Jha Awanindra Kumar, Chandra Subhash, Shankar Daya, Murmu Dhyan Chand, Noorani Mohammad Kashif, Tewari Nishant Kumar
Department of Orthodontics and Dentofacial Orthopaedics, Rajendra Institute of Medical Sciences, Dental Institute, Ranchi, IND.
Department of Dentistry, Patna Medical College and Hospital, Patna, IND.
Cureus. 2023 Jul 19;15(7):e42134. doi: 10.7759/cureus.42134. eCollection 2023 Jul.
Despite recent breakthroughs in caries preventive measures, one of the biggest issues clinicians confront is preventing demineralization while undergoing orthodontic therapy. The buildup of plaques around orthodontic brackets over time causes white spot lesions (WSLs). The goal of the present research was to assess the prevalence of WSLs in patients undergoing orthodontic treatment before starting therapy and at six and 12 months into therapy, adopting the visual examination approach.
We looked for WSLs on tooth surfaces gingival to an archwire because this is the area most likely to experience enamel demineralization during orthodontic treatment. The visual assessment was conducted using the following scale at baseline, six months, and 12 months for orthodontic patients: score 0: no demineralization or noticeable white patches on the surface; score 1: mild demineralization with a visible white spot but no surface disruption; score 2: moderate demineralization with a noticeable WSL that has a roughened surface but does not need repair; and score 3: severe demineralization with a noticeable WSL that needs repair. Fisher's exact test was used after a chi-square analysis to determine whether there were any differences between all three categories (six months, 12 months, and control).
The frequency of WSL in patients at 12 months of orthodontic treatment was 46.57%, while it was 11.86% in patients who just started orthodontic treatment. The difference was statistically significant (p = 0.01), showing that the frequency was greater in patients at 12 months of orthodontic treatment as compared to patients who had just started undergoing orthodontic treatment. The frequency of WSL in patients at six months of orthodontic treatment was 37.34%, while it was 11.86% in patients who just started orthodontic treatment. The difference was statistically significant (p = 0.03), showing that the frequency was greater in patients at six months of orthodontic treatment as compared to patients who had just started undergoing orthodontic treatment. The frequency of WSL in patients at six months of orthodontic treatment was 37.34%, while it was 46.57% in patients at 12 months of orthodontic treatment. The frequency was greater in patients at 12 months of orthodontic treatment as compared to patients at six months of orthodontic treatment; however, the difference was non-significant statistically (p = 0.76).
This clinical investigation revealed that the number of WSLs increased significantly during the first six months of treatment and then increased gradually until the final 12 months. During the first few months of treatment, doctors should assess the patients' dental hygiene habits and, if necessary, take further precautions to prevent demineralization.
尽管最近在龋齿预防措施方面取得了突破,但临床医生面临的最大问题之一是在正畸治疗过程中预防牙釉质脱矿。随着时间的推移,正畸托槽周围牙菌斑的堆积会导致白斑病变(WSLs)。本研究的目的是采用视觉检查方法,评估正畸治疗患者在治疗开始前、治疗6个月和12个月时WSLs的患病率。
我们在弓丝龈方的牙齿表面寻找WSLs,因为这是正畸治疗期间最容易发生牙釉质脱矿的区域。对正畸患者在基线、6个月和12个月时使用以下量表进行视觉评估:0分:表面无脱矿或明显白色斑块;1分:轻度脱矿,有可见白斑,但表面无破坏;2分:中度脱矿,有明显的WSL,表面粗糙但无需修复;3分:重度脱矿,有明显的WSL,需要修复。在进行卡方分析后,使用Fisher精确检验来确定所有三个类别(6个月、12个月和对照组)之间是否存在差异。
正畸治疗12个月患者的WSL发生率为46.57%,而刚开始正畸治疗的患者为11.86%。差异具有统计学意义(p = 0.01),表明正畸治疗12个月的患者发生率高于刚开始正畸治疗的患者。正畸治疗6个月患者的WSL发生率为37.34%,而刚开始正畸治疗的患者为11.86%。差异具有统计学意义(p = 0.03),表明正畸治疗6个月的患者发生率高于刚开始正畸治疗的患者。正畸治疗6个月患者的WSL发生率为37.34%,而正畸治疗12个月患者的发生率为46.57%。正畸治疗12个月的患者发生率高于正畸治疗6个月的患者;然而,差异无统计学意义(p = 0.76)。
这项临床研究表明,WSLs的数量在治疗的前6个月显著增加,然后逐渐增加直至最后12个月。在治疗的最初几个月,医生应评估患者的口腔卫生习惯,必要时采取进一步预防措施以防止脱矿。