WHITE SPOT LESIONS IN FIXED ORTHODONTIC TREATMENT AND CURRENT PREVENTION METHODS – REVIEW

Abstract

Demineralization is the most undesired side effects of fixed orthodontic treatment, especially associated with poor oral hygiene. Orthodontic treatment with fixed appliances increases the risk for development of white spot lesions (WSL) due to the creation of additional retention sites on surfaces generally not susceptible to caries. Appearance of these spots after the completion of orthodontic treatment can lead to poor esthetics, patient dissatisfaction and legal complication. This highlights the need for assessing the saliva, oral hygiene status and caries rate before beginning of treatment and initiating preventive measures. Depending on the oral environment, WSL can develop into cavities, stay stable for a long time, or heal to a certain extent. Thus, the prevention of WSL is crucial to prevent tooth decay as well as minimize tooth discoloration that could compromise the treatment results

Keywords

• White Spot Lesion,Orthodontics

SABİT ORTODONTİK TEDAVİDE BEYAZ NOKTA LEZYONLARI VE GÜNCEL ÖNLEME YÖNTEMLERİ – DERLEME

Abstract

Demineralizasyon, özellikle zayıf ağız bakımı ile ilişkili sabit ortodontik tedavinin istenmeyen bir yan etkisidir. Sabit ortodontik apareyler bakteri plağının birikimi için ciddi retantif bölgeler oluşturur. Bu alanlarda biriken bakterilerin asidik ürünleri minenin yüzey altı demineralizasyonu ve bunu takiben oluşan beyaz nokta lezyonlarının (BNL) oluşumundan sorumludurlar. Bu lezyonlar ortodontik tedavi sonrasında kötü estetik ve hasta memnuniyetsizliği gibi problemlerin ortaya çıkmasına sebep olur. Bu sorunlar ortodontik tedavi öncesinde hastanın tükürük, ağız bakım durumu ve çürük riskinin belirlenmesini ve gerektiğinde başlangıç koruyucu uygulamaların değerlendirmesini önemli hale getirmiştir.  Bireyin çürük riski, ağız bakımı ve ağız ortamının durumuna bağlı olarak, beyaz nokta lezyonları ilerleme göstererek kavite oluşturabilir, ilerlemeden uzun süre kalabilir ya da geri döndürülebilecek seviyede ise iyileşebilirler. Bundan dolayı beyaz nokta lezyonlarının önlenmesi; diş çürüğü oluşumu ve estetik problemlerin önüne geçilmesi ve dolayısıyla arzulanan sabit ortodontik tedavi başarısının gerçekleştirilmesi açısından oldukça önemlidir.

Keywords

• Beyaz Nokta Lezyonu, Ortodonti

References

1. Øgaard B, Bishara S, Duschner H: Enamel effects during bonding- debonding and treatment with fixed appliances. In Risk Management in Orthodontics. Experts Guide to Malpractice. Ed. Graber T, Eliades T, Athanasiou A. Chicago, Quintessence, p:19-46, 2004,
2. Ogaard B, Rİlla G, Arends J. Orthodontic appliances and enamel demineralization. Part 1. Lesion development. Am J Orthod Dentofacial Orthop 1988;94:68-73.
3. Zachrisson BU, Zachrisson S. Caries incidence and oral hygiene during orthodontic treatment. Scand J Dent Res 1971;79:394-401.
4. Zachrisson BU. A post treatment evaluation of direct bonding in orthodontics. Am J Orthod Dentofacial Orthop 1977;71:173-89.
5. Machen DE. Legal aspects of orthodontic practice: risk management concepts. Am J Orthod Dentofacial Orthop 1991;100: 93-4.
6. Bishara SE, Ostby AW. White Spot Lesions: Formation, Prevention, and Treatment. Semin Orthod 2008;14:174-82.
7. Fejerskov O, Nyvad B, Kidd EAM. Clinical and histological manifestations of dental caries. In: Fejerskov O, Kidd EAM, editors Dental caries: the disease and its clinical management. Blackwell Munksgaard, Copenhagen, Denmark, pp: 71-99, 2003.
8. Summitt JB, Robbins JW, Schwartz RS: Fundamentals Contemporary Approach. 3rd ed. Hanover Park, IL, Quintessence Publishing, pp: 2-4, 2006. A

