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Background: White spot lesions (WSL) are common side effects of orthodontic treatment with fixed appliances, in which the surface layer of enamel is demineralised. Thus, remineralisation, that is a partial or complete reversal, of these lesions can occur as they affect the surface enamel. Remineralisation with low-dose fluoride, in addition to optimal oral hygiene and diet, has been recommended to manage WSL. The aim of the planned trial is to assess the effectiveness of a fluoride-containing bioactive glass toothpaste (BioMin™) in its ability to remineralise post-orthodontic demineralised WSL. Methods: A single-centre, double-blind randomised clinical trial to assess intervention with Bio-Min toothpaste on WSL forming on the teeth of young people completing orthodontic treatment. Discussion: Remineralisation of WSL can vary depending on the individual and the site of the lesion. There is a range of oral fluoride delivery methods which include toothpastes, oral rinses, and gel preparations, which can aid remineralisation of these lesions. Identifying effective methods of remineralisation to manage this common and unsightly complication of fixed appliance therapy can improve the health and aesthetics of dentition. Trial registration: ISRCTN.com International Standard Randomised Controlled Trials Number (ISRCTN) 14479893. Registered on 14 May 2020 [ABSTRACT FROM AUTHOR]

Objective: To investigate the impact of various degrees of white spot lesions (WSLs) of maxillary anterior teeth on the aesthetic perception and treatment satisfaction among orthodontic patients, orthodontists and other dental specialists and to evaluate the differences among the three groups. Methods: A total of 45 orthodontic patients (OP), 45 orthodontists (OR) and 45 other dental specialists (OS) were recruited. Subjective evaluations of perceived aesthetics and treatment satisfaction were performed towards eight digitally generated photographs of maxillary anterior teeth with incremental degrees of WSLs using a numerical visual analogue scale (VAS) from 0 to 100. Data were collected and analysed with descriptive statistics, repeated one‐way analysis of variance and multivariable generalized estimating equations. Results: A total of 135 valid questionnaires were collected. Regarding aesthetic scores for WSLs, OP gave more positive scores than OR and OS (p <.05) towards excessive white spot formation without colouration and were more tolerant than OR (p <.05) towards excessive white spot formation with slight colouration. The level of treatment satisfaction for slight to severe WSLs without cavitation was higher in OP than OR. Patients with higher education levels had more negative scores for aesthetic perception and treatment satisfaction (p <.05). Patients who brushed teeth more frequently scored lower in treatment satisfaction (p <.05). Conclusions: Orthodontists were the most critical when evaluating aesthetics and treatment satisfaction for slight to severe WSLs without cavitation. For orthodontic patients, better oral hygiene habits and higher education levels were associated with more critical attitudes towards WSLs. [ABSTRACT FROM AUTHOR]

Abstract Background White spot lesions (WSL) are common side effects of orthodontic treatment with fixed appliances, in which the surface layer of enamel is demineralised. Thus, remineralisation, that is a partial or complete reversal, of these lesions can occur as they affect the surface enamel. Remineralisation with low-dose fluoride, in addition to optimal oral hygiene and diet, has been recommended to manage WSL. The aim of the planned trial is to assess the effectiveness of a fluoride-containing bioactive glass toothpaste (BioMin™) in its ability to remineralise post-orthodontic demineralised WSL. Methods A single-centre, double-blind randomised clinical trial to assess intervention with Bio-Min toothpaste on WSL forming on the teeth of young people completing orthodontic treatment. Discussion Remineralisation of WSL can vary depending on the individual and the site of the lesion. There is a range of oral fluoride delivery methods which include toothpastes, oral rinses, and gel preparations, which can aid remineralisation of these lesions. Identifying effective methods of remineralisation to manage this common and unsightly complication of fixed appliance therapy can improve the health and aesthetics of dentition. Trial registration ISRCTN.com International Standard Randomised Controlled Trials Number (ISRCTN) 14479893 . Registered on 14 May 2020

