Lingual appliances reduce the incidence of white spot lesions during orthodontic multibracket treatment
Volume 148, Issue 3, September 2015, Pages 414–422
Introduction
The
aim of this study was to assess the incidence of white spot lesions
(WSLs) in subjects treated with customized lingual multibracket
appliances—separately for maxillary anterior teeth 12 to 22 (according
to the Fédération Dentaire Internationale numbering system) as well as
for tooth groups 15 to 45, 16 to 46, and 17 to 47—and to determine the
impact of patient-related and treatment-related variables on the
frequencies of new WSLs.
Methods
Of
214 subjects comprehensively treated between June 1, 2011, and May 31,
2014, in 1 orthodontic center (Bad Essen, Germany) with a completely
customized lingual appliance (WIN; DW Lingual Systems, Bad Essen,
Germany), 174 (47% boys, 53% girls; mean age, 14.35 ± 1.23 years
[minimum, 11.35 years; maximum, 17.91 years]) were recruited with
inclusion criteria of completed lingual multibracket treatment of their
maxillary and mandibular permanent teeth 17 to 47 (4582 teeth in the
study), and age less than 18 years at the initial appointment. WSL
assessment was accomplished using standardized digital high-resolution
maxillary and mandibular occlusal photographs taken before bracketing
and after debonding. Nonparametric analysis of variance was performed,
taking into account the subjects' grouped ages (≤16 or >16 years),
sexes, and treatment durations.
Results
Of
the total population of subjects, 41.95% developed at least 1 new WSL
when all teeth, 17 to 47, were considered, and this incidence was 27.01%
for tooth group 16 to 46, or 10.59% of subjects and 4.74% of the
maxillary incisors (12 to 22). Of all teeth under consideration, 3.19%
developed a WSL during treatment. The frequencies of decalcification
were not significantly increased in preadolescents (≤16 years) compared
with adolescents (>16 years). Treatment duration had a significant
adverse impact on WSL formation in tooth groups 15 to 45 and 16 to 46,
and in complete dental arches (teeth 17 to 47).
Conclusions
Subject-related
and tooth-related WSL incidences of both single tooth groups and
complete dental arches in subjects treated with the lingual WIN
appliance were distinctly reduced when compared with previous reports of
enamel decalcification after conventional labial multibracket
treatment.
Comments