Presence Of White Spot Lesions Research Articles

Efficacy of F-ACP-Containing Dental Mousse in the Remineralization of White Spot Lesions after Fixed Orthodontic Therapy: A Randomized Clinical Trial.

Fixed appliance (FA) therapy predisposes patients to white spot lesions (WSLs). The F-ACP complex (amorphous calcium phosphate nanoparticles enriched with carbonate and fluorine and coated with citrate) has been effective for in vitro enamel remineralization. The aim of this study was to evaluate the efficacy of the F-ACP complex in remineralizing WSLs after FA therapy. One hundred and six adolescents (aged 12-20 years) were randomized into study and control groups after FA therapy. Patients in the study group were advised to use dental mousse containing F-ACP applied within Essix retainers for six months. The presence of WSLs was recorded at baseline (T0), 3 months (T1), and 6 months (T2) according to the International Caries Detection and Assessment System (ICDAS). Visual Plaque Index (VPI) and Gingival Bleeding Index (GBI) were recorded. Among 106 study participants, 91 (52 and 39 in study and control groups, respectively) completed the study. The results showed that the ICDAS score was significantly lower (p < 0.001) in the study group than in the control group between T0 and T2. The application of mousse containing the F-ACP complex inside Essix retainers for six months is effective in remineralizing white spot lesions in patients after FA therapy without side effects.

Biofilm and clinical data between volunteers with self-ligating and conventional brackets: an observational study

Introduction: Fixed orthodontic appliances can lead to enamel demineralization and gingival changes due to increased biofilm. Aim: To detect the presence of Prevotella intermedia, Tannerella forsythia, Streptococcus mutans, Scardovia wiggsiae, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Porphyromonas gingivalis in oral biofilm and presence of white spot lesions and gingivitis in users of self-ligating and conventional brackets. Design: This observational controlled study was conducted from January to December 2020. The participants used fixed orthodontic therapy for 6 months and were divided into a conventional and a self-ligating bracket group. The participants underwent clinical examination, and biofilm samples were collected from their lower incisors. Results: No differences were found in the bacteria detection between the groups (p&gt;0.05). However, white spot lesions were more common in users of self-ligating brackets (p=0.019). There was no association between clinical data and the detection of any microorganism (p&gt;0.05). The fluorescence intensity of A. actinomycetemcomitans was higher in self ligating brackets than in conventional brackets (p&lt;0.05). Implications: The microbial diversit did not differ between the types of brackets; however, the presence of white spot lesions and the amount of A. actinomycetemcomitans were higher in patients with self-ligating brackets.

Incidence, severity, and risk factors for white spot lesions in adolescent patients treated with clear aligners.

This study was aimed to clarify the incidence, severity, and clinical risk factors for white spot lesions (WSLs) in adolescent patients treated with clear aligners. Pre-treatment and post-treatment intraoral photographs of 203 adolescent patients undergoing clear aligner therapy were retrospectively evaluated to assess the occurrence and severity of WSLs. Information on patients' general oral condition and orthodontic treatment was collected from clinical medical documents, retrospective questionnaires, and ClinCheck® software. Independent risk factors and model performance were determined by multivariate logistic regression and receiver operating characteristic curve analysis. Thirty-five percent of adolescent patients developed WSLs during clear aligner treatment. Logistic regression analysis revealed that the presence of WSLs before treatment (OR 2.484, 95% CI 1.245-4.957), frequency of drinking carbonated beverages (OR 1.508, 95% CI 1.045-2.177), and number of anterior attachments (OR 2.192, 95% CI 1.502-3.198) were risk factors for the occurrence of WSLs in adolescent patients treated with clear aligners (P < .05), whereas the number of times they brushed each day (OR 0.656, 95% CI 0.454-0.947) and frequency of aligner cleaning after eating while wearing them (OR 0.611, 95% CI 0.433-0.861) were protective factors against WSLs (P < .05). The incidence of WSLs was high in adolescent patients treated with clear aligners. Few brushings each day, pre-treatment WSLs, a high frequency of drinking carbonated beverages, a low frequency of aligner cleaning after eating while wearing them, and a high number of anterior attachments are strongly associated with the development of WSLs in adolescent patients treated with clear aligners.

What’s new for the clinician – summaries of recently published papers (June 2023)

There has been a huge increase in the number of adolescents and young adults on fixed orthodontic treatment for periods longer than 1 year. Often the desired outcome of having a perfectly aligned set of teeth has been marred by the significant increase in the presence of white spot lesions (WSLs). These lesions are commonly observed on the labial surfaces of the maxillary incisors adjacent to the brackets, thus jeopardising the final aesthetic result of the treatment and having limited chances of improvement even after the orthodontic appliances are removed.1 The incidence and prevalence of WSLs during multibracketed fixed orthodontic treatment are relatively high with a wide range, and the problem is quite alarming for the orthodontists and patients.1 Patients with multibracketed fixed orthodontic appliances have been considered to be at moderate to high risk for caries and various preventive strategies have been examined to prevent the development of WSLs, among which topical fluorides have been studied widely and found to be efficacious in reducing the incidence of WSLs around the brackets.1 Among the various forms of topical fluorides studied, varnishes are deemed critical for preventing the WSL formation. The efficacy of topical fluoride varnishes has been established through multiple systematic reviews1 with a preventive fraction of about 43% and 37% in permanent and primary dentitions respectively, compared with that in the placebo or no treatment.

In-vitro effect of a single application of CPP-ACP pastes and different fluoridated solutions on the prevention of dental caries around orthodontic brackets.

To assess the in-vitro effect of single applications of CPP-ACP pastes and different fluoridated solutions on the prevention of dental caries around orthodontic brackets. Tooth/bracket sets (n=65) were immersed in artificial saliva (1h at 37ºC) and randomly subjected to single applications (100µL; 1min) of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP emulsion), CPP-ACP with fluoride (CPP-ACPF emulsion), solutions of titanium tetrafluoride (TiF4) or sodium fluoride (NaF), or no treatment (CG). Multispecies biofilm (5 x 105 CFU/mL) was formed in the presence of 2% sucrose. After 24 h, the pH and the concentration of total soluble fluoride (TSF) were analyzed by culture medium. The presence of active white spot lesions (WSL) evaluated by macroscopic examination and the percent surface mineral loss (%SML) were analyzed. Also, the topography of enamel was detected by analysis of scanning electron microscopy (SEM). The data was assessed by chi-square, Kruskal-Wallis, and Mann-Whitney tests (p < 0.05). Fluoride-containing compounds led to a smaller pH reduction than did CPP-ACP and CG (p<0.05). There was difference in TSF between the groups (p<0.05), denoted as TiF4> NaF > CPP-ACPF > CPP-ACP > CG. Regarding the presence of WSL and %SML, the NaF group obtained lower values (p<0.05), while TiF4 and CPP-ACPF were similar (p>0.05). SEM demonstrated that fluoride-free groups had a larger surface dissolution. Fluoridated groups including solutions and CPP-ACPF were more effective than CPP-ACP in reducing enamel demineralization around orthodontic brackets after a single application.

Prevalence of White Spot Lesions in Patients Treated with Passive Selfligation Orthodontic Appliances: A Retrospective Study

Introduction: White Spot Lesions (WSLs), also known as “white opacity,” are the result of the demineralisation occurring on tooth surfaces in patients undergoing fixed orthodontic treatment. In addition to the various other factors, development of WSLs can also be influenced by the type of brackets and ligation employed. Aim: Evaluating the prevalence of WSL among patients who underwent fixed orthodontic treatment with passive self-ligation mechanotherapy. Materials and Methods: This retrospective study was conducted using photographic records of patients who received orthodontic treatment using a passive self-ligation system at Saveetha Dental College in Chennai, Tamil Nadu, India. The records of 97 patients in the age range of 10 to 30 years who received orthodontic treatment using the Damon self-ligating system regardless of gender were obtained from April 2016 to April 2021. The presence of WSL was investigated retrospectively before and after treatment. Modified Gorelick’s scale was used for scoring the lesions. Statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) software version 17.0 and paired t-tests were done. Results: Data of total of 97 subjects (45 females (46.39%) and 52 males (54.63%), mean age: 17.70±5.72 years) undergoing orthodontic treatment with self-ligation brackets was included in the study. The overall prevalence percent of WSLs in the study was 71.13%. The prevalence of WSLs among females was 70.5% and in males, it was 73%. There was no statistical significance for association between gender and severity of WSLs and there was a statistical significance for association of age group and severity of WSLs in upper lateral incisors and canines (p&lt;0.05). Conclusion: The most commonly involved teeth were upper central incisors and second premolars, and the overall WSLs incidence in subjects undergoing passive self-ligation therapy was 71.9 %. No influence of the gender was noted and severe lesions were commonly noted in maxillary lateral incisors of young individuals.

