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Background/Aims: During endoscopy, white spots (WS) are sometimes observed around benign or malignant colorectal tumors; however, few reports have investigated WS, and their significance remains unknown. Therefore, we investigated the significance of WS from clinical and pathological viewpoints and evaluated its usefulness in endoscopic diagnosis. Methods: Clinical data of patients with lesions diagnosed as epithelial tumors from January 1, 2019, to December 31, 2020, were analyzed (n=3,869). We also performed a clinicopathological analysis of adenomas or carcinomas treated with endoscopic resection (n=759). Subsequently, detailed pathological observations of the WS were performed. Results: The positivity rates for WS were 9.3% (3,869 lesions including advanced cancer and non-adenoma/carcinoma) and 25% (759 lesions limited to adenoma and early carcinoma). Analysis of 759 lesions showed that the WS-positive lesion group had a higher proportion of cancer cases and larger tumor diameters than the WS-negative group. Multiple logistic analysis revealed the following three statistically significant risk factors for carcinogenesis: positive WS, flat lesions, and tumor diameter =5 mm. Pathological analysis revealed that WS were macrophages that phagocytosed fat and mucus and were white primarily because of fat. Conclusions: WS are cancer-related findings and can become a new criterion for endoscopic resection in the future. [ABSTRACT FROM AUTHOR]

Aims This study aimed to assess the effect of G-CEM, a fluoride-releasing cement, on the development of white spot lesions (WSLs) and their severity around orthodontic brackets. Methods and Materials This case-control study was conducted by reviewing 140 dental records of fixed orthodontic patients presenting to an orthodontic clinic. The patients were assigned to two groups (n = 70). In group 1, Transbond XT resin cement, and in group 2, G-CEM had been used for bracket bonding. The frequency and severity of WSLs in each group were evaluated by assessing the available post-treatment photographs of patients and notes left by their orthodontist in their records in this regard. The number of teeth with WSLs in each patient was recorded, and the severity of lesions was categorised by Gorelick’s analysis. Statistical Analysis Comparisons were made using independent t-test, Wilcoxon test and Mann–Whitney test (alpha = 0.05). Results In both the maxilla and mandible, the prevalence of WSLs was significantly higher in the Transbond XT group than in the G-CEM group (P = 0.01). The difference in frequency of WSLs between the maxilla and mandible was not significant within each group (P > 0.05). Tooth #22 had the highest frequency of WSLs (11.4%) in the Transbond XT group, while teeth #12 and #36 had the highest frequency of WSLs (2.9%) in the G-CEM group. The difference in frequency of WSLs was not significant between males and females (P > 0.05). Conclusion Bracket bonding with G-CEM fluoride-releasing cement significantly reduced the development of WSLs around orthodontic brackets.

This systematic review examines studies focusing on tooth bleaching and its effects on healthy enamel or incipient caries and bacterial adhesion. The aim is to explore the impact of different bleaching agents on incipient caries lesions and healthy enamel. Clinical studies, in vitro studies, and observational studies that compared at least two groups were included. A search strategy was used to select studies from the MEDLINE via Pubmed and Scopus databases. Two evaluators performed data extraction, screening, and quality assessment independently. Only studies written in English were included. From 968 initial records, 28 studies were selected for a full-text evaluation. Of these, 7 studies were classified as cluster 1 (bacterial adherence on teeth), 12 studies as cluster 2 (no bacteria involved), 4 studies as cluster 3 (no teeth deployment), and 5 clinical studies were cluster 4. Of the selected studies, 6 (21.4%) supported increased bacterial attachment capacity and cariogenic dynamics, 4 (14.3%) decreased adhesion and cariogenic activity, 7 (25%) showed no difference, and 11 (39.3%) followed a different methodological approach and could not be categorized. The risk of bias appeared to be high, mainly because of the different methodologies in the studies, so we cannot reach a confident conclusion. Nevertheless, as far as carbamide peroxide bleaching is concerned, there does not seem to be a clinically significant alteration, neither in microorganism counts nor in enamel microstructure. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to assess the effect of G-CEM, a fluoride-releasing cement, on the development of white spot lesions (WSLs) and their severity around orthodontic brackets. Methods and Materials: This case-control study was conducted by reviewing 140 dental records of fixed orthodontic patients presenting to an orthodontic clinic. The patients were assigned to two groups (n = 70). In group 1, Transbond XT resin cement, and in group 2, G-CEM had been used for bracket bonding. The frequency and severity of WSLs in each group were evaluated by assessing the available post-treatment photographs of patients and notes left by their orthodontist in their records in this regard. The number of teeth with WSLs in each patient was recorded, and the severity of lesions was categorised by Gorelick's analysis. Statistical Analysis: Comparisons were made using independent t-test, Wilcoxon test and Mann--Whitney test (alpha = 0.05). Results: In both the maxilla and mandible, the prevalence of WSLs was significantly higher in the Transbond XT group than in the G-CEM group (P = 0.01). The difference in frequency of WSLs between the maxilla and mandible was not significant within each group (P > 0.05). Tooth #22 had the highest frequency of WSLs (11.4%) in the Transbond XT group, while teeth #12 and #36 had the highest frequency of WSLs (2.9%) in the G-CEM group. The difference in frequency of WSLs was not significant between males and females (P > 0.05). Conclusion: Bracket bonding with G-CEM fluoride-releasing cement significantly reduced the development of WSLs around orthodontic brackets. [ABSTRACT FROM AUTHOR]

