ArticleJournal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie2026
Incidence and distribution of white spot lesions after clear aligner versus fixed appliance therapy : A retrospective digital photograph and intraoral scan analysis.
Article in Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo compare the incidence, severity, and regional distribution of white spot lesions (WSLs) between clear aligner therapy (CAT) and fixed appliance therapy (FAT) using standardized intraoral photographs supported by digital scans. MATERIALS AND
methodsThis retrospective comparative study included pre- (T0) and posttreatment (T1) records of 100 patients treated with CAT or FAT. Enamel demineralization was assessed using the Enamel Decalcification Index (EDI; 0-3). All evaluations were performed by two calibrated, blinded examiners. Statistical analyses were conducted using SPSS (p < 0.05; version 21.0, IBM, Armonk, NY, USA).
resultsPosttreatment WSL counts were significantly lower in the maxillary and mandibular anterior regions in the CAT group, with no significant differences in the posterior regions. Although WSLs increased in both groups, the increase was lower after CAT. Total WSL counts were also significantly lower after CAT. In the FAT group, lesion development was more pronounced in the mandibular anterior region.
conclusionCAT was associated with lower WSL burden and fewer newly developed lesions than FAT, particularly in the anterior regions. However, given the observational design, findings should be interpreted as associations rather than causal effects.
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