Abstract
One common negative side effect of orthodontic treatment with fixed appliances is the development of white spot lesions (WSLs) around brackets. This study is aimed at comparing the efficacy of various oral hygiene practices in preventing enamel demineralization around orthodontic brackets under similar in vitro conditions. The study included 90 extracted bovine incisors, which were randomized into six groups: fluoride toothpaste (FT), nonfluoride toothpaste (NFT), fluoride varnish plus fluoride toothpaste (FV+FT), CPP-ACP varnish plus fluoride toothpaste (CPP-ACP+FT), medical minerals gel plus nonfluoride toothpaste (MMG+NFT), and no intervention (control). All groups were subjected to demineralization and remineralization cycles. Visual appraisals were used to evaluate the changes in the enamel surface appearance at the beginning and end of the experiment. The changes in the demineralization degree were evaluated by measuring the Ca+2 concentration in the demineralization solution at different time points. The majority of teeth in the CPP-ACP+FT group exhibited no shift in appearance, whereas in the other groups, a slight change in enamel translucency was observed. At all the time points, the Ca+2 concentration in the demineralization solution in the CPP-ACP+FT group was the least among all other groups. At day 5, MMG+NFT's preventive efficacy was significantly higher than FV+FT's, but at days 10, 15, and 19, their efficacy was similar. However, at all the time points, MMG+NFT's efficacy was significantly higher than that of control, whereas FV+FT's efficacy was decreased at days 10, 15, and 19 and was close to the efficacy of control. To fight WSLs, early diagnosis was of great importance and examination of the tooth surface after air-drying for 5 s was recommended.
Highlights
One of the most common negative side effects of fixed orthodontic treatment is the development of incipient caries lesions [1]
Studies have shown that while it takes at least 6 months for caries to develop in a patient not submitted to orthodontic treatment, it takes around 1 month [2, 3] to develop in an orthodontic patient because of the difficulty these patients have with performing oral hygiene [4]
If this study finds that medical minerals gel is effective in prevention, this gel may possibly be added to the list of advised products that can be used to reduce demineralization and the occurrence of white spot lesions (WSLs) during orthodontic treatment
Summary
One of the most common negative side effects of fixed orthodontic treatment is the development of incipient caries lesions [1]. Studies have shown that while it takes at least 6 months for caries to develop in a patient not submitted to orthodontic treatment, it takes around 1 month [2, 3] to develop in an orthodontic patient because of the difficulty these patients have with performing oral hygiene [4]. This information shows the rapid progression of this disease and the need for continual follow-up of these patients [2]. Investigations have put the incidence of white spot lesion (WSL) during orthodontic treatment with fixed appliances at 73% to 95% [5, 6]
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