According to modern ideas, the carious process at the white spot stage is reversible, so all the attention of scientists is directed to the development of means to restore the crystal lattice of tooth enamel. The purpose of the study is to evaluate morphological changes in caries at the white spot stage and the process of structural remineralization of the carious lesion area. Clinically active initial lesions were detected visually, using optical magnification and positive staining. Structural changes in enamel were studied by scanning electron microscopy of surface impressions obtained from the surface of demineralized enamel. Remineralizing therapy was carried out by applying ApaCare restorative gel (Germany) with nanodispersed highly active hydroxyapatite. Determination of the intensity of dental caries by the DMFT and dmft index showed 9.04 ± 0.40 points on average in the group of subjects, children with code 1 according to the ICDAS index made up 50.8%. Colour reactions showed 7.80 ± 0.21 points on average in the group. SEM visualized characteristic structural changes in the area of the carious spot – an increase in the porosity of the enamel surface with exposure of the fine crystalline structure and destruction of interprismatic fibrillar structures. When using a remineralizing agent, a roller-like deposition of an amorphous remineralizing substance is characteristic, and at the final stage, a smooth enamel surface with a fine crystal lattice is restored. The restoration of the prismatic structure of the enamel occurs due to the mineralization of the preserved fibrillar walls in the interprismatic space. Clinically, at this stage, the enamel visually restores its original shine, smoothness, and colour. In 81.8% of cases, the dye did not penetrate the previously demineralized enamel. The high level of non-cavitated active caries lesions can be largely controlled by the use of remineralizing agents. Further research involves studying the quantitative characteristics of the processes of de- and remineralization of tooth enamel.

Background: Graphene-based materials have great prospects for application in dentistry and medicine due to their unique properties and biocompatibility with tissues. The literature on the use of graphene oxide in orthodontic treatment was reviewed. Methods: This systematic review followed the PRISMA protocol and was conducted by searching the following databases: PubMed, Scopus, Web of Science, and Cochrane. The following search criteria were used to review the data on the topic under study: (Graphene oxide) AND (orthodontic) ALL FIELDS. For the Scopus database, results were narrowed to titles, authors, and keywords. A basic search structure was adopted for each database. Initially, a total of 74 articles were found in the considered databases. Twelve articles met the inclusion criteria and were included in the review. Results: Nine studies demonstrated the antibacterial properties of graphene oxide, which can reduce the demineralization of enamel during orthodontic treatment. Seven studies showed that it is biocompatible with oral tissues. Three studies presented that graphene oxide can reduce friction in the arch-bracket system. Two studies showed that it can improve the mechanical properties of orthodontic adhesives by reducing ARI (Adhesive Remnant Index). Three studies demonstrated that the use of graphene oxide in the appropriate concentration can also increase the SBS (shear bond strength) parameter. One research study showed that it can increase corrosion resistance. One research study suggested that it can be used to accelerate orthodontic tooth movement. Conclusion: The studies included in the systematic review showed that graphene oxide has numerous applications in orthodontic treatment due to its properties. [ABSTRACT FROM AUTHOR]

This systematic review examines studies focusing on tooth bleaching and its effects on healthy enamel or incipient caries and bacterial adhesion. The aim is to explore the impact of different bleaching agents on incipient caries lesions and healthy enamel. Clinical studies, in vitro studies, and observational studies that compared at least two groups were included. A search strategy was used to select studies from the MEDLINE via Pubmed and Scopus databases. Two evaluators performed data extraction, screening, and quality assessment independently. Only studies written in English were included. From 968 initial records, 28 studies were selected for a full-text evaluation. Of these, 7 studies were classified as cluster 1 (bacterial adherence on teeth), 12 studies as cluster 2 (no bacteria involved), 4 studies as cluster 3 (no teeth deployment), and 5 clinical studies were cluster 4. Of the selected studies, 6 (21.4%) supported increased bacterial attachment capacity and cariogenic dynamics, 4 (14.3%) decreased adhesion and cariogenic activity, 7 (25%) showed no difference, and 11 (39.3%) followed a different methodological approach and could not be categorized. The risk of bias appeared to be high, mainly because of the different methodologies in the studies, so we cannot reach a confident conclusion. Nevertheless, as far as carbamide peroxide bleaching is concerned, there does not seem to be a clinically significant alteration, neither in microorganism counts nor in enamel microstructure.

According to modern ideas, the carious process at the white spot stage is reversible, so all the attention of scientists is directed to the development of means to restore the crystal lattice of tooth enamel. The purpose of the study is to evaluate morphological changes in caries at the white spot stage and the process of structural remineralization of the carious lesion area. Clinically active initial lesions were detected visually, using optical magnification and positive staining. Structural changes in enamel were studied by scanning electron microscopy of surface impressions obtained from the surface of demineralized enamel. Remineralizing therapy was carried out by applying ApaCare restorative gel (Germany) with nanodispersed highly active hydroxyapatite. Determination of the intensity of dental caries by the DMFT and dmft index showed 9.04 ± 0.40 points on average in the group of subjects, children with code 1 according to the ICDAS index made up 50.8%. Colour reactions showed 7.80 ± 0.21 points on average in the group. SEM visualized characteristic structural changes in the area of the carious spot – an increase in the porosity of the enamel surface with exposure of the fine crystalline structure and destruction of interprismatic fibrillar structures. When using a remineralizing agent, a roller-like deposition of an amorphous remineralizing substance is characteristic, and at the final stage, a smooth enamel surface with a fine crystal lattice is restored. The restoration of the prismatic structure of the enamel occurs due to the mineralization of the preserved fibrillar walls in the interprismatic space. Clinically, at this stage, the enamel visually restores its original shine, smoothness, and colour. In 81.8% of cases, the dye did not penetrate the previously demineralized enamel. The high level of non-cavitated active caries lesions can be largely controlled by the use of remineralizing agents. Further research involves studying the quantitative characteristics of the processes of de- and remineralization of tooth enamel. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopadie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Coupling fluid flow, heat transfer, solidification, and particle dissolution behavior, the white spot formation in the vacuum arc remelting process is simulated. The effect of particle initial diameter, dropping position, and dropping height on the remelting behavior is investigated. The results show that the particle from the electrode drops through the arc zone with gravity force and the diameter is reduced in the high‐temperature zone. As the diameter is lower than 5 mm, the particle completely dissolves and the white spot formation can be eliminated. The particle dissolution is less affected by the liquid pool depth, but it is mainly affected by the high‐temperature zone distribution, which is closely related to the electric arc generation. Because of the limited high‐temperature zone near the ingot side surface, the particle from the ingot crown is more difficult to remelt, compared with that from the electrode. Moreover, it is found that the dropping height obviously affects the particle remelting behavior. As the dropping height decreases from 25 to 0, the particle critical diameter that can fully dissolve increases from 4.2 to 6.6 mm. [ABSTRACT FROM AUTHOR]

