Beyaz Nokta Lezyonları: Tanı ve Tedavi Yöntemleri

Abstract

Beyaz nokta lezyonları, sağlıklı mine ile demineralize alan arasındaki kırılma indeksi farkı sonucunda çevredeki sağlıklı mineden açıkça ayırt edilebilen, süt beyazı opak görünüme sahip başlangıç çürük lezyonlarıdır. Bu lezyonların tanısının konulup erken tedavi edilmesi, çürüğün ilerlemesiyle oluşacak diş dokusundaki aşırı madde kaybını engeller. Bu derlemede, beyaz nokta lezyonlarının oluşumu, tanı ve tedavi yöntemleri incelenmiştir.

Keywords

• Diş çürüğü
• beyaz nokta lezyonu
• demineralizasyon
• remineralizasyon
• rezin infiltrant

WHITE SPOT LESIONS: DIAGNOSIS AND TREATMENT METHODS

Abstract

White spot lesions are early caries lesions with a milky white opaque appearance, clearly distinguishable from the surrounding intact enamel due to the difference in refractive index between the intact enamel and the demineralized area. Diagnosing these lesions and treating them early prevents the excessive loss of material in the dental tissue that will occur as the caries progresses. This review is mainly focusing on, the development, diagnosis and management of the white spot lesions.

Keywords

• Dental caries
• white spot lesion
• demineralization
• remineralization
• resin infiltrant

References

1. Longbottom C, Ekstrand K, Zero D, Kambara M. Novel preventive treatment options. Monogr Oral Sci. 2009;21:156-163.
2. Çelik EU, Katirci G. Treatment of incipient carious lesions. J Dent Fac Atatürk Uni. 2011;2011(1):48-56.
3. Gangrade A, Gade V, Patil S, Gade J, Chandhok D, Thakur D. In vitro evaluation of remineralization efficacy of different calcium-and fluoride-based delivery systems on artificially demineralized enamel surface. J Conserv Dent. 2016;19(4):328-331.
4. Ten Cate JM. Contemporary perspective on the use of fluoride products in caries prevention. Br Dent J. 2013;214(4):161-167.
5. Julien KC, Buschang PH, Campbell PM. Prevalence of white spot lesion formation during orthodontic treatment. Angle Orthod. 2013;83(4):641-647.
6. Lovrov S, Hertrich K, Hirschfelder U. Enamel demineralization during fixed orthodontic treatment- incidence and correlation to various oral-hygiene parameters. J Orofac Orthop. 2007;68(5):353-563.
7. Khalaf K. Factors affecting the formation, severity and location of white spot lesions during orthodontic treatment with fixed appliances. J Oral Maxillofac Res. 2014;5(1):e4.
8. Mount GJ. Defining, classifying, and placing incipient caries lesions in perspective. Dent Clin North Am. 2005;49(4):701-723.

