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Methods used to determine demineralization of enamel associated with orthodontic treatment: a review Harshavardhan Kidiyoor Roopak D Naik Dental Update 2024 4:4, 707-709.
Authors
HarshavardhanKidiyoor
BDS, MDS
Reader, Department of Orthodontics and Dentofacial Orthopaedics
Reader, Department of Orthodontics and Dentofacial Orthopaedics, SDM College of Dental Sciences and Hospital, Sattur, Dharwad – 580 009 Karnataka, India
Demineralization/decalcification of the enamel around orthodontic brackets, seen clinically as white spot lesions, remain a sometimes neglected part of orthodontic care. Even though there are numerous studies on decalcification, most of them are based on subjective evaluation of enamel samples. The various techniques used to determine enamel demineralization associated with orthodontic treatment have not been directly compared and the operator is left with limited choice. Since these techniques have their own limitations, the selection of a protocol for the study of demineralization of enamel should be based on the true merit of the technique and its relevance to the study. Hence, the various methods used to determine demineralization of enamel during orthodontic treatment have been critically evaluated and their application in clinical orthodontics and research discussed.
Clinical Relevance: Dental enamel has very limited regenerative capacity; hence prevention of its demineralization is of prime concern to a dentist in general and to an orthodontist specifically. The appearance of white spots/damage to healthy enamel after orthodontic treatment is both unaesthetic and legally questionable. Further, there is a lack of correlation among the various methods suggested to evaluate enamel demineralization. The current article not only summarizes the various methods but also suggests relevant steps to prevent the demineralization of enamel.
Article
Decalcification is defined as loss of calcified tooth substance. It occurs when the pH of the oral environment favours the diffusion of calcium and phosphate ions out of enamel.1 The clinical appearance of a white spot lesion (Figure 1) is caused by an optical phenomenon due to subsurface tissue loss and is exaggerated by thorough drying.2 Preventing this decalcification that may occur during orthodontic treatment is of importance because these lesions are unaesthetic, potentially irreversible and cariogenic. From a legal standpoint, DE Machen, an orthodontist and an expert in dental jurisprudence, has stated that the responsibility of assessment, notification and prevention of any decalcification, which occurs during orthodontic treatment, lies with the practitioner.3
Studies on enamel evaluation during/after orthodontic treatment have shown varying degrees of demineralization. The various methods used for evaluation of demineralization of enamel are as follows:
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