Arnold M. Geiger

Reducing white spot lesions in orthodontic populations with fluoride rinsing

A clinical study was conducted to determine if rinsing frequency with a neutral 0.05% sodium fluoride rinse influenced white spot lesion formation associated with orthodontic brackets. Patients from two private orthodontic practices participated. Each received home-care instructions and were told to use 10 ml of sodium fluoride rinse daily before bedtime. The rinse was supplied free of charge to determine if this affected compliance with its prescribed use. Compliance was measured by recording the number of bottles used by each patient. As assessment of oral hygiene status was conducted, and at the time of debonding, white spot lesions were recorded. Only 13% of the 206 participants fully complied with the rinse protocol; 42% of the subjects used 10 ml approximately every other day; and 45% used the rinse less frequently. A significant dose response relationship was noted in which those who rinsed at least once every other day had fewer lesions (21%) than those who rinsed less frequently (49%). It was concluded that a significant reduction in enamel white spot lesions can be achieved during orthodontic therapy through the use of a 10 ml neutral sodium fluoride rinse. The more closely patients complied with the prescribed use, the more likely they could expect a decrease in the occurrence of lesions.

The effect of a fluoride program on white spot formation during orthodontic treatment

W hite spot formation (decalcification) of the labial enamel surface subsequent to orthodontic treatment has been recognized as a problem. This has been reported as a clinical observation”* and quantitative studies on the incidence and prevention of decalcification have been reported.3-i0 Equal susceptibility to white spot formation has been reported whether teeth are banded or bonded.g There has been general agreement that the development of white spots seems to be related to (1) the retention of plaque on the gingival side of brackets or bands, (2) oral hygiene efficiency, and (3) the inherent resistance of the individual. Studies have documented the beneficial effect of preventive fluoride programs during multibanded orthodontic treatment. Such studies have reported on officeapplied and self-administered programs.5*7 However, no studies have reported on the effect of a preventive fluoride protocol during orthodontic treatment with bonded appliances; nor have there been studies reporting on the severity and prevention of white spot formation on all individual teeth. This article presents the results of a clinical study in which an experimental preventive fluoride program was routinely used in the orthodontic offices of the authors. The study was designed to provide answers to the following questions. 1. Was the preventive fluoride program beneficial in reducing the incidence and severity of white spots after full-term bonded orthodontic treatment? 2. Will such preventive efforts reduce the white

Relationship of occlusion and periodontal disease: part IX-incisor inclination and periodontal status.

In this study population the following observations have been made: Periodontal destruction, gingival inflammation and mobility were not significantly related to axial inclination of the incisor teeth. Labial gingival recession of the mandibular incisor was related to linguoversion (less than 85 degrees to GoGn). No other associations between incisor inclination and labial or lingual recession were found. Age was not related to either maxillary or mandibular incisor inclination. The periodontal-incisor inclination relationships reported above for periodontal destruction and gingival inflammation were not altered by the factor of age. Study of the secondary influence of incisor inclination on the relationships of selected occlusal factors and periodontal pathosis showed: A. Severe overjet (more than 6mm) had been found to be associated with more periodontal destruction. With severe overjet maxillary incisors in linguoversion (less than 100 degrees to SN) were somewhat healthier than all others. Among the same cases of severe overjet mandibular incisors in labioversion had slightly more disease than all others. B. The absence of a significant correlation between anterior overbite or crowding reported previously was not influenced by incisor inclination. C. Facial alveolar bone thickness, observed clinically, was studied for its relation to periodontal destruction and gingival inflammation. Thick facial alveolar bone was found to be associated with increased pathosis. This finding was not consistent for the maxillary and mandibular incisor and the influence of other factors might be suspected: Incisor inclination had no effect on the bone thickness-periodontal disease findings.

Orthodontic management of ankylosed permanent posterior teeth: A clinical report of three cases

Ankylosed permanent posterior teeth may have a better prognosis than has been generally assumed. Three case reports offer testimony to the effectiveness of surgical luxation (loosening) with forced eruption induced by elastic force. Individual teeth, the occlusion, and the alveolar process may be preserved by early and aggressive treatment. The prognosis may be questionable, but the effect is preferable to premature extraction.