9. Guerrieri A, Gaucher C, Bonte E, Lasfargues J. Minimal intervention dentistry: Part 4. Detection and diagnosis of initial caries lesions. Br Dent J. 2012;213(11):551-557.
10. Ekstrand K, Qvist V, Thylstrup A. Light microscope study of the effect of probing in occlusal surfaces. Caries Res. 1987;21(4):368-374.
11. Korkut B, Tağtekin DA, Yanikoğlu F. Early diagnosis of dental caries and new diagnostic methods: QLF, diagnodent, electrical conductance and ultrasonic system. EÜ Diş Hek Fak Derg. 2011;32(2):55-67.
12. Yang J, Dutra V. Utility of radiology, laser fluorescence, and transillumination. Dent Clin North Am. 2005;49(4):739-752.
13. Tracy KD, Dykstra BA, Gakenheimer DC, et al. Utility and effectiveness of computer-aided diagnosis of dental caries. Gen Dent. 2011;59(2):136-144.
14. Kühnisch J, Bücher K, Henschel V, Hickel R. Reproducibility of DI AGNOdent 2095 and DİAGNOdent Pen measurements: Results from an in vitro study on occlusal sites. Eur J Oral Sci. 2007;115(3):206-211.
15. Amaechi BT, Higham SM. Quantitative light-induced fluorescence: a potential tool for general dental assessment. J Biomed Opt. 2002;7(1):7-13.
16. Jablonski-Momeni A, Liebegall F, Stoll R, Heinzel- Gutenbrunner M, Pieper K. Performance of a new fluorescence camera for detection of occlusal caries in vitro. Lasers Med Sci. 2013;28(1):101-109.
17. Rodrigues J, Hug İ, Diniz M, Lussi A. Performance of fluorescence methods, radiographic examination and ICDAS II on occlusal surfaces in vitro. Caries Res. 2008;42(4):297-304.
18. Lussi A, İmwinkelried S, Pitts N, Longbottom C, Reich E. Performance and reproducibility of a laser fluorescence system for detection of occlusal caries in vitro. Caries Res. 1999;33(4):261-266.
19. Pittsab N, Losb P, Biesakb P, et al. Ac-Impedance Spectroscopy technique for monitoring dental caries in human teeth. Caries Res. 2007;41(4):321-322.
20. Amaechi BT. Emerging technologies for diagnosis of dental caries: The road so far. J Appl Phys. 2009;105(10):102047.
21. Rochlen GK, Wolff MS. Technological advances in caries diagnosis. Dent Clin North Am. 2011;55(3):441-452.
22. Young DA, Featherstone JD. Digital imaging fiber-optic trans-illumination, F-speed radiographic film and depth of approximal lesions. J Am Dent Assoc. 2005;136(12):1682- 1687.
23. Tassery H, Levallois B, Terrer E, Manton D, Otsuki M, Koubi S, et al. Use of new minimum intervention dentistry technologies in caries management. Aust Dent J. 2013;58:40-59.
24. Ziv V, Gazit D, Beris D, Feuerstein O, Aharonov L, Bab I. Correlative ultrasonic histologic and roentgenographic assessment of approximal caries. Caries Res. 1998;32:294.
25. Gazit D, Ziv V, Bab İ, Findler M, Barak S, Torpaz E, et al. In vitro in vivo assessment of approximal caries using ultrasonic waves. J Dent Res. 1998;77:766.
26. Yanikoglu FC, Ozturk F, Hayran O, Analoui M, Stookey G. Detection of natural white spot caries lesions by an ultrasonic system. Caries Res. 2000;34(3):225-232.
27. Simon JC, Kang H, Staninec M, et al. Near‐IR and CP‐ OCT imaging of suspected occlusal caries lesions. Lasers Surg Med. 2017;49(3):215-224.
28. Braga MM, Saveriano de Benedetto M, Imparato JCP, Mendes FM. New methodology to assess activity status of occlusal caries in primary teeth using laser fluorescence device. J Biomed Opt. 2010;15(4):047005.
29. Kühnisch J, Bücher K, Henschel V, et al. Diagnostic performance of the universal visual scoring system (UniViSS) on occlusal surfaces. Clin Oral Invest. 2011;15(2):215-223.
30. Young DA, Nový BB, Zeller GG, et al. The American Dental Association caries classification system for clinical practice: A report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2015;146(2):79-86.
31. Swift EJ, CM Sturdevant, Roberson T, Heymann HO. Sturdevant's Art and Science Of Operative Dentistry. 5th ed. Edinburg. Elsevier Health Sciences, 2006.
32. Balakrishnan M, Simmonds RS, Tagg JR. Dental caries is a preventable infectious disease. Aust Dent J. 2000;45(4):235-245.
33. Peker K, Bermek G. The importance of fermentable carbohydrates in the aetiology and prevention of dental caries. J İstanb Univ Fac Dent. 2008;42(3-4):1-9.
34. Swarup JS, Rao AJ. Enamel surface remineralization: Using synthetic nanohydroxyapatite. Contemp Clin Dent. 2012;3(4):433-436.
