Dissertations / Theses on the topic 'Orthodontics and demineralization'

Enamel demineralization is a concern in orthodontic patients with poor oral hygiene. To curtail this problem, amorphous calcium phosphate (ACP) containing adhesives have been developed. The purpose of this in vitro study was to evaluate the cariostatic potential of an ACP containing orthodontic bonding agent adjacent to brackets. Sixty human molars were randomly distributed into: ACP adhesive, resin modified glass ionomer cement (RMGIC), and conventional composite resin groups (N=20 each). Brackets were bonded following the manufacturer’s instructions. Tooth enamel through a 2mm window around the brackets was cycled in demineralization (6 hrs) and remineralization (18 hrs) solutions. After 14 days, teeth embedded in resin and were sectioned. Knoop indentations were performed to determine enamel hardness. There were no statistically significant differences between the control and experimental groups. However, both Fuji Ortho LC (RMGIC), and Aegis Ortho (ACP) showed a trend toward a reduction in demineralization. In addition, it was also shown that the initial acid etching of the enamel significantly reduces enamel hardness.

Purpose: To evaluate the efficacy of a fluoride-containing orthodontic primer in preventing demineralization adjacent to brackets and compare the quality of enamel on tooth surfaces that received interproximal reduction (IPR). Methods: Patients at the VCU Orthodontic clinic who consented to orthodontic treatment involving extraction of at least 2 premolars were recruited to this pilot clinical study. Brackets were bonded to premolars using one of two primers, fluoride-containing experimental or control. IPR was also performed, and the experimental primer was applied to randomly selected teeth. Extracted teeth were analyzed visually for the presence of white spot lesions (WSLs). Micro-CT analyses were also performed to evaluate demineralization and measure the lesions. Results: A total of 18 teeth from 6 subjects were included in the following analyses. Based on micro-CT imaging, lesions were found on 89% of teeth treated with the experimental primer compared to 67% with the control primer, but this difference was not statistically significant (p=0.5765). There was also no significant difference between the depths of the lesions (p=1.00), handedness (p=0.5765), hygiene (p=0.7804), or time in the mouth (p=0.5601). According to visual examination, there was no significant difference in the incidence of WSLs between the two groups (89% and 89%; p=1.00) Also, there was no association with treatment (p=1.00), handedness (p=1.00), hygiene (p=0.1373), or time in the mouth (p=0.2987). No differences were noted on the microstructural characteristics of enamel at the IPR sites. Conclusion: Fluoride-containing primers do not seem to provide any additional benefit over conventional non-fluoride primers in orthodontic patients.

Objective: The purpose of this study was to compare in vitro the effectiveness of Novamin powered technology Oravive and TopexRenew, with Crest and Colgate's PreviDent 5000 Plus in decreasing demineralization and preventing white spot lesion formation on extracted human teeth. Materials and Methods: Eighty-two extracted non-carious human third molar teeth without observable white-spot lesions, decalcification, or dental fluorosis were used for this in vitro study. The teeth in the study were suspended in their respective treatment slurry and cycled through remineralization and demineralization solutions for ten continuous days. Following the cycling protocol the teeth were sectioned using the hard tissue microtome producing three to five sections per tooth. The sections were photographed under a polarized light microscope and subsequently measured using Image Pro Plus computer software. Results: The post-hoc Bonferroni multiple comparison test indicated that the mean lesion depths observed in Control and Oravive groups were significantly greater than the other three treatment groups, while the mean lesion depth observed in Prevident was significantly lower than those in Renew and Crest. Moreover, no significant difference was found between Control and Oravive or between Renew and Crest. Conclusions: Renew (5% novamin; 5000 ppm F) performed at the same level as Crest (1100 ppm F) and inferior than Prevident 5000 Plus (5000 ppm F). Novamin by itself (Oravive, 5% Novamin) performed at the same level as the non-fluoridated Control group. Prevident 5000 Plus (5000 ppm F) was the most effective product in this study for the prevention of enamel demineralization and white spot lesion formation.

Thesis (M.S.)--West Virginia University, 2005.
Title from document title page. Document formatted into pages; contains x, 243 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 128-139).

The purpose of this study was to investigate the effects of a fluoride releasing orthodontic primer on demineralization adjacent to brackets. Twenty-two patients were recruited for this study. One premolar was randomly chosen as the experimental tooth, the contralateral tooth was the control. Teeth were visually analyzed for white spot lesions (WSLs). Knoop microhardness was used to determine hardness. Visual examination results showed no significant difference in the number of WSLs observed between Opal Seal and Transbond XT over the duration of this study. Solid conclusions could not be drawn from the results of microhardness testing. Therefore, it cannot be concluded that there is a difference in enamel hardness between Opal Seal and Transbond XT. However, prior to 90 days, teeth showed a significant difference in WSLs. Suggesting a protective effect of Opal Seal that diminished with time. Future studies are necessary to determine the clinical performance of this product.

The purpose of this study was to compare, in vitro, the effectiveness of the resin sealants ProSeal™, OrthoCoat™, SeLECT Defense™, and Biscover LV™ on the inhibition of enamel demineralization after being subjected to extensive mechanical toothbrush abrasion. Seventy-five extracted third molars were divided into five groups - control, ProSeal, SeLECT Defense, OrthoCoat, and Biscover LV. All of the teeth, with the exception of the control group, weretreated with one of the four sealant materials per the manufacturer's instructions. Teeth were mounted in an acrylic ring and stabilized with a vinyl polysiloxane impression material. The mounted teeth were placed in the Prototech Toothbrush Wear Simulator and a soft-bristled toothbrush was placed over the buccal surface of the tooth. Each tooth was subjected to 15,000 horizontal strokes at a rate of 120 strokes/minute and each toothbrush received a constant force of 280 g to stimulate normal manual brushing, simulating about 2 years of manual toothbrushing. Teeth from all groups were painted with a thin layer of acid-resistant varnish (nail polish), leaving a 1 mm window of exposed enamel on the buccal surface. They were then placed into a constantly circulating, room-temperature standard tenCate Demineralizing Solution (pH=4.4) consisting of 2.20mM Ca2+, 2.20 mMPO4 3-, 0.05mM Acetic acid and 0.025ppm F- for 96 hours. Three sections were made of each tooth and the sections were examined under a polarized light microscope. Descriptive statistics were conducted with the study data. The one-way ANOVA with post-hoc Ryan-Einot-Gabriel-Welsch multiple range test was used to determine whether there was a significant difference in lesion depth between sealant materials. The following conclusions were made: All materials tested provided a significant reduction in enamel demineralization as compared to untreated controls. SeLECT Defense and OrthoCoat both resulted in a 64% decrease in lesion depth. Biscover LV provided a 67% decrease in lesion depth. Pro Seal provided significantly more protection (82% reduction) than the other three sealant materials: SeLECT Defense, OrthoCoat, and Biscover LV. Pro Seal, SeLECT Defense, OrthoCoat, and Biscover LV, should all be considered effective preventive treatments that do not require patient compliance for success. Pending further clinical investigation, Pro Seal should still be considered the gold standard for preventing enamel demineralization in orthodontic patients.

Oral Biology
M.S.
Incipient caries lesions or white spot lesions are one of the most common clinical problems resulting from orthodontic treatment with fixed appliances. Literature has shown that infrared photothermal radiometry and modulated luminescence (PTR-LUM), used by The Canary System for caries detection, is capable of monitoring artificially created carious lesions and their evolution during demineralization. Recently, a water-based calcium aluminate glass ionomer luting cement, Ceramir, has shown bioactive surface apatite formation that may influence local remineralization. This in vitro study’s objective was to evaluate effects of bioactive cement on enamel demineralization around orthodontic brackets compared to composite resin cement. A sample of 32 caries-free extracted human teeth was collected under an IRB-exempt protocol. Orthodontic brackets were cemented to each tooth with either Transbond XT or Ceramir. A 3x3 mm window adjacent to the bracket was created with acid-resistant varnish f
Temple University--Theses

