scholarly journals Assessment of Mineral Gain in White Spot Lesions Using CPP-ACP and CPP-ACFP in Different Clinical Protocols: A Proof of Concept Study

2021 ◽  
Vol 3 (4) ◽  
pp. 1-1
Author(s):  
Carol Tran ◽  
◽  
Laurence J. Walsh ◽  
Keyword(s):  
Cross Sections ◽  
Random Sequence ◽  
Model Systems ◽  
White Spot ◽  
White Spot Lesion ◽  
White Spot Lesions ◽  
Proof Of Concept ◽  
Clinical Model ◽  
Tooth Surfaces ◽  
Tooth Mousse

Subsurface remineralization can be promoted by the topical application of nanoparticles of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). To assess changes in enamel white spot lesions, an in situ proof-of-concept investigation was performed using 5 subjects (all of whom were healthy young adults) with a cross-over study design. Custom orthodontic brackets were attached to the buccal surfaces of the maxillary second premolar and first molar teeth. Each bracket had a recess that held a slab of enamel with a standardized 100 μm deep white spot lesion (WSL). Changes in mineral were evaluated in lesion cross sections using backscatter electron imaging (BSE) and electron probe microanalysis (EPMA). The following products were applied twice daily for 2 weeks: GC Tooth Mousse™ (CPP-ACP), Tooth Mousse Plus™ (CPP-ACFP), CPP-ACFP Mineral Enhanced (CPP-ACFP Enh), or the vehicle paste of CPP-ACFP containing 900 ppm fluoride. To ensure blinding, all products had identical flavours and packaging. For each subject, the products were used in a random sequence, with washout periods between products. Compared to the baseline situation, favourable changes in white spot lesions occurred with all products. Analysis of enamel samples in cross section showed improvements in mineral levels, as seen in BSE grey scale levels from the enamel surface through the lesion. These were accompanied by enhanced calcium and phosphorus levels as seen using EPMA. The ranking of products for subsurface mineral gain, from best to worst, was: CPP-ACFP = CPP-ACFP Enh > CPP-ACP > vehicle with fluoride. Rapid remineralization occurred in this clinical model, which is due to a combination of factors: the enamel slabs were located on tooth surfaces exposed to parotid saliva, the surfaces were brushed regularly to remove dental plaque biofilm, and compliance with twice daily topical use of products was high. Such model systems may be useful for screening new product formulations for their effect on enamel WSL.

scholarly journals Prevalence of White Spot Lesion during Orthodontic Treatment with Fixed Appliance

2019 ◽  
Vol 9 (2) ◽  
pp. 40-42
Author(s):  
Md Ali Kawsar ◽  
Md Nurul Islam ◽  
Moutithi Sen ◽  
Subodh Chandra Chakraborty ◽  
Muhammad Tanvir Siddiqui
Keyword(s):  
Orthodontic Treatment ◽  
Demographic Data ◽  
Significant Risk ◽  
White Spot ◽  
White Spot Lesion ◽  
White Spot Lesions ◽  
Orthodontic Appliance ◽  
Fixed Appliance ◽  
Group 12 ◽  
Dentofacial Orthopedics

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

scholarly journals External Bleaching Effect on the Color and Luminosity of Inactive White-Spot Lesions after Fixed Orthodontic Appliances

2007 ◽  
Vol 77 (4) ◽  
pp. 646-652 ◽  
Author(s):  
Michael Knösel ◽  
Rengin Attin ◽  
Klaus Becker ◽  
Thomas Attin
Keyword(s):  
White Spot ◽  
Orthodontic Appliances ◽  
White Spot Lesions ◽  
Color Matching ◽  
Orthodontic Appliance ◽  
Anterior Teeth ◽  
Fixed Orthodontic Appliances ◽  
Tooth Surfaces ◽  
Initial Lesions ◽  
Fixed Orthodontic Appliance

Abstract Objective: To evaluate the effect of external bleaching on the color and luminosity of inactive white-spot lesions (WSLs) present after fixed orthodontic appliance treatment as means for achieving color matching of the WSLs with adjacent tooth surfaces. Materials and Methods: Ten patients with inactive WSLs after therapy with fixed orthodontic appliances were selected. At baseline, the lightness of maxillary incisors and canines was assessed with a colorimeter. Color determinations were performed in the area of the initial lesions (F1) and at adjacent, sound enamel areas (F2). Then, anterior teeth were bleached once with a bleaching gel for 60 minutes. After a break of 14 days, in-office bleaching was followed by a 2-week home bleaching period with daily home bleaching for 1 hour. After this, color determinations were repeated. Additionally, patients were asked to fill out a questionnaire to provide information about their degree of contentment with the treatment. Results: The lightness values of both the F1 and F2 regions were significantly higher after bleaching as compared with baseline. F2 L-values increased significantly more as compared with F1, indicating a better color matching of these two areas in comparison with baseline. All patients were satisfied with the outcome of the bleaching therapy. Conclusion: External bleaching is able to satisfactorily camouflage WSLs visible after therapy with fixed orthodontic appliances.

scholarly journals In vitro Caries-Preventive Effect of Fluoridated Orthodontic Resins against Cariogenic Challenge Stimulation

2012 ◽  
Vol 13 (4) ◽  
pp. 452-455 ◽  
Author(s):  
Bhushan Arun Jawale ◽  
Neeraj Patil ◽  
Rahul Redasani ◽  
Lalit Chaudhari ◽  
JB Garde ◽  
...  
Keyword(s):  
Artificial Saliva ◽  
White Spot ◽  
White Spot Lesion ◽  
White Spot Lesions ◽  
Preventive Effect ◽  
Bonding Agents ◽  
Ph Cycling ◽  
Preventive Methods ◽  
Caries Lesions

ABSTRACT Aim The aim of the present study was to evaluate the in vitro caries preventive effect of fluoridated orthodontic resins under pH cycling with two types of acid demineralizing saliva. Materials and methods Brackets were bonded to 120 extracted human premolars, using Rely-a-bond (n = 40), Tru- Bond (n = 40) and Ortho-one (n = 40) orthodontic bonding agents. Each group of resin was divided into 2 subgroups (n = 20): immersion in remineralizing artificial saliva for 14 days and acid saliva with pH 4.3. After 14 days of pH cycling the caries preventive effect on the development of white spot lesion was evaluated considering the presence of inhibition zones to white spot lesions using two scores: 0 = absence and 1 = presence. Kruskal-Wallis ANOVA and Mann-Whitney U tests were used. Results Formation of white spot lesions was observed only under pH cycling using acid saliva with pH 4.3; with Rely-a-bond and Tru-Bond being significantly more effective in preventing the appearance of white spot lesions effect than Ortho-one. Conclusion The acidity of the demineralizing solution influenced the formation of white spot lesions around orthodontic brackets under highly cariogenic conditions. Rely-a-bond and Tru-bond presented higher caries-preventive effect than Orthoone. Clinical significance The development of fluoride-containing materials cannot be regarded as a permanent means to control dental caries lesions, but a complement along with other preventive methods. How to cite this article Patil N, Jawale B, Redasani R, Chaudhari L, Garde JB, Chauhan VS. In vitro Caries-Preventive Effect of Fluoridated Orthodontic Resins against Cariogenic Challenge Stimulation. J Contemp Dent Pract 2012;13(4):452-455.

scholarly journals Use of Resin Infiltrate for the Treatment of White spot Lesions on Dental Enamel: Case Report

2019 ◽  
Vol 21 (2) ◽  
pp. 134
Author(s):  
Rosa Maria Pereira Moisés Barbosa de Andrade ◽  
Ruchele Dias Nogueira ◽  
Maria Angélica Hueb Menezes-Oliveira ◽  
Cesar Penazzo Lepri ◽  
Vinícius Rangel Geraldo-Martins
Keyword(s):  
Tooth Enamel ◽  
Dental Enamel ◽  
Composite Resins ◽  
White Spot ◽  
White Spot Lesion ◽  
White Spot Lesions ◽  
Invasive Treatment ◽  
Resin Infiltration ◽  
Non Invasive ◽  
Infiltration Technique

