The Effect of Nano Chitosan Surface Coating on White Spot Lesions Development in Clear Aligner Therapy Patients

Inclusion Criteria:

• Patients presenting with mild to moderate malocclusion (sagittal, vertical, transverse discrepancies, or crowding) that could be treated using clear aligners within a maximum treatment period of one year and without the need for extraction therapy.
• Medically healthy patients with no systemic diseases or medical conditions that could affect enamel integrity, salivary flow, oral hygiene status, or periodontal health.
• Patients with no history of previous orthodontic treatment, dental trauma, or parafunctional habits such as bruxism.
• Patients with good oral hygiene and absence of active periodontal disease, including gingivitis or periodontitis.
• Patients willing to comply with the prescribed clear aligner wear protocol for a minimum of 22 hours per day.
• Patients who agreed to participate in the study and signed the informed consent form.

Exclusion Criteria:

• Previous orthodontic treatment that could influence baseline enamel condition or white spot lesion assessment.
• Presence of active carious lesions, cavitated lesions, severe enamel hypoplasia, or developmental enamel defects.
• Extensive restorations on anterior teeth that could interfere with Quantitative Light-Induced Fluorescence (QLF) imaging and analysis.
• Systemic diseases or medical conditions affecting salivary flow, enamel integrity, oral hygiene, or periodontal health.
• Use of medications known to affect salivary secretion, enamel mineralization, or oral microbial balance.
• Poor oral hygiene or presence of active periodontal disease, including gingivitis or periodontitis.