DENTAL CARIES MANAGEMENT IN YOUNG CHILDREN WITH INTERIM THERAPEUTIC RESTORATION

Caries are the most common case in every individual, including children who are still at an early age. Caries in primary teeth can occur in the early period of tooth eruption, which begins with the presence of white spot lesions. Dental caries are known as Early Childhood Caries (ECC) at an early age. ECC is used for caries in primary teeth up to 71 months. Many factors trigger the occurrence of ECC. Early treatment is very important to prevent comprehensive damage. Usually, the operator will face conditions that are not conducive to treatment. Young children generally will behave uncooperatively, have very high mobility, cry, and have difficulty opening their mouths, so it will be difficult for the operator to give treatment. One of the most therapy is dental restoration. The treatment approach will depend on the severity of the case; treatment can be in the form of non-operative therapy, dental restoration, or the last stage extraction if the teeth cannot be maintained. This case report will discuss the treatment of primary tooth cavity lesions without pulp involvement in young children through Interim therapeutic Restoration (ITR) and strategies that need to be implemented to support the success of treatment and prevent the damage from worsening. The result showed that ITR wa successfully performed in young children with cooperative behavior to prevent more extensive tooth decay.

Effectiveness of a Selective Etching Technique in Reducing White Spots Formation around Lingual Brackets: A Prospective Cohort Clinical Study

The risk of developing white spot lesions (WSLs) after orthodontic treatment with lingual brackets is generally considered lower than with labial ones, even if plaque accumulation is frequently higher due to the increased difficulty level in oral hygiene maintenance. In this prospective clinical study, selective enamel etching technique effectiveness in reducing plaque accumulation and WSLs was tested. Thirty patients were bonded with a split-mouth approach: two randomly selected opposite quadrants were used as the test sides, using customized plastic etching guides, and the other two as control sides, applying traditional direct etching methods. The plaque presence around the braces was recorded after 1, 3, 6, and 12 months according to a lingual plaque accumulation index (LPAI), as was the presence of WSLs. PAI measured values were significantly higher in the control sides during the observation period. Test and control sides differed significantly for new WSL onset only after 12 months of treatment. Therefore, the present research demonstrated that this guided enamel etching technique allowed for significant reduction in plaque accumulation around the lingual brackets and reduced onset of white spots after one year of treatment.

Efficacy of CO lasers in preventing dental caries in partially erupted first permanent molars: a randomized 18-month clinical trial.

The aim of this controlled randomized double-blinded clinical trial was to evaluate the use of a CO2 laser with or without topical application of acidulated fluorides in the prevention of dental caries in partially erupted first permanent molars. We selected 61 healthy children at high risk of caries, all between 6 and 8 (7.1 ± 0.8) years of age and with 4 partially erupted first permanent molars. A CO2 laser device emitting at 10.6μm was used (0.5W, 0.05mJ per pulse, 10kHz). Each first molar in an individual was randomly assigned to one treatment: (L) CO2 laser (0.066J/cm2); (FL) 1.23% acidulated fluoride gel and CO2 laser (0.066J/cm2); (V) 5% fluoride varnish, or (S) sealant (control). Patients were followed-up at 3, 6, 12, and 18months after treatment, through direct visual examination and by an operator blinded to the treatments (kappa ≥ 0.70). The International Caries Detection and Assessment System (ICDAS-II) index was used to assess the soundness of tooth structure or the presence of white spot lesions, cavitated enamel, and/or dentin lesions. The Yildiz Visual Index was used to evaluate sealant retention. Results were evaluated using Kaplan-Meier survival analysis, and the hazard ratio of the treatments was estimated using shared frailty models with a gamma distribution, which considered the patient as a cluster. There were no significant differences among treatments compared to sealants. After 18months, the use of a CO2 laser with or without acidulated fluorides was shown to be effective in preventing caries on the occlusal surface of partially erupted permanent first molars in children at high risk for caries.