Purpose Evaluation of the efficacy of two novel formulations of arginine and theobromine in remineralizing artificial enamel defects using in vitro testing techniques- Microhardness and SEMMaterials and methods Enamel slabs measuring 3 mm by 3 mm by 1.5 mm were created using 11 healthy premolars that were excised for orthodontic treatment. Group 1 (control, treated with merely a remineralization solution), Group 2 (0.05% arginine in 10 ml distilled water), and Group 3 (2% theobromine in 10 ml distilled water) were the three groups to which the slabs were randomly allocated (n = 7 per group). The pH cycle was run for 14 days, starting with a 72-h demineralization period and ending with 11 days of remineralization in the corresponding solutions. Prior to and during remineralization, microhardness was measured, and surface features were assessed using scanning electron microscopy (SEM). Statistical analysis, including Paired T Test, one-way ANOVA, and post hoc Tukey tests, determined that the mean values were significant at the 0.05 level.Results The control group showed a mean microhardness increase from 192.09 ± 19.30 to 208.58 ± 5.76. The arginine group increased significantly from 217.20 ± 4.24 to 304.00 ± 15.96, and the theobromine group from 214.09 ± 7.67 to 283.14 ± 10.91. Statistical analysis indicated that both arginine and theobromine groups had significantly greater microhardness improvements compared to the control (p

Abstract Orthodontic adhesive doped with sulfur-modified TiO2 promotes antibacterial effect. The objective of the study was to characterize the physical, mechanical and antibacterial properties of the orthodontic bracket adhesive, doped with modified titanium dioxide nanoparticles. Sulfur-doped TiO2 was synthetized and morphological topography was analyzed with TEM and SEM imaging. The catalytic performance during the degradation of rhodamine B was assessed. Nanomaterial was added at four concentration (1, 3, 6, and 10 wt%) to a commercial orthodontic adhesive. The shear bond strength and microhardness of a resin-based orthodontic adhesive containing S-TiO2 were evaluated. The inhibitory effect of the pure and doped adhesives against Escherichia coli and Streptococcus mutans was examined. As the results, the highest antimicrobial activity and good adhesive properties were noticed for light-cured orthodontic adhesive doped with 3% of S-TiO2. In this case, orthodontic adhesives with strong and long-lasting bactericidal properties can be created through the incorporation of modified TiO2 without negatively influencing microhardnesses, and bonding ability. White spot lesion and demineralization, which occurs very often in patients during orthodontic treatment, can be therefore minimized.

The aim of this study was to compare the efficacy of resin infiltration and bifluoride varnish in white spot lesions (WSLs) in children between the ages of 8 and 15. Methods and Results: This study was conducted at Alma Mater Europaea Campus College "Rezonanca" (Pristina, Kosovo) and enrolled 60 participants (34 females and 26 males) between the ages of 8 and 15 years with WSLs in the vestibular surface on permanent anterior teeth. The participants were randomly assigned to the resin infiltration (Icon®) group (Group 1, n=30) and the bifluoride varnish (F&A Biflu) group (Group 2, n=30). Both materials were applied on permanent anterior teeth with WSLs in enamel. WSLs were assessed using ICDAS-II (International Caries Detection and Assessment System) criteria by visual inspection, which were coded as 1 and 2. Lesions were evaluated before the material was applied (T0), just after application (T1), and at a 6-month follow-up (T2). A total of 173 teeth from 60 participants were included in our study. Group 1 showed a significant decrease in ICDAS-II scores throughout time intervals T0-T1 (P=0.001), T0-T2 (P=0.001), and T1-T2 (P=0.041). In Group 2, there was no visible difference between T0-T1 (P=1.00) but a significant decrease between T0-T2 (P=0.001) and T1-T2 (P=0.001). Comparisons between the two groups in relation to T0, T1, and T2 were analyzed using the independent samples t-test. Significant differences have been presented in two cases at T1 (P=0.001) and T2 (P=0.003). ICDAS-II scores decreased significantly in Group 1. Conclusion: The application of RI in WSLs was found to be more effective than the application of BFV. While the effects of BFV in WSLs persisted over time, the effect of RI was evident as soon as WSLs were treated. Moving forward, we recommend considering RI as a favorable option for WSL treatment. Future studies with long-term follow-ups are necessary to corroborate these results.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: White spot lesions are one of the most common problem during and after orthodontic therapy. The present study was accomplished to evaluate the ability of Magnesium gel at different concentration and diode laser in combination compared with commercially available 1.23%APF in color restoring of WSL on permanent teeth. Materials and Methods: In this in vitro study, 42 human caries-free premolar teeth were randomely divided into 6 experimental groups: Group A: Control (artificial saliva), Group B: 0.5%MgCl2 gel, Group C: 1%MgCl2 gel, Group D: 0.5%MgCl2 gel and Diode laser, Group E: 1%MgCl2 gel and Diode laser and Group F: 1.23%APF. The difference between the displayed color and the original color standard (ΔE) was assessed by colorimeter. The surface topography of teeth samples from each tested group was examined by a SEM. Collected data were investigated using one-way ANOVA followed by Duncan post hoc test at p ≤ 0.05. Result: A significant difference in (ΔE) was noticed among groups (p= 0.006). Group (B) showed the lowest ΔE value (9.4±1.6), followed by group (D) (10.2±1.1), group (F) (10.4±2.6), group (A) (11.6±1.3), group (C) (12.9 ±2.3) and group (E) (13.2±1.3). Conclusion: 0.5% magnesium gel is as 1.23% APF gel in color restoring of white spot lesion. No synergistic effect between materials and diode laser. [ABSTRACT FROM AUTHOR]

Fixed appliance (FA) therapy predisposes patients to white spot lesions (WSLs). The F-ACP complex (amorphous calcium phosphate nanoparticles enriched with carbonate and fluorine and coated with citrate) has been effective for in vitro enamel remineralization. The aim of this study was to evaluate the efficacy of the F-ACP complex in remineralizing WSLs after FA therapy. One hundred and six adolescents (aged 12–20 years) were randomized into study and control groups after FA therapy. Patients in the study group were advised to use dental mousse containing F-ACP applied within Essix retainers for six months. The presence of WSLs was recorded at baseline (T0), 3 months (T1), and 6 months (T2) according to the International Caries Detection and Assessment System (ICDAS). Visual Plaque Index (VPI) and Gingival Bleeding Index (GBI) were recorded. Among 106 study participants, 91 (52 and 39 in study and control groups, respectively) completed the study. The results showed that the ICDAS score was significantly lower (p < 0.001) in the study group than in the control group between T0 and T2. The application of mousse containing the F-ACP complex inside Essix retainers for six months is effective in remineralizing white spot lesions in patients after FA therapy without side effects. [ABSTRACT FROM AUTHOR]

In this preliminary study, a multidisciplinary method based on high-resolution analytical techniques (such as microcomputed tomography, Raman Microspectroscopy, scanning electron microscopy, and Vickers microhardness test) was exploited to evaluate the alterations that occur in human teeth at the initial stage of the carious lesion. To this purpose, six extracted molars displaying a natural white spot lesion (WSL) were investigated. Specific morphological, structural, and chemical parameters, such as the mineral density, indentation hardness, molecular and elemental composition, and surface micromorphology were obtained on the WSL, and the results were statistically compared (t-test, p < 0.05) to those of the sound enamel on the same tooth. In the WSL, with respect to the sound area, a decrease in the mineral density and crystallinity was detected together with differences in the molecular composition and surface microstructure, such as the occurrence of micropores and irregularities. Moreover, the elemental analysis highlighted in WSL showed a statistically significant decrease in Ca and P percentages. In conclusion, this multidisciplinary approach allows us to fully characterize the area of interest, providing a deeper knowledge of these enamel lesions, which could have important clinical implications. [ABSTRACT FROM AUTHOR]

