Risk factors for incidence and severity of white spot lesions during treatment with fixed orthodontic appliances
- PMID:20691360
- DOI: 10.1016/j.ajodo.2008.10.019
Risk factors for incidence and severity of white spot lesions during treatment with fixed orthodontic appliances
Abstract
Introduction: The development of incipient caries, or white spot lesions (WSLs), is a significant clinical problem in orthodontics. The purpose of this study was to retrospectively determine the incidence and severity of WSLs by examining pretreatment and posttreatment digital photographs.
Methods: A total of 332 consecutive finished patients from a university graduate orthodontic clinic were evaluated. Initial and final digital images were compared to assess WSLs. The facial surfaces of the anterior 8 maxillary teeth were analyzed. The percentage area of WSL per total facial tooth surface was calculated to control for magnification differences. Reliability of the method was assessed by comparison with direct clinical examination data. Patient and operator factors, and treatment complexity and outcomes were evaluated as predictors of WSL incidence and severity.
Results: Agreement between direct clinical examination and digital photo data was excellent, with an intraclass correlation coefficient 0.88 and a 0.3% average difference between methods. The incidence of at least 1 WSL on the labial surface of the anterior 8 maxillary teeth was 36%. The order of incidence was lateral incisor (34%), canine (31%), premolar (28%), and central incisor (17%).
Conclusions: Risk factors for the development of incipient caries during orthodontic treatment were young age (preadolescent) at the start of treatment, number of poor hygiene citations during treatment, unfavorable clinical outcome score, white ethnic group, and inadequate oral hygiene at the initial pretreatment examination. The use of computer software to evaluate digital photos retrospectively is a valid method for assessing the incidence and severity of WSLs on the maxillary anterior incisors, canines, and premolars.
Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Comment in
- One-third of orthodontic patients receiving fixed appliances in a US graduate clinic have new iatrogenic demineralized white lesions at the end of treatment.Benson P.Benson P.J Evid Based Dent Pract. 2011 Jun;11(2):105-6. doi: 10.1016/j.jebdp.2011.03.012.J Evid Based Dent Pract. 2011.PMID:21605839No abstract available.
Similar articles
- Incidence of caries lesions among patients treated with comprehensive orthodontics.Richter AE, Arruda AO, Peters MC, Sohn W.Richter AE, et al.Am J Orthod Dentofacial Orthop. 2011 May;139(5):657-64. doi: 10.1016/j.ajodo.2009.06.037.Am J Orthod Dentofacial Orthop. 2011.PMID:21536209
- [Resin infiltration of white spot lesions during the fixed orthodontic appliance therapy].Ogodescu A, Ogodescu E, Talpoş S, Zetu I.Ogodescu A, et al.Rev Med Chir Soc Med Nat Iasi. 2011 Oct-Dec;115(4):1251-7.Rev Med Chir Soc Med Nat Iasi. 2011.PMID:22276478Romanian.
- White-spot lesions during multibracket appliance treatment: A challenge for clinical excellence.Enaia M, Bock N, Ruf S.Enaia M, et al.Am J Orthod Dentofacial Orthop. 2011 Jul;140(1):e17-24. doi: 10.1016/j.ajodo.2010.12.016.Am J Orthod Dentofacial Orthop. 2011.PMID:21724067
- A contemporary review of white spot lesions in orthodontics.Heymann GC, Grauer D.Heymann GC, et al.J Esthet Restor Dent. 2013 Apr;25(2):85-95. doi: 10.1111/jerd.12013. Epub 2013 Feb 19.J Esthet Restor Dent. 2013.PMID:23617380Review.
- Dental caries and fluorides in relation to fixed orthodontic treatment: a review.Ng'ang'a PM, Ogaard B.Ng'ang'a PM, et al.East Afr Med J. 1993 Feb;70(2):75-7.East Afr Med J. 1993.PMID:8513745Review.
Cited by
- Incidence of white spot lesions among patients treated with clear aligners and traditional braces.Buschang PH, Chastain D, Keylor CL, Crosby D, Julien KC.Buschang PH, et al.Angle Orthod. 2019 May;89(3):359-364. doi: 10.2319/073118-553.1. Epub 2018 Dec 17.Angle Orthod. 2019.PMID:30556747Free PMC article.
- Influence of active reminders on oral hygiene compliance in orthodontic patients.Eppright M, Shroff B, Best AM, Barcoma E, Lindauer SJ.Eppright M, et al.Angle Orthod. 2014 Mar;84(2):208-13. doi: 10.2319/062813-481.1. Epub 2013 Sep 12.Angle Orthod. 2014.PMID:24028316Free PMC article.Clinical Trial.
- Comparative analysis of long-term biofilm formation on metal and ceramic brackets.Lindel ID, Elter C, Heuer W, Heidenblut T, Stiesch M, Schwestka-Polly R, Demling AP.Lindel ID, et al.Angle Orthod. 2011 Sep;81(5):907-14. doi: 10.2319/102210-616.1. Epub 2011 May 4.Angle Orthod. 2011.PMID:21542722Free PMC article.
- Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis.Salerno C, Grazia Cagetti M, Cirio S, Esteves-Oliveira M, Wierichs RJ, Kloukos D, Campus G.Salerno C, et al.Eur J Orthod. 2024 Apr 1;46(2):cjae008. doi: 10.1093/ejo/cjae008.Eur J Orthod. 2024.PMID:38387465Free PMC article.
- Usefulness of an app in improving oral hygiene compliance in adolescent orthodontic patients.Zotti F, Dalessandri D, Salgarello S, Piancino M, Bonetti S, Visconti L, Paganelli C.Zotti F, et al.Angle Orthod. 2016 Jan;86(1):101-7. doi: 10.2319/010915-19.1. Epub 2015 Mar 23.Angle Orthod. 2016.PMID:25799001Free PMC article.Clinical Trial.
MeSH terms
Related information
LinkOut - more resources
Full Text Sources
Medical