White-Spot Lesions in Orthodontics: Incidence and Prevention

The most common negative effect of orthodontic treatment with fixed appliances is the development of incipient carious lesions around brackets. The objectives of this chapter are to present some of the results of two studies aiming: 1) to evaluate patients treated with comprehensive orthodontics to determine the incidence of new carious lesions during treatment; and 2) to investigate the potential of ACP-containing resin cement and other treatments (fluoride varnish, resin sealer, MI Paste) to prevent incipient carious lesions on bracketed teeth. In the first study, 350 orthodontic patients were selected randomly. The preand post-treatment photographs of the patients were examined to determine lesion development. The labial surface of each tooth was scored with a standardized system based on the International Caries Determination and Assessment System II. The independent variables were collected by chart abstraction. In the second study, 100 extracted human premolars were allocated randomly to five groups (N = 20). Brackets were bonded with ACP-cement (Aegis-Ortho), Transbond