Role of taste perception in white spot lesion formation during orthodontic treatment.

To investigate the role of individual's taste sensitivity using 6-n-propylthiouracil (PROP) in the development of white spot lesions (WSLs) in adolescent orthodontic patients. 44 healthy adolescents, aged 12 to 16 years old, who were in fixed-appliance orthodontic treatment for at least 6 months, consented to participate in this cross-sectional study. Data regarding participants' demographic information, oral hygiene practices, and dietary habits were obtained by a questionnaire. An oral clinical examination was performed to determine the oral hygiene status, the presence of WSLs and dental caries experience. The taste phenotype of the participants was evaluated through PROP test and they were accordingly divided into PROP nontasters and PROP tasters. The sample consisted of 24 subjects in the WSL group and 20 subjects in the WSL-free group. The WSL group demonstrated higher mean plaque score (48.2), mean decayed, missing, and filled surfaces (2.38), and mean decayed, missing, and filled teeth (1.96) scores compared to the WSL-free group (38.7, 0.85, and 0.55, respectively), but no significant differences were found. Most subjects in the WSL group were PROP nontasters (66.6%) whereas most subjects in the WSL-free group were PROP tasters (75%); a significant difference was observed between the groups (P = .006). The prevalence of white spot lesions was significantly higher in adolescent orthodontic patients who were PROP nontasters compared to PROP tasters. A PROP taste perception could be a potential risk factor for the formation of WSLs during fixed orthodontic treatment that warrants further attention.

Effect of TiF4 varnish on microbiological changes and caries prevention: in situ and in vivo models.

The aim of this study was to evaluate microbiological changes, oral soft tissue toxicity, and caries-preventive effect of an experimental titanium tetrafluoride (TiF4) varnish compared with a commercially available fluoride varnish (NaF), using in situ and in vivo models. The treatment groups were the following: TiF4 varnish (experimental varnish), Duraphat® (fluoride positive control), placebo varnish (no fluoride), and no treatment (negative control). The varnishes were applied once over the enamel surface using a microbrush. For the in vivo study, 48 Wistar rats were infected with Streptococcus sobrinus 6715, received a treatment, and were submitted to a cariogenic challenge. After 4weeks, S. sobrinus, oral soft tissue toxicity, presence, and severity of caries were evaluated. For the in situ study, 12 volunteers took part in this randomized crossover, double-blind study performed in four phases of 14days each. They used intraoral appliances containing four enamel specimens that received the varnish according treatment group. After 24h, the varnish was removed and plaque accumulation was allowed. A 20% sucrose solution was dripped over the enamel blocks (10×/day for 5min each). Total streptococci, S. mutans, Lactobacillus, Candida spp. counts, and presence of white spot lesions were evaluated. Lesion depth was also quantified by micro-CT. For the in vivo study, the fluoride (F-varnishes) showed a statistically significant reduction in the percentage of S. sobrinus compared to the negative control (p < 0.05). Toxicological analysis revealed no abnormalities in oral tissues of rats from all groups, and both F-varnishes reduced the number and severity of caries lesions, without significant differences (p < 0.05). No statistical differences in microbiological counts were seen for the in situ experiment (p > 0.05). However, the specimens treated with TiF4 exhibited lower percentage of white spot lesions and the lesion depth was significantly reduced by F-varnishes (p < 0.05). F-varnishes showed reduction in the percentage of S. sobrinus in vivo, no oral soft tissue toxicity, and a caries-preventive effect in vivo and in situ. NaF varnish is largely used due its capacity to form CaF2-like layer on enamel. Therefore, development of studies focused on other fluoride compounds such as a TiF4 varnish, which may have greater efficacy than NaF against tooth demineralization, is important.