Abstract Early diagnosis of white spot lesions allows non-invasive treatment to be indicated for the remineralization of active lesions. The goal was to report the clinical Protocol for the treatment of white spot lesion of a patient by the technique of resin infiltration, observing whether there is change of color on the white spot of the dental enamel after its treatment. The selected patient was 16 years old with good overall health, who featured white spot lesion of the dental enamel on tooth 13, classified as ICDAS score 2. The tooth was photographed, and its color was evaluated with the spectrophotometer in accordance with the CIELhC system. For comparison purposes, the color of tooth enamel in an area adjacent to the lesion was evaluated. The treatment of the lesion was performed with the resin infiltrate Icon (DMG, Hamburg, Germany), following the manufacturer's instructions. The color of the tooth was re-evaluated after the application of the resin infiltrate. At the end of the procedure, it was observed that the treatment of white spot lesion by resin infiltration technique reached its goal because, in addition to being minimally invasive, it was highly approved by patient and it provided the masking of the white spot lesion on the dental enamel. Keywords: Dental Caries. Dental Enamel. Composite Resins. ResumoO diagnóstico precoce de lesões de mancha branca permite que um tratamento não invasivo seja indicado para a remineralização das lesões ativas. O objetivo foi relatar o protocolo clínico para tratamento de lesão de mancha branca ativa de um paciente pela técnica do infiltrante resinoso, observando se existe alteração de cor da mancha branca do esmalte dental após o seu tratamento. Foi selecionada uma paciente, de 16 anos de idade, com boa saúde geral e que apresentava lesão de mancha branca no esmalte dental do dente 13, classificada pelo escore 2 do ICDAS. O dente foi fotografado e sua cor foi avaliada com o espectrofotômetro de acordo com o sistema CIELhC. Para fins de comparação, foi avaliada a cor do esmalte dental em uma área adjacente à lesão. O tratamento da lesão foi realizado com a resina infiltrante Icon (DMG, Hamburgo, Alemanha), seguindo as recomendações do fabricante.  A cor do dente foi reavaliada após a aplicação do infiltrante. Ao final do procedimento, observou-se que o tratamento da lesão de mancha branca pela técnica da resina infiltrante atingiu seu objetivo pois, além de ter sido minimamente invasiva, foi bem avaliada pela paciente e proporcionou o mascaramento da lesão de mancha branca do esmalte dental. Palavras-chave: Cárie Dentária. Esmalte Dentário. Resinas Compostas.

scholarly journals Unconventional Non-Invasive Diagnostic Techniques and Treatment of White Spot Lesions in Paediatric Dentistry and Orthodontics

2017 ◽  
Vol 13 (15) ◽  
pp. 339
Author(s):  
Ogodescu Alexandru ◽  
Igna Andreea ◽  
Ogodescu Emilia ◽  
Luca Magda
Keyword(s):  
Early Stage ◽  
New Technology ◽  
Diagnostic Techniques ◽  
White Spot ◽  
White Spot Lesion ◽  
White Spot Lesions ◽  
Resin Infiltration ◽  
Non Invasive ◽  
Infiltration Technique ◽  
Carious Process

Minimal Intervention Dentistry (MID), a concept that aims to minimize the interventional procedures applied on teeth affected by dental caries, emphasizes the importance of prevention and detection of lesions in early stage. The white spot lesion (WSL) is the first visible stage of the carious process, affecting the enamel. Their detection and treatment has been significantly improved in the last decade through new technology available. Our paper describes a non-invasive detection method, using a lighttransmission device (transillumination of the teeth using Diagnocam, by Kavo) , combined with a resin infiltration technique (using Icon, by DMG) of the WSL.

scholarly journals Preventive effect of fluoridated orthodontic resins subjected to high cariogenic challenges

2010 ◽  
Vol 21 (3) ◽  
pp. 211-215 ◽  
Author(s):  
Paula Passalini ◽  
Tatiana Kelly da Silva Fidalgo ◽  
Erika Machado Caldeira ◽  
Rogerio Gleiser ◽  
Matilde da Cunha Gonçalves Nojima ◽  
...  
Keyword(s):  
Color Change ◽  
Artificial Saliva ◽  
Orthodontic Brackets ◽  
White Spot ◽  
White Spot Lesion ◽  
White Spot Lesions ◽  
Preventive Effect ◽  
Ph Cycling ◽  
Inhibition Zones

