2016 AAO Annual Session - Demineralized Lesions During Orthodontic Treatment: Evidence-based Prevention / Deproteinization of Tooth Enamel Surfaces to Prevent White Spot Lesions and Bracket Bond Failure: A Revolution

Demineralized Lesions During Orthodontic Treatment: Evidence-based Prevention

Based on a recent updated Cochrane systematic review, this lecture will examine the effectiveness of several methods used to prevent demineralized lesions during orthodontic treatment. The evidence for each approach will be reviewed and a prevention guideline presented.

After this lecture you will be able to:

• Describe several approaches for the prevention of demineralised lesions during orthodontic treatment
• Evaluate the evidence for the effectiveness of each approach
• Outline an evidence-based prevention guideline

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

Orthodontic treatment success is jeopardized by the risk of development of white spot lesions (WSLs) around orthodontic brackets. Unfortunately, the formation of WSLs still remains a common complication during treatment in patients with poor oral hygiene. Nearly 75% of orthodontic patients are reported to develop 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 fluoride-releasing, resin-modified glass ionomer cement (RMGIC) to bond brackets, with deproteinization of the enamel surface prior to phosphoric acid etching.

After this lecture you will be able to:

• Explain why enamel is protected from WSLs when brackets are bonded with RMGIC
• Describe why enamel deproteinization with Clorox, prior to etching, increases bracket SBS, diminishing bracket bond failure incidence, both with composite resin and with RMGIC