Management of post orthodontic white spots lesions

Dhiab, Azmi Ben

http://hdl.handle.net/10400.26/38684

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Authors

Dhiab, Azmi Ben

Advisor(s)

Bugaighis, Iman

Abstract(s)

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.