Prevelance of white spot lesions and caries during the orthodontic treatment

Öz

Objective: To investigate the incidence of white spot lesions (WSL) and caries prevelance in patients treated with fixed orthodontic appliances. Material and Methods: A total of 63 individuals were divided into two groups: Study (n:31) Control(n:32). In the study group,patient were treated with fixed orthodontic appliances. The oral hygiene care therapy was provided to these patients before orthodontic treatment and at each control appointments.The patients were also required to use high flouride toothpaste and flouride mouth washes.On the other hand, the control group patients,did not receive any orthodontic appliances and oral hygiene therapy.Caries prevalence was detected by DMFT index,while WSL was scored by Gorelick index.The measurements of WSL and caries by these indexes were done 1 day before the start of orthodontic treatment (T0) and at the end of the orthodontic treatment(T1).The data was statistically analyzed byWilcoxon Signed Ranks, Mann-Whitney tests and the statistical significance was defined as p<0,05. Results:The patients in the study group who received hygiene care therapy and used topical fluorides were found to have less WSL and DMFT score than that of control patients.(p<0,05) In the control group, the prevalence of patients who developed at least WSL was %11.1 , whereas at the end of experiment ,it was % 25,4. Number of WSL and DMFT score did not differ significantly between T0 and T1 for the study group(p>0,05). Conclusion:The present study showed that oral hygiene care is most important factor in the development of WSL and caries. Thus, preventive programmes should be emphesized to all orthodontic patients. The responsibility of an orthodontist is to minimize the risk of the patient having decalcification as a consequence of orthodontic treatment by educating and motivating the patients for excellent oral hygiene practice . Key words: DMFT, white spot lesion,orthodontic treatment

Anahtar Kelimeler

• -

Ortodontik Tedavi Sırasında Beyaz Nokta Lezyonları ve Çürüklerin Görülme Prevelansı

Öz

Amaç: Sabit ortodontik tedavi gören hastalarda çürük ve beyaz nokta lezyon prevelansını araştırmaktır. Gereç ve Yöntemler: Toplam 63 kişi iki gruba ayrıldı: Çalışma (n: 31) Kontrol (n: 32). Çalışma grubunda hastalar, sabit ortodontik apareylerle tedavi edildi.Bu hastalara ortodontik tedavi öncesi ve her kontrol muayenesinde ağız hijyen bakım terapisi verildi.Hastalara aynı zamanda yüksek florlu diş macunu ve ağız gargaraları kullanmaları sağlandı.Diğer taraftan,kontrol grubu hastalarına,ortodontik aparey ve ağız bakım hijyeni uygulanmadı.Çürük indeks prevelansı DMFT ile saptanırken, beyaz nokta lezyon Gorelick indeksi ile tespit edildi.İndekslerle yapılan BNL ve çürük ölçümleri ortodontik tedavi başlamadan bir gün öncesi (T0) ve ortodontik tedavi sonrası (T1)uygulandı.Veriler Wilcoxon Signed Ranks, Mann-Whitney testleri ile analiz edildi. İstatistiksel anlamlılık P< 0.05 olarak tanımlandı. Sonuç:Ağız bakım eğitimi ve topikal flor kullanılan çalışma grubundaki hastalarda BNL ve DMFT değerleri kontrol grubu hastalara göre daha düşük olarak bulundu.(p<0,05) Kontrol grubunda, hastaların en düşük BNL prevelansı %11.1iken, tedavi sonunda, bu de/ğer % 25,4dür.Çalışma grubunda, BNL ve DMFT değerlerinde T0 ve T1 arasında anlamlı bir farklılık yoktur.(p>0,05) Bu çalışma oral hijyen bakımının, BNL ve çürük gelişiminde en önemli faktör olduğunu göstermiştir.Böylece, önleyici programlar tüm ortodonti hastalarında vurgulanmalıdır. Bir ortodontistin sorumluluğu, mükemmel ağız bakım için hastaları motive ederek ve eğiterek ortodontik tedavinin bir sonucu olan dekalsifikasyonlu hasta riskini minimize etmektir. Anahtar Kelimeler: DMFT, beyaz nokta lezyon,orthodontik tedavi

Anahtar Kelimeler

• DMFT, Beyaz Nokta Lezyon

Kaynakça

1. Balensefien JW, Madonia JV. Study of dental plaque in orthodontic patients. J Dent Res 1970;49:320-324.
2. Bishara SE, Ostby AW. White spot lesions: formation, prevention, and treatment. Semin Orthod 2008;14:174-182.
3. Staley RN. Effect of fluoride varnish on demineralization around orthodontic brackets. Sem Orthod 2008;14(3):194- 199.
4. Boersma J G, Van der Veen M H, Lagerweij M D, Bokhout B, Prahl-Andersen B. Caries prevalence measured with QLF after treatment with fixed orthodontic appliances: influencing factors. Caries Research 2005;39:41-47.
5. Summitt JB, Robbins JW, Schwartz RS. Fundamentals of Operative Dentistry: A Contemporary Approach, 3rd ed. Hanover Park, IL, Quintessence Publishing, Chapter 1, 2006; 2-4.
6. Abe M. Microflora around the bracket by direct bonding system. Nichidai-Koko-Kagaku 1990;16:429-440.
7. Gorelick L, Geiger AM, Gwinnet AJ. Incidence of white spot formation after bonding and banding. Am J Orthod 1982;81:93-98.
8. Øgaard B. Prevalence of white spot lesions in 19-year olds: a study on untreated and orthodontically treated persons 5 years after treatment. Am J Orthod Dentofacial Orthop 1989; 96:423-427.

