Quantification of White Spot Lesions around Orthodontic Brackets with Image Analysis

Abstract

Objective: To investigate the use of image analysis for diagnosis and quantification of artificial white spot lesions on digital photographs before and after removal of orthodontic brackets. Materials and Methods: Enamel demineralization was artificially induced on the labial surface of 20 teeth bonded with orthodontic brackets. Standardized digital photographs were taken at angles of 90Њ and 110Њ to the labial surface, before and after bracket removal. All images were analyzed by two observers using image-processing software, and the area of the white spot lesion was calculated. Reproducibility was assessed by the Pearson correlation coefficient for interobserver reliability and by the paired t-test for differences between observers. Differences between the known and the measured demineralization area were tested using the t-test. Differences between both stages and angles were assessed by application of the paired t-test. Results: Reproducibility was very good for all measurements. For the photographs taken at an angle of 110Њ, there was a statistically significant but clinically irrelevant difference between the observers. The difference between the surface measured and the true surface was dependent on the stages and angles but was always Ͻ1 mm 2 . Conclusion: Image analysis is a reproducible and reliable method for quantification of artificial enamel demineralization around orthodontic brackets.

Predicting improvement of postorthodontic white spot lesions

“…One of the strengths of our study is the methods of evaluation that were utilized, as we Our objective measure of improvement assessed the change in percent of tooth surface affected (proportional change), which has been used in many previous studies 15,[17][18][19][20] , rather than absolute measurements of luminance or size 21,22 . The comparison of proportional change also allows for us to account for any differences in magnification and angulations of teeth, when using photograph images.…”

Análise in vitro da Influência da Aplicação Tópica de Fluoreto nas Propriedades Mecânicas de uma Resina Ortodôntica sob Ciclagem de pH

“…Apesar da vantagem que o aparelho ortodônti co fi xo atual apresenta, exibindo menor superfí cie retenti va de placa quando comparado ao anti go sistema de cimentação de bandas, o aparecimento de lesões de mancha branca durante o tratamento conti nua sendo uma constante, ocorrendo entre 2% e 96% dos casos [6][7][8] . Sabe-se, entretanto, que o problema de desmineralização do esmalte ao redor de aparatos ortodônti cos associase, principalmente, à retenção de placa bacteriana, culminando na redução do pH da placa e conseqüente perda de mineral da estrutura dentária, em especial em pacientes que não possuem hábitos adequados de higiene bucal [9][10][11] . Lesões de mancha branca têm o potencial para desenvolver-se em até 4 semanas após o início do tratamento ortodônti co, podendo levar à cavitação do esmalte, caso não haja remineralização a fi m de paralisar este processo 9,12 .…”

“…Sabe-se, entretanto, que o problema de desmineralização do esmalte ao redor de aparatos ortodônti cos associase, principalmente, à retenção de placa bacteriana, culminando na redução do pH da placa e conseqüente perda de mineral da estrutura dentária, em especial em pacientes que não possuem hábitos adequados de higiene bucal [9][10][11] . Lesões de mancha branca têm o potencial para desenvolver-se em até 4 semanas após o início do tratamento ortodônti co, podendo levar à cavitação do esmalte, caso não haja remineralização a fi m de paralisar este processo 9,12 . Portanto, é de grande valia lançar mão de condutas preventi vas, a fi m de que a perda de estrutura dentária seja evitada.…”

“…A literatura aponta que diferentes formas de fl uoretos associadas às instruções de higiene oral e controle da dieta podem contribuir para inibir a desmineralização durante a terapia ortodônti ca 9,10 . Entretanto, materiais com fl uoretos incorporados à sua composição apresentam uma rápida liberação, perdendo seu efeito protetor em poucos dias 13 .…”

Clinical Evaluation of Enamel Demineralization during Orthodontic Treatment: An in vivo Study using GC Tooth Mousse Plus

“…At this incipient stage of demineralization, the surface of the enamel which is undergoing spontaneous demineralization, and remineralization was evaluated at a higher magnification. 20 Trimpeneers et al 8 used intraoral photographic slides before and after mean treatment period of 21 months and white spot lesion were analyzed only after debonding the appli ance. Gorelick L et al 4 evaluated visually for mean intraoral exposure of 22 months and in few patients, least exposure intraorally was 12 months which is sufficient for white spots to develop.…”