Enamel defects during orthodontic treatment

Background/Aim: Orthodontic treatment has an inherent potential for causing defects to enamel in the course of bonding and debonding procedures, interproximal enamel stripping and induce the presence of white spot lesions, enamel discoloration or wear. The aim of this study is to present the stages of orthodontic therapy associated with potential damage to enamel and list the enamel alterations observed in each stage. Material and Methods: A literature search was carried out in MEDLINEPubMed database for papers published up to and including February 2015. Results: Enamel loss is induced by cleaning with abrasives before etching, the acid etching process itself, forcibly removing brackets, and mechanical removal of composite remnants with rotary instruments. Loss of enamel or topographic changes in the form of cracks, scarring and scratches may occur. Clinicians may cause structural damage of enamel by interproximal enamel stripping. Additionally, the enamel surface may become demineralized due to plaque accumulation around the orthodontic attachments. Additional complications are enamel color alterations due to its microstructural modifications or discoloration of adhesive remnants and enamel wear due to contact with the brackets of the opposing teeth. Conclusions: Therapeutic procedures performed in the course of orthodontic treatment may cause irreversible physical damage to the outermost enamel. To avoid this, the orthodontic practitioner should take great care in every stage of the treatment and manage the enamel surface conservatively. Moreover, patients should follow an effective oral hygiene regimen. Given these conditions enamel damage during orthodontic therapy is eliminated and longevity of the dentition is promoted.

Evaluation of the anti-cariogenic potential and bond strength to enamel of different fluoridated materials used for bracket bonding

Abstract Objective To evaluate the in vitro and in situ anti-cariogenic potential and bond strength to enamel of materials containing fluoride (F), used for bracket bonding: Transbond XT (GT, negative control), Transbond Plus Color Change (GTF), Transbond-Self-Etching Primer (GSAF) and Vitremer (GV, positive control). Material and method In the in vitro study, the specimens were premolars with bonded brackets (n=12/group). After pH cycling, the F release, bond strength, fracture mode and presence of white spot lesions were assessed. In the in situ study, the specimens were enamel fragments with bonded brackets (n=12/group). Twelve volunteers wore palatal appliances in 4 phases, with cariogenic challenge. Bond strength, fracture mode and change in surface hardness (%SH) were determined. Result Relative to the in vitro study, F release (ppm) was: GT=0.257±0.068c; GTF=0.634±0.100b; GSAF=0.630±0.067b; GV=2.796±1.414a. Only GV showed no white spot lesions. Bond strength values (MPa) were GT=7.62±7.18a; GTF=5.15±6.91ab; GSAF=3.42±2.97bc; GV=2.87±2.09c. Adhesive fracture was the most frequent type, except for GTF. In the in situ study, %SH was: GT=-56.0±18.3a; GTF=-57.6±11.9a; GSAF=-57.1±11.3a; GV=-52.4±25.8a. Bond strength values were GT=9.5±4.4a; GTF=11.1±5.9a; GSAF=13.2± 6.6a; GV=6.6±4.0a. Cohesive fracture in material was the most frequent type, except for GTF. Conclusion Vitremer (GV) showed the highest anti-cariogenic potential in the in vitro study. However, it was not confirmed by the in situ study. Regarding bond strength values from the in situ study, all materials were shown to be adequate for clinical practice.

Microbial profile of dental plaque associated to white spot lesions in orthodontic patients immediately after the bracket removal

ObjectiveDenaturing Gradient Gel Electrophoresis (DGGE) is suggested to predict caries risk in young children. Such a tool would be valuable in orthodontic patients undergoing treatment with fixed appliances. In this cross-sectional study the applicability of DGGE and conventional microbiology for caries risk assessment in orthodontic patients were assessed. DesignDental plaque was obtained from orthodontic patients immediately prior to bracket removal. Presence of white spot lesions (WSL) was assessed immediately post debracketing. DGGE-patterns and band counts were assessed using varying automated band detection settings and compared to visually detected bands to determine optimum settings. Optimum settings were used to compare band patterns in subjects with or without WSL. Microbiological samples were assessed for total colony forming units (CFU’s) and percentages of aciduric flora, Streptococcus mutans, Lactobacillus spp. and Candida albicans. ResultsThirty-seven subjects were included with a mean age of 15.4yr (SD 1.6yr; 28 with WSL; 9 without WSL). Depending on settings, DGGE outcomes were different. Optimum minimum profiling absolute to the most intense band of 4% showed no significant difference in band numbers for subjects with or without WSL (p=0.845). Optimum settings for minimum profiling relative to the most intense band of 15% showed significant lower band numbers for subjects with WSL than those without (p=0.007). No differences between groups were observed for microbiological parameters. ConclusionThe analysis of DGGE-patterns is ambiguous. Software settings significantly affected outcomes. DGGE-patterns and band numbers like CFU counts were not predictive with respect to WSL formation in these orthodontic patients.

