Effectiveness of a Selective Etching Technique in Reducing White Spots Formation around Lingual Brackets: A Prospective Cohort Clinical Study

Abstract

The risk of developing white spot lesions (WSLs) after orthodontic treatment with lingual brackets is generally considered lower than with labial ones, even if plaque accumulation is frequently higher due to the increased difficulty level in oral hygiene maintenance. In this prospective clinical study, selective enamel etching technique effectiveness in reducing plaque accumulation and WSLs was tested. Thirty patients were bonded with a split-mouth approach: two randomly selected opposite quadrants were used as the test sides, using customized plastic etching guides, and the other two as control sides, applying traditional direct etching methods. The plaque presence around the braces was recorded after 1, 3, 6, and 12 months according to a lingual plaque accumulation index (LPAI), as was the presence of WSLs. PAI measured values were significantly higher in the control sides during the observation period. Test and control sides differed significantly for new WSL onset only after 12 months of treatment. Therefore, the present research demonstrated that this guided enamel etching technique allowed for significant reduction in plaque accumulation around the lingual brackets and reduced onset of white spots after one year of treatment.

Evaluation of orthodontists’ attitudes and practices regarding residual resin removal methods

“…However, the result obtained after removing the adhesive residue from dental enamel should be considered as more important than the techniques used, since the smaller the area involved by the clinical procedures carried out and/or the less rough the enamel surface becomes, the less plaque will be retained. 26 , 27 …”

Ortodoncia lingual: su biomecánica y efectividad. Una revisión de la literatura

“…Existe una mayor predisposición a desarrollar manchas blancas con la ortodoncia lingual, sin embargo, aquellos brackets personalizados de bases grandes protegen casi toda la superficie lingual o palatina y por ende protegen al diente de ácidos generados por la acumulación de placa lo que impide el deterioro de la superficie dental (Dalessandri et al, 2021).…”