽  
Zaid Al-Bitar ◽  
Ahmad M. Hamdan

ABSTRACT Objectives To compare the effect of various degrees of decalcification after orthodontic treatment (white spot lesions) on orthodontists', general dentists', and laypersons' ratings of smile esthetics. Materials and Methods Eight photographs representing incrementally altered tooth decalcification lesions of maxillary anterior teeth ranging from mild to severe were shown randomly to the study participants. Photographs were rated by a matched sample of orthodontists (N = 42), general dentists (N = 52), and laypeople (N = 58). A visual analogue scale (VAS) was used to assess perceptions of smile esthetics. Results The three groups of raters could distinguish between different decalcification levels. Raters gave more negative scores as the decalcification level increased. Conclusions The three groups of raters were able to distinguish between various degrees of decalcification lesions. General dentists were the most critical of all groups when rating decalcification lesions.


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