35. Azarpazhooh A, Limeback H. Clinical efficacy of casein derivatives: A systematic review of the literature. J Am Dent Assoc. 2008;139(7):915-924.
36. Golpayegani MV, Sohrabi A, Biria M, Ansari GJJod. Remineralization effect of topical NovaMin versus sodium fluoride (1.1%) on caries-like lesions in permanent teeth. J Dent (Tehran). 2012;9(1):68-75.
37. Patil N, Choudhari S, Kulkarni S, Joshi SR. Comparative evaluation of remineralizing potential of three agents on artificially demineralized human enamel: An in vitro study. J Conserv Dent. 2013;16(2):116-120.
38. Featherstone JDB. Prevention and reversal of dental caries: Role of low level fluoride. Community Dent Oral Epidemiol. 1999;27(1):31-40.
39. Featherstone JDB. The science and practice of caries prevention. J Am Dent Assoc. 2000;131(7):887-899.
40. Pliska BT, Warner GA, Tantbirojn D, Larson BE. Treatment of white spot lesions with ACP paste and microabrasion. Angle Orthod. 2012;82(5):765-769.
41. Gu X, Yang L, Yang D, Gao Y, Duan X, Zhu X, et al. Esthetic improvements of postorthodontic white-spot lesions treated with resin infiltration and microabrasion: A split-mouth, randomized clinical trial. Angle Orthod. 2019;89(3):372-377.
42. Sunil CR, Sujana V, Choudary TM, Nagesh B. In vitro action of various carbamide peroxide gel bleaching agents on the micro hardness of human enamel. Contemp Clin Dent. 2012;3(2):193-196.
43. Attin T, Kielbassa AM, Schwanenberg M, Hellwig E. Effect of fluoride treatment on remineralization of bleached enamel. J Oral Rehabil. 1997;24(4):282-286.
44. Donly KJ. The adolescent patient: Special whitening challenges. Compendium of continuing education in dentistry (Jamesburg, NJ : 1995). Compend Contin Educ Dent. 2003;24(4a):390-396.
45. 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(5):553-560.
46. 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(3):251-259.
47. Fekrazad R, Ebrahimpour L. Evaluation of acquired acid resistance of enamel surrounding orthodontic brackets irradiated by laser and fluoride application. Lasers Med Sci. 2014;29(6):1793-1798.
48. Freitas PM, Soares-Geraldo D, Biella-Silva AC, Silva AV, Silveira BL, Eduardo CP. İntrapupal temperature variation during Er, Cr: YSGG enamel irradiation on carries prevention. J Appl Oral Sci. 2008;16(2):95-99.
49. Raucci-Neto W, de Castro-Raucci LMS, Lepri CP, Faraoni-Romano JJ, da Silva JMG, Palma-Dibb RG. Nd: YAG laser in occlusal caries prevention of primary teeth: A randomized clinical trial. Lasers Med Sci. 2015;30(2):761-768.
50. Valério R, Rocha C, Galo R, Borsatto M, Saraiva MCP, Corona SAM. CO2 laser and topical fluoride therapy in the control of caries lesions on demineralized primary enamel. Sci World J. 2015;2015:547569.
51. Yazicioğlu O, Ulukapi H. The investigation of non- invasive techniques for treating early approximal carious lesions: An in vivo study. Int Dent J. 2014;64(1):1-11.
52. Wallace A, Deery C. Management of opacities in children and adolescents. Dent Update. 2015;42(10):951-958.
53. Jo S-Y, Chong H-J, Lee E-H, et al. Effects of various toothpastes on remineralization of white spot lesions. Korean J Orthod. 2014;44(3):113-118.
54. Paris S, Meyer-Lueckel H, Cölfen H, Kielbassa A. Penetration coefficients of commercially available and experimental composites intended to infiltrate enamel carious lesions. Dent Mater. 2007;23(6):742-748.
55. Meyer-Lueckel H, Paris S. Progression of artificial enamel caries lesions after infiltration with experimental light curing resins. Caries Res. 2008;42(2):117-124.
56. Paris S, Meyer-Lueckel H, Kielbassa AM. Resin infiltration of natural caries lesions. J Dent Res. 2007;86(7):662-666.
57. Liu G, Yang L, Gao L, et al. Durability of infiltrated resin application on white spot lesions after different challenges: An ex vivo study. J Prosthet Dent. 2024;131(3):500-507
58. Al-Mamoori RMH, Al Haidar AHM. Effect of resin infiltration and microabrasion on the microhardness of the artificial white spot lesions (An in vitro study). J Bagh Coll Dent. 2022;34(1):44-50.
59. Araújo G, Naufel F, Alonso R, Lima D, Puppin-Rontani RM. Influence of staining solution and bleaching on color stability of resin used for caries infiltration. Oper Dent. 2015;40(6):250-256.