9. Russell AL. The differential diagnosis of fluoride and nonfluoride enamel opacities. J Public Health Dent 1961;21:143-6.
10. Ogaard B. Prevalence of white spot lesions in 19- year-olds: orthodontically treated persons 5 years after treatment. Am J Orthod Dentofacial Orthop 1989;96:423-7. on untreated and
11. Boersma JG, Van der Veen MH, Lagerweij MD, Bokhout B, Prahl-Andersen B. Caries prevalence measured with QLF after treatment with fixed orthodontic appliances: influencing factors. Caries Res 2005;39:41-7.
12. Ogaard B, Larsson E, Henriksson T, Birkhed D, Bishara SE. Effects of combined application of antimicrobial and fluoride varnishes in orthodontic patients. Am J Orthod Dentofacial Orthop 2001;120:28-35.
13. Mitchell L. Decalcification during orthodontic treatment with fixed appliances. Br J Orthod 1992;19:199-205.
14. Gorelick L, Geiger AM, Gwinnett AJ. Incidence of white spot formation after bonding and banding. Am J Orthod 1982;81:93-8.
15. Geiger AM, Gorelick L, Gwinnett AJ, Griswold PG. The effect of a fluoride program on white spot formation during orthodontic treatment. Am J Orthod Dentofacial Orthop 1988;93:29-37.
16. Banks PA, Chadwick SM, Asher-McDade C, Wright JL. Fluoride releasing elastomerics: a prospective controlled clinical trial. Eur J Orthod 2000;22:401- 7.
17. Artun J, Brobakken B. Prevalence of carious white spots after orthodontic treatment with multibonded appliances. Eur J Orthod 1986;8:229-34.
18. Zachrisson BJ. Fluoride application procedures in orthodontic practice, current concepts. Angle Orthod 1975;45:72-81.
19. Chapman JA, Roberts WE, Eckert GJ, Kula KS, González-Cabezas C. Risk factors for incidence and severity of white spot lesions during treatment with fixed orthodontic appliances. Am J Orthod Dentofacial Orthop 2010;138:188-94.
20. Chang HS, Walsh LJ, Freer TJ. Enamel demineralization during orthodontic treatment. Aetiology and prevention. Aust Dent J 1997;42:322-7.
21. Featherstone JD. The science and practice of caries prevention. J Am Dent Assoc 2000;131:887- 99.
22. Rosenbloom RG, Tinanoff N. Salivary Streptococcus mutans levels in patients before, during, and after orthodontic treatment. Am J Orthod Dentofacial Orthop 1991;100:35-7.
23. Zimmer BW, Rottwinkel Y. Assessing patient- specific decalcification risk in fixed orthodontic treatment and its impact on prophylactic procedures. Am J Orthod Dentofacial Orthop 2004;126:318-24.
24. Boyd RL, Murray P, Robertson PB. Effect of rotary electric toothbrush versus manual toothbrush on periodontal status during orthodontic treatment. Am J Orthod Dentofacial Orthop 1989;96:342-7.
25. Heintze SD, Jost-Brinkmann PG, Loundos J. Effectiveness of three different types of electric toothbrushes compared with a manual technique in orthodontic patients. Am J Orthod Dentofacial Orthop 1996;110:630-8.
26. Robinson PG, Deacon SA, Deery C, Heanue M, Walmsley AD, et al. Manual versus powered toothbrushing for oral health. Cochrane Database Syst Rev 2005;CD002281.
27. De Leeuw NH. Resisting the onset of dissolution incorporation of fluoride. J Phys Chem 2003;108:1809-11. through the
28. Forss H. Efficiency of fluoride programs in the light of reduced caries levels in young populations. Acta Odontol Scand 1999;57:348-51.
29. Riordan PJ. Fluoride supplements for young children: an analysis of the literature focusing on benefits and risks. Community Dent Oral Epidemiol
30. O’Reilly MM, Featherstone JD. Demineralization and appliances: an in vivo study. Am J Orthod Dentofacial Orthop 1987;92:33 40. orthodontic
31. Baydaş B, Kavrut F. Ortodontik Tedavi Gören Bireylerde Farklı Ağız Gargaralarının Ağız Sağlığına Etkilerinin Değerlendirilmesi. Atatürk Üniv. Diş. Hek. Fak. Derg. 2005;15:12-21.
32. Derks A, Katsaros C, Frencken JE, Van’t Hof MA, Kuijpers-Jagtman AM. Caries-inhibiting effect of preventive measures during orthodontic treatment with fixed appliances. A systematic review. Caries Res 2004;38:413-20.
33. Alexander SA, Ripa LW. Effects of self-applied topical fluoride preparations in orthodontic patients. Angle Orthod 2000;70:424-30.
