Bevinagidad Sangamesha, Setty Swati, Patil Anand, Thakur Srinath
Department of Periodontics, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheswara University, Dharwad, Karnataka, India.
Department of Orthodontics, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheswara University, Dharwad, Karnataka, India.
J Indian Soc Periodontol. 2020 Mar-Apr;24(2):117-121. doi: 10.4103/jisp.jisp_440_19. Epub 2020 Mar 2.
The initial carious lesions are the so-called "white spot" lesions (WSLs), which implies that there is a subsurface area with most of the mineral loss beneath a relatively intact enamel surface. It is common in patients who are taking orthodontic treatment. Salivary reservoir of calcium and phosphorous counteracts the demineralization and encourages re-mineralization providing protection against caries challenge. This study was aimed to estimate and correlate the oral hygiene status, WSLs and salivary calcium, phosphorus, alkaline phosphatase (ALP), and pH in patients undergoing fixed orthodontic therapy.
All clinical and biochemical parameters were recorded in 27 patients before starting orthodontic treatment and at 6 months of orthodontic treatment. The salivary calcium, phosphorous, ALP, and pH were determined by Arsenazo III method, Molybdate - UV and the International Federation of Clinical Chemistry method, respectively. International caries detection and assessment system index for WSL, orthodontic plaque index, bleeding on probing, and gingival index were recorded. Shapiro-Wilk's test and Wilcoxon test were applied to the data collected for statistical analysis.
There was a statistically significant increase with ALP levels, orthodontic plaque index score, gingival index score, and bleeding on probing index score. A statistically significant reduction was seen with respect to levels of calcium and pH.
Maxillary canines and lateral incisors were the most affected teeth with WSLs (78.84%). There is a need for more stringent prevention programs and oral hygiene practices prior to initiation of orthodontic treatment and also during orthodontic treatment.
最初的龋损是所谓的“白斑”病变(WSLs),这意味着在相对完整的釉质表面下方存在一个矿物质大量流失的表层下区域。这在接受正畸治疗的患者中很常见。唾液中的钙和磷储备可抵消脱矿作用,并促进再矿化,从而提供防龋保护。本研究旨在评估接受固定正畸治疗的患者的口腔卫生状况、WSLs与唾液钙、磷、碱性磷酸酶(ALP)及pH之间的关系并进行相关性分析。
在27例患者开始正畸治疗前及正畸治疗6个月时记录所有临床和生化参数。唾液钙、磷、ALP及pH分别采用偶氮胂III法、钼酸盐 - 紫外法及国际临床化学联合会方法测定。记录WSLs的国际龋病检测与评估系统指数、正畸菌斑指数、探诊出血及牙龈指数。对收集的数据应用夏皮罗 - 威尔克检验和威尔科克森检验进行统计分析。
ALP水平、正畸菌斑指数评分、牙龈指数评分及探诊出血指数评分有统计学意义的升高。钙水平和pH有统计学意义的降低。
上颌尖牙和侧切牙是受WSLs影响最严重的牙齿(78.84%)。在开始正畸治疗前以及正畸治疗期间,需要更严格的预防方案和口腔卫生措施。