title: Fluoride-Releasing Materials to Prevent White Spot Lesions around Orthodontic Brackets: A Systematic Review.
abstract: The relation between orthodontic fixed appliances use and enamel demineralization is well established. Different preventive approaches have been suggested to this problem, but controversy remains about which is the best. The aim of this study was to perform a systematic review of clinical trials that investigated the effectiveness of materials containing fluorides to lute brackets or cover the bonding interface in order to inhibit the development and progression of white spot lesions. The null hypothesis was that fluoride materials do not affect the incidence of white spot lesions around brackets. A MEDLINE search was conducted for randomized clinical trials evaluating the development of white spot lesions in patients using fixed orthodontic appliances, followed by meta-analysis comparing the results for patients for whom dental materials containing fluorides were used (experimental group) to those for whom these materials were not used (control group). The pooled relative risk of developing white spot lesions for the experimental group was 0.42 (95% confidence interval: 0.25 to 0.72); hence, when fluoride-releasing materials are used, the patient has 58% less risk of white spot lesion development. Regarding white spot lesion extent, the pooled mean difference between the experimental and control groups was not statistically significant (-0.12; 95% confidence interval: -0.29 to 0.04). In conclusion, the results of the present systematic review suggest that fluoride-releasing materials can reduce the risk of white spot lesions around brackets. However, when white spot lesions had already occurred, there is no evidence that fluoride-releasing materials reduce the extent of these lesions.
authors.affiliation: Graduate Program in Dentistry, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
authors.forename: Patrícia Layane de Menezes Macêdo
authors.initials: PL
authors.lastname: Nascimento
authors.affiliation: Graduate Program in Dentistry, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
authors.forename: Micaelle Tenório Guedes
authors.initials: MT
authors.lastname: Fernandes
authors.affiliation: Graduate Program in Health Sciences, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
authors.forename: Fabricio Eneas Diniz de
authors.initials: FE
authors.lastname: Figueiredo
authors.affiliation: Graduate Program in Dentistry, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
authors.forename: André Luis
authors.initials: AL
authors.lastname: Faria-E-Silva
mesh_terms: D005459:Fluorides / Q000737:chemistry*; D006801:Humans; D016910:Orthodontic Brackets
chemical_list: D005459:Fluorides