34. Blinkhorn AS, Holloway PJ, Davies TG. Combined effects of a fluoride dentifrice and mouthrinse on the incidence of dental caries. Community Dent Oral Epidemiol 1983;11:7-11.
35. Arends J, Lodding A, Petersson LG. Fluoride uptake in enamel. In vitro comparison of topical agents. Caries Res 1980;14:403-13.
36. Schmit JL, Staley RN, Wefel JS, Kanellis M, Jakobsen JR, et al. Effect of fluoride varnish on demineralization adjacent to brackets bonded with RMGI cement. Am J Orthod Dentofacial Orthop 2002;122:125-34.
37. Matalon S, Slutzky H, Weiss EI. Antibacterial properties of 4 orthodontic cements. Am J Orthod Dentofacial Orthop 2005;127:56-63.
38. Graf I, Jacobi BE. Bond strength of various fluoride-releasing orthodontic bonding systems. Experimental study. J Orofac Orthop 2000;61:191- 8.
39. Gorton J, Featherstone JD. In vivo inhibition of demineralization around orthodontic brackets. Am J Orthod Dentofacial Orthop 2003;123:10-4.
40. Marcusson A, Norevall LI, Persson M. White spot reduction when using glass ionomer cement for bonding in orthodontics: a longitudinal and comparative study. Eur J Orthod 1997;19:233-42.
41. Storie DJ, Regennitter F, von Fraunhofer JA. Characteristics of a fluoride-releasing elastomeric chain. Angle Orthod 1994;64:199-209.
42. Marsh PD. Are dental diseases examples of catastrophes? ecological 2003;149:279-94. Microbiology
43. Anderson MH. A review of the efficacy of chlorhexidine on dental caries and the caries infection. Journal of Calif Dent Assoc 2003;31:211- 4. 44. Emilson C, Linquist B, Wennerholm K. Recolonization of human tooth surfaces by streptococcus mutans after suppression by chlorhexidine treatment. J Dent Res 1987;66:1503- 8.
44. Rose RK. Effects of an anticariogenic casein phosphopeptide streptococcal model dental plaques. Arch Oral Biol 2000;45:569-75. calcium diffusion in
45. Shaw L, Murray JJ, Burchell CK, Best JS. Calcium and phosphorus content of plaque and saliva in relation to dental caries. Caries Res 1983;17:543- 8.
46. Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptide- stabilized calcium phosphate solutions. J Dent Res 1997;76:1587-95.
47. Reynolds EC, Cai F, Shen P, Walker GD. Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugar- free chewing gum. J Dent Res 2003;82:206-11.
48. Rose RK. Binding characteristics of streptococcus mutans for calcium and casein phosphopeptide. Caries Res 2000;34:427-31.
49. Iijima Y, Cai F, Shen P, Walker G, Reynolds C, Reynolds EC. Acid resistance of enamel subsurface lesions remineralized by a sugar-free chewing gum containing calcium phosphate. Caries Res 2004;38:551-6.
50. Dawes C, Macpherson LM. Effects of nine different chewinggums and lozenges on salivary flow rate and pH. Caries Res 1992;26:176-82.
51. Scheinin A, Makinen KK, Ylitalo K. Turku sugar studies: Final report on the effect of sucrose, fructose and xylitol diets on the caries incidence in man. Acta Odontol Scan 1976;34:179-216.
52. Makinen KK, Bennett CA, Hujoel PP, Isotupa KP, Pape HR, Makinen PL. Xylitol chewing gums and caries rates: a 40-month cohort study. J Dent Res 1995;74:1904-13.
53. Zimmer S, Robke FJ, Roulet JF. Caries prevention with flüoride varnish in a socially deprived community. Community Dent Oral Epidemiol
54. Isokangas P, Alanen P, Tiesko J, Makinen KK. Xylitol chewing gum in caries prevention: a field study in children. J Am Dent Assoc 1984;117:315- 20.
55. Dawes C, Macpherson LM. Effects of nine different chewing gums and lozenges on salivary flow rate and pH. Caries Res 1992;26:176-82.
56. Oho T, Morioka T. A possible mechanism of acquired acid resistance of human dental enamel by laser irradiation. Caries Res 1990;24:86-92.
57. Elaut J, Wehrbein H. The effects of argon laser curing of a resin adhesive on bracket retention and enamel decalcification: a prospective clinical trial. Eur J Orthod 2004;26:553-60.
58. Anderson AM, Kao E, Gladwin M, Benli O, Ngan P. The effects of argon laser irradiation on enamel decalcification: An in vivo study. Am J Orthod Dentofacial Orthop 2002;122:251-9.