To evaluate the changes in lesion depth and mineral density of resin infiltration-treated white spot lesions against a simulated oral environment using thermal and acidic challenges in vitro. Two enamel slabs were prepared from each buccal surface of permanent human premolars, for a total of 56 slabs. Artificial white spot lesions were induced. One specimen was treated with resin infiltration, while the other was used as an untreated control. A micro-CT was used to assess the lesion depth and mineral density of each specimen. Subsequently, all specimens were subjected to 10,000 cycles of thermocycling and pH cycling for 10 days before being re-evaluated using the micro-CT. Lesion depth and mineral density were examined and compared between before and after aging procedures within each group by the paired sample t -test. The independent samples t -test was utilized to compare lesion depth progression and percentage change of mineral density between groups. After aging, there was both a significant lesion depth progression and a mineral loss in the control and resin infiltration groups. Mean lesion depth progression was 132.88 ± 4.18 µm for the control group and 52.31 ± 4.16 µm for resin infiltration group. Percentage mineral density loss as a percentage for the control and resin infiltration groups were 16.1 ± 0.64 % and 8.83 ± 0.30 %, respectively. The resin infiltration group demonstrated a significantly lower mean lesion depth progression and percentage changes in mineral loss compared to the control group. The lesion depth and mineral density changes in the resin infiltrated-treated group were lower than untreated white spot lesions after aging procedures using thermal and acidic challenges. Resin infiltration is a promising approach to inhibit the progression of white spot lesions related to the initial stage of dental caries. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the effect of adding CPP-ACP into a daily-use toothpaste on the remineralization of enamel caries lesions.Methods: Thirty enamel blocks were obtained from bovine incisors. Each specimen was divided into three equal parts. One-third of each block was coated with varnish to serve as a sound control area, while the remaining two-thirds underwent a demineralization process. After demineralization, another one-third of the surface was varnished, leaving only one-third of the enamel to undergo remineralization. The enamel blocks were divided into three groups (n=10), according to the remineralization treatment applied as follows: Group 1: fluoride-containing toothpaste, Group 2: CPP-ACP-containing toothpaste, and Group 3: fluoride- and CPP–ACP–containing toothpaste. Remineralization was assessed through the Vickers microhardness test at various depths (20, 50, 120 and 200 µm). The data were analyzed by ANOVA and LSD test, and P< 0.05 was considered statistically significant.Results: There was a significant difference in remineralization efficacy between the groups at the depth of 20 µm (P 0.001). Pairwise comparisons revealed that the toothpaste containing both fluoride and CPP-ACP had a significantly greater microhardness than other experimental groups (P 0.05). No significant difference was observed between the study groups concerning microhardness at 50, 120 and 200 µm depths (P 0.05).Conclusions: CPP-ACP can serve as a suitable alternative to fluoride in daily-use toothpaste for enamel remineralization. The concurrent use of fluoride and CPP-ACP in toothpaste can generate a synergistic remineralizing effect at the enamel surface layer.

Background Initial caries lesion (ICLs) adjacent to orthodontic brackets are the most common side effect of orthodontic treatment with fixed appliances. The reported prevalence is uncertain and varies considerably across studies, from 27% to 97%. Objectives This paper was designed to evaluate and synthesize the available evidence on the prevalence and incidence rates of ICLs in relation to orthodontic treatment. Selection criteria: The review (Prospero protocol CRD42023412952) included randomized and non-randomized clinical trials of interventions, cohort studies, and cross-sectional studies, published after 1990 on the prevalence or incidence of ICLs during or after orthodontic treatment with fixed appliances. Search methods: Pubmed, Scopus, and Embase databases were searched from 1990 until 01 May 2023. The risk of bias assessment was performed with RoB 2 and ROBINS-I tool and the Joanna Briggs Institute Critical Appraisal Checklist. Data collection and analysis: The proportion of individuals with ICLs, reported as the number/percentage of individuals/teeth with ICLs or mean number of ICLs per subject, were used to synthesize results. Results The search yielded a total of 468 papers; 21 studies were included in the systematic review, 2 of which were not included in the meta-analysis. The prevalence rate [95%CI] of ICLs was 0.57% [0.48; 0.65] in 1448 patients, 0.22% [0.14; 0.33] in 11583 teeth, with a mean number of lesions equal to 2.24 [1.79; 2.70] in 484 patients evaluated. The incidence rate of new carious lesions developed during orthodontic treatment was 0.48% [0.33; 0.63] in 533 patients, 0.15% [0.08; 0.26] in 1890 teeth with a mean number of ICLs equal to 2.29 [1.12; 3.46] in 208 patients evaluated. Limitations Although the high number of included studies and the overall good quality, there was a significant heterogeneity in the collected data. Conclusion The prevalence and incidence rates of ICLs in subjects undergoing orthodontic treatment are quite high and raise some concerns in terms of risk assessment of orthodontic treatment. ICLs represent an alarming challenge for both patients and professionals. Effective caries prevention strategies during treatment need to be considered and implemented where appropriate. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the effect of adding CPP-ACP into a daily-use toothpaste on the remineralization of enamel caries lesions. Methods: Thirty enamel blocks were obtained from bovine incisors. Each specimen was divided into three equal parts. One-third of each block was coated with varnish to serve as a sound control area, while the remaining two-thirds underwent a demineralization process. After demineralization, another one-third of the surface was varnished, leaving only one-third of the enamel to undergo remineralization. The enamel blocks were divided into three groups (n=10), according to the remineralization treatment applied as follows: Group 1: fluoride-containing toothpaste, Group 2: CPP-ACP-containing toothpaste, and Group 3: fluoride- and CPP-ACP-containing toothpaste. Remineralization was assessed through the Vickers microhardness test at various depths (20, 50, 120 and 200 µm). The data were analyzed by ANOVA and LSD test, and P< 0.05 was considered statistically significant. Results: There was a significant difference in remineralization efficacy between the groups at the depth of 20 µm (P<0.001). Pairwise comparisons revealed that the toothpaste containing both fluoride and CPP-ACP had a significantly greater microhardness than other experimental groups (P<0.05). No significant difference was observed between the study groups concerning microhardness at 50, 120 and 200 µm depths (P>0.05). Conclusions: CPP-ACP can serve as a suitable alternative to fluoride in daily-use toothpaste for enamel remineralization. The concurrent use of fluoride and CPP-ACP in toothpaste can generate a synergistic remineralizing effect at the enamel surface layer. [ABSTRACT FROM AUTHOR]