Assessment of White Spot Lesions and In-Vivo Evaluation of the Effect of CPP-ACP on White Spot Lesions in Permanent Molars of Children.

As hindrance of remineralisation process occurs during orthodontic therapy resulting in decalcification of enamel because number of plaque retention sites increases due to banding and bonding of appliances to teeth. The present analytic study was undertaken to assess the occurrence of white spot lesions in permanent molars of children with and without orthodontic therapy and to evaluate the effect of Casein PhosphoPeptide-Amorphous Calcium Phosphate (CPP-ACP) on white spot lesions in post-orthodontic patients in a given period of time. The study comprised of examination of 679 first permanent molars which were examined to assess the occurrence of smooth surface white spot lesions in children of 8 to 16 years age group. Group I comprised subjects without any orthodontic treatment and Group II comprised of subjects who had undergone orthodontic therapy. The sample size was calculated using the epi-info6 computer package. Treatment group included 20 post-orthodontic patients examined with at least one white spot lesion within the enamel who received remineralizing cream (GC Tooth Mousse, Recaldent, GC Corporation.) i.e., CPP-ACP cream two times a day for 12 consecutive weeks. Computerized image analysis method was taken to evaluate white spot lesions. These frequency and percentages were compared with chi-square test. For comparison of numeric data, paired t-test was used. Of the total 278 (49.6%) first permanent molars showed occurrence of smooth surface white spot lesions out of 560 in Group I and 107 (89.9%) first permanent molars showed presence of white spot lesions out of 119 debanded first permanent molars of children examined in Group II. CPP-ACP therapy group showed reduction in severity of codes which was found to be highly significant after 12 weeks and eight weeks on gingival-third, p-value (<0.001) and significant after eight weeks and four weeks on middle-third according to ICDAS II criteria and computerized image analysis. CPP-ACP therapy minimum for 12 weeks is highly recommended as post-orthodontic treatment need in management of smooth surface white spot lesions on teeth undergoing fixed orthodontic therapy according to the present study.

Evaluation of Caries Prevalence in Children of Rural Karad Area

Dental caries is the most prevalent oral disease. Its very high morbidity potential has brought this disease into the main focus of the dental health profession. There is practically no geographic area in the world whose inhabitants do not exhibit some evidence of dental caries. It affects both the sexes, all races, all socioeconomic status, and all age groups.1 The seriousness and societal costs of dental caries in preschool children are enormous. National data shows that caries is highly prevalent in poor and near-poor Indian preschool children, yet this disease is infrequently treated. The etiology includes elevated colonization levels of Streptococcus mutans, frequent sugar consumption, and developmental defects in primary teeth. A necessary first step in preventing dental caries in preschool children is evaluating the child’s caries risk factors that include socioeconomic status, previous caries experience, presence of white spot lesions, presence of visible plaque, perceived risk by dental professionals, and microbiologic testing for the presence or quantity of S. mutans. Based on this knowledge, different preventive strategies, as well as different intensities of preventive therapies, can be employed.

Analysis of the association between polymorphisms in MMP2, MMP3, MMP9, MMP20, TIMP1, and TIMP2 genes with white spot lesions and early childhood caries.

Matrix metalloproteinases and their inhibitors might be involved in enamel formation. This study aimed to evaluate the association between polymorphisms in MMP2, MMP3, MMP9, MMP20, TIMP1, and TIMP2 with white spot lesions (WSL) and early childhood caries (ECC). A cross-sectional study was performed on 786 children aged from 2 to 6 years in Brazil. After clinical evaluation, they were classified into groups with disease (the presence of WSL and/or ECC) and without disease (the absence of WSL or ECC). Genotyping of the selected polymorphisms was carried out with TaqMan real-time PCR, using genomic DNA extracted from buccal cells. Allele and genotype frequencies were compared between groups. Chi-square test, odds ratio (OR), and logistic regression were used (P ≤ 0.05). The dmft score was 1.3 (SD: 2.4), and 41.34% of the children have at least one caries lesion. In MMP9, the GG genotype was more frequent in the group without disease (P = 0.006). In a recessive model, WSL was associated with the marker rs1711437 in MMP20 (P = 0.019; OR = 1.20, 95% CI 1.02-1.42). The marker rs1784418 in MMP20 showed an association between the allele G distribution for the WSL group (P = 0.020; OR = 0.73, 95% CI 0.55-0.96). MMP9 and MMP20 are involved in WSL and ECC development.

