Background: Orthodontic treatment with fixed appliances is frequently associated with difficulties in maintaining good oral hygiene and creation of plaque-retentive areas on tooth surfaces that are typically more prone to the development of caries; such drawbacks may result in white spot lesion (WSL) development that affects the esthetic outcome following bracket debonding. This review article focuses on orthodontic WSLs development, prevention, and remineralization potential via incorporating various remineralizing / antibacterial additives into orthodontic adhesives. Results: Unbalanced enamel demineralization and remineralization processes, along with rapid alterations in the dental plaque bacterial ecology, particularly acidogenic bacteria, are the causes of the start and progression of a carious lesion. Without significantly compromising an adhesive mechanical performance, several antibacterial and remineralizing substances have been added to orthodontic adhesives in an effort to reduce bacterial colonization and promote remineralization. Conclusions: Antibacterial and/or remineralizing substances were utilized as additives in the creation of innovative orthodontic adhesive systems to address white spot lesions (WSLs) and improve the ability of enamel remineralization. Compared to adding only one agent, including multiple agents in an orthodontic adhesive system may have a greater impact on lowering enamel demineralization and improving enamel remineralization during orthodontic therapy.
Enamel White Spot Lesions (EWSLs) are a common dental condition characterized by being opaque or chalky white in appearance. In this review, an overview of the etiology, prevention, and treatment techniques for EWSLs is presented. Enamel demineralization caused by bacteria in dental plaque which releases acids upon the consumption of fermentable carbohydrates causing mineral loss is thought to be the main cause of those lesions, which could be predisposed through orthodontic treatment, poor diet, inadequate oral hygiene and certain medical conditions. So, sustaining an adequate carbohydrate consumption, proper fluoride exposure and good oral hygiene are some of the practices which aid in these lesions’ prevention. Although the suc
... Show MoreABSTRACT Background:- White spot lesions are common esthetic problem that compromise the success of orthodontic treatment. This study aimed to assess white spot lesions in patients with fixed orthodontic appliance at different time intervals. Materials & Methods:- Thirty two patients (24 females and 8 males) were included in this study and they underwent clinical examination for white spot lesions using enamel decalcification index at four time intervals: (2-3 weeks after appliance insertion, 2, 4 and 6 months). Results:- The patients were free of white spot lesions at the appliance insertion visit. The mean of white spot lesions was 2.22 which were increased significantly during six months to reach 24.59 at the end of study. There was a si
... Show MoreBackground: The aim of this study is to evaluate the color change ∆E of the dental enamel following treatment with 2 kinds of protector (icon infiltrant, clinpro varnish) before fixed orthodontic treatment to avoid the possible white spot lesions. Materials and Methods: Fifty four subjects treated with fixed appliances were divided into 3 groups: the 1st group was control, while the 2nd and 3rd groups were treated with icon infiltrant and clinpro varnish before bonding procedure, respectively. Color parameters (L,a,b) were recorded for the middle and gingival thirds before and after bonding procedure to get the ∆E of each group. Results: One-way ANOVA test showed a non-significant difference in ∆E between the 3 groups a
... Show MoreThis research aims to find how three different types of mouthwashes affect the depth of artificial white spot lesions. Teeth with various depths of white spot lesions were immersed in either splat mouthwash, Biorepair mouthwash, Sensodyne mouthwash, or artificial saliva (control)twice daily for one minute for 4 weeks and 8 weeks at 37°C. After this immersion procedure, lesion depth was measured using a diagnosed pen score. A one-way analysis of variance, Dunnett T3 and Tukey's post hoc α = .05 were used to analyze the testing data. Splat mouthwash enhanced the WSL remineralization and made the lowest ΔF compared with other mouthwashes in shallow and deep enamel after 4 and 8 weeks of treatment. In the repair groups, after 4 weeks
... Show MoreBackground: White-spot lesion is one of the problems associated with the fixed orthodontic treatment. The aims of this in-vitro study were to investigate enamel damage depth on adhesive removal when the adhesive were surrounded by sound, demineralized or demineralized enamel that had been re-mineralized prior to adhesive removal using 10% Nano-Hydroxy apatite and to determine the effect of three different adhesive removal techniques. Materials and methods: Composite resin adhesive (3M Unitek) was bonded to 60 human upper premolars teeth which were randomly divided in to three groups each containing ten sound teeth and ten teeth with demineralized and re-mineralized lesions adjacent to the adhesive. A window of 2 mm was prepared on the bucca
... Show MoreBackground: White spot lesion is the first visible sign of dental caries that is characterized by demineralized lesion underneath an intact surface. Several studies demonstrated that they could be treated using noninvasive techniques like the use of fluoride or casein phospho-peptide and amorphous calcium phosphate. Improvement in aesthetic outcomes by covering the demineralized enamel is one of the advantages of the use of resin infiltration and opal-ustre microabrasion, which are two new techniques that had been used for treatment of white spot lesion. The purpose of this study was to evaluate the impact of resin infiltration and microabrasion in the microhardness of the artificial white spot lesions at various depths. Material and method
... Show MoreObjective To evaluate recently developed acidic calcium-phosphate (CaP) pastes as conservative enamel-conditioning systems for bracket bonding and investigate their effects on the shear bond strength, adhesive residues, and enamel damage in comparison to a conventional 37 % phosphoric acid (PA) gel. Materials and methods Two experimental etchant pastes consisting of hydroxyapatite and monocalcium phosphate monohydrate were prepared by mixing them with 37 % and 10 % PA solutions, respectively. These were characterized using X-ray diffraction. Metal brackets were bonded to 90 freshly extracted human premolars and assigned to three groups, depending on etchant type: 37 % PA-gel (control) and the two experimental (HPA and MPA) pastes. Shear bon
... Show MoreBackground: White spot lesions (WSLs) are subsurface enamel demineralization manifested as white opacities which had an esthetic problem. The purpose of this in-vitro study was to evaluate the lesion depth improvement of WSLs following application of fluoride varnish, tooth mousse and resin infiltration (ICON). Materials and methods: Artificial WSLs were created on 120 premolar teeth using demineralization solution with pH (4-4.5). Samples randomly allocated into four groups; fluoride varnish, tooth mousse, ICON and untreated group. Groups were discolored in Cola and orange juice for 24 hours. Teeth were ground sectioned by longitudinal cutting then these sections examined and photographed under stereomicroscope at 12X magnification then an
... Show MoreThis study aimed to incorporate hydroxyapatite nanoparticles (nHA) or amorphous calcium phosphate nanoparticles (nACP) into a self-etch primer (SEP) to develop a simplified orthodontic bonding system with remineralizing and enamel preserving properties.
nHA and nACP were incorporated into a commercial SEP (Transbond™ plus) in 7% weight ratio and compared with the plain SEP as a control. Shear bond strengths (SBS), enamel damage, and adhesive remnant index (ARI) scores were evaluated at 24 h