Introduction. White spot lesions are early signs of demineralization, which may or may not lead to the development of caries. An inactive white spot lesion might act as an arrested dental caries and affect the esthetic appearance by displaying a milky white color. These lesions need a non-invasive or a minimally invasive treatment. One of the materials taken into consideration in treating these lesions is ICON, a biomimetic material that infiltrates the white spots and can reestablish the esthetic function. The aim of the current study was to evaluate the esthetic efficacy of a minimally invasive technique and a relatively new product on the dental market, ICON, in the treatment of different non-cavitated carious lesions. Case presentation. A 14-year-old patient presented to the dental clinic with asymptomatic, non-cavitating lesions on the cervical aspect of all permanent teeth. The lesions were diagnosed as incipient caries on the buccal, occlusal, and palatal surfaces of the teeth, and the proposed treatment to arrest their progression and improve the esthetic appearance was the use of the ICON infiltration technique. Conclusion. The ICON resin infiltration treatment increased esthetics, visibly diminishing the appearance of non-cavitating carious lesions.

Coronavirus desease 2019 (COVID-19) is a pandemic that has occurred in the world since 2019. Researchers have carried out various ways in dealing with this disease, starting from the screening stage to the stage of treatment and therapy for COVID-19 patients. As the gateway to the COVID-19 problem, screening has an essential role in a diagnosis that leads to appropriate treatment. In this paper, we will focus on the screening stage using digital image processing techniques, namely in calculating the area of white spots in the lungs of COVID-19 patients. The white patches are an early indication of how badly COVID-19 is attacking the patient. We use X-Ray Thorax image objects as research data in this paper. Although the current experimental results show that this method has a successful performance of 71.11%, it is pretty promising for further development due to its simplicity. [ABSTRACT FROM AUTHOR]

Background: Graphene-based materials have great prospects for application in dentistry and medicine due to their unique properties and biocompatibility with tissues. The literature on the use of graphene oxide in orthodontic treatment was reviewed. Methods: This systematic review followed the PRISMA protocol and was conducted by searching the following databases: PubMed, Scopus, Web of Science, and Cochrane. The following search criteria were used to review the data on the topic under study: (Graphene oxide) AND (orthodontic) ALL FIELDS. For the Scopus database, results were narrowed to titles, authors, and keywords. A basic search structure was adopted for each database. Initially, a total of 74 articles were found in the considered databases. Twelve articles met the inclusion criteria and were included in the review. Results: Nine studies demonstrated the antibacterial properties of graphene oxide, which can reduce the demineralization of enamel during orthodontic treatment. Seven studies showed that it is biocompatible with oral tissues. Three studies presented that graphene oxide can reduce friction in the arch-bracket system. Two studies showed that it can improve the mechanical properties of orthodontic adhesives by reducing ARI (Adhesive Remnant Index). Three studies demonstrated that the use of graphene oxide in the appropriate concentration can also increase the SBS (shear bond strength) parameter. One research study showed that it can increase corrosion resistance. One research study suggested that it can be used to accelerate orthodontic tooth movement. Conclusion: The studies included in the systematic review showed that graphene oxide has numerous applications in orthodontic treatment due to its properties.

Background/aims: During endoscopy, white spots (WS) are sometimes observed around benign or malignant colorectal tumors; however, few reports have investigated WS, and their significance remains unknown. Therefore, we investigated the significance of WS from clinical and pathological viewpoints and evaluated its usefulness in endoscopic diagnosis., Methods: Clinical data of patients with lesions diagnosed as epithelial tumors from January 1, 2019, to December 31, 2020, were analyzed (n=3,869). We also performed a clinicopathological analysis of adenomas or carcinomas treated with endoscopic resection (n=759). Subsequently, detailed pathological observations of the WS were performed., Results: The positivity rates for WS were 9.3% (3,869 lesions including advanced cancer and non-adenoma/carcinoma) and 25% (759 lesions limited to adenoma and early carcinoma). Analysis of 759 lesions showed that the WS-positive lesion group had a higher proportion of cancer cases and larger tumor diameters than the WS-negative group. Multiple logistic analysis revealed the following three statistically significant risk factors for carcinogenesis: positive WS, flat lesions, and tumor diameter ≥5 mm. Pathological analysis revealed that WS were macrophages that phagocytosed fat and mucus and were white primarily because of fat., Conclusions: WS are cancer-related findings and can become a new criterion for endoscopic resection in the future.

Introduction: Fluoride agents to prevent white spot lesions are used often during orthodontic treatment. The beneficial effects of fluoride, when consumed within permissible limits on dental structures, are well known. Their implications on underlying biological tissues, however, are unknown. Mouthwashes and dentifrices with fluorides are associated with metal ion release into the mouth with possible cell genotoxicity. Since these cariostatic agents are frequently used during orthodontic therapy, a deeper understanding of the effects of fluoride on oral tissues was considered necessary. Methodology: Three groups of patients (30 each)--group 1 (untreated controls), group 2 (non-fluoridated), and group 3 (Fluoridated) were analyzed. Patients in groups 2 and 3 were bonded with the same bracket prescription and treated with similar archwire sequences. Buccal mucosal cells at 4 specific time periods (before treatment, 1 week, 30 days, and 6 months) were collected, using a wooden tongue depressor, and assessed for any nuclear abnormalities. Comparisons of changes were made with an untreated control group and also between the non-fluoridated and fluoridated groups. Relevant conclusions were drawn after analysis of the results. Results: Greater number of nuclei were observed at the 30-day time interval in the fluoridated group, which was statistically significant at P < .001. Conclusion: Use of fluoridated oral hygiene products in patients undergoing fixed orthodontic treatment with NiTi archwires could increase the risk of micronuclei formation in buccal mucosal cells. [ABSTRACT FROM AUTHOR]

Nipple pain is a common reason for premature cessation of breastfeeding. Despite the benefits of breastfeeding for both infant and mother, clinical support for problems such as maternal nipple pain remains a research frontier. Maternal pharmaceutical treatments, and infant surgery and bodywork interventions are commonly recommended for lactation-related nipple pain without evidence of benefit. The pain is frequently attributed to mammary dysbiosis, candidiasis, or infant anatomic anomaly (including to diagnoses of posterior or upper lip-tie, high palate, retrognathia, or subtle cranial nerve abnormalities). Although clinical protocols universally state that improved fit and hold is the mainstay of treatment of nipple pain and wounds, the biomechanical parameters of pain-free fit and hold remain an omitted variable bias in almost all clinical breastfeeding research. This article reviews the research literature concerning aetiology, classification, prevention, and management of lactation-related nipple–areolar complex (NAC) pain and damage. Evolutionary and complex systems perspectives are applied to develop a narrative synthesis of the heterogeneous and interdisciplinary evidence elucidating nipple pain in breastfeeding women. Lactation-related nipple pain is most commonly a symptom of inflammation due to repetitive application of excessive mechanical stretching and deformational forces to nipple epidermis, dermis and stroma during milk removal. Keratinocytes lock together when mechanical forces exceed desmosome yield points, but if mechanical loads continue to increase, desmosomes may rupture, resulting in inflammation and epithelial fracture. Mechanical stretching and deformation forces may cause stromal micro-haemorrhage and inflammation. Although the environment of the skin of the nipple–areolar complex is uniquely conducive to wound healing, it is also uniquely exposed to environmental risks. The two key factors that both prevent and treat nipple pain and inflammation are, first, elimination of conflicting vectors of force during suckling or mechanical milk removal, and second, elimination of overhydration of the epithelium which risks moisture-associated skin damage. There is urgent need for evaluation of evidence-based interventions for the elimination of conflicting intra-oral vectors of force during suckling. [ABSTRACT FROM AUTHOR]

Background: The present study determined white spots with the help of quantitative light-induced fluorescence (QLF) in patients undergoing fixed orthodontics. Materials and Methods: Sixty-four patients undergoing fixed orthodontics above 12 years underwent debonding, and the presence of carious lesion was assessed at baseline and after 6 weeks, 6 months, and 2 years. QLF images were taken with intraoral fluorescence camera. QLF images were examined visually for signs of demineralization, and scoring system was used. Results: It is found that there was fluorescence loss over a period of time. The median sum of fluorescence loss per patient was 55.6% and 29.2% and 101.4% at quartiles at baseline which changed to 51.2% and 26.5% at the first quartile and 101.4% at the second quartile. At 2 years, it was 43.7% and at the first quartile was 22.1% and at the second quartile was 99.1%. There was significant improvement at T2 (P < 0.05), however, between baseline and F1 and between F1 and F2, there was nonsignificant improvement (P > 0.05). The median value for total lesion area per patient was 3.6 mm2 with quartiles 1.2 mm2 and 8.2 mm2 at baseline, 2.6 mm2 with quartiles 0.7 mm2 and 6.3 mm2 at 6 weeks, 2.3 mm2 with quartiles 0.7 mm2 and 6.3 mm2 at 6 months, and 1.8 mm2 with quartiles 0.5 mm2 and 5.8 mm2 at 2 years which was statistically significant (P < 0.05). Conclusion: The authors found that white spots during fixed orthodontic treatment and after debonding is a common phenomenon. Although there was improvement in disappearance of these lesions, complete removal cannot be ensured.

The restoration of fractures in anterior teeth is a common yet challenging procedure. The goal is to create restorations that preserve as much healthy tooth structure as possible, have excellent longevity, and blend imperceptibly with the patient's natural dentition. When treating a single anterior tooth, the restoration should mimic the characteristics of the adjacent teeth. This article describes the restoration of a Class IV fractured tooth that has an excellent color match and mimics the enamel white spots. [ABSTRACT FROM AUTHOR]

White spots (WS) are one of the most undesirable side effects in patients undergoing orthodontic therapy and are usually located around bracket bases and even detected under the molar bands. The aim of the present cross-sectional study was to evaluate the WS lesion during orthodontic therapy and the correlation between WS and oral hygiene habits. Patients requiring orthodontic treatment with a fixed appliance were screened for the inclusion/exclusion criteria, and 74 subjects were finally enrolled. Each patient received three examinations: at T0, the day of the application of the fixed appliance; at T1, three months later; and at T2, six months after treatment start. After calculating descriptive statistics, differences between groups were evaluated with an independent sample t-test. The first type error was set as p ≤ 0.01. The observed prevalence of WS lesions was 59.5% on T1 and 60.8% on T2. The most affected teeth result to be upper molars, lower left first molar, upper right central incisor and upper left lateral incisor, upper right canine, upper left first premolar, and lower right first molar. A higher frequency of daily tooth brushing was accompanied by a lower prevalence of WS. No significant effect of sex was observed.

Copyright of Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopadie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

White spots are commonly found in bean‐based fermented food, which will significantly lower the product quality. This study aimed to analyze the composition of white spots and further reveal the source and influencing factors of white spots in bean‐based fermented food using soybean paste as study model. The results showed that white spots were mainly composed of 40.96% free tyrosine and 37.94% tyrosine in combination form. During soybean paste fermentation, tyrosine was found to be produced by the actions of proteolytic enzymes secreted by Aspergillus oryzae 3.042 instead of the microbial metabolism and the excessive accumulation of tyrosine in soybean paste led to the formation of white spots. Among all influencing factors, high temperature treatment favored the formation of white spots. The existence of soy peptone and phenylalanine would postpone the precipitation of tyrosine while promoting the aggregation of the tyrosine precipitation. Field emission scanning electron microscope analysis showed that tyrosine would accumulate around the soybean protein particles and treatment at 120 °C would disrupt the structure of tyrosine–protein complex. Based on the above results, we proposed that treatment of soybean paste at temperature lower than 80 °C was the current practically applicable method to control the formation of white spots in soybean paste. Practical Application: This study developed a new idea to understand the composition and formation of white spots in soybean paste, which would provide guidance for prevention and control of white spots during the production of soybean paste for manufacturers and researchers. [ABSTRACT FROM AUTHOR]

This study investigated the combined effect of CO2 laser irradiation and Remin Pro paste on microhardness of enamel white spot lesions (WSLs). Seventy-eight intact premolars were randomly assigned into six groups and then stored in a demineralizing solution to create WSLs. Afterwards, the teeth in group 6 (negative control) remained untreated, while groups 1 and 4 were exposed to CO2 laser irradiation (20 Hz, 1 W, 30 s) and Remin Pro paste, respectively. In groups 2 and 3, the teeth were exposed to laser either before (group 2) or after (group 3) Remin Pro application. The teeth in groups 1 to 5 were then immersed in artificial saliva for 90 days while subjected to fluoride mouthwash and weekly brushing. Finally, the teeth were sectioned, and Vickers microhardness was measured at the enamel surface and at 50, 100, and 150 μm from the surface. One sample of each group was also examined with scanning electron microscope (SEM). Data were analyzed by two-way analysis of variance (ANOVA) and Tukey's test. The significance was set at 0.05. Laser irradiation followed by Remin Pro application (group 2) caused a significant increase in total WSLs' microhardness compared with laser alone (group 1) and control groups (P < 0.05). Microhardness at depths of 100 and 150 μm was also significantly greater in group 2 compared with those of group 3 and control groups (P < 0.05). Combined application of CO2 laser with Remin Pro paste, when laser is irradiated before the paste, is suggested for re-hardening of WSLs in deep layers of enamel. [ABSTRACT FROM AUTHOR]

The prevalence of white spots on teeth has increased in recent years. Regardless of their etiology, these lesions are characterized by a reduction in the enamel's mineral phase, which is replaced by organic fluids. This causes an alteration of its chemical composition that affects its optical characteristics. Subsurface demineralization increases the pore volume of enamel, which in turn changes its optical refraction and results in the opaque color of white spot lesions. Here, we examined a non-invasive clinical technique used for eliminating these white spot lesions from enamel via two HCl-based products at different concentrations (6.6% and 15%). We used a digital method for evaluating the volumetric changes produced in dental enamel by the application of both products, one of which involved chemical erosion and the other, abrasive erosion. The mean volume of the enamel eliminated was −0.042 mm in 15% HCl, and −0.12 mm in 6.6% HCl. Thus, both 15% HCl and 6.6% HCl are capable of eroding the surface of the tooth enamel without reaching dentin. Moreover, 6.6% HCl produced a greater erosion of the dental enamel and left the surface a texture typical of an abrasive chemical-erosive product. The 15% HCl, however, produced an etching pattern typical of an erosive chemical with open enamel prisms prepared for subsequent adhesive procedures and restorers. [ABSTRACT FROM AUTHOR]

Background: The present study determined white spots with the help of quantitative light-induced fluorescence (QLF) in patients undergoing fixed orthodontics. Materials and Methods: Sixty-four patients undergoing fixed orthodontics above 12 years underwent debonding, and the presence of carious lesion was assessed at baseline and after 6 weeks, 6 months, and 2 years. QLF images were taken with intraoral fluorescence camera. QLF images were examined visually for signs of demineralization, and scoring system was used. Results: It is found that there was fluorescence loss over a period of time. The median sum of fluorescence loss per patient was 55.6% and 29.2% and 101.4% at quartiles at baseline which changed to 51.2% and 26.5% at the first quartile and 101.4% at the second quartile. At 2 years, it was 43.7% and at the first quartile was 22.1% and at the second quartile was 99.1%. There was significant improvement at T2 (P < 0.05), however, between baseline and F1 and between F1 and F2, there was nonsignificant improvement (P > 0.05). The median value for total lesion area per patient was 3.6 mm2 with quartiles 1.2 mm2 and 8.2 mm2 at baseline, 2.6 mm2 with quartiles 0.7 mm2 and 6.3 mm2 at 6 weeks, 2.3 mm2 with quartiles 0.7 mm2 and 6.3 mm2 at 6 months, and 1.8 mm2 with quartiles 0.5 mm2 and 5.8 mm2 at 2 years which was statistically significant (P < 0.05). Conclusion: The authors found that white spots during fixed orthodontic treatment and after debonding is a common phenomenon. Although there was improvement in disappearance of these lesions, complete removal cannot be ensured. [ABSTRACT FROM AUTHOR]

The objective of this study was to systematically examine the effect of high‐pressure processing and package headspace on package integrity and properties. Working pressures were 400 and 600 MPa, and starting vessel temperatures were 30°C, 60°C, and 90°C. Coextruded and laminated multilayers packaging films were studied: film A: (PA/EVOH/PP) and film B: (PET‐AlOx‐OC/PA6/PP), respectively. The films were made into pouches (0.05 m × 0.10 m) and filled with 30‐mL water as a model food. Various headspace volumes (0, 0.05, 0.10, 0.15, 0.20, 0.25, and 0.30‐cc air/mL H2O) were introduced into the packaging before processing. Imaging was used to quantify defects such as the formation of white spots on the package surface and delamination of film layers. The results showed that the headspace level and processing initial temperature had a greater effect than the operating pressure on visual defects. The package with 0% headspace did not show any physical damage to the tested films. Furthermore, thermal and mechanical analyses showed that the coextruded film A had better resistance to testing conditions than the laminated structure of film B. The X‐ray diffraction results showed that film B had more defects than film A that altered the crystalline structure. Visual observation revealed white spots and delamination in the inside layer (PP) in both films. The same processing conditions affected the oxygen and water vapour transmission rates of film B more than film A. This work provides a basic guideline to select the right headspace for a given type of packaged food whenever heat and pressure are used simultaneously. Package headspace induced physical damage in high‐pressure and high‐temperature processing. The damage avoided by reducing the headspace, whereas high pressure without heat did not affect the package. EVOH‐based film A had better resistance to the high‐pressure and high‐temperature process conditions compared with AlOx‐coated PET film B. [ABSTRACT FROM AUTHOR]

Abstract The assessment of photovoltaic (PV) modules performance and reliability at operating conditions is very important considering the large investment in PV power plans. One of the important parameters on PV modules reliability is the degradation rate (Rd). This parameter has an important implication on the return-on-investment calculations. The aim of this study is to investigate the degradation rates of two PV technologies (monocrystalline (m-Si) and thin film (TF) based) after more than two years of outdoor exposure in semi-arid conditions. In the first step, the performance drop of the electrical parameters will be analysed for each technology. After that, comparison of the technologies durability in harsh atmosphere will be presented. Moreover, modules with the highest degradation rate values were selected for electroluminescence (EL) measurements to deeply investigate the degradation. The results show that the average powers Rd are 1.5 %/year and 1.73 %/year for the m-Si and TF modules respectively. Those values are significantly higher than those reported either in the literature or those employed in financial calculations. [ABSTRACT FROM AUTHOR]

Highlights • The effectiveness of PDT was compared vs US as prophylactic methods for oral decontamination during the orthodontic treatment. • There were no statistically significant differences in FMPS, FMBS, PD, ICDAS scores at T1, T2 and T3 follow-ups between the procedures. • There were no intergroup differences in microbial counts of P. gingivalis , P. intermedia and mutans streptococci at T1, T2 and T3 follow-ups. • PDT and US allowed in a similar way the control of the extent of the enamel demineralization until 6 months post-treatment. • PDT and US allowed in a similar way the control of the progression of the gingival inflammation until 9 months post-treatment. Abstract Introduction The complex designs of fixed orthodontic appliances hinder proper access for cleaning, favouring the development of gingival inflammation and white spot lesions around brackets. The aim of this study was to evaluate the effectiveness to avoid these undesirable effects by using two prophylactic methods: Photodynamic Therapy (PDT) and conventional ultrasonic scaler (US), in patients during fixed orthodontic treatment. Materials and methods Twenty patients under orthodontic treatment for at least 15 months were randomly divided into two groups: PDT mediated by methylene blue (MB) and US. Both treatments were applied in repeated doses (four times in intervals of 2 weeks in the beginning of the study (T0), with booster doses at 3, 6 and 9 months, T1, T2 and T3, respectively). Periodontal clinical parameters (full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS) and probing depth (PD)) were recorded as well as the International Caries Detection and Assessment System (ICDAS) index. Samples of subgingival plaque and saliva (for determination of 4 periodontopathogens and mutans streptococci, respectively), were collected at T0 and at the follow-ups of T1, T2 and T3. Results The evolution of FMPS, FMBS, PD, ICDAS scores as well as the counts of periodontopathogens and salivary mutans streptococci was similar after US or PDT implementation. Greatest periodontal scores reduction took place at T1 for FMBS and PD and at T2 for FMPS. Main microbial reduction took place at T1. ICDAS index began to increase from T2. No statistically significant intergroup differences were observed. Conclusions Additional treatment of PDT or US in repeated doses delayed undesired side effects during fixed orthodontic treatment in young patients with low caries risk and signs of gingival inflammation. [ABSTRACT FROM AUTHOR]

The prevalence of white spots on teeth has increased in recent years. Regardless of their etiology, these lesions are characterized by a reduction in the enamel’s mineral phase, which is replaced by organic fluids. This causes an alteration of its chemical composition that affects its optical characteristics. Subsurface demineralization increases the pore volume of enamel, which in turn changes its optical refraction and results in the opaque color of white spot lesions. Here, we examined a non-invasive clinical technique used for eliminating these white spot lesions from enamel via two HCl-based products at different concentrations (6.6% and 15%). We used a digital method for evaluating the volumetric changes produced in dental enamel by the application of both products, one of which involved chemical erosion and the other, abrasive erosion. The mean volume of the enamel eliminated was −0.042 mm in 15% HCl, and −0.12 mm in 6.6% HCl. Thus, both 15% HCl and 6.6% HCl are capable of eroding the surface of the tooth enamel without reaching dentin. Moreover, 6.6% HCl produced a greater erosion of the dental enamel and left the surface a texture typical of an abrasive chemical-erosive product. The 15% HCl, however, produced an etching pattern typical of an erosive chemical with open enamel prisms prepared for subsequent adhesive procedures and restorers.

Background-White spots, discoloration, recession, root resoption occur during orthodontic treatment if proper hygiene not maintin.The aim of this study was to report the effect of oral hygiene on ortho treatment. Materials and Method-100 patient were observed during ortho treatment thoroughly and proper oral hygiene instructions were given toeachand every patient.Patients who follow oral hygiene during fixed orthodontic treatment observed with no white spots,decalicification,discoration on their teeth .People who unable to follow oral hygiene white spots, decalcification ,discoloration visible on their teeth. Result-One hundred patients were studied who maintain their oral health while ortho treatment do not develop side effects such as white sports,discoration of the teeth as compared to other people who unable to maintain their oral hygiene while ortho treatment. 90% people suffer white spots,discoration of teeth who unable to maintain oral hygiene during ortho treatment. Conclusion-Oral hygiene plays very important role in the ortho treatment. [ABSTRACT FROM AUTHOR]

Objective: To assess the scientific evidence regarding the influence of reminder therapy on plaque index, gingival index, and white spots in patients subjected to orthodontic treatment. Materials and Methods: Randomized clinical trials were searched in the electronic databases LILACS, PubMed, SciELO, Scopus, Web of Science, Embase, LIVIVO, and Cochrane Library. The databases OpenThesis and OpenGrey were used to capture the "gray literature," preventing selection and publication biases. The risk of bias was assessed by the Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials tool. The software Review Manager was used for the meta-analysis. The heterogeneity among studies was assessed through the I2 statistic. A summary of the overall strength of evidence available was assessed using the Grades of Recommendations Assessment, Development, and Evaluation tool. Results: A total of 332 records were found, from which only 7 articles met the inclusion criteria and were subjected to analysis. Reminder therapy showed improved scores for the plaque index (standardized mean difference=-1.22; 95% confidence interval=-2.03 to-0.42; P=.003) and the gingival index (standardized mean difference = 1.49; 95% confidence interval=-2.61 to 0.37; P = .009). Moreover, there was lower occurrence of white spots (relative risk = 0.53; 95% confidence interval = 0.38 to 0.74; P<.001) when reminder therapy was implemented. Conclusions: According to the existing high-quality evidence, reminder therapy is a valuable strategy and may contribute to the reduction of plaque and gingival indices as well as to the lower occurrence of white spots in patients subjected to orthodontic treatment. [ABSTRACT FROM AUTHOR]

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This paper examines the case of ‘white spots’ in the absorption of European funds for the level of urban and rural municipalities in Romania. The ‘white spots’ are those municipalities that have not succeeded to absorb any euro from the entire volume of available European funds, for the period of 2009-2015. The paper defines the absorption of European funds as a case of attracting financial resources from the external environment, therefore as a case of organizational effectiveness for public organizations. The results of the analysis are mainly based on a secondary analysis of the local budgets execution database, for the period of 2009-2015. In addition to other quantitative data sources, a series of interviews with mayors representing ‘white spots’ has been conducted. The study identifies several characteristics of white spots municipalities, differentiated according to: i) territorial distribution; ii) fiscal capacity; iii) size of the organization and locality; iv) previous experience in European funded projects; v) local level of human development; vi) environmental factors and resource munificence as well as vii) other factors.

Nowadays, dentists are facing increased aesthetic demands from patients. Corrections of shade, shape, texture and position are the most requested. The shade of the teeth is a very important concern for patients, especially when white spots cover a big part of their front teeth. On the other hand, all of the focus in the last few years has been to create more conservative techniques to solve this problem. Erosion/infiltration protocol using Icon (DMG, Hamburg, Germany) is one of the most conservative and efficient protocols. The Icon treatment was initially proposed as a simple and minimally invasive alternative for caries treatment of initial proximal lesions, but surprisingly the technique proved a high ability to mask the white spots by modifying the refractive index of the lesion. The aim of this article isto describe this technique in detail using a clinical case. [ABSTRACT FROM AUTHOR]

Objectives: The development of white spot lesions around orthodontic brackets and gingivitis is a common problem during orthodontic treatment with fixed appliances. This prospective randomized double-blind controlled clinical trial investigated the preventive efficacy of a one-time application of two commonly used fluoride varnishes in patients with low to moderate caries risk. Materials and methods: Ninety adolescent orthodontic patients with a low to moderate caries risk were prospectively randomized to three groups of 30 patients each: (1) standardized dental hygiene with fluoride toothpaste and one-time application of placebo varnish (control) or (2) of elmex® fluid or (3) of Fluor Protector S on all dental surfaces at the start of fixed therapy. The extent of enamel demineralization and gingivitis was determined with the ICDAS and the gingivitis index (GI) at baseline and after 4, 12, and 20 weeks. Results: Each treatment group showed a significant increase of the ICDAS index, but not of the GI over the course of time with no significant intergroup differences detectable. Conclusions: A one-time application of fluoride varnish at the start of orthodontic treatment did not provide any additional preventive advantage over sufficient dental hygiene with fluoride toothpaste with regard to formation of white spots and gingivitis in patients with a low to moderate caries risk. Clinical relevance: In dental practice, patients often receive an application of fluoride varnish at the start of orthodontic treatment with fixed appliances. However, the efficacy of this procedure is still unclear. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence of white spot lesions in orthodontic patients treated with fixed or-thodontic appliances at different treatment periods and to reveal the teeth most commonly affected by white spot lesions. Materials and Methods: Forty eight patients (31 females and 17 males) treated with fixed orthodontic appliance were included in this study. The patients were examined for the pres-ence of white spot before insertion of the appliance and after its removal using visual examination. Results: This study showed that there was a significant increase in the formation of white spot lesions along with the increase in treatment duration in male group, while females showed no significant dif-ference in white spots at different durations. The first molars were the most affected teeth by white spots followed by canines and second premolars. Conclusion: This clinical study showed that the teeth in buccal segment were affected by white spots more than incisors and the prevalence of white spots increased when the duration of treatment increased.

Se realizó un estudio observacional descriptivo de corte transversal con la finalidad de identificar la prevalencia de lesiones incipientes de caries dental (LIC) y su relación con la higiene bucal en niños de 5-11 años del Área de Salud Integral Comunitaria (ASIC) Macandona, Municipio Maracaibo del Estado de Zulia en Venezuela, en el periodo de enero a diciembre de 2006. El universo fue de 220 niños, de entre ellos se seleccionaron 120 que asistieron a la consulta en el periodo establecido y cumplieron con los criterios de inclusión. Las LIC se detectaron por el método clínico visual-táctil sin presión, el nivel de higiene bucal por índice de higiene bucal revisado y el antecedente de cepillado con flúor se obtuvo al interrogar a los padres. La medida resumen de datos fue el porcentaje y se empleó la prueba de diferencia de proporciones. El 33,3 % de los niños presentó dos LIC, de ellos el 60,7 % correspondió al sexo femenino; el 42,9 % de los niños con 2 LIC mostró higiene bucal inadecuada y los que utilizaron dentífricos fluorados diariamente estaban menos afectados. Ello permite concluir que más de la mitad de los niños presentaron LIC, y que las lesiones incipientes fueron más frecuentes en el sexo femenino, en los niños con deficiente higiene bucal, y en los que no utilizaban dentífricos fluorados diariamente.A cross-sectional, descriptive and observational study was conducted to identify the prevalence of dental caries incipient lesions (CIL) and its relation to oral hygiene in children aged 5-11 of Community Integral Health Area (CIHA) in Macandona municipality, Zulia State, Venezuela from January to December, 2006. Sample included 220 children selecting 120 seen in consultation during the established period and fulfilling the inclusion criteria. The CILs were detected by visual/tactile clinical method without pressure, the oral hygiene level by revised oral hygiene rate and the background of fluorine brushing was achieved by asking parents. The abstract measure of data was the percentage and we used the ratio difference test. The 33.3 % of children had two CILs, from then the 60.7 % was a female sex; the 42.9 % of children with two CILs showed a inappropriate oral hygiene and those used daily fluorine toothpaste were less involved. It allows us to conclude that the half of children had CIL, and that the incipient lesions were more frequent in female sex, in children with a poor oral hygiene, and in those no used fluorine toothpaste daily.

Early-stage dental demineralization, called white spots (WS), get their name from the characteristic colour that enamel takes on due to the acid attack of salivary cariogenic bacteria. They are often associated with fixed orthodontic therapy (FOT) and, if left untreated, evolve into caries with repercussions on oral health and dental aesthetics. This review aims to identify the most effective prophylaxis strategies to prevent WS during FOT. The search for the reviewed studies was conducted on the Pubmed, Scopus, and Web of Science databases, selecting English-only articles published in the 5 years from January 2018 to January 2023. The keywords used were "WS" and "fixed orthodontic*", using "AND" as the Boolean operator. A total of 16 studies were included for qualitative analysis. Prevention begins with maintaining proper oral hygiene; fluoride in toothpaste, mouthwashes, gels, varnishes, and sealants can be added to prophylaxis and used regularly. Using a laser in combination with fluoride helps prevent the occurrence of WS and assists in the repair processes of initial lesions. Further studies are needed to establish international guidelines for preventing WS in orthodontically treated patients.

Supra-optimal intake of sodium fluoride (NaF) during early childhood results in formation of irreversible enamel defects. Monofluorophosphate (MFP) was considered as less toxic than NaF but equally cariostatic. We compared the potency of MFP and NaF to induce pre-eruptive sub-ameloblastic cysts and post-eruptive white spots and pits in developing hamster enamel. Hamster pups were injected subcutaneously with either NaF or MFP in equimolar doses of either 9 mg or 18 mg F/kg body weight. At 9 mg F/kg, MFP induced more but smaller sub-ameloblastic cysts with a collective cyst volume twice as large as that induced by NaF. Eight days after F injection, all F-injected groups had formed 4-6 white spots per molar, with an additional 2 pits per molar in the low MFP group. Twenty-eight days after injection, most white spots had turned into pits (5-6 per molar) and only the high MFP group still contained 2 white spots per molar. We conclude that parenterally applied MFP is more potent in inducing enamel defects than NaF. Most white spots formed turn into pits by functional use of the dentition. The higher potency of parenteral MFP may be associated with sustained elevated F levels in the enamel organ by enzymatic hydrolysis of MFP by alkaline phosphatase activity. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the diagnostic performance and accuracy of four plaque indices for orthodontic patients. Materials and methods: The plaque accumulation of 140 maxillary incisors with bonded brackets was recorded using intra-oral photographs and assessed using four different plaque indices: the orthodontic plaque (OP) index, the modified orthodontic plaque (MOP) index, the Quigley and Hein (QHP) index and the modified Navy plaque (MNP) index. The assessment was performed twice within a time interval of 4 weeks by four different examiner groups: orthodontists, dentists, students and orthodontic assistants. Results: No significant differences were detected for the OP and MOP indices among the examiner groups. A significant difference was found for the QHP and MNP indices. The inter- and intra-examiner reliability of the OP and MOP indices was good. In contrast, the reliability for the QHP and MNP indices was moderate to poor with few exceptions. The discrimination performance of the OP and MOP indices was excellent. The sum of the sensitivity and specificity was generally lower for the QHP and MNP indices compared with the OP and MOP indices. Conclusion: OP and MOP indices showed good performance. The QHP and MNP indices are not appropriate for orthodontic purposes. Clinical relevance: Traditional plaque indices reflect the typical pattern of plaque accumulation for patients without multi-bracket appliances. The performance of these indices for orthodontic patients has never been investigated. Orthodontic plaque indices that focus on the surface along the gingival margin and areas around the bracket exhibit higher diagnostic performance and accuracy compared with traditional indices. [ABSTRACT FROM AUTHOR]