IADR Abstract Archives
Early Enamel Lesions During Fixed-Orthodontic Therapy, Systematic Review and Meta-Analysis
Objectives: The development of carious lesions around brackets and bands is the among one of the most common side effect of orthodontic treatment with fixed appliances. Early Enamel caries lesions (EECLs) with a characteristic chalky white appearance are a public health problem because as they are the first step of carious lesions that may evolve into cavitated lesions if left untreated. The prevalence of EECLs, related to orthodontic treatment, described varies widely across studies, ranging from 27% to 97%. Based on these premises, the purpose of this systematic review is to evaluate, summarize and analyze the incidence and prevalence rates of EECLs in relation to orthodontic treatment.
Methods: The present systematic review was registered a priori in Prospero (CRD4202341295), and databases were searched for appropriate studies. The risk of bias assessment was carried using the Cochrane collaboration’s RoB 2 and RoB 1 tool for RCT and NRSI studies, respectively and the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data for cross-sectional and longitudinal studies. Prometa3 Software was used for the meta-analysis.
Results: Out of 286 papers 21 met the inclusion criteria and 19 of them were included in meta-analysis, the incidence rate of new carious lesions formed during orthodontic treatment was 0.47 in 540 patients, 0.15 in 1890 teeth with a mean number of EECLs equal to 2.29 in 208 patients evaluated; the prevalence rate of EECLs in patients undergoing orthodontic treatment was 0.57 in 1450 patients, 0.19 in 12346 teeth with a mean number of EECLs equal to 2.24 in 484 patients evaluated.
Conclusions: Incidence and prevalence rates of EECLs in patients undergoing orthodontic treatment are quite high and meaningful. This diffuse burden of EECLs development is an alarming challenge and deserves considerable attention from both patients and professionals, which should lead to a greater focus on effective caries prevention.
Methods: The present systematic review was registered a priori in Prospero (CRD4202341295), and databases were searched for appropriate studies. The risk of bias assessment was carried using the Cochrane collaboration’s RoB 2 and RoB 1 tool for RCT and NRSI studies, respectively and the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data for cross-sectional and longitudinal studies. Prometa3 Software was used for the meta-analysis.
Results: Out of 286 papers 21 met the inclusion criteria and 19 of them were included in meta-analysis, the incidence rate of new carious lesions formed during orthodontic treatment was 0.47 in 540 patients, 0.15 in 1890 teeth with a mean number of EECLs equal to 2.29 in 208 patients evaluated; the prevalence rate of EECLs in patients undergoing orthodontic treatment was 0.57 in 1450 patients, 0.19 in 12346 teeth with a mean number of EECLs equal to 2.24 in 484 patients evaluated.
Conclusions: Incidence and prevalence rates of EECLs in patients undergoing orthodontic treatment are quite high and meaningful. This diffuse burden of EECLs development is an alarming challenge and deserves considerable attention from both patients and professionals, which should lead to a greater focus on effective caries prevention.