Title	Remineralizing Agents Can Effectively Prevent and Reduce White Spot Lesions Caused by Orthodontic Treatment
Clinical Question	Can remineralizing agents be effective in preventing and reducing post orthodontic white spot lesions?
Clinical Bottom Line	Remineralizing agents can effectively prevent and reduce white spot lesions caused by orthodontic treatment.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 22051486 Robertson/2011 60 active orthodontic patients RCT Key results This study was conducted on sixty active orthodontic patients and they were asked to use fluoride tray for 3 to 5 minutes each day at night. Fifty patient completed the trial (26 using the MI paste and 24 using the placebo paste). Patient were followed at 4-week intervals for 3 months. The enamel decalcification index score in MI group reduced by 53.5%, However the placebo paste group increase by 91.1% (P<0.05). MI paste prevented and decreased white spot lesions while placebo paste had the opposite effect. 19887683 Bailey/2009 45 active orthodontic patients RCT Key results This study was conducted on forty-five participants (aged 12–18 yrs) with 408 white-spot lesions 23 using the remineralizing cream and 22 using the placebo. Product was applied twice daily for 12 weeks. Clinical assessments were performed according to ICDAS II criteria. Ninety-two percent of lesions were assessed as code 2 or 3. For these lesions, 31% more had regressed with the remineralizing cream than with the placebo (OR = 2.3, P = 0.04) at 12 weeks. Significantly more post-orthodontic white spot lesions regressed with the remineralizing cream compared with a placebo over 12 weeks.
Evidence Search	The following search strategy was used in Pub Med: Remineralizing Agents, Post Orthodontic White Spot Lesions
Comments on The Evidence	The studies represented the full spectrum of patients with post orthodontic white spot lesions. The criteria for conclusions were explicit and credible. The diagnostic work-ups were comprehensive and consistently applied. The follow up was 4-week intervals for 3 months for the first study and 4, 8, and 12 wks follow up for the second study. There were no competing interest in either study.
Applicability	The study participants were representative of orthodontic patients. The selection/use of remineralizing agents is feasible in the orthodontic setting and it can prevent and decrease white spot lesions.
Specialty	(General Dentistry) (Orthodontics) (Pediatric Dentistry) (Prosthodontics) (Restorative Dentistry) (Dental Hygiene)
Keywords	Remineralizing Agents, Post Orthodontic White Spot Lesions
ID#	2512
Date of submission	07/26/2013
E-mail	Neda.borna@ucdenver.edu
Author	Neda Borna
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Ronald N. Brown, DDS
Faculty mentor e-mail	Ronald.Brown@ucdenver.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available