9. Richter AE, Arruda AO, Peters MC, Sohn W. Incidence of caries lesions among patients treated with comprehensive orthodontics. Am J Orthod Dentofacial Orthop 2011;139:657- 664.
10. Hadler-Olsen S, Sandvik K, El-Agroudi MA, Øgaard B. The incidence of caries and white spot lesions in orthodontically treated adolescents with a comprehensive caries prophylactic regimen-a prospective study. Eur J Orthod 2012;34:633-639.
11. Mizrahi E. Enamel demineralization following orthodontic treatment. Am J Orthod 1982;82:62- 67.
12. Akin M, Tezcan M, Ileri Z, Basciftci FA. Incidence of white spot lesion during fixed orthodontic treatment. Turkish J Orthod 2013;26:98–102.
13. Chatterjee R, Kleinberg I. Effect of orthodontic band placement on the chemical composition of human incisor tooth plaque. Arch Oral Biol 1979;100:24-97.
14. Bloom RH, Brown LR. A study of the effects of orthodontic appliances on the oral microbial flora. Oral Surg 1964;17:658- 667.
15. Zachrisson BU, Zachrisson S. Caries incidence and oral hygiene during orthodontic treatment. Scand J Dent Res 1971;79:394-401.
16. Willmot DR, Brook AH. The incidence of post-orthodontic demineralized enamel lesions in an orthodontic clinic. J Dent Res 1999;78:1049.
17. Zimmer BW, Rottwinkel Y. Assessing paitent-specific decalcification risk in fixed orthodontic treatment and its impact on prophylactic procedures. Am J Orthod Dentofac Orthop 2004;126:318-324.
18. Ogaard B, Rezk-Lega F, Ruben J, Arends J. Cariostatic effect and fluoride release from a visible light-curing adhesive for bonding of orthodontic brackets. Am J Orthod 1992;101:303-307.
19. Şengün A, Sarı Z, Ramoğlu SI, Malkoç S, Duran I. Evaluation of the dental plaque pH recovery effect of a xylitol lozenge on patients with fixed orthodontic appliances. Angle Orthod 2004;74:240-244.
20. Pascotto RC, Navarro MF, Capelozza FL, Cury JA. In vivo effect of a resin-modified glass ionomer cement on enamel demineralization around orthodontic brackets. Am J Orthod 2004;125:36-41.
21. Derks A, Katsaros C, Frencken JE, van’t Hof MA, Kujipers- Jagtman AM. Caries- Inhibiting Effect of Preventive Measures during Orthodontic Treatment with Fixed Appliances, Caries Res 2004;38:413-420.
22. Marini I, Peeliccioni GA, Vecchiet F, Alessandri Bonetti G, Checci L. A retentive system for intra-oral fluoride release during orthodontic treatment. European Journal of Orthodontics 1999:21:695-701.
23. Altenburger MJ, Schirrmeister JF, Wrbas KT, Hellwig E. Remineralization of artificial interproximal carious lesions using a fluoride mouthrinse. Am J Dent 2007;20(6):385-399.
24. Øgaard B, Rolla G, Arends J, ten Cate JM. Orthodontic appliances and enamel demineralization. Part 2. Prevention and treatment of lesions. Am J Orthod Dentofacial Orthop 1988;94:123-128.
25. O’Reilly MM, Featherstone JDB. Demineralization and remineralization around orthodontic appliances: an in vivo study. Am J Orthod 1987;92:33–40.
26. Geiger AM, Gorelick L, Gwinnett AJ, Benson BJ. Reducing white spot lesions in orthodontic populations with fluoride rinsing. Am J Orthod Dentofacial Orthop 1992;101:403-407.
27. Gorton J, Featherstone JDB. In vivo inhibition of demineralization around orthodontic brackets. Am J Orthod Dentofacial Orthop 2003;123:10-14.
28. Sonis AL, Snell W. An evaluation of a fluoride-releasing, visible light-activated bonding system for orthodontic bracket placement. Am J Orthod Dentofacial Orthop 1989; 95: 306– 311.
29. Banks PA, Chadwick SM, Asher-McDade C, Wright JL. Fluoride-releasing elastomerics–a prospective controlled clinical trial. Eur J Orthod 2000;22:401–407.
30. Sadeq A, Risk JM, Pender N , Higham SM, Valappil SP. Evaluation of the co-existence of the red fluorescent plaque bacteria P.gingivalis with S. gordonii and S. mutans in white spot lesion formation during orthodontic treatment. Photodiagnosis Photodyn Ther. 2015 Mar 23. pii: S1572- 1000(15)00028-9. doi: 10.1016/j.pdpdt.2015.03.001. [Epub ahead of print]
31. James JW, Miller BH, English JD, Tadlock LP, Buschang PH. Effects of high speed curing devices on shear bond strength and microleakage of orthodontic brackets. Am J Orthod Dentofacial Orthop 2003;123:555–561.
32. Bas-Kalkan A, Orhan M, Üsümez S. Minenin farklı içerikli asitler ile pürüzlendirilmesinin braket tutuculuğuna etkisi. Türk Ortodonti Dergisi 2007;1:35-42.
33. Arıkan S, Arhun N, Arman A, Cehreli SB. Microleakage beneath Ceramic and Metal Brackets Photopolymerized with LED or Conventional Light Curing Units. Angle Orthod 2006;76:1035-1040.
34. Murray JJ. The prevention of dental disease. Oxford University Pres, United States, 2th Edition, 1989.
35. Heymann GC, Grauer D. A contemporary review of white spot lesions in orthodontics. J Esthet Restor Dent. 2013 Apr;25(2):85-95. doi: 10.1111/jerd.12013. Epub 2013 Feb 19. 36. Greene LE, Bearn DR. Reducing white spot lesion incidence during fixed appliance therapy. Dent Update. 2013 Jul-Aug;40(6):487-90.
36. Chang HS, Walsh LJ, Freer TJ. Enamel demineralization during orthodontic treatment. Aetiology and treatment. Aust Dent J 1997;42:322-327.
37. Vorhies AB, Donly KJ, Staley RN, Wefel JS. Enamel demineralization adjacent to orthodontic brackets bonded with hybrid glass ionomer cements: an in vitro study. Am J Orthod 1998;114:668-674.
38. Meyers MJ. Protection of enamel under orthodontic bands. Am J Orthod 1952;38:866-874.
39. Mizrahi E. Surface distribution of enamel opacities following orthodontic treatment. Am J Orthod 1983;84:323- 331.
40. Newburn E. Cariology. 3rd edn. Chicago: Quintessence, 1989:29-61.
41. Morrier JJ. White spot lesions and orthodontic treatment. Prevention and treatment. Orthod Fr. 2014 Sep;85(3):235-44. doi: 10.1051/orthodfr/2014016. Epub 2014 Aug 28.
42. Fejerskov O. Changing paradigms in concepts on dental caries: Consequences for oral health care. Caries Res 2004; 38:182-191.
43. Berlin-Broner Y, Levin L, Ashkenazi M. Awareness of orthodontists regarding oral hygiene performance during active orthodontic treatment. Eur J Paediatr Dent. 2012 Sep;13(3):187-91.
44. Artun J, Thylstrup A. A clinical and scanning electron microscopic study of surface changes of incipient caries lesions after debonding. Scand J Dent Res 1968;94:193-201.
45. Maxfield BJ, Hamdan AM, Tüfekçi E, Shroff B, Best AM, Lindauer SJ. Development of white spot lesions during orthodontic treatment: perceptions of patients, parents, orthodontists, and general dentists. Am J Orthod Dentofacial Orthop. 2012 Mar;141(3):337-44.
46. Hamdan AM, Maxfield BJ, Tüfekçi E, Shroff B, Lindauer SJ. Preventing and treating white-spot lesions associated with orthodontic treatment: a survey of general dentists and orthodontists. J Am Dent Assoc. 2012 Jul;143(7):777-83.
47. Weerheijm KL, Groen HJ, Bast AJ, Kieft JA, Eijkman MA, van Amerongen WE. Clinically undetected occlusal dentine caries: a radiographic comparison. Caries Res 1992; 26:305-309.