2013 Annual Session - Deproteinization of Tooth Enamel Surfaces to Prevent White Spot Lesions and Bracket Bond Failure: A Revolution in Orthodontic Bonding / Impact of Molar Hypomineralization on Orthodontics

Deproteinization of Tooth Enamel Surfaces to Prevent White Spot Lesions and Bracket Bond Failure: A Revolution in Orthodontic Bonding

The success of orthodontic treatment is jeopardized by the risk of development of white spot lesions around orthodontic brackets. Unfortunately, the formation of white spot lesions still remains a common complication during treatment in patients with poor oral hygiene. Nearly half of orthodontic patients are reported to develop noticeable enamel decalcification because of prolonged plaque retention around brackets. It is the orthodontist’s responsibility to minimize the risk of patients having enamel decalcifications as a consequence of orthodontic treatment. This can be achieved by using hybrid, fluoride-releasing, and glass ionomer cement.

Learning Objectives:

• State that enamel is protected from white spot lesions when brackets are bonded with hybrid, fluoride-releasing, glass ionomer cement.
• Evaluate that enamel de-proteinization with Clorox prior to etching increases bracket bond strength
• Recognize that incidence of bracket bond failure is diminished when the enamel surface is de-proteinized before etching and bonding brackets, both with composite resin and also with glass ionomer cement.

Impact of Molar Hypomineralization on Orthodontics

Molar hypomineralization (MH) is a discrete pathological entity that has previously been confused with hypoplasia and caries. It has specific characteristics, etiological associations and treatment. It is widespread in the community, and has a major economic impact on the need for dental treatment. MH, rather than caries, may be the cause of the "bombed out first molars" that are a common problem in orthodontics. This presentation will discuss the condition, efforts to determine its cause and prevention, and how orthodontists can co-operate with referring pediatric and general dentists to care for their affected patients.

Learning Objectives:

• Identify molar hypomineralization and distinguish it from hypoplasia and caries
• Discuss the difficulties faced by pediatric and general dentists when treating affected patients, thereby improving co-operative patient management.