Abstract Background White spot lesions represent the first stage of caries and their prevalence has been increasing in recent years, particularly in patients undergoing orthodontic treatment. DIferential diagnosis and lesion activity are essential to decide on the clinical approaches to treatment. The aim of this study is to understand if the new diagnostic tools such as fluorescence, microradiography and computed microtomography have the potential to change the conventional treatment of white spots”. Methods A systematic search of available studies in the literature was carried out, using PRISMA guidelines, in Pubmed and Scopus electronic databases and manually to identify relevant articles to answer the PICO question: “Do the new diagnostic tools have the potential to change the conventional treatment of white spots?”. This systematic review included randomized controlled trials (RCT), cross-sectional and longitudinal studies complying with the following inclusion criteria: (i) studies in humans, (ii) studies about white spot lesions, (iii) studies published between 2012 and 2023, (iv) studies having both diagnosis and treatment and (v) studies with full text available. In this review we excluded other systematic reviews of clinical trials and in vitro studies. The RoB tool was used to assess the risk of bias. Results The systematic literature search identified 143 potentially relevant references, which after applying the exclusion criteria, resulted in 20 articles. Regarding diagnostic methods, most articles found were based on conventional methods of visual examination (n:10) or fluorescence (n:7). The least referenced diagnostic techniques were based on the use of clinical photographs (n:2), cross-sectional microradiography (n:1) and computed microtomography (n:1). The use of DIAGNOdent was reported by 3 in vitro studies. With regard to therapies, most studies reported the use of infiltrating resin (n:7) and fluoride-based products (n:5). Other studies have reported the use of self-assembling peptide P11-4 (n:1), home care (n:1), casein phosphopeptide-amorphous calcium phosphate (n:2) and hydrochloric acid (n:1). Combination therapies were also considered. Conclusion Diagnostic tool does not have the potential to change the form of treatment, whether it is a conventional method or a more differentiated one.

This comprehensive review of 25 studies on white spot lesion (WSL) treatment in children highlights the effectiveness of resin infiltration (RI) and the potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) as prominent treatment options. These findings are underscored by comparative studies, emphasizing the importance of long-term effects and age-specific considerations in treatment planning. The diversity in study types and diagnostic methods underscores the need for personalized approaches to WSL management. While common conclusions emerge, such as the efficacy of CPP-ACP and RI, contrasting findings remind us of the complexity of WSL management. The call for further research, particularly long-term studies, indicates the evolving nature of this field and the need for refining treatment protocols. Moreover, these studies emphasize the significance of conservative approaches, including regular oral hygiene practices and minimally invasive interventions, as integral components of a holistic WSL treatment strategy.