The aim of the present study was to evaluate the in vitro caries preventive effect of fluoridated orthodontic resins under pH cycling with two types of acid demineralizing saliva. Brackets were bonded to 60 bovine incisors, using either Transbond Plus Color Change (n=30) or Orthodontic Fill Magic (n=30) orthodontic resins. Each group of resin was divided into 3 subgroups (n=10): immersion in remineralizing artificial saliva for 14 days, pH cycling with high cariogenic challenge in acid saliva with pH 5.5, and acid saliva with pH 4.5. After 14 days of pH cycling, the caries preventive effect on the development of white spot lesion was evaluated considering the presence of inhibition zones to white spot lesions using two scores: 0= absence and 1= presence. Kruskal Wallis and Mann-Whitney tests (a=0.05) were used. Formation of white spot lesions was observed only under pH cycling using acid saliva with pH 4.5; with Transbond Plus Color Change being significantly more effective (p<0.05) in preventing the appearance of white spot lesions effect than Orthodontic Fill Magic. The acidity of the demineralizing solution influenced the formation of white spot lesions around orthodontic brackets under highly cariogenic conditions. Transbond Plus Color Change resin presented higher caries preventive effect than Orthodontic Fill Magic.

scholarly journals Effects of fluoride and Aloe vera tooh gel in artificial white spot lesions in vitro

2016 ◽  
Vol 64 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Tânia Mara da SILVA ◽  
Beatriz Maria da FONSECA ◽  
Ana Luísa Leme Simões SALES ◽  
Priscila HOLLEBEN ◽  
Márcia Carneiro VALERA ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Aloe Vera ◽  
White Spot ◽  
White Spot Lesion ◽  
White Spot Lesions ◽  
Repeated Measures Anova ◽  
Ph Cycling ◽  
Knoop Microhardness ◽  
Bovine Enamel

ABSTRACT Objective: The aim of this study was to evaluate the effects of toothbrushing using a fluoride toothpaste and Aloe vera tooth gel on artificial white spot lesions through the Knoop microhardness (KHN) analysis. Methods: Sound bovine enamel samples (2 mm/diameter and 2 mm/depth) were prepared and immersed in artificial white spot lesion for 24 h. The preparation of artificial white spot lesions was performed by pH-cycling process. The samples were randomly divided into two groups (n=20), according the dentifrice used: containing fluoride (Colgate Total 12) or Aloe vera (Forever Bright Aloe Vera Toothgel). The top surface of samples was submitted to 10,000, 25,000, 50,000 and 100,000 brushing cycles (200 g load) in an automatic brushing machine with abrasive slurry. The KHN analysis were evaluated at baseline, after immersion in artificial white spot lesion and after 10,000, 25,000, 50,000 and 100,000 cycles of brushing. Data were analyzed by two-way repeated measures ANOVA and Tukey tests (p=0.05). Results: The KHN values significantly increased after brushing cycles compared to demineralized means. No significant differences showed for dentifrice factor (p=0.263). However, there were statistically significant differences between groups in cycles of brushing times (p=0.0001). Conclusion: The toothpastes (containing fluoride or Aloe vera) were effective in increasing the superficial microhardness of artificial white spot lesions.

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

2016 ◽  
Vol 27 (1) ◽  
pp. 101-107 ◽  
Author(s):  
Patrícia Layane de Menezes Macêdo Nascimento ◽  
Micaelle Tenório Guedes Fernandes ◽  
Fabricio Eneas Diniz de Figueiredo ◽  
André Luis Faria-e-Silva
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Confidence Interval ◽  
White Spot ◽  
Control Group ◽  
Orthodontic Appliances ◽  
White Spot Lesion ◽  
White Spot Lesions ◽  
Fixed Orthodontic Appliances ◽  
Experimental Group

Abstract 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.

