Acta Scientific Dental Sciences (ASDS)(ISSN: 2581-4893)

Research Article Volume 7 Issue 2

Efficacy of Three Different Remineralising Agents on White Spot Lesions During Fixed Orthodontics Treatment - A Controlled Clinical Trial

Priyanka Choudhary*, Payal Sharma, Achint Juneja and Shuchi Shrivastava

Department of Orthodontics and Dentofacial Orthopedics, ITS CDSR Dental College Murad Nagar Ghaziabad, UP, India

*Corresponding Author: Priyanka Choudhary, Department of Orthodontics and Dentofacial Orthopedics, ITS CDSR Dental College Murad Nagar Ghaziabad, UP, India.

Received: December 19, 2022; Published: January 05, 2023


Aim: The aim of the present article was to deepen the discussion of inducing a rapid increase in the volume of dental plaque which has a lower pH which in turns result in white spot lesions.

Methods: Based on evidences found in the literature, the method focussed in providing the basis for clinical decision-making.

Results: The present study showed that significant decalcification occurred within only 6 months after orthodontic bonding by using products like Clinpro creme, MI varnish, tooth min. Considering how quickly these lesions can develop and become irreversible, early diagnosis is of critical importance. Given the high number of lesions that were found at 6 months, it is crucial to evaluate the oral hygiene status of patients during the first months of orthodontic treatment, and if necessary, to implement preventive actions immediately, in order to prevent demineralization.

Conclusion: In the present study, we demonstrated that the tendency of plaque to accumulate around fixed orthodontic appliances can result in rapid demineralization. Despite recent advances, prevention of demineralization during orthodontic treatment is one of the greatest challenges faced by clinicians. For each patient, there is a need to develop an oral hygiene protocol that should be followed both at home and at the dental practice.

Keywords:Fixed Orthodontics Appliance; White Spot Lesions; Remineralization Agents