Orientador: Lídia Parsekian Martins
Resumo: Objetivo: avaliar a ação de adesivo nanoparticulado com capacidade de liberação de flúor na prevenção de lesões de mancha branca (LMB) em pacientes sob tratamento ortodôntico. Materiais e Métodos: em 37 indivíduos, submetidos a tratamento ortodôntico, foram aplicados um adesivo ortodôntico convencional (Transbond XT) e um adesivo nanoparticulado com a capacidade de liberar flúor (Opal Seal), em um design split mouth. Antes da colagem e ao fim do tratamento, os pacientes foram submetidos a exame clínico e fotografias intrabucais. Durante o período de avaliação também foram realizadas avaliações mensais da quantidade de adesivo presente, visto por luz UV-A. Para comparação dos adesivos utilizamos uma ANOVA Multifatorial, sendo o score ao final do tratamento como variável dependente. No estudo da concordância entre os métodos de avaliação, foi realizado o Coeficiente de Correlação Ordinal de Spearman e a Análise de Concordância de Bland-Altman. Para o tempo de permanência do adesivo Opal Seal, utilizamos uma curva de sobrevivência, e na comparação do índice de descolagem utilizamos também uma curva de sobrevivência e a Análise de Sobrevivência de Kaplan-Meier. Resultados: Não houve diferença entre os adesivos testados, qualquer que fosse o método de avaliação utilizado, de forma que a formação de manchas brancas não difere entre os adesivos (p=0,581). Não houve um dente que fosse mais afetado por LMB em relação aos demais dentes avaliados (p=0,861). Não houve diferença entre os ... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Objective: Evaluate the action of nanoparticulate adhesive with fluoride release capacity in the prevention of white spot lesions (WSL) in patients under orthodontic treatment. Materials and methods: In 37 individuals undergoing orthodontic treatment, a conventional orthodontic adhesive (Transbond XT) and a nanoparticulate adhesive with the ability to release fluoride (Opal Seal) were applied in a split mouth design. Before bonding and at the end of treatment, patients were submitted to clinical examination and intraoral photographs. During the evaluation period, monthly assessments of the amount of adhesive present were also performed, as seen by UV-A light. To compare the adhesives, we used multifactorial ANOVA, with score at the end of treatment as dependent variable. In the study of the concordance between the evaluation methods, the ordinal Spearman correlation coefficient and the Bland-Altman concordance analysis were performed. For the remain time of the Opal Seal adhesive, a survival curve was used, and in the comparison of the debonding index, the survival curve and the Kaplan-Meier survival analysis were also used. Results: There was no difference between the tested adhesives, whatever the evaluation method used, so that the formation of WSL does not differ between the adhesives (p= 0.581). There was no tooth that was more affected by WSL in relation to the other teeth evaluated (p= 0.861). There was no difference between the methods of evaluation (P = 0,581) and th... (Complete abstract click electronic access below)
Doutor

Purpose: This in vitro study evaluated the effectiveness of using a 37% phosphoric acid liquid etchant along with MI Paste Plus™ powered technology compared to using MI Paste Plus™ alone or to an artificially created saliva solution in decreasing the demineralization and enhancing the remineralization of artificial carious lesions created on extracted human teeth. The teeth were analyzed and compared using polarized light microscopy, quantitative light-induced fluorescence, and digital photography. Materials and Methods: One hundred three recently extracted non-carious human third molar teeth without observable white-spot lesions, decalcification, or dental fluorosis were selected for this twelve day study and randomly divided into four treatment groups as follows: Group 1 (Control) - Artificial saliva solution (27 teeth) Group 2 (MIP) - MI Paste Plus™ application for 30 minutes daily for 12 days (26 teeth) Group 3 (15MIP) - 15 second etch every third day and MI Paste Plus™ application for 30 minutes daily for 12 days (25 teeth) Group 4 (1MIP) - 1 minute etch on day one ONLY and application of MI Paste Plus™ for 30 minutes daily for 12 days (25 teeth). Results: Results of one<–>way ANOVA revealed there was a significant effect for the type of treatment on the lesion depth (p = 0.0027). The post-hoc Tukey-Kramer's test indicated there was a statistically significant difference between the two groups (15MIP and 1MIP) that incorporated an acid etch in combination with MI Paste Plus™ and the group with exposure to MI Paste Plus™ alone (MIP). In addition, results of one<–>way ANOVA showed that there was no statistically significant effect for type of treatment on the change in fluorescence (p = 0.1417) or the change in density (p = 0.1934). Conclusions: The results of the present study revealed there was a significant effect for the type of treatment on the lesion depth (p = 0.0027). However, the only significant difference found was between the two groups (15MIP and 1MIP) that incorporated an acid etch in combination with MI Paste Plus™ and the group with exposure to MI Paste Plus™ alone (MIP). Thus, daily applications of MI Paste Plus™, with or without an acid etch, did not produce a statistically significant difference in mean lesion depth when compared to the control (artificial saliva group). In addition, the results of the present study showed that there was no statistically significant effect for type of treatment on the change in fluorescence (p = 0.1417) or the change in density (p = 0.1934). Further research is needed to evaluate MI Paste Plus™ capability in prevention of demineralization and/or enhancement of remineralization by conducting randomized clinical trials.

Thesis (M.S.)--West Virginia University, 2001.
Title from document title page. Document formatted into pages; contains viii, 118 p. : ill. Vita. Includes abstract. Includes bibliographical references (p. 65-73).

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CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
A desmineralização do esmalte dentário durante o tratamento ortodôntico é, ainda, um problema significante na Ortodontia. A presença de um aparato metálico retentivo sobre uma superfície dentária plana permite um sítio ideal para retenção de bactérias e restos alimentares, dificultando a higienização. O presente trabalho teve como objetivo avaliar através da lupa estereoscópica e da microscopia eletrônica de varredura, o efeito de um adesivo ortodôntico e um selante de fóssulas e fissuras na prevenção da desmineralização do esmalte ao redor dos bráquetes ortodônticos após exposição dos dentes à solução desmineralizadora. Foram utilizados 90 incisivos bovinos separados em três grupos de 30 dentes cada: grupo adesivo (G1), grupo selante de fóssulas (G2) e grupo controle (G3). Após a colagem dos bráquetes, os dentes foram submetidos a uma solução desmineralizadora durante 14 dias com monitoramento do pH através de um peagômetro. A análise por lupa estereoscópica e microscopia eletrônica de varredura mostrou que em todos os 90 dentes foram observados a ocorrência de desmineralização ao redor do bráquete ortodôntico. Entretanto, as áreas de perda de esmalte foram diferentes nos três grupos (ANOVA, p < 0,001). O grupo G2 apresentou uma redução significativa na incidência de desmineralização do esmalte (71,9%), enquanto esta redução no grupo G1 foi de 38%, quando comparados com grupo G3 (Tukey, p < 0,001). À microscopia eletrônica de varredura pode-se verificar a presença de crateras, poros e perda da camada aprismática do esmalte nos três grupos. O uso de selantes de fóssulas e fissuras para proteção da superfície vestibular dos dentes reduziu significativamente a desmineralização do esmalte in vitro.
The demineralization of dental enamel during orthodontic treatment is still a significant problem in Orthodontics. The presence of a retentive metallic apparatus on a dental flat surface allows an ideal site for retention of bacteria and food debris, making the cleaning difficult. This study aimed to evaluate through the stereoscopic microscope and scanning electron microscopy, the effect of an orthodontic adhesive and pit and fissure sealant preventing demineralization of enamel around orthodontic brackets after exposure of the teeth to demineralized solution. Ninety bovine incisors were used in three separate groups of 30 teeth each: adhesive group (G1), sealant of fossulae group (G2) and control group (G3). After bonding of brackets, the teeth were demineralized in a solution during 14 days with pH monitoring by a pH Meter. The analysis by stereoscopic microscope and scanning electron microscopy showed that in all 90 teeth was observed the occurrence of demineralization around orthodontic brackets. However, the areas of loss of enamel were different in the three groups (ANOVA, p < 0,001). The G2 group showed a significant reduction in the incidence of demineralization of enamel (71,9%), while the reduction in G1 was 38% when compared with group G3 (Tukey, p < 0,001). Scanning electron microscopy verified the presence of craters, pores and loss of the enamel aprismatic layer in the three groups. The use of pit and fissure sealant for protecting the labial surface of the teeth resulted in a significantly reduction of enamel demineralization in vitro.

UVOD Početne karijesne lezije gleđi (bele mrlje) se definišu kao područija demineralizovane gleđi, koja nastaju kao posledica neadekvatnog higijensko-dijetetskog režima. Prevencija belih mrlja je neophodna, kako bi se dobio maksimalan učinak terapije fiksnim ortodontskim aparatima. U prevenciji i terapiji belih mrlja se primenjuju preparati na bazi kazein- fosfopeptid – amorfnog kalcijum fosfata (CPP-ACP) i preparati na bazi fluorida. Ciljevi istraživanja su bili da se ispita prisustvo početnih karijesnih lezija gleđi, nakon tretmana fiksnim ortodontskim aparatima i da se istraži uspešnost terapije početnih karijesnih lezija gleđi. MATERIJAL I METODE RADA U studiju je bilo uključeno 100 pacijenata, uzrasta od 15-50 godina, kod kojih je indikovana terapija fiksnim ortodontskim aparatima na Klinici za stomatologiju Vojvodine. Pacijenti su bili podeljeni u dve grupe, eksperimentalnu (pacijenti koji su koristili preparate na bazi kazein- fosfopeptid – amorfnog kalcijum fosfata i standardne preparate za oralnu higijenu) i kontrolnu (koji su koristili samo standardne preparate za oralnu higijenu). Analizirane su fotografije pacijenata napravljene pre početka tretmana, nakon uklanjanja fiksnih ortodontskih aparata i nakon terapije početnih karijesnih lezija. Formirana je baza podataka, koja je bila korišćena za potrebe ovog istraživanja, u okviru „Onyxceph“ softverskog programa. U istraživanju se koristio upitnik, sastavljen većinom od pitanja zatvorenog tipa. REZULTATI Rezultati istraživanja pokazuju da je većina ispitanika bila ženskog pola (68%). Početne karijesne lezije su bile češće dijagnostikovane kod muškog pola. Najveći broj pacijenata je bio iz grupe mlađeg odraslog doba (42%) i adolescenata (32%). Kod 73% pacijenata, koji su prošli tretman fiksnim ortodontskim aparatima, dijagnostikovane su početne karijesne lezije zuba na kraju tretmana. Pacijenti koji su više puta u toku dana konzumirali konditorske proizvode, u toku ortodontskog tretmana, su imali najviši procenat belih mrlja (87,5%). ZAKLJUČCI Potvrđene su obe hipoteze: 1. Prevalencija početnih karijesnih lezija gleđi nakon fiksne ortodontske terapije bila je viša od 60%, kod pacijenata koji su minimum godinu dana nosili fiksni ortodontski aparat. 2. Terapija belih mrlja preparatima Tooth Mousse (CPP-ACP) je dala značajno bolje rezultate, u odnosu na grupu ispitanika koji su koristiti samo standardna sredstva za održavanje oralne higijene. Na osnovu dobijenih rezultata kliničkih istraživanja može se zaključiti da je prevalencija početnih karijesnih lezija gleđi proporcionalno veća kod pacijenata koji su imali slabiju oralnu higijenu u toku ortodontskog tretmana, u poređenju sa pacijentima koji su imali visoku svest o važnosti higijensko-dijetetskog režima. Primena Tooth Mousse pasta u tretmanu početnih karijesnih lezija gleđi od značajne je važnosti za remineralizaciju zubne gleđi. Dužina trajanja ortodontskog tretmana nije dovedena u direktnu vezu sa pojavom početnih karijesnih lezija gleđi.
INTRODUCTION The initial carious lesions (white spots) indicate an area of demineralization of enamel as a result of an inadequate hygiene-dietary regime. The prevention of white spots lesions (WSL) is necessary in order to obtain the maximum effect of the therapy with fixed orthodontic appliances. In the prevention and treatment of white spots, products based on casein-phosphopeptide-amorphous calcium phosphate (CPP-ACP) are applied as well as preparations based on fluoride. The aims of the study were to examine the presence of initial carious lesions on the surface of the tooth after treatment with fixed orthodontic appliances and to assess the success of the therapy of initial caries lesions. MATERIAL AND METHODS The study included 100 patients aged 15-50 who were treated with fixed orthodontic appliances, at the public Dentistry Clinic of Vojvodina. Patients were divided into two groups: experimental (patients who used Tooth Mousse paste and standard oral hygiene products) and control group (using only standard oral hygiene products). The photos of patients were made and analyzed in three stages of the study - before the beginning of the treatment, after the removal of fixed orthodontic appliances and after the therapy of initial caries lesions. Using the "Onyxceph" software program, the database was created, which was used for the purposes of this research. The questionnaire composed mostly of close-ended questions was used for the purpose of this survey. RESULTS The restates of this study indicated that a majority of respondents were female. (68%). The initial carious lesions were more commonly diagnosed in men. The majority of patients with WSL were in group of young adult people (42%) and adolescents (32%). In 73% of all patients who were treated with fixed orthodontic appliances, were diagnosed WSL on the end of the orthodontic treatment. Patients who consumed confectionery products several times during the day, during the orthodontic treatment, had the highest percentage of white spots lesions (87.5%). CONCLUSION Both hypotheses have been confirmed: 1.The prevalence of initial carious lesions of the tooth enamel after fixed orthodontic therapy was higher than 60% in patients who had fixed orthodontic appliances for at least a year. 2. White spot therapy with Tooth Mousse's products showed significantly better results compared to a group of subjects who only used standard oral hygiene products. On the basis of the obtained results of clinical trials, it can be concluded that the prevalence of initial caries lesions is proportionally greater in patients with lower oral hygiene during orthodontic treatment, compared to patients who had higher awareness of the importance of the hygiene-dietary regime. The use and application of Tooth Mousse paste in the treatment of initial carious lesion is vital for the re-mineralization of the enamel surface.

Orthodontic treatment is a common occurrence with up to 29.7% of the adolescent population (Bollen, Cunha-Cruz et al., 2007) and 1% of the adult population (Whitesides, Pajewski et al., 2008) receiving fixed braces. This type of treatment poses significant risks to the hard and soft tissues. One of the most common complications of fixed orthodontic appliance treatment is the demineralization and subsequent white spot lesion development in the enamel (Travess, Roberts-Harry et al., 2004. White spot lesions are the early sign of dental caries and the incidence of white spot lesions in orthodontic patients has been reported as being as high as 50 per cent (Gorelick, Geiger et al., 1982; Lundström and Krasse, 1987; Lovrov, Hertrich et al., 2007) with white spot lesions sometimes occurring as early as 1 month after banding (Ogaard, Rølla et al., 1988). Currently available chair-side saliva tests measure bacterial counts or acid production of the entire oral microflora. These tests tend to be able to predict patients who are at a low risk of demineralization more accurately than those at an increased risk. There is no single test to suit all individuals that can reliably identify at risk patients (Hausen, 1997;Reich, Lussi et al., 1999; Zimmer, Bizhang et al., 2008). The aim of this short-term study was to evaluate a technique to predict white spot lesion development in patients undergoing fixed appliance orthodontic treatment, and to analyse salivary bacteria to determine any differences in their metabolism. Fifty-two patients due to start fixed appliance orthodontic treatment agreed to participate in the study. Saliva samples collected before braces were placed and during treatment at six-eight week intervals, were mixed with a potassium phosphate buffer solution containing sucrose (10% w/v), at pH 5.7, and rate of pH change was measured over 30 minutes. Demineralisation development was determined from standardized intra-oral photographs. Subjects whose samples showed the greatest pH change towards acid production were selected for further salivary analysis. Ten of the higher risk individuals were further analysed, along with ten low risk individuals. Samples were grown on TSY20B plates, and pure strains of mutans streptococci were isolated and re-grown. These were then suspended in tryptone-soya broth and after 48 hours optical density, terminal pH and acid analysis using HPLC were measured and analysed. Of the fifty-two participants, three developed demineralisation. Two were identified as high risk from their initial saliva test, one as low risk, giving the test a sensitivity of 67% and specificity of 94%. There was no statistically significant change over time in the subjects, which indicated the risk status is unlikely to change. There was no statistically significant difference between the high and low risk groups in salivary microflora metabolism. The major acid produced in each case was lactic acid, with acetic acid being produced at lower concentrations. This test has the potential to be developed into a commercial chair-side saliva test. However, further testing is continuing and aims to follow the cohort of patients through the entirety of their treatment.
Thesis (D.Clin.Dent.) -- University of Adelaide, School of Dentistry, 2011

Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
White Spot Lesions (WSLs) are a common iatrogenic finding along brackets used in orthodontic treatment. WSLs are frequently noticed as small opaque lesions with lessened radiolucency which might have a lasting unaesthetic effect. These lesions might range from small lines along bracket peripheries and less frequently might be observed as larger demineralized areas with or without cavitation. The development of WSLs is principally enhanced by the accumulated plaque around brackets due to a compromised oral hygiene that might be aggravated by the presence of dental crowding. Furthermore, The presence of fixed orthodontic apparatus leads to alteration in the oral microflora causing reduction in the PH level and increased bacterial adherence to the metal facade through electrostatic effect. There are several preferences for treatment of WSL, ranging from conservative approaches relying on remineralization to invasive techniques. The severity of lesions is a determinant of which option is most appropriate. The management of WSLs is based on remineralization strategies or in other situations on a minimal-invasive camouflage of the lesions. Although orthodontic WSLs are one of the most frequent and most visible adverse effects of comprehensive fixed appliance treatment, the efficacy of their intervention continues to be assessed in the literature and up to date there is no consensus on the best evidence-based approach to manage such lesions. Therefore, the aim of the present thesis is to review and critically appraise the contemporary evidence related to causes, diagnosis, prevention, risk evaluation and management of WSL associated with orthodontic appliances. Furthermore, clinical recommendations that might be useful for both the general dentist as well as the orthodontist. This literature review will be undertaken by searching the database engines, Pubmed, Medline, Google Scholar, B-on and Science Direct. The search will include the literature published inbetween 2005-2021.

A ortodontia proporciona melhoria estética e oclusão adequada, no entanto constitui risco de conduzir a cáries dentárias. Os dispositivos ortodônticos acarretam a retenção de placa bacteriana e dificultam a higienização adequada das superfícies dentárias. Os objectivos desta revisão consistem em averiguar a prevalência da doença de cárie no paciente ortodôntico, considerando os factores de risco associados à introdução deste e as alterações decorrentes no meio oral e assim como os métodos preventivos e tratamentos. Para a sua realização foram utilizados livros e artigos científicos pelos motores de busca: Pubmed, ResearchGate, Scielo e B-on.
The orthodontic treatment provides aesthetics improvements and correct dental occlusion, however it promotes an higher risk of dental caries. Orthodontics appliances lead to plaque retention and hamper an effective hygiene of dental surfaces. The aims of this review are to determine the prevalence of caries lesions in the orthodontic patient, considering the risk factors associated with the introduction of orthodontic appliances resulting in changes of the oral environment, as well as preventive methods and treatments. For the realization of this review were used books and scientific articles by search engines: Pubmed, ResearchGate, Scielo and B-on.