The prevalence of enamel white spot lesions before and after fixed orthodontic treatment among patients attending Shorish Dental Center

Objectives: This study was done to determine the prevalence of WSLs among orthodontic patients visiting Shorish Dental Center in Sulaimani City during 4 months (1st June 2013- 30 sep 2013) requiring fixed orthodontic treatment.&#x0D; Materials and Methods: Six hundred and seventy patients (223control and 447study groups) who attended orthodontic department of Shorish Dental Center during 4 months were included in this study. The presence of white spot lesions was determined by visual examination in two groups of patients. The study group consisted of patients who did wear fixed orthodontic appliance, and the control group consisted of patients who didn’t having their braces placed on their teeth.&#x0D; Results: Out of 477 orthodontic patients, 148 cases presents WSL, and their prevalence was equal to (31%). Conclusion: The development of white spot lesion during orthodontic treatment with fixed appliance was not a significant clinical problem and its prevalence didn’t affect by the age and the gender of the patients, suggesting that any preventive therapy provided appeared to be effective.&#x0D; Conclusions: Fixed orthodontic appliance was not a critical factor that contributed to the development of WSL. The age and the gender of the patient didn’t play a role in the prevalence of the WSLs.

Prevalence of white-spot lesions before and during orthodontic treatment with fixed appliances

The aim of the study was to determine the prevalence of white-spot lesions (WSLs) in patients with fixed orthodontic appliances. The cross-sectional study sample consisted of three groups of patients: group I, 59 patients treated orthodontically for 6 months; group II, 64 patients treated for 12 months; group 0 (control), 68 patients examined immediately before appliance placement. All groups were treated with a 0.022-inch slot preadjusted appliance and they wore a functional fixed appliance. The presence of WSLs was evaluated by visual examination using the scoring system proposed by Gorelick. The groups were evaluated for differences in the prevalence of at least one WSL using Fisher's exact test, followed by Bonferroni pairwise comparisons. The prevalence of WSLs by tooth type was evaluated with logistic regression (P < 0.05). Intraobserver agreement was assessed by means of the Cohen ĸ statistical method. There were no significant differences in the prevalence of WSLs between patients treated for 6 and 12 months (P = 0.855); however, there were significantly more WSLs in groups I and II than in group 0 (P = 0.000). No significant differences were found between girls and boys (P = 1.000). The mandibular first molars and maxillary lateral incisors were the most affected teeth, in both the treated and untreated groups. The study revealed significant decalcification at 6 months after orthodontic bonding. Considering how quickly these lesions can develop and become irreversible, early diagnosis is of critical importance.

Caries risk profiles in 2- to 6-year-old Greek children using the Cariogram

To assess the caries risk profiles in 2- to 6-year-old Greek children using a computer-based program and to evaluate the contribution of various risk factors. The study group consisted of 814 preschool children. A questionnaire on family, demographic and socioeconomic factors, general health, oral hygiene and dietary behavior was completed by the parents. Children were examined for cavitated and white-spot lesions (WSL). Salivary mutans streptococci (MS) and buffer capacity were estimated. Caries risk profiles were assessed with Cariogram. Cavitated lesions were found in 30% of the children; WSL were found in 26% of those included. MS and low buffer capacity were detected in 28% and 26% of the children, respectively. The majority (70%) displayed neglected oral hygiene. Based on the questionnaires, 83% of the children had a cariogenic diet, and 17% did not use any form of fluoride. The Cariogram revealed that 26% of the children had high caries risk, while only 9% exhibited low caries risk. The most significant caries risk variables, determined by regression analysis (R(2)=0.88), were insufficient fluoride exposure (ß=0.160) and the presence of WSL (ß= 0.159). One-fourth of the children were categorised as high caries risk. The presence of WSL and lack of fluoride exposure were the most significant caries risk determinants.