A New Method for Quantifying Labial White Spot Lesions

2020 ◽  
Author(s):  
Christina Erbe ◽  
Luisa Hartmann ◽  
Irene Schmidtmann ◽  
Daniela Ohlendorf ◽  
Heinrich Wehrbein
Keyword(s):  
Logistic Regression ◽  
White Spot ◽  
White Spot Lesions ◽  
Evaluation Tool ◽  
Anterior Teeth ◽  
Increased Risk ◽  
Before And After ◽  
Tooth Surfaces ◽  
Male Patients ◽  
Multibracket Appliance

Abstract Aims: This study aimed to evaluate the prevalence as well as incidence of White Spot Lesions (WSL) before and after labial multibracket appliance (MB) therapy. The goal was also to determine the intensity of WSL based on the Enamel Decalcification Index (EDI) by Banks & Richmond (1994). Moreover, this study investigated the scope of WSL by using a newly-developed evaluation tool. Materials & methods: Digital photographs of 121 patients (63 ♂, 58 ♀) with labial metal brackets were analyzed retrospectively before and after MB therapy. The patients were 12.5±2.1 years old. The treatment took 3.1±1.4 years. Adult patients as well as patients with structural or restaurative modifications were excluded from the study. All patients received standardized prophylactic instructions. The labial surfaces of anterior teeth, canine teeth, and premolars in the upper (UJ) and lower jaws (LJ) were evaluated by using the Enamel Decalcification Index (EDI) by Banks & Richmond (1994, levels 0-3) and a specially developed scaled graticule with concentric circles to quantify the extent of WSL (in %). The statistical data analysis was based on crosstabulations and logistic regression. Results: Before MB, 69.4% of the patients had WSL. After MB therapy, 97.5% of the patients presented at least one WSL. The incidence amounted to 28.1%. Before MB, 18.4% of the tooth surfaces (TS) showed an EDI level of 1-3. After MB, 51.8% of the TS featured WSL. Before and after MB, the prevalence for WSL was higher on UJ and LJ canine teeth and premolars than on incisors. 18.2% of the TS showed a WSL to the extent of ≥ 20-100% before MB and 52.3% after MB. The majority (40.8%) of the newly-developed WSL concerned ≥ 40% of TS. The incidence in the UJ was highest for the first and second premolars (71-79%), followed by the lateral incisors (61-63%). In the LJ, the incidence was highest for the second and first premolars (64-76%) and lowest for incisors (22-35%). The logistic regression showed a statistically increased risk to develop WSL after MB for lateral incisors, UJ canine teeth, and for UJ and LJ premolars in male patients. The probability for developing a new distal WSL is higher than developing gingival, mesial, and occlusal WSL. Conclusion: Labial MB therapy is found to drastically increase the risk of developing WSL. Particularly, premolars and canine teeth showed an increased prevalence. In using the specially developed evaluation index, we were able to verify through simple handling and intra-rater reliability a concise quantification of the extent of labial WSL.

scholarly journals Contact with Fluoride-Releasing Restorative Materials Can Arrest Simulated Approximal Caries Lesion

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Camila de Almeida Brandão Guglielmi ◽  
Ana Flávia Bissoto Calvo ◽  
Tamara Kerber Tedesco ◽  
Fausto Medeiros Mendes ◽  
Daniela Prócida Raggio
Keyword(s):  
Contact Point ◽  
White Spot ◽  
White Spot Lesion ◽  
White Spot Lesions ◽  
Double Blind ◽  
Restorative Materials ◽  
Ph Cycling ◽  
Approximal Surface ◽  
Mineral Loss

Previous studies have suggested that the presence of white-spot lesion is very probable when adjacent surface is affected by cavitated lesions. This study evaluated the potential of different fluoride-releasing restorative materials in arresting enamel white-spot lesions in approximal surface in contact with them,in vitro(I) andin situ(II). White-spot lesions were formed in 240 primary enamel specimens via pH-cycling. They were put in contact with cylindrical blocks of 6 materials (n=20): composite resin, 2 high-viscous glass ionomer cements (HVGIC), resin-modified GIC, resin-modified nanoionomer, and polyacid-modified resin. In both studies I and II, these settings were designed to simulate the contact point between the restoration and simulated approximal lesion. For study I, they were subjected to a new pH-cycling cariogenic challenge for 7 or 14 days (n=10). For study II, a randomized double-blindin situdesign was conducted in two phases (7/14 days) to promote cariogenic challenge. At the end of both studies, specimens were collected for mineral analysis by cross-sectional microhardness. Higher mineral loss was observed for lesions in contact with resin (p<0.001). HVGICs were the most efficient in preventing mineral loss, whereas other materials presented an intermediate behavior. It is concluded that fluoride-releasing materials can moderately reduce white-spot lesions progression, and HVGIC can arrest enamel lesion in approximal surface in contact with them.

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