title: Assessment of White Spot Lesions and In-Vivo Evaluation of the Effect of CPP-ACP on White Spot Lesions in Permanent Molars of Children.
abstract: BACKGROUND
  As hindrance of remineralisation process occurs during orthodontic therapy resulting in decalcification of enamel because number of plaque retention sites increases due to banding and bonding of appliances to teeth.
  
  
  OBJECTIVE
  The present analytic study was undertaken to assess the occurrence of white spot lesions in permanent molars of children with and without orthodontic therapy and to evaluate the effect of Casein PhosphoPeptide-Amorphous Calcium Phosphate (CPP-ACP) on white spot lesions in post-orthodontic patients in a given period of time.
  
  
  METHODS
  The study comprised of examination of 679 first permanent molars which were examined to assess the occurrence of smooth surface white spot lesions in children of 8 to 16 years age group. Group I comprised subjects without any orthodontic treatment and Group II comprised of subjects who had undergone orthodontic therapy. The sample size was calculated using the epi-info6 computer package. Treatment group included 20 post-orthodontic patients examined with at least one white spot lesion within the enamel who received remineralizing cream (GC Tooth Mousse, Recaldent, GC Corporation.) i.e., CPP-ACP cream two times a day for 12 consecutive weeks. Computerized image analysis method was taken to evaluate white spot lesions. These frequency and percentages were compared with chi-square test. For comparison of numeric data, paired t-test was used.
  
  
  RESULTS
  Of the total 278 (49.6%) first permanent molars showed occurrence of smooth surface white spot lesions out of 560 in Group I and 107 (89.9%) first permanent molars showed presence of white spot lesions out of 119 debanded first permanent molars of children examined in Group II. CPP-ACP therapy group showed reduction in severity of codes which was found to be highly significant after 12 weeks and eight weeks on gingival-third, p-value (<0.001) and significant after eight weeks and four weeks on middle-third according to ICDAS II criteria and computerized image analysis.
  
  
  CONCLUSIONS
  CPP-ACP therapy minimum for 12 weeks is highly recommended as post-orthodontic treatment need in management of smooth surface white spot lesions on teeth undergoing fixed orthodontic therapy according to the present study.
authors.affiliation: Senior Lecturer, Department of Pediatric and Preventive Dentistry, Maharaja Ganga Singh Dental College and Research Centre , Sriganganagar, Rajasthan, India .
authors.forename: Deepti
authors.initials: D
authors.lastname: Munjal
authors.affiliation: Professor, Department of Pediatric and Preventive Dentistry, MM College of Dental Sciences and Research , Mullana, Ambala, Haryana, India .
authors.forename: Shalini
authors.initials: S
authors.lastname: Garg
authors.affiliation: Professor, Department of Pediatric and Preventive Dentistry, MM College of Dental Sciences and Research , Mullana, Ambala, Haryana, India .
authors.forename: Abhishek
authors.initials: A
authors.lastname: Dhindsa
authors.affiliation: Senior Lecturer, Department of Oral Pathology and Microbiology, Maharaja Ganga Singh Dental College and Research Centre , Sriganganagar, Rajasthan, India .
authors.forename: Gagandeep Kaur
authors.initials: GK
authors.lastname: Sidhu
authors.affiliation: Senior Lecturer, Department of Pediatric and Preventive Dentistry, Maharaja Ganga Singh Dental College and Research Centre , Sriganganagar, Rajasthan, India .
authors.forename: Harsimran Singh
authors.initials: HS
authors.lastname: Sethi
keywords: Casein phosphopeptide-amorphous calcium phosphate; Decalcification; Incipient caries lesions; Orthodontics