Abstract
White spot lesion (WSL) infiltration has been recommended immediately after debonding of orthodontic brackets. It is however not clear if established inactive WSLs can also be masked through infiltration
Orthodontic treatment of a 19-year-old patient had to be terminated prematurely due to development of multiple WSLs of varying severity. Three months after debonding, the patient presented for lesion infiltration. After etching with 15% HCl gel and re-wetting of the dried surfaces it seemed that a good outcome could be expected. Lesion infiltration led to complete masking of less severe WSLs. The visual appearance of moderate and severe WSLs was improved but they were still visible after treatment.
Inactive WSLs may not represent an increased caries risk, but patients are often bothered esthetically. Infiltration by repeated etching might be a viable approach even for inactive WSLs. Controlled clinical trials are needed to investigate the long-term performance of this technique.
Zusammenfassung
Die Infiltration initialer kariöser Läsionen (Kreideflecke, White- Spot-Läsionen) wird unmittelbar nach der Entfernung kieferorthopädischer Brackets empfohlen. Es ist jedoch unklar, ob auch etablierte Kreideflecken durch Infiltration maskiert werden können.
Bei einem 19-jährigen Patienten musste die festsitzende orthodontische Phase wegen Auftretens multipler initial kariöser Läsionen vorzeitig beendet werden. Drei Monate nach der Entfernung der Brackets wurde der Patient zur Infiltration vorstellig. Nach dem Ätzen mit 15%igem HCl-Gel konnte durch gezieltes Wiederbefeuchten der getrockneten Zahnoberflächen das zu erwartende Ergebnis antizipiert werden. Die Infiltrationstechnik führte zur vollständigen Maskierung weniger stark ausgeprägter Kreideflecke. Stärker demineralisierte Läsionen wurden optisch verbessert, waren aber nach der Behandlung noch immer sichtbar.
Inaktive Kreideflecke sprechen nicht unbedingt für ein erhöhtes Kariesrisiko, aber Patienten stören sich häufig an der kosmetischen Einbuße. Die Infiltration dieser Läsionen mit multiplen Ätzschritten könnte auch für inaktive Kreideflecke sinnvoll sein. Es fehlen jedoch Langzeitdaten aus klinischen Untersuchungen zur Validierung dieser Methode.
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Neuhaus, K.W., Graf, M., Lussi, A. et al. Late Infiltration of Post-orthodontic White Spot Lesions. J Orofac Orthop 71, 442–447 (2010). https://doi.org/10.1007/s00056-010-1038-0
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DOI: https://doi.org/10.1007/s00056-010-1038-0