Abstract Background To explore the relationship between changes in salivary cytokine levels and the occurrence of white spot lesions in adolescents receiving clear aligner orthodontic treatment and investigate the predictive value of various factors for lesion occurrence. Methods We retrospectively analyzed sixthy eight adolescent in the permanent dentition period, who received clear aligner orthodontics in our hospital were randomly divided into two groups according to the occurrence or aggravation of white spot lesions after treatment. The general condition of the oral cavity was analyzed, saliva was collected, and inflammation-related cytokines with varying transcription levels between groups were screened by transcriptome analysis. The expression levels of inflammatory cytokines in the saliva of the patients in the two groups were measured, and the risk factors for white spot lesions were screened by correlation analysis and binary logistic regression analysis. The value of the independent and combined application of risk factors for predicting the occurrence of white spot lesions in adolescent patients after invisible orthodontic treatment was analyzed by receiver operating characteristic (ROC) curve analysis. Results Transcriptome and GO and KEGG pathway analyses showed that there were differences in the transcription levels of inflammatory cytokines such as CXCL1, CXCL2, CXCL8, CCL3, CCL4, IL-1β and IL-2 between groups. The levels of CXCL8, CCL3, CCL4, IL-1β and IL-2 in the saliva of patients with white spot lesions were significantly higher in patients after invisible orthodontic treatment (P

Background: White spot lesions represent the first stage of caries and their prevalence has been increasing in recent years, particularly in patients undergoing orthodontic treatment. DIferential diagnosis and lesion activity are essential to decide on the clinical approaches to treatment. The aim of this study is to understand if the new diagnostic tools such as fluorescence, microradiography and computed microtomography have the potential to change the conventional treatment of white spots". Methods: A systematic search of available studies in the literature was carried out, using PRISMA guidelines, in Pubmed and Scopus electronic databases and manually to identify relevant articles to answer the PICO question: "Do the new diagnostic tools have the potential to change the conventional treatment of white spots?". This systematic review included randomized controlled trials (RCT), cross-sectional and longitudinal studies complying with the following inclusion criteria: (i) studies in humans, (ii) studies about white spot lesions, (iii) studies published between 2012 and 2023, (iv) studies having both diagnosis and treatment and (v) studies with full text available. In this review we excluded other systematic reviews of clinical trials and in vitro studies. The RoB tool was used to assess the risk of bias. Results: The systematic literature search identified 143 potentially relevant references, which after applying the exclusion criteria, resulted in 20 articles. Regarding diagnostic methods, most articles found were based on conventional methods of visual examination (n:10) or fluorescence (n:7). The least referenced diagnostic techniques were based on the use of clinical photographs (n:2), cross-sectional microradiography (n:1) and computed microtomography (n:1). The use of DIAGNOdent was reported by 3 in vitro studies. With regard to therapies, most studies reported the use of infiltrating resin (n:7) and fluoride-based products (n:5). Other studies have reported the use of self-assembling peptide P11-4 (n:1), home care (n:1), casein phosphopeptide-amorphous calcium phosphate (n:2) and hydrochloric acid (n:1). Combination therapies were also considered. Conclusion: Diagnostic tool does not have the potential to change the form of treatment, whether it is a conventional method or a more differentiated one. [ABSTRACT FROM AUTHOR]

Introduction: Streptococcus mutans and Lactobacillus count is found to be higher in orthodontic patients and is one of the leading causes of white spot lesion formation. Probiotics are emerging as alternative methods of plaque control. Aims and Objectives: To determine the effects of different types of probiotics on S. mutans and Lactobacillus levels in saliva of orthodontic patients. Materials and Methods: A total of 140 subjects were divided into Control group (Group I) with 20 subjects and study group taking probiotics (Group II) with 120 subjects. Saliva samples were taken at baseline (T 0), after three weeks (T 1), and after six weeks (T 2). The samples were diluted and incubated on specific agar media plates. The colonies observed were expressed in colony forming units per milliliter (CFU/ml) of saliva. Group II was further subdivided into six subgroups based on probiotic intake with 20 subjects in each subgroup. Results: Statistically significant difference was found in salivary microbial counts in all the probiotic groups (p < 0.05). The highest reduction in count of S. mutans (653.00 ± 102.23 CFU/ml to 84.1 ± 30.48 CFU/ml) and Lactobacilli (87.35 ± 15.64 CFU/ml to 14.60 ± 8.28 CFU/ml) was seen in the lozenges group. Conclusion: Probiotics decrease the number of salivary S. mutans and Lactobacilli and lozenges could be considered for orthodontic fixed appliance patients. [ABSTRACT FROM AUTHOR]

