Sabit Ortodontik Tedaviyle Gelişebilen Beyaz Nokta Lezyonları, Güncel Teşhis ve Tedavi Yöntemleri
Özet
Sabit ortodontik tedavinin en sık görülen olumsuz yan etkilerinden biri, çürük lezyonlarının gelişmesidir. Ortodontik braketler, ligatürler, bantlar ve diğer ataşmanların çevresinde beyaz nokta lezyonları gelişebilir çünkü bu apareyler diş yüzeylerinde bakteriyel biyofilm birikiminin temizlenmesini zorlaştırır. Bu nedenle mine yüzeyinde demineralizasyonların görülebilme sıklığı bu hastalarda hiç tedavi görmeyenlere oranla artmaktadır.
Mine yüzeyi incelendiğinde çürüğün başlangıç göstergesi olarak klinikte karşımıza ilk olarak beyaz nokta lezyonları çıkmaktadır. Diş yüzeyinde biriken plağın uzun süre etki etmesiyle meydana gelen bu lezyonlar minede kavitasyon göstermeyen ancak mineral yapısının bozulmasıyla meydana geldiği için sağlıklı mineye göre daha pöröz yapıda görülen dekalsifikasyon odaklarıdır. Sıradan çürüklerin gelişimi genellikle en az altı ayı gerektirirken, beyaz nokta lezyonları braket tatbikinden bir ay sonra braket çevresinde görülmeye başlayabilmektedir. Sabit veya hareketli apareylerle yapılan tedaviler modern ortodontide önemli bir unsurdur ancak beyaz nokta lezyonları gibi gelişen yan etkiler ortodontik tedavinin estetik sonucunu da negatif yönde etkilemektedir.
Zaman içerisinde yeni tekniklerin gelişmesiyle lezyonların teşhisi ve tedavisi için alternatifler artmaktadır. Nasıl ki koruyucu önlemler almak önemli ise, gelişen lezyonların tedavisinde doğru tedavi yöntemini uygulamak da son derece önemlidir. Bu sayede lezyonların ilerlemesi önlenebilir.
One of the most common negative side effects of fixed orthodontic treatment is the development of caries lesions. White spot lesions may develop around orthodontic brackets, ligatures, bands and other attachments because these appliances make it difficult to clean bacterial biofilm accumulation on tooth surfaces. For this reason, the frequency of demineralization on the enamel surface is higher in these patients compared to those who have not received any treatment.
When the enamel surface is examined, the first clinical indicator of caries is white spot lesions. These lesions, which occur as a result of the long-term effect of plaque accumulated on the tooth surface, are decalcification foci that do not show cavitation in the enamel but are more porous than healthy enamel because they occur due to the deterioration of the mineral structure. While the development of ordinary caries usually requires at least six months, white spot lesions can begin to appear around the brackets one month after the bracket application. Treatments with fixed or removable appliances are an important element in modern orthodontics, but developing side effects such as white spot lesions also negatively affect the aesthetic results of orthodontic treatment.
Over time, with the development of new techniques, alternatives for the diagnosis and treatment of lesions are increasing. Just as it is important to take preventive measures, it is also extremely important to apply the correct treatment method in the treatment of developing lesions. In this way, the progression of lesions can be prevented.
Referanslar
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Sadıkoğlu İS. White spot lesions: recent detection and treatment methods. Cyprus Journal of Medical Sciences. 2020;5(3):260-6.
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Referanslar
Choi YY. Relationship between orthodontic treatment and dental caries: results from a national survey. International dental journal. 2020;70(1):38-44.
Puleio F, Fiorillo L, Gorassini F, Iandolo A, Meto A, D’Amico C, et al. Systematic review on white spot lesions treatments. European journal of dentistry. 2022;16(01):41-8.
Richter AE, Arruda AO, Peters MC, Sohn W. Incidence of caries lesions among patients treated with comprehensive orthodontics. American Journal of Orthodontics and Dentofacial Orthopedics. 2011;139(5):657-64.
Jha AK, Chandra S, Shankar D, Murmu DC, Noorani MK, Tewari NK. Evaluation of the prevalence of white spot lesions during fixed orthodontic treatment among patients reporting for correction of malocclusion: a prevalence study. Cureus. 2023;15(7).
Farooq I, Bugshan A. The role of salivary contents and modern technologies in the remineralization of dental enamel: a narrative review. F1000Research. 2020;9.
