Abstract
This retrospective pilot study used a newly developed evaluation tool to assess the prevalence and incidence of White Spot Lesions (WSL) before and after multibracket appliance (MB) therapy. Digital photographs of 121 adolescent patients (63 ♂, 58 ♀) with metal brackets were analyzed retrospectively before and after MB therapy. The labial surfaces of anterior teeth, canine teeth, and premolars in the upper (UJ) and lower jaws (LJ) were evaluated using the Enamel Decalcification Index (EDI) by Banks and Richmond (Eur J Orthod, 16(1):19–25, 1994, levels 0–3) and a specially developed digitally scaled graticule with concentric circles to quantify the extent of WSL (in %). The statistical data analysis was based on crosstabulations and logistic regression. Before MB, 69.4% of the patients presented at least one WSL and 97.5% after, an increase of 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. 18.2% of the TS showed a WSL to the extent of ≥ 20–100% before and 52.3% after MB. The incidence in the UJ (71–79%) as well as the LJ (64–76%) was highest for the first and second premolars and lowest for LJ incisors (22–35%). The probability for developing a new distal WSL is higher than developing gingival, mesial or occlusal WSL. Labial MB therapy drastically increases the risk of developing WSL. We verified a concise quantification of the extent of labial WSL with the evaluation index.
Highlights
This retrospective pilot study used a newly developed evaluation tool to assess the prevalence and incidence of White Spot Lesions (WSL) before and after multibracket appliance (MB) therapy
We examined the medical records of all patients who had been treated with MB appliances in the upper jaw (UJ) and lower jaw (LJ) and had completed their treatment within the last 10 years
The intra-rater reliability of evaluating the digital photographs resulted in an Intraclass Correlation Coefficient (ICC) of 0.99 for the Enamel Decalcification Index (EDI) index and of 0.96 for the evaluation index
Summary
This retrospective pilot study used a newly developed evaluation tool to assess the prevalence and incidence of White Spot Lesions (WSL) before and after multibracket appliance (MB) therapy. Abbreviations WSL White spot lesions MB Multibracket appliance EDI Enamel decalcification index UJ Upper LJ Lower jaws TS Tooth surfaces QLF Quantitative light-induced fluorescence g Gingival m Mesial d Distal o Occlusal ICC Intraclass correlation coefficient. The literature specifies that occurrence of WSL is common during fixed orthodontic treatment with an incidence and prevalence rate of 45.8% and 68.4%, r espectively[8]. This large variation is due to differences with respect to Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany. The use of topical fluorides can significantly reduce the risk of W SL15 when applied locally in various forms to reduce demineralization processes and stimulate r emineralization[16,17]
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