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2017 Annual Session Conference

AS17B35B - Deproteinization of Tooth Enamel Surfaces to Prevent White Spot Lesions and Bracket Bond Failure

Apr 24, 2017 8:30am ‐ Apr 24, 2017 9:00am


Orthodontic treatment success is jeopardized by the risk of development of white spot lesions (WSLs) around orthodontic brackets. Unfortunately, the formation of WSLs still remains a common complication during treatment in patients with poor oral hygiene. Nearly 75% of orthodontic patients are reported to develop enamel decalcification because of prolonged plaque retention around brackets. It is the orthodontist’s responsibility to minimize the risk of patients having enamel decalcifications as a consequence of orthodontic treatment. This can be achieved by using fluoride-releasing, resin-modified glass ionomer cement (RMGIC) to bond brackets, with deproteinization of the enamel surface prior to phosphoric acid etching.

Learning Objectives:

  • Describe the incidence of new WSLs at the completion of orthodontic treatment.
  • Explain why the enamel surfaces surrounding the bracket bases are protected from WSLs when brackets are bonded with RMGICs.
  • Describe why enamel deproteinization with Clorox (5.25% Sodium Hypochlorite), prior to etching, increases bracket SBS, diminishing bracket bond failure incidence, both with composite resin and with RMGIC (Justus et al, Seminars in Orthodontics, March 2010).


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