Deproteinization of tooth enamel surfaces to prevent white spot lesions and bracket bond failure: A revolution in orthodontic bonding

Orthodontic treatment success is jeopardized by the risk of development of white spot lesions (WSLs) around orthodontic brackets. Unfortunately, the formation of WSLs still remains a common complication during treatment in patients with poor oral hygiene. Nearly 75% of orthodontic patients are reported to develop enamel decalcification because of prolonged plaque retention around brackets. It is the orthodontist's responsibility to minimize the risk of patients having enamel decalcifications as a consequence of orthodontic treatment. This can be achieved by using hybrid, fluoride-releasing, glass ionomer cement to bond brackets, with deproteinization of the enamel surface before phosphoric acid etching.