Munjal Deepti, Garg Shalini, Dhindsa Abhishek, Sidhu Gagandeep Kaur, Sethi Harsimran Singh
Senior Lecturer, Department of Pediatric and Preventive Dentistry, Maharaja Ganga Singh Dental College and Research Centre , Sriganganagar, Rajasthan, India .
Professor, Department of Pediatric and Preventive Dentistry, MM College of Dental Sciences and Research , Mullana, Ambala, Haryana, India .
J Clin Diagn Res. 2016 May;10(5):ZC149-54. doi: 10.7860/JCDR/2016/19458.7896. Epub 2016 May 1.
As hindrance of remineralisation process occurs during orthodontic therapy resulting in decalcification of enamel because number of plaque retention sites increases due to banding and bonding of appliances to teeth.
The present analytic study was undertaken to assess the occurrence of white spot lesions in permanent molars of children with and without orthodontic therapy and to evaluate the effect of Casein PhosphoPeptide-Amorphous Calcium Phosphate (CPP-ACP) on white spot lesions in post-orthodontic patients in a given period of time.
The study comprised of examination of 679 first permanent molars which were examined to assess the occurrence of smooth surface white spot lesions in children of 8 to 16 years age group. Group I comprised subjects without any orthodontic treatment and Group II comprised of subjects who had undergone orthodontic therapy. The sample size was calculated using the epi-info6 computer package. Treatment group included 20 post-orthodontic patients examined with at least one white spot lesion within the enamel who received remineralizing cream (GC Tooth Mousse, Recaldent, GC Corporation.) i.e., CPP-ACP cream two times a day for 12 consecutive weeks. Computerized image analysis method was taken to evaluate white spot lesions. These frequency and percentages were compared with chi-square test. For comparison of numeric data, paired t-test was used.
Of the total 278 (49.6%) first permanent molars showed occurrence of smooth surface white spot lesions out of 560 in Group I and 107 (89.9%) first permanent molars showed presence of white spot lesions out of 119 debanded first permanent molars of children examined in Group II. CPP-ACP therapy group showed reduction in severity of codes which was found to be highly significant after 12 weeks and eight weeks on gingival-third, p-value (<0.001) and significant after eight weeks and four weeks on middle-third according to ICDAS II criteria and computerized image analysis.
CPP-ACP therapy minimum for 12 weeks is highly recommended as post-orthodontic treatment need in management of smooth surface white spot lesions on teeth undergoing fixed orthodontic therapy according to the present study.
在正畸治疗过程中，由于矫治器与牙齿的结扎和粘接增加了菌斑滞留部位的数量，从而阻碍了再矿化过程，导致釉质脱钙。
本分析研究旨在评估接受和未接受正畸治疗的儿童恒牙中白斑病变的发生率，并在给定时间段内评估酪蛋白磷酸肽 - 无定形磷酸钙（CPP - ACP）对正畸后患者白斑病变的影响。
该研究包括对679颗第一恒磨牙的检查，这些磨牙来自8至16岁年龄组的儿童，用于评估光滑面白斑病变的发生率。第一组包括未接受任何正畸治疗的受试者，第二组包括接受过正畸治疗的受试者。样本量使用epi - info6计算机软件包计算。治疗组包括20名正畸后的患者，这些患者在釉质内至少有一处白斑病变，他们连续12周每天两次接受再矿化乳膏（GC护齿泡沫，Recaldent，GC公司），即CPP - ACP乳膏治疗。采用计算机图像分析方法评估白斑病变。这些频率和百分比通过卡方检验进行比较。对于数值数据的比较，使用配对t检验。
在第一组的560颗第一恒磨牙中，共有278颗（49.6%）出现了光滑面白斑病变；在第二组接受检查的儿童的119颗已解除矫治器的第一恒磨牙中，有107颗（89.9%）出现了白斑病变。根据ICDAS II标准和计算机图像分析，CPP - ACP治疗组的代码严重程度有所降低，在牙龈三分之一处12周和8周后发现差异极显著（p值<0.001），在中间三分之一处8周和4周后差异显著。
根据本研究，对于接受固定正畸治疗的牙齿上的光滑面白斑病变的管理，强烈建议至少进行12周的CPP - ACP治疗作为正畸后治疗的需求。
