Critical evaluation of incidence and prevalence of white spot lesions during fixed orthodontic appliance treatment: A meta-analysis

Dhinahar Sundararaj, Sudhakar Venkatachalapathy, Akshay Tandon, Aaron Pereira, Dhinahar Sundararaj, Sudhakar Venkatachalapathy, Akshay Tandon, Aaron Pereira

Abstract

Objective: Development of dental caries, specifically, white spot lesions (WSLs), continues to be a well-recognized and troubling side effect of orthodontic fixed appliance therapy, despite vast improvement in preventive dental techniques and procedures. The aim of this meta-analysis is to evaluate, determine, and summarize the incidence and prevalence rates of WSLs during orthodontic treatment that have been published in the literature.

Materials and methods: According to predetermined criteria, databases were searched for appropriate studies. References of the selected articles and relevant reviews were searched for any missed publications.

Results: In the 14 studies evaluated for WSLs, the incidence of new carious lesions formed during orthodontic treatment in patients was 45.8% and the prevalence of lesions in patients undergoing orthodontic treatment was 68.4%.

Conclusion: The incidence and prevalence rates of WSLs in patients undergoing orthodontic treatment are quite high and significant. This widespread problem of WSL development is an alarming challenge and warrants significant attention from both patients and providers, which should result in greatly increased emphasis on effective caries prevention.

Keywords: Demineralization; incidence; orthodontic fixed appliances; prevalence; white spot lesions.

Figures

Figure 1
Figure 1
Flowchart of the selection of studies

References

    1. Gorelick L, Geiger AM, Gwinnett AJ. Incidence of white spot formation after bonding and banding. Am J Orthod. 1982;81:93–8.
    1. Rosenbloom RG, Tinanoff N. Salivary Streptococcus mutans levels in patients before, during, and after orthodontic treatment. Am J Orthod Dentofacial Orthop. 1991;100:35–7.
    1. Lundström F, Krasse B. Streptococcus mutans and lactobacilli frequency in orthodontic patients: The effect of chlorhexidine treatments. Eur J Orthod. 1987;9:109–16.
    1. Ogaard B. Prevalence of white spot lesions in 19-year-olds: A study on untreated and orthodontically treated persons 5 years after treatment. Am J Orthod Dentofacial Orthod. 1989;96:423–7.
    1. Ogaard B, Rølla G, Arends J. Orthodontic appliances and enamel demineralization. Part 1. Lesion development. Am J Orthod Dentofacial Orthop. 1988;94:68–73.
    1. O’Reilly MM, Featherstone JD. Demineralization and remineralization around orthodontic appliances: An in vivo study. Am J Orthod Dentofacial Orthop. 1987;92:33–40.
    1. Light RJ, Pillemer DB. Cambridge, Mass: Harvard University Press; 1984. Summing Up: The Science of Reviewing Research.
    1. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50:1088–101.
    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;139:657–64.
    1. Mizrahi E. Enamel demineralization following orthodontic treatment. Am J Orthod. 1982;82:62–7.
    1. Stratemann MW, Shannon IL. Control of decalcification on orthodontic patients by daily self-administered application of a water free 0.4% stannous fluoride gel. Am J Orthod. 1974;66:273–9.
    1. Artun J, Brobakken BO. Prevalence of carious white spots after orthodontic treatment with multibonded appliances. Eur J Orthod. 1986;8:229–34.
    1. Boersma JG, van der Veen MH, Lagerweij MD, Bokhout B, Prahl-Andersen B. Caries prevalence measured with QLF after treatment with fixed orthodontic appliances: Influencing factors. Caries Res. 2005;39:41–7.
    1. Akin M, Tazcan M, Ileri Z, Basciftci FA. Incidence of white spot lesion during fixed orthodontic treatment. Turkish J Orthod. 2013;26:98–102.
    1. Sagarika N, Suchindran S, Loganathan S, Gopikrishna V. Prevalence of white spot lesion in a section of Indian population undergoing fixed orthodontic treatment: An in vivo assessment using the visual International Caries Detection and Assessment System II criteria. J Conserv Dent. 2012;15:104–8.
    1. Geiger AM, Gorelick L, Gwinnett AJ, Griswold PG. The effect of a fluoride program on white spot formation during orthodontic treatment. Am J Orthod Dentofacial Orthop. 1988;93:29–37.
    1. Khalaf K. Factors affecting the formation, severity and location of white spot lesions during orthodontic treatment with fixed appliances. J Oral Maxillofac Res. 2014;5:e4.
    1. Julien KC, Buschang PH, Campbell PM. Prevalence of white spot lesion formation during orthodontic treatment. Angle Orthod. 2013;83:641–7.
    1. Lucchese A, Gherlone E. Prevalence of white-spot lesions before and during orthodontic treatment with fixed appliances. Eur J Orthod. 2013;35:664–8.
    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;140:e17–24.
    1. Tufekci E, Dixon JS, Gunsolley JC, Lindauer SJ. Prevalence of white spot lesions during orthodontic treatment with fixed appliances. Angle Orthod. 2011;81:206–10.
    1. Alcouffe F. Oral hygiene behavior: Differences between men and women. Clin Prev Dent. 1989;11:6–10.
    1. Ostberg AL, Halling A, Lindblad U. Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents. Acta Odontol Scand. 1999;57:231–6.
    1. Sakki TK, Knuuttila ML, Anttila SS. Lifestyle, gender and occupational status as determinants of dental health behavior. J Clin Periodontol. 1998;25:566–70.
    1. Vivaldi-Rodrigues G, Demito CF, Bowman SJ, Ramos AL. The effectiveness of a fluoride varnish in preventing the development of white spot lesions. World J Orthod. 2006;7:138–44.
    1. Ogaard B, Duschner H, Ruben J, Arends J. Microradiography and confocal laser scanning microscopy applied to enamel lesions formed in vivo with and without fluoride varnish treatment. Eur J Oral Sci. 1996;104:378–83.
    1. McNeill CJ, Wiltshire WA, Dawes C, Lavelle CL. Fluoride release from new light-cured orthodontic bonding agents. Am J Orthod Dentofacial Orthop. 2001;120:392–7.
    1. Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res. 1997;76:1587–95.
    1. Al-Khateeb S, Forsberg CM, de Josselin de Jong E, Angmar-Månsson B. A longitudinal laser fluorescence study of white spot lesions in orthodontic patients. Am J Orthod Dentofacial Orthop. 1998;113:595–602.
    1. Backer Dirks O. The clinical testing of agents for the prevention of dental caries. Adv Fluorine Res. 1966;4:1–2.
    1. Artun J, Thylstrup A. Clinical and scanning electron microscopic study of surface changes of incipient caries lesions after debonding. Scand J Dent Res. 1986;94:193–201.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться