Prevention and Treatment of White Spot Lesions in Orthodontic Patients.
Prevention and Treatment of White Spot Lesions in Orthodontic Patients.
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DOI：
10.4103/ccd.ccd_216_17
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发表时间：
2017-01
影响因子：
1.2
通讯作者：
Kachuie M
中科院分区：
文献类型：
--
作者：
Khoroushi M;Kachuie M
考虑到正畸治疗的目标是提高面部和牙齿的美观，固定正畸治疗期间和之后，固定正畸器具周围的牙釉质脱钙表现为白斑病变（wsl）是一个主要挑战。与没有牙套作为固定器械的对照组相比，带状或粘接的牙齿显示出明显更高的wsl率，并且粘接材料促进了生物膜的保留。第一步是通过建立良好的口腔卫生习惯和局部使用氟化物进行预防，包括使用高氟化物牙膏、含氟化物漱口水、凝胶、清漆、含氟化物粘合材料和弹性结扎。最近，其他材料和方法也被推荐使用，包括酪蛋白磷酸肽-无定形磷酸钙、防腐剂、益生菌、多元醇、密封剂、激光、牙齿漂白剂、树脂渗透和微磨蚀。本文根据最新的证据，综述了目前在正畸治疗中和治疗后处理牙釉质脱矿的方法、危险因素和预防措施。
Decalcification of enamel, appearing as white spot lesions (WSLs), around fixed orthodontic appliances is a major challenge during and after fixed orthodontic treatment by considering the fact that the goal of orthodontic treatment is to enhance facial and dental esthetic appearance. Banded or bonded teeth exhibit a significantly higher rate of WSLs compared to the controls with no braces as fixed appliances and the bonding materials promote retention of biofilms. These lesions are managed in the first step by establishing good oral hygiene habits and prophylaxis with topical fluorides, including high-fluoride toothpastes, fluoride mouthwashes, gels, varnishes, fluoride-containing bonding materials, and elastic ligatures. Recently, other materials and methods have been recommended, including the application of casein phosphopeptides-amorphous calcium phosphate, antiseptics, probiotics, polyols, sealants, laser, tooth bleaching agents, resin infiltration, and microabrasion. This article reviews the currently used methods to manage enamel demineralization during and after orthodontic treatment and the risk factors and preventive measures based on the latest evidence.