In humans, the oral cavity is highly complex and composed of hundreds of bacterial species, with the distribution of bacterial species varying qualitatively and quantitatively according to habitat. In teeth, dental plaque develops favorably on surfaces protected from mechanical friction, such as the sub-gingival area, approximal surfaces between two teeth, and the pits and fissures of the occlusal surfaces. Fixed orthodontic appliances are an example of creating retentive areas, therefore increasing the plaque accumulation and the number of cariogenic microorganisms. Thus, enamel decalcification or the development of White Spot Lesions (WSLs) on the enamel surface is by far the most important iatrogenic effect of fixed orthodontic appliance therapy. Such initial enamel decalcifications can be seen as early as four weeks after the beginning of fixed orthodontic appliances, and may remain a long time after the orthodontic treatment is completed. Despite improvements in materials and preventive efforts, the risk of enamel demineralization, caused by orthodontic treatment, continues to be a considerable side effect. Studies have shown that more than 50% of orthodontic patients may experience an increase in the number of WSLs with fixed orthodontic appliances, and are more susceptible to the development of WSLs than untreated patients.
The goal of the lecture is to share with you my investigations, which has been done to investigate the occurrence of enamel demineralization using different orthodontic brackets materials and adhesive systems as well as to discuss some new methods that could minimize the WSLs in orthodontic patients.