  1. Lucchese A and Gherlone E. “Prevalance of white spot lesions before and during orthodontic treatment with fixed appliances”. European Journal of Orthodontics 5 (2013): 664-668.
  2. Bengham AW., et al. “Effectiveness of pit and fissures sealants in reducing spot lesions during orthodontic treatment”. The Angle Orthodontist 2 (2009): 338-345.
  3. Karad A., et al. “White Spot Lesions in Orthodontic Patients: An Expert Opinion”. Journal of International Oral Health 11 (2019): 172-180.
  4. Sardana D., et al. “Effectiveness of professional fluorides against enamel white spot lesions during fixed orthodontic treatment: A systematic review and meta-analysis”. Journal of Dentistry 82 (2019): 1-10.
  5. Sonesson M., et al. “Fluoride varnish for the prevention of white spot lesions during orthodontic treatment with fixed appliances: a randomized controlled trial”. European Journal of Orthodontics (2019): 1-5.
  6. Khalaf K. “Factors Affecting the Formation, Severity and Location of white spot lesions during Orthodontic Treatment with Fixed Appliances”. Journal of Oral and Maxillofacial Research 1 (2014): e4.
  7. Restrepo M., et al. “Control of white spot lesions with use of fluoride varnish or chlorhexidine gel during orthodontic treatment A Randomized Clinical Trial”. Journal of Clinical Pediatric Dentistry 4 (2016): 274-280.
  8. Hadler-Olsen S., et al. “The incidence of caries and white spot lesions in orthodontically treated adolescents with a comprehensive caries prophylactic regimen-a prospective study”. European Journal of Orthodontics5 (2012): 633-639.
  9. Enaia M., et al. “White spot lesions during multibracket appliance treatment: A challenge for clinical excellence”. American Journal of Orthodontics and Dentofacial Orthopedics1 (2011): e17-24.
  10. Tao S., et al. “Efficacy of fluorides and CPP-ACP vs fluorides monotherapy on early caries lesions: a systemic review and meta analysis”. PLoS One4 (2018): e0196660.
  11. Abufarwa M., et al. “The Longevity of casein phosphopeptide- amorphous calcium phosphate fluoride varnish's preventive effects: assessment of white spot lesion formation”. The Angle Orthodontist 1 (2019): 10-15.
  12. Kau CH., et al. “Effect of fluoride dentifrices on white spot lesions during orthodontic treatment: A randomized trial”. The Angle Orthodontist 3 (2019): 365-371.
  13. Kaur G., et al. “Comparative evaluation of two different remineralizing agents on the microhardness of bleached enamel surface: Results of an in- vitro study”. Indian Journal of Dental Research 2 (2015): 176-179.
  14. Shivakumar KM., et al. “International Caries Detection and Assessment System: A new paradigm in detection of dental caries”. Journal of Conservative Dentistry 1 (2009): 10-16.
  15. Bhoopathi PH., et al. “Caries Detection with ICDAS and the WHO Criteria: A Comparitive Study”. Journal of Clinical and Diagnostic Research12 (2017): 9-12.
  16. Kavvadia K., et al. “Validation of fluorescence devices for evaluation of white spot lesions in orthodontic patients”. European Archives of Paediatric Dentistry 2 (2018): 83-89.
  17. Chapman JA., et al. “Risk factors for incidence and severity of white spot lesions during treatment with fixed orthodontic appliances”. American Journal of Orthodontics and Dentofacial Orthopedics2 (2010): 188-194.
  18. Tufekci E., et al. “Prevalence of white spot lesions during orthodontic treatment with fixed appliances”. The Angle Orthodontist 2 (2011): 206-210.
  19. Maxfield BJ., et al. “Development of white spot lesions during orthodontic treatment: Perceptions of patients, parents, orthodontists, and general dentists”. American Journal of Orthodontics and Dentofacial Orthopedics 3 (2012): 337-344.
  20. Julien KC., et al. “Prevalence of white spot lesion formation during orthodontic treatment”. The Angle Orthodontist 83 (2013): 641-647.
  21. Senestraro SV., et al. “Minimally invasive resin infiltration of arrested white spot lesions”. The Journal of the American Dental Association 9 (2013): 997-1005.
  22. Singh S., et al. “Effects of various remineralizing agents on the outcome of post-orthodontic white spot lesions (WSLs): a clinical trial”. Progress in Orthodontics 25 (2016): 1-8.
  23. Wakamatsu N., et al. “Effect of tooth surface coating material containing S-PRG filler on white spot lesions of young permanent teeth”. The Japanese Journal of Pediatric Dentistry 1 (2018): 40-45.
  24. Karabekiroglu S., et al. “Effectiveness of different preventive agents on initial occlusal and proximal caries lesions: A follow-up study”. Journal of Dental Sciences 13 (2018): 109-115.
  25. Karabekiroglu S., et al. “Effectiveness of Remineralization Treatments on Incipient Lesions: A Controlled Clinical Trial”. International Journal of Oral and Dental Health 054 (2018): 1-9.
  26. Raghis T., et al. “Enamel resistance to demineralisation around orthodontic brackets after CO2 laser irradiation: a randomised clinical trial”. Journal of Orthodontics (2018): 1-9.
  27. Korkmaz YN and Yagci A. “Comparing the effects of three different fluoride-releasing agents on white spot lesion prevention in patients treated with full coverage rapid maxillary expanders”. Clinical Oral Investigations 23 (2019): 3275-3285.
  28. Hu H., et al. “Effectiveness of remineralising agents in prevention and treatment of orthodontically induced white spot lesions: a protocol for a systematic review incorporating network meta-analysis”. The BioMed Center 339 (2019): 1-11.
  29. Parihar AV., et al. “Efficacy of Various Agents in Reducing White Spot Lesions around Orthodontic Brackets: A Meta-Analysis”. International Journal of Orthodontics 30 (2019): 71-78.
  30. Tahmasbi S., et al. “Prevention of white spot lesions using three remineralizing agents: An in vitro comparative study”. Journal of Dental Research, Dental Clinics, Dental Prospects 1 (2019): 36-42.
  31. Wang Y., et al. “CPP-ACP may be effective, but not significantly greater than using fluorides alone, in preventing and treating white spot lesions around orthodontic brackets”. Journal of Evidence-Based Dental Practice 1 (2020): 1-3.
  32. Lale S., et al. “In Vitro Comparison of Fluoride, Magnesium, and Calcium Phosphate Materials on Prevention of White Spot Lesions around Orthodontic Brackets”. BioMed Research International (2020): 1-11.
  33. Bangi SL., et al. “Evaluation of Three Commercially Available Materials in Reducing the White Spot Lesions During Fixed Orthodontic Treatment: A Prospective Randomized Controlled Trial”. Journal of Indian Orthodontic Society 2 (2020): 100-105.
  34. Lopatiene K., et al. “Prevention and treatment of white spots lesions during and after treatment with fixed orthodontic appliances: a sytematic literature review”. Journal of Oral and Maxillofacial Research 2 (2016): e1.
  35. Almosa NA., et al. “Diagnosing the severity of buccal caries lesions in governmental and private orthodontic patients at debonding, using the ICDAS-II and the DIAGNOdent Pen”. The Angle Orthodontist 3 (2014): 430-436.
  36. Davila JM., et al. “Adhesives penetration in human artificial and natural white spots”. Journal of Dental Research 5 (1975): 999-1008.


Citation: Priyanka Choudhary., et al. “Efficacy of Three Different Remineralising Agents on White Spot Lesions During Fixed Orthodontics Treatment - A Controlled Clinical Trial".Acta Scientific Dental Sciences 7.2 (2023): 46-55.


Copyright: © 2023 Priyanka Choudhary., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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