Sadıkoğlu İS. White spot lesions: recent detection and treatment methods. Cyprus Journal of Medical Sciences. 2020;5(3):260-6.
Sampson V, Sampson A. Diagnosis and treatment options for anterior white spot lesions. British dental journal. 2020;229(6):348-52.
MIRANDA IJL, da SILVA GC, CASTRO ML. LESÕES CARIOSAS INCIPIENTES: UMA REVISÃO DE LEITURA. Facit Business and Technology Journal. 2022;2(36).
Piacenza SPB. Reabilitação de uma lesão de mancha branca com a técnica ICON®: Relato de caso clínico: Universidade Fernando Pessoa (Portugal); 2021.
Akın M, Başçiftçi F. Ortodontik Tedavi Sırasında Beyaz Nokta Lezyon Oluşumu. Selcuk Dental Journal. 2021;8(1):45-9.
Cangül S. Başlangıç Çürük Lezyonlarının Teşhis ve Tedavi Yöntemleri. ADOLESANDA BESLENME. 2016:73.
Romaniuk D. Prevalence and intensity of dental caries of pregnant women in different trimesters of pregnancy: Полтавський державний медичний університет; 2021.
Bilgin G. Başlangıç mine çürüklerinin remineralizasyonlarının çeşitli materyallerle incelenmesi ve yeni bir çürük teşhis metodu ile değerlendirilmesi: Marmara Universitesi (Turkey); 2012.
Devinsky O, Boyce D, Robbins M, Pressler M. Dental health in persons with disability. Epilepsy & Behavior. 2020;110:107174.
Wishney M. Potential risks of orthodontic therapy: a critical review and conceptual framework. Australian dental journal. 2017;62:86-96.
GÜNGÖR E, DUMAN S. Çürük Riskinin Değerlendirilmesi: Uluslararası Çürük Sınıflandırması ve Yönetim Sistemi (Iccms). Bütün Yayın Hakları Saklıdır Kaynak gösterilerek tanıtım için yapılacak kısa alıntılar dışında yayıncının ve editörün yazılı izni olmaksızın hiçbir yolla çoğaltılamaz.158.
Sun F, Ahmed A, Wang L, Dong M, Niu W. Comparison of oral microbiota in orthodontic patients and healthy individuals. Microbial pathogenesis. 2018;123:473-7.
Bergamo AZN, de Oliveira KMH, Matsumoto MAN, Nascimento Cd, Romano FL, da Silva RAB, et al. Orthodontic appliances did not increase risk of dental caries and periodontal disease under preventive protocol. The Angle Orthodontist. 2019;89(1):25-32.
Shankarappa S, Burk JT, Subbaiah P, Rao RN, Doddawad VG. White spot lesions in fixed orthodontic treatment: Etiology, pathophysiology, diagnosis, treatment, and future research perspectives. Journal of Orthodontic Science. 2024;13(1):21.
de Carvalho TP. White Spot Lesions: Diagnosis and Treatment: A Systematic Review. PQDT-Global. 2023.
Nunes L, Lucena F, Araújo D, Freitas M, Navarro MFdL, Wang L. Índices para classificação do desenvolvimento de cárie: ICDAS ou CAST? Anais. 2014.
Maia AMA, de Freitas AZ, de L. Campello S, Gomes ASL, Karlsson L. Evaluation of dental enamel caries assessment using quantitative light induced fluorescence and optical coherence tomography. Journal of biophotonics. 2016;9(6):596-602.
Fathima F, Mathew B. Quantitative light-induced fluorescence (QLF) in orthodontics–A review. Eur J Mol Clin Med. 2021;8:303-12.
Jallad M. Performance of several diagnostic systems on detection of occlusal primary caries in permanent teeth 2014.
Kim BR, Kang SM, de Josselin de Jong E, Kwon HK, Kim BI. In vitro red fluorescence as an indicator of caries lesion activity. Operative dentistry. 2019;44(4):405-13.
Kang S-M, Jeong S-H, Kim H-E, Kim B-I. Photodiagnosis of White Spot Lesions after Orthodontic Treatment with a Quantitative Light-induced Fluorescence-Digital System: A Pilot Study. Oral Health & Preventive Dentistry. 2017;15(5).
Erbe C, Hartmann L, Schmidtmann I, Ohlendorf D, Wehrbein H. A novel method quantifying caries following orthodontic treatment. Scientific reports. 2021;11(1):21347.
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