Does orthodontic treatment using fixed appliances cause initial caries lesions?

Area of Science:

• Dental Research
• Orthodontics
• Caries Prevention

Background:

• Orthodontic treatment with fixed appliances is common for correcting malocclusions.
• The potential for increased risk of dental caries during orthodontic therapy is a significant concern for patients and clinicians.

Purpose of the Study:

• To systematically review and meta-analyze the incidence and prevalence of initial caries lesions (ICLs) in patients undergoing orthodontic therapy with fixed appliances.
• To evaluate the association between treatment duration and demographic/treatment-related variables with ICL development.

Main Methods:

• Systematic review and meta-analysis of RCTs, NRSIs, cohort, and cross-sectional studies.
• Electronic search of PubMed, Scopus, and Embase (1990-May 2023).
• PICOS framework used for review question; meta-analysis conducted on comparable studies, assessing ICL prevalence and incidence rates.

Main Results:

• 21 studies included; 19 in meta-analysis. Prevalence of ICLs: 57% of patients, 2.24 lesions/patient, 22% of surfaces affected.
• Incidence of ICLs: 48% of patients, 2.29 new lesions/patient, 15% of surfaces affected.
• Both prevalence and incidence positively correlated with orthodontic treatment duration; no age association found.

Conclusions:

• Orthodontic therapy with fixed appliances is associated with an increased risk of developing initial caries lesions.
• Treatment duration is a significant factor influencing ICL development.
• Implementing preventive strategies during orthodontic treatment is crucial to mitigate caries risk.