Prevention and Treatment of White Spot Lesions During and After Treatment with Fixed Orthodontic Appliances: a Systematic Literature Review

Kristina Lopatiene, Marija Borisovaite, Egle Lapenaite, Kristina Lopatiene, Marija Borisovaite, Egle Lapenaite

Abstract

Objectives: The aim of the systematic literature review is to update the evidence for the prevention of white spot lesions, using materials containing fluoride and/or casein phosphopeptide-amorphous calcium phosphate during and after treatment with fixed orthodontic appliances.

Material and methods: Information search for controlled studies on humans published between January 2008 and February 2016 was performed in PubMed, ScienceDirect, Embase, The Cochrane Library. Inclusion criteria were: the English language, study on humans, patients undergoing orthodontic treatment with fixed appliances, randomized or quasi-randomized controlled clinical studies fluoride-containing product or casein derivates used throughout the appliance therapy or straightaway after debonding.

Results: 326 articles were reviewed (Embase 141, PubMed 129, ScienceDirect 41, Cochrane 15). Twelve clinical studies fulfilled all inclusion criteria. Use of fluoridated toothpaste had a remineralizing effect on white spot lesions (WSLs) (P < 0.05); fluoride varnish and casein supplements were effective in prevention and early treatment of WSLs (P < 0.05).

Conclusions: Early detection of white spot lesions during orthodontic treatment would allow implementing preventive measures to control the demineralization process before lesions progress. The systemic review has showed that the usage of fluoride and casein supplements in ameliorating white spot lesions during and after fixed orthodontic treatment is significantly effective. However the use of casein phosphopeptide-amorphous calcium phosphate can be more beneficial than fluoride rinse in the reduction of demineralization spots.

Keywords: casein phosphopeptide-amorphous calcium phosphate nanocomplex; dental white spot; fluoride; orthodontic brackets; orthodontics.

Figures

Figure 1
Figure 1
White spot lesions after orthodontic treatment with fixed appliances.
Figure 2
Figure 2
PRISMA flow diagram illustrating the literature search protocol.