Copyright of Diyala Journal of Medicine is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: To explore the relationship between changes in salivary cytokine levels and the occurrence of white spot lesions in adolescents receiving clear aligner orthodontic treatment and investigate the predictive value of various factors for lesion occurrence. Methods: We retrospectively analyzed sixthy eight adolescent in the permanent dentition period, who received clear aligner orthodontics in our hospital were randomly divided into two groups according to the occurrence or aggravation of white spot lesions after treatment. The general condition of the oral cavity was analyzed, saliva was collected, and inflammation-related cytokines with varying transcription levels between groups were screened by transcriptome analysis. The expression levels of inflammatory cytokines in the saliva of the patients in the two groups were measured, and the risk factors for white spot lesions were screened by correlation analysis and binary logistic regression analysis. The value of the independent and combined application of risk factors for predicting the occurrence of white spot lesions in adolescent patients after invisible orthodontic treatment was analyzed by receiver operating characteristic (ROC) curve analysis. Results: Transcriptome and GO and KEGG pathway analyses showed that there were differences in the transcription levels of inflammatory cytokines such as CXCL1, CXCL2, CXCL8, CCL3, CCL4, IL-1β and IL-2 between groups. The levels of CXCL8, CCL3, CCL4, IL-1β and IL-2 in the saliva of patients with white spot lesions were significantly higher in patients after invisible orthodontic treatment (P < 0.05). Correlation analysis and binary logistic regression analysis showed that elevated levels of CXCL8, IL-1β and IL-2 were independent risk factors for the occurrence of white spot lesions (P < 0.05). CXCL8 had the highest independent predictive value for the occurrence of white spot lesions (AUC = 0.773, P < 0.05), and the combination of IL-1β and IL-2 was also of high value in predicting the occurrence of white spot lesions. Conclusion: After invisible orthodontic treatment, the oral microenvironment, including inflammatory cytokine levels, in adolescent patients changes; in particular, the levels of inflammatory cytokines such as CXCLs and ILs change. CXCL8 expression is significantly associated with the occurrence of white spot lesions and is an important potential target for the prevention and treatment of white spot lesions in the future. [ABSTRACT FROM AUTHOR]

The article provides consensus recommendations for preventing and managing white spot lesions (WSLs) during orthodontic treatment, emphasizing the importance of individualized caries management measures and effective plaque control. Topics include caries risk assessment, selection of orthodontic treatment modality, use of fluoride, and transitional care after orthodontic treatment, addressing the multifaceted approach to minimize the risk of WSLs and promote oral health.

Fixed appliance (FA) therapy predisposes patients to white spot lesions (WSLs). The F-ACP complex (amorphous calcium phosphate nanoparticles enriched with carbonate and fluorine and coated with citrate) has been effective for in vitro enamel remineralization. The aim of this study was to evaluate the efficacy of the F-ACP complex in remineralizing WSLs after FA therapy. One hundred and six adolescents (aged 12–20 years) were randomized into study and control groups after FA therapy. Patients in the study group were advised to use dental mousse containing F-ACP applied within Essix retainers for six months. The presence of WSLs was recorded at baseline (T0), 3 months (T1), and 6 months (T2) according to the International Caries Detection and Assessment System (ICDAS). Visual Plaque Index (VPI) and Gingival Bleeding Index (GBI) were recorded. Among 106 study participants, 91 (52 and 39 in study and control groups, respectively) completed the study. The results showed that the ICDAS score was significantly lower (p < 0.001) in the study group than in the control group between T0 and T2. The application of mousse containing the F-ACP complex inside Essix retainers for six months is effective in remineralizing white spot lesions in patients after FA therapy without side effects.

