White spot lesions: Does etching really matter?

Abstract

Aim: The clinical significance of acid etching prior to orthodontic bonding is controversial. In the present study, we evaluated the effect of 15 seconds of acid etching on enamel demineralization. Methods:Twenty-seven human molars were sectioned and assigned to two groups.Under standardized conditions, the enamel surfaces were imaged using FluoreCam to obtain baseline data. Group 1 was etched using 37% phosphoric acid for 15 seconds, rinsed with water, and then imaged again; group 2 was only rinsed with water. Water rinse was collected for calcium chemical analysis using inductively-coupled plasma auger electron spectrometry. Both groups were subjected to 9 days of pH cycling, after which final FluoreCam images were obtained. Following pH cycling, there was no statistically-significant between-group difference in overall enamel demineralization. Conclusion:Initial demineralization caused by 15 seconds of acid etching does not increase enamel susceptibility to further demineralization. This suggests that acid etching does not increase the risk of developing white spot lesions during orthodontics. K E Y W O R D Sacid etching, caries detection, enamel demineralization, light-induced fluorescence, white spot lesion

The longevity of casein phosphopeptide–amorphous calcium phosphate fluoride varnish's preventative effects: Assessment of white spot lesion formation

“…Demineralization of the control group increased 127% during the first 4 weeks, 71% during the next 4 weeks, and 62% during the last 4 weeks, confirming that demineralized enamel is less likely to demineralize than sound enamel. 23 This explains why WSL development is greatest during the first 6 months of orthodontic treatment. 28 Deceleration of demineralization might be attributed to the formation of fluoridated hydroxyapatite (HA) crystals that are less soluble and more resistant to further acid attacks than the original HA crystals.…”

“…Pretreatment images of the enamel surfaces were recorded under standardized conditions using the FluoreCam. 23 The FluoreCam device was positioned a fixed distance from a mounting table. A mold was prepared for each specimen using a vinyl polysiloxane impression material (Exaflex Putty, GC America, Inc, Alsip, Ill), into which the root of each specimen was inserted horizontally.…”

The quality of etched enamel in different regions and tooth types and its significance in bonding and the development of white spot lesions

“…A 37% phosphoric acid gel etchant (Reliance Orthodontic Products, Itasca, Ill) was then applied to cover the entire buccal surface of each sample, left in place for 15 seconds, copiously rinsed with water, and then dried with an oil-and moisture-free syringe until a frosted appearance of the enamel surface was visually apparent. [13][14][15]…”

White spot lesions in fixed orthodontic treatment: Etiology, pathophysiology, diagnosis, treatment, and future research perspectives

“…During fixed orthodontic treatment, it is very hard for the patient to maintain excellent oral hygiene as the brackets, bands, wires, elastics, and other appliances and attachments worn intra-orally provide a platform for food retention, plaque formation, and then colonization by acidogenic bacteria like Streptococcus mutans and Lactobacillus . [ 3 4 5 6 ] Moreover, the process of etching of the enamel done using phosphoric acid before bonding the brackets to the tooth surface using composite resins causes some amount of superficial demineralization. [ 4 ]…”

“…[ 3 4 5 6 ] Moreover, the process of etching of the enamel done using phosphoric acid before bonding the brackets to the tooth surface using composite resins causes some amount of superficial demineralization. [ 4 ]…”