Incidence of White-Spot Lesions among Patients treated with Orthodontic Multibracket Appliance

Aim: The aim of this study was to retrospectively quantify the incidence of white spot lesions (WSLs) in young adults by examining orthodontic pre- and post-treatment digital photographs. Methods: One hundred patients (64 F, 36 M) were selected following these inclusion criteria: aged 14-30 years old, no filling or structural abnormalities of maxillary anterior teeth, multibracket (MB) appliance treatment duration of at least 18 months and final retention period of at least 6 months. Initial and final digital images were compared to evaluate preexisting and posttreatment WSLs on the facial surfaces of the anterior 8 maxillary teeth. Orthodontic treatment complexity and outcomes were evaluated as predictors of WSL incidence. Results: Twenty-three patients showed preexisting WSLs. New WSLs manifested in 32% of patients after their orthodontic treatment. The order of incidence was lateral incisor (41%), central incisor (28%), premolar (19%), canine (12%). Females were significantly (P<0.005) more susceptible than males. The highest risk of developing WSLs was associated with preexisting WSLs, low patients' compliance, unfavourable clinical outcome score, white ethnic group, and inadequate domiciliary oral hygiene. Conclusions: WSLs are one of the most undesired side effects of MB appliance treatment. The use of digital photos to retrospectively evaluate patients' clinical manifestations is also a valid method for examining the incidence and severity of WSLs.