**7. Conclusion**

This chapter presented laser technology as an alternative to caries removal, attending the conservative principals of dentistry, assuring that minimally invasive procedures can be used to treat caries lesions.

#### **8. Acknowledgement**

The authors would like to thank to Dr. Wagner de Rossi, Dr. Marcus Paulo Raele, Prof Moises O. Santos, Leandro Matiolli Machado and Prof. Carolina Benetti for their kind assistance during irradiations; and also to Prof. Dr. Alessandra Pereira de Andrade for her assistance with figures management. Authors also wish to thank FAPESP (#2010/10126-3) for partially supporting the project of writing this book chapter.

#### **9. References**


Caries-affected substrate obtained in vitro by the microbiological method significantly contributes to the field of adhesion, because it will allow laboratory tests to be performed on standard caries-affected dentine, which is a clinically relevant substrate. The microbiological method allows the production of artificial caries-affected dentine effectively induced for 7 days and demineralization depth is standardized and it is confirmed by optical coherence tomography (OCT) (Azevedo et al., 2011). Efforts have been made to produce artificial caries-affected dentine and bond strength studies must be conducted, especially in laser irradiated tissues, to associate the use of laser to remove caries and long lasting clinical

This chapter presented laser technology as an alternative to caries removal, attending the conservative principals of dentistry, assuring that minimally invasive procedures can be

The authors would like to thank to Dr. Wagner de Rossi, Dr. Marcus Paulo Raele, Prof Moises O. Santos, Leandro Matiolli Machado and Prof. Carolina Benetti for their kind assistance during irradiations; and also to Prof. Dr. Alessandra Pereira de Andrade for her assistance with figures management. Authors also wish to thank FAPESP (#2010/10126-3)

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**White-Spot Lesions in Orthodontics:** 

The most common negative effect of orthodontic treatment with fixed appliances is the development of incipient carious lesions around brackets. The objectives of this chapter are to present some of the results of two studies aiming: 1) to evaluate patients treated with comprehensive orthodontics to determine the incidence of new carious lesions during treatment; and 2) to investigate the potential of ACP-containing resin cement and other treatments (fluoride varnish, resin sealer, MI Paste) to prevent incipient carious lesions on bracketed teeth. In the first study, 350 orthodontic patients were selected randomly. The preand post-treatment