Chambers C, Stewart S, Su B, Sandy J, Ireland A
1] Bristol Dental Hospital, Department of Child Dental Health, Lower Maudlin Street, Bristol, BS1 2LY [2] Royal United Hospital Bath, Combe Park, Bath, BA1 3NG.
Br Dent J. 2013 Nov;215(10):505-11. doi: 10.1038/sj.bdj.2013.1094.
Orthodontic treatment, like all aspects of dentistry, exposes the clinician to the risk of malpractice and litigation. Demineralisation of tooth enamel is still one of the main complications of orthodontic treatment and it is essential patients are made aware of this risk during the consent process. There are a variety of fluoride delivery systems (mouthrinse, varnish, bonding system, and elastics), which can be used to prevent white spot lesion (WSL) formation. Glass-ionomer bonding cements (GIC) have also been shown to reduce WSL formation and have the benefit of not relying on patient compliance. However, these materials have not found widespread acceptance, possibly due to handling characteristics. A number of new technologies, principally fillers and coatings, have recently become available with potential antimicrobial and antibiofilm properties. Coatings can be applied to brackets and wires, which prevent bacterial adhesion. However, the longevity of these coatings is questionable. There are a number of methods available aimed at reducing the incidence of WSL, but they all have limitations. Capitalising on technological advances will enable the production of tailor made orthodontic brackets and adhesive systems, which provide long-term protection against WSL without relying on patient compliance.
与牙科的所有领域一样，正畸治疗使临床医生面临医疗事故和诉讼风险。牙釉质脱矿仍然是正畸治疗的主要并发症之一，在知情同意过程中让患者了解这种风险至关重要。有多种氟化物输送系统（漱口水、涂剂、粘结系统和弹力线）可用于预防白斑病变（WSL）的形成。玻璃离子粘结水门汀（GIC）也已被证明可减少WSL的形成，且具有不依赖患者依从性的优点。然而，这些材料尚未得到广泛认可，可能是由于其操作特性。一些主要为填料和涂层的新技术最近已具备潜在的抗菌和抗生物膜特性。涂层可应用于托槽和弓丝，以防止细菌粘附。然而，这些涂层的耐久性存在疑问。有多种方法可用于降低WSL的发生率，但它们都有局限性。利用技术进步将能够生产定制的正畸托槽和粘结系统，在不依赖患者依从性的情况下提供针对WSL的长期保护。