Objective To evaluate the effect of high-fluoride mouth rinse and high-fluoride toothpaste on the development of demineralized lesions (DLs) during orthodontic treatment. Trial design Three-armed parallel-group randomized controlled trial. Methods The trial was performed with 270 adolescent orthodontic patients. Randomization was performed in blocks of 30, enrolling the patients into one of the following groups: the fluoride mouth rinse (FMR) group receiving 0.2% sodium fluoride (NaF) mouth rinse plus 1450 ppm fluoride (F) toothpaste; high-fluoride toothpaste (HFT) group receiving 5000 ppm F toothpaste; and the Control (CTR) group receiving 1450 ppm F toothpaste. Inclusion criteria were patients scheduled for treatment in both arches with fixed appliances and age between 12 and 20 years. The primary outcome variable was the proportion of participants with at least one new demineralized lesion as assessed on digital photos taken before and after treatment, analysed by a blinded clinician. The analysis included all teeth or teeth in the aesthetic zone, i.e. all central incisors, lateral incisors, and canines. A random sample of 30 participants was assessed to check intra- and inter-reliability. For pairwise comparison between groups, Fisher's non-parametric permutation test was used for continuous variables. Blinding was employed during the caries registration and data analysis. Recruitment October 2010 to December 2012 Results In total, 270 patients were randomized, of which 22 were excluded during treatment. Therefore, 248 participants were included in the study. The number of patients with an increase of ≥1 DL, including only central- and lateral incisors and canines, during orthodontic treatment, was significantly lower in the HFT group, 51/85 60%, compared to the CTR group, 64/82 78%, RR 0.77 (CI 0.62; 0.95), P =.01 and in the FMR group, 47/81 58%, compared to the CTR group, RR 0.74 (CI 0.60; 0.92), P <.01. Conclusions To prevent demineralized lesions in the aesthetic zone, high-fluoride mouth rinse and high-fluoride toothpaste may be recommended. Limitations The protocol was not registered, and the present study did not use a double-blinded design. [ABSTRACT FROM AUTHOR]

OBJECTIVES: In order to assess the changes in tooth orthodontic adhesive interface microleakage after applying a caries resin penetrated to the sound enamel tooth surface in different storage media. MATERIALS AND METHODS: A total of 60 human maxillary first premolars (orthodontic extraction) were collected by random separation of the teeth into two equal groups. The control group was classified into three subgroups (n = 10) (control in deionized water, control in milk, and control in energy drink), while the experimental one (treated with ICON) was categorized into three subgroups (n = 10) (ICON in deionized water, ICON in milk, and ICON in energy drink) incubation phase lasted three weeks in total. RESULTS: A one‑way analysis of variance (ANOVA) yielded a significant difference between all experimental subgroups (ICON in deionized water, ICON in milk, and ICON in energy drink) and control subgroups (control in deionized water, control in milk, and control in energy drink). The control group in the energy drink subgroup had the highest mean microleakage value when compared to the other subgroups, whereas the resin‑infiltrated group in deionized water had the lowest mean value. According to the results of the T‑test, ICON pre‑treatment tooth samples had significantly lower mean values of microleakage than non‑ICON tooth samples. CONCLUSIONS: The adhesive system (control group) revealed that a resin infiltrate on a sound enamel surface prior to orthodontic bracket bonding reduced bracket tooth interface microleakage in all examined samples. The ICON‑infiltrated surface was discovered to provide a secondary preventive strategy against white spot lesion development by reducing microleakage under brackets. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of a 5% sodium fluoride varnish with functionalized tri-calcium phosphate (fTCP) on post-orthodontic white spot lesions. A secondary aim was to study if the patients and their clinicians perceived clinical improvements. Method and materials: Fifty-nine patients with at least two visible WSLs on their maxillary incisors, canines, or first premolars present at the debonding of fixed appliances (baseline) were enrolled and assigned to a Varnish group (Clinpro White Varnish, 3M Espe) receiving topical applications at baseline and after 8 weeks, or a Control group treated with a fluoride-free mock product. The primary endpoint was white spot lesion appearance after 16 weeks, assessed from photographs using the modified ICDAS white spot lesion score (0 to 3). The patients and the dental examiners rated the white spot lesions subjectively with aid of a visual analog scale. Results: Fifty-seven patients completed the study. After 16 weeks, 62% of the white spot lesions in the Varnish group were completely reversed (score 0) compared to 39% in the Control group. The treatment effect was statistically significant (OR 0.22; 95% CI 0.08 to 0.59, P = .003) after adjusting for baseline oral hygiene index and type of tooth. A significant correlation (P < .05) was observed between patients' and orthodontists' perception of the lesions. Conclusion: The 5% sodium fluoride varnish with fTCP appeared clinically effective in reversing post-orthodontic white spot lesions 16 weeks after debonding. The patients and the clinicians agreed on the obtained esthetic improvements. [ABSTRACT FROM AUTHOR]