References

    1. Bergstrand F, Twetman S. A review on prevention and treatment of post-orthodontic white spot lesions - evidence-based methods and emerging technologies. Open Dent J. 2011;5:158-62.
    1. Øgaard B. White spot lesions during orthodontic treatment: mechanisms and fluoride preventive aspects. Seminars in Orthod. 2008 Sep;14(3):183-93.
    1. 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.
    1. Lucchese A, Gherlone E. Prevalence of white-spot lesions before and during orthodontic treatment with fixed appliances. Eur J Orthod. 2013 Oct;35(5):664-8.
    1. Baeshen HA, Lingström P, Birkhed D. Effect of fluoridated chewing sticks (Miswaks) on white spot lesions in postorthodontic patients. Am J Orthod Dentofacial Orthop. 2011 Sep;140(3):291-7.
    1. Chapman JA, Roberts WE, Eckert GJ, Kula KS, González-Cabezas C. Risk factors for incidence and severity of white spot lesions during treatment with fixed orthodontic appliances. Am J Orthod Dentofacial Orthop. 2010 Aug;138(2): 188-94.
    1. Al Maaitah EF, Adeyemi AA, Higham SM, Pender N, Harrison JE. Factors affecting demineralization during orthodontic treatment: a post-hoc analysis of RCT recruits. Am J Orthod Dentofacial Orthop. 2011 Feb;139(2):181-91.
    1. Huang GJ, Roloff-Chiang B, Mills BE, Shalchi S, Spiekerman C, Korpak AM, Starrett JL, Greenlee GM, Drangsholt RJ, Matunas JC. Effectiveness of MI Paste Plus and PreviDent fluoride varnish for treatment of white spot lesions: a randomized controlled trial. Am J Orthod Dentofacial Orthop. 2013 Jan;143(1):31-41.
    1. Beerens MW, Boekitwetan F, van der Veen MH, ten Cate JM. White spot lesions after orthodontic treatment assessed by clinical photographs and by quantitative light-induced fluorescence imaging; a retrospective study. Acta Odontol Scand. 2015 Aug;73(6):441-6.
    1. Brown MD, Campbell PM, Schneiderman ED, Buschang PH. A practice-based evaluation of the prevalence and predisposing etiology of white spot lesions. Angle Orthod. 2016 Mar;86(2):181-6.
    1. Pliska BT, Warner GA, Tantbirojn D, Larson BE. Treatment of white spot lesions with ACP paste and microabrasion. Angle Orthod. 2012 Sep;82(5):765-9.
    1. Yuan H, Li J, Chen L, Cheng L, Cannon RD, Mei L. Esthetic comparison of white-spot lesion treatment modalities using spectrometry and fluorescence. Angle Orthod. 2014 Mar;84(2):343-9.
    1. Karlinsey RL, Mackey AC, Stookey GK, Pfarrer AM. In vitro assessments of experimental NaF dentifrices containing a prospective calcium phosphate technology. Am J Dent. 2009 Jun;22(3):180-4.
    1. Mayne RJ, Cochrane NJ, Cai F, Woods MG, Reynolds EC. In-vitro study of the effect of casein phosphopeptide amorphous calcium fluoride phosphate on iatrogenic damage to enamel during orthodontic adhesive removal. Am J Orthod Dentofacial Orthop. 2011 Jun;139(6):e543-51.
    1. Cochrane NJ, Cai F, Huq NL, Burrow MF, Reynolds EC. New approaches to enhanced remineralization of tooth enamel. J Dent Res. 2010 Nov;89(11):1187-97.
    1. Yetkiner E, Wegehaupt F, Wiegand A, Attin R, Attin T. Colour improvement and stability of white spot lesions following infiltration, micro-abrasion, or fluoride treatments in vitro. Eur J Orthod. 2014 Oct;36(5):595-602.
    1. hen H, Liu X, Dai J, Jiang Z, Guo T, Ding Y. Effect of remineralizing agents on white spot lesions after orthodontic treatment: a systematic review. Am J Orthod Dentofacial Orthop. 2013 Mar;143(3):376-382.e3.
    1. Guzmán-Armstrong S, Chalmers J, Warren JJ. Ask us. White spot lesions: prevention and treatment. Am J Orthod Dentofacial Orthop. 2010 Dec;138(6):690-6.
    1. Enaia M, Bock N, Ruf S. White-spot lesions during multibracket appliance treatment: A challenge for clinical excellence. Am J Orthod Dentofacial Orthop. 2011 Jul;140(1):e17-24.
    1. Agarwal A, Pandey H, Pandey L, Choudhary G. Effect of fluoridated toothpaste on white spot lesions in postorthodontic patients. Int J Clin Pediatr Dent. 2013 May;6(2):85-8.
    1. Srivastava K, Tikku T, Khanna R, Sachan K. Risk factors and management of white spot lesions in orthodontics. J Orthod Sci. 2013 Apr;2(2):43-9.
    1. Asaizumi M, Karlinsey RL, Mackey A, Kato T, Kuga T. In vitro assessments of white-spot lesions treated with NaF plus tricalcium phosphate (TCP) toothpastes using microtomography (micro-CT). J Dent Oral Hyg. 2013 Jul;5(7):68-76. URL: .
    1. Montasser MA, El-Wassefy NA, Taha M. In vitro study of the potential protection of sound enamel against demineralization. Prog Orthod. 2015;16:12.
    1. Willmot D. White spot lesions after orthodontic treatment. Seminars in Orthod. 2008 Sep;14(3):209-19.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336-41.
    1. Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration. 2011. URL: .
    1. Akin M, Basciftci FA. Can white spot lesions be treated effectively? Angle Orthod. 2012 Sep;82(5):770-5.
    1. Du M, Cheng N, Tai B, Jiang H, Li J, Bian Z. Randomized controlled trial on fluoride varnish application for treatment of white spot lesion after fixed orthodontic treatment. Clin Oral Investig. 2012 Apr;16(2):463-8.
    1. Bailey DL, Adams GG, Tsao CE, Hyslop A, Escobar K, Manton DJ, Reynolds EC, Morgan MV. Regression of post-orthodontic lesions by a remineralizing cream. J Dent Res. 2009 Dec;88(12):1148-53.
    1. Richter AE, Arruda AO, Peters MC, Sohn W. Incidence of caries lesions among patients treated with comprehensive orthodontics. Am J Orthod Dentofacial Orthop. 2011 May;139(5):657-64.
    1. Al Mulla AH, Kharsa SA, Birkhed D. Modified fluoride toothpaste technique reduces caries in orthodontic patients: A longitudinal, randomized clinical trial. Am J Orthod Dentofacial Orthop. 2010 Sep;138(3):285-91.
    1. Robertson MA, Kau CH, English JD, Lee RP, Powers J, Nguyen JT. MI Paste Plus to prevent demineralization in orthodontic patients: a prospective randomized controlled trial. Am J Orthod Dentofacial Orthop. 2011 Nov;140(5): 660-8.
    1. Bröchner A, Christensen C, Kristensen B, Tranæus S, Karlsson L, Sonnesen L, Twetman S. Treatment of post-orthodontic white spot lesions with casein phosphopeptide-stabilised amorphous calcium phosphate. Clin Oral Investig. 2011 Jun;15(3):369-73.
    1. Beerens MW, van der Veen MH, van Beek H, ten Cate JM. Effects of casein phosphopeptide amorphous calcium fluoride phosphate paste on white spot lesions and dental plaque after orthodontic treatment: a 3-month follow-up. Eur J Oral Sci. 2010 Dec;118(6):610-7.
    1. Bishara SE, Ostby AW. White spot lesions: formation, prevention and treatment. Seminars in Orthod. 2008 Sep;14(3): 174-82.
    1. Farhadian N, Miresmaeili A, Eslami B, Mehrabi S. Effect of fluoride varnish on enamel demineralization around brackets: an in-vivo study. Am J Orthod Dentofacial Orthop. 2008 Apr;133(4 Suppl):S95-8.
    1. Behnan SM, Arruda AO, González-Cabezas C, Sohn W, Peters MC. In-vitro evaluation of various treatments to prevent demineralization next to orthodontic brackets. Am J Orthod Dentofacial Orthop. 2010 Dec;138(6):712.e1-7; discussion 712-3.
    1. Benson PE, Parkin N, Millett DT, Dyer FE, Vine S, Shah A. Fluorides for the prevention of white spots on teeth during fixed brace treatment. Cochrane Database Syst Rev. 2004;(3):CD003809. Review. Update in: Cochrane Database Syst Rev. 2013;12:CD003809.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit