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Objectives: The study aimed to survey current strategies against enamel demineralization during multibracket therapy (MBT) and guide a prevention concept based on existing scientific evidence., Materials and Methods: The survey comprised questions on the prevention and management of white spot lesions (WSL). The questionnaire was sent via email to orthodontists working in practices and universities throughout Germany. The analysis involved descriptive statistics using the chi-square test (p < 0.05)., Results: A prevention protocol was used before MBT by 80.6% of the participants. Less than a quarter of the participants regularly applied topical fluoride (gel or varnish) during MBT. According to the respondents' assessment, the prevalence of WSL during MBT is 11.6%, mainly observed in 12- to 15-year-old male patients. Orthodontists graduating after 2000 tended to recommend and apply fluoride-containing materials more often than their senior colleagues (p = 0.039). Participants from private practices applied fluoride varnish or gel more frequently than those from university clinics (p = 0.013). Fluoridation was the most common (70.7%) treatment for WSL after MBT, followed by resin infiltration (21.2%). The majority (80.9%) of the participants favor a guideline for preventing WSL., Conclusions: WSL prevention during MBT is challenging. Males in puberty are predominantly affected. Younger orthodontists are more concerned about the prevention of WSL during MBT., Clinical Relevance: The non-negligible prevalence of individuals with WSL emphasizes the need for dental education and health care reform. This would help to implement standardized procedures and establish innovative applications., (© 2022. The Author(s).)

The emergence of new concepts and mechanisms for remineralization is of great interest to study. The study objective was to evaluate the clinical efficiency of use of modern remineralizing formulas: "Enamel-sealing liquid" ("Tiefenfluorid", Humanchemie, Germany), "FluoroLux" (TechnoDent, Russia), "InnoDent" (PLC, "InnoDent", Kazakhstan) and ClinproTM XT Varnish (3M ESPE, Germany) in treatment of focal demineralization. According to the number of studied drugs in the framework of a clinical study, four groups of patients with a diagnosis of caries of enamel were formed (n=36): Group 1 (n=9 people, 30 teeth); Group 2 (n=9 people, 29 teeth); Group 3 (n=9 people, 28 teeth); Group 4 (n=9 people, 31 teeth). Evaluation of the clinical efficacy of enamel caries treatment was carried out using 1) vital staining with a 2% aqueous solution of methylene blue followed by evaluation using a control gradation 10-point grayscale; 2) laser-fluorescence method using the apparatus "DiagnoDent Pen" (KaVo). Statistical processing of the obtained results was performed using the Wilcoxon and Money-Whitney test. The confidence level was considered at p≤0.05. According to the data of laser fluorescence of enamel and vital staining, the median index with high statistical significance decreased in all groups after 3 months compared with the data before treatment. Thus, all the studied drugs showed remineralizing activity in the elimination of enamel demineralization foci. This study is the basis for the search and development of new remineralizing compounds for the prevention and treatment of focal enamel demineralization.

Cost-benefit or cost-cost analyses are becoming increasingly important in dentistry. Therefore, the aim of the present study was to evaluate the economic consequences of caries prevention with fluorides. German epidemiological data were used in a system dynamics model to assess the lifelong costs of caries in a population. Without fluoride prevention, lifelong treatment for caries resulted in mean costs of 6,976 euro and a present value of 932 euro per person (5% discounting). In different scenarios of constant, increasing, or decreasing caries-controlling effects, and of limited (age 6-18 yr) or lifelong application, the combination of fluoride salt, fluoride toothpaste, and fluoride gel were most cost-effective. They reduced the costs for caries treatment and prophylaxis to 482, euro or to a present value of 148 euro (5% discounting), when applied from age 6-18 yr, and to 211-213 euro for lifelong use (present value, 5% discounting). In conclusion, a lifelong model of costs of caries demonstrates that the use of fluorides in caries prevention is highly cost-effective.