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Post-orthodontic initial caries, seen as White Spot Lesions, in the aesthetic zone

  • E6
  • Dr. Giovanni Sammarco
  • Italy
  • Product: Curodont Repair
Before
  • Figure 1: Before: Initial carious lesions (seen as white spot lesions) 21, 22​
After
  • Figure 2: The 16-month follow up showed significant reduction in size and appearance of the white spot lesions​

Patient Presentation and examination: 

  • Personal information and dental history: 25-year-old male, with a history of fixed orthodontic treatment between the ages of 11 and 15
  • Intraoral examination: White discolorations observed on maxillary anterior teeth, most prominent along the disto-facial line angle of 21 and mesio-facial line angle of 22.(Figure 1)

Diagnosis: 

  • 21, 22: Initial carious lesions (ICDAS Score 2) on the labial surfaces, secondary to fixed orthodontic treatment

Treatment: 

  • The lesions were treated with one application of Curodont Repair.
  • Curodont Protect was prescribed to be used twice a week at home at bedtime.

Follow-up: At the 16-month post-treatment follow-up, significant reduction in lesion sizes and appearance was observed, indicative of caries regression. (Figure 2) The oral hygiene instructions were reinforced.

Take-away: Fixed orthodontic treatment is often accompanied by development of initial caries around the bonded brackets, due to the increased difficulty in oral hygiene maintenance.* Such lesions may present an additional esthetic challenge. Curodont Repair can be used as a non-invasive management of these lesions resulting in arrest and regression through Guided Enamel Regeneration.

*Mizrahi E. Am J Orthod. 1982;82:62-7

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