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. 2021 Nov 1;11(1):21347.
doi: 10.1038/s41598-021-00561-7.

A novel method quantifying caries following orthodontic treatment

Christina Erbe  1 , Luisa Hartmann  2 , Irene Schmidtmann  3 , Daniela Ohlendorf  4 , Heinrich Wehrbein  2
Affiliations

A novel method quantifying caries following orthodontic treatment

Christina Erbe et al. Sci Rep. .

Abstract

This retrospective pilot study used a newly developed evaluation tool to assess the prevalence and incidence of White Spot Lesions (WSL) before and after multibracket appliance (MB) therapy. Digital photographs of 121 adolescent patients (63 ♂, 58 ♀) with metal brackets were analyzed retrospectively before and after MB therapy. The labial surfaces of anterior teeth, canine teeth, and premolars in the upper (UJ) and lower jaws (LJ) were evaluated using the Enamel Decalcification Index (EDI) by Banks and Richmond (Eur J Orthod, 16(1):19-25, 1994, levels 0-3) and a specially developed digitally scaled graticule with concentric circles to quantify the extent of WSL (in %). The statistical data analysis was based on crosstabulations and logistic regression. Before MB, 69.4% of the patients presented at least one WSL and 97.5% after, an increase of 28.1%. Before MB, 18.4% of the tooth surfaces (TS) showed an EDI level of 1-3. After MB, 51.8% of the TS featured WSL. 18.2% of the TS showed a WSL to the extent of ≥ 20-100% before and 52.3% after MB. The incidence in the UJ (71-79%) as well as the LJ (64-76%) was highest for the first and second premolars and lowest for LJ incisors (22-35%). The probability for developing a new distal WSL is higher than developing gingival, mesial or occlusal WSL. Labial MB therapy drastically increases the risk of developing WSL. We verified a concise quantification of the extent of labial WSL with the evaluation index.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Description of the Enamel Decalcification Index (EDI) by Banks and Richmond to measure the intensity of White Spot Lesions.
Figure 2
Figure 2
Evaluation tool with graticule and concentric circles.
Figure 3
Figure 3
(a, b) Bar diagrams describing the prevalence of WSL of upper teeth (a) and lower teeth (b). The x-axis divides the examined teeth according to the time of their examination (WSL prior to MB; WSL after MB). The y-axis displays the percentage that corresponds to the occurrence of WSL; only the positive results (WSL = 1) were included.
Figure 4
Figure 4
Bar diagram describing the WSL prevalence distributed by percentage of intensity (with Enamel Decalicification Index, EDI). The x-axis shows EDI levels 0–3 and their percentage of the WSL evaluation prior to and after MB. The y-axis specifies the prevalence in %.
Figure 5
Figure 5
Percentaged distribution of the evaluation index according to the occurrence of WSL. The x-axis of the bar diagram shows the evaluation index (0–100%) and its distribution by percentage upon evaluating WSL, prior to and after MB respectively. The y-axis shows the prevalence in %.
Figure 6
Figure 6
Incidence distribution based on intensity (EDI).
Figure 7
Figure 7
Distribution of the incidence according to extent (%).
See this image and copyright information in PMC

References

    1. Micheelis W, Schiffner U. Vierte Deutsche Mundgesundheitsstudie (DMS IV) Ärzte Verlag; 2006.
    1. Artun J, Brobakken BO. Prevalence of carious white spots after orthodontic treatment with multibonded appliances. Eur. J. Orthod. 1986;8(4):229–234. doi: 10.1093/ejo/8.4.229. - DOI - PubMed
    1. Gontijo L, Cruz Rde A, Brandão PR. Dental enamel around fixed orthodontic appliances after fluoride varnish application. Braz. Dent. J. 2007;18(1):49–53. doi: 10.1590/S0103-64402007000100011. - DOI - PubMed
    1. Ogaard B. Cariologic aspects of orthodontic treatment. Nor. Tannlaegeforen Tid. 1989;99(20):802–805. - PubMed
    1. Robertson AJ, Toumba KJ. Cross-polarized photography in the study of enamel defects in dental paediatrics. J. Audiov. Media Med. 1999;22(2):63–70. doi: 10.1080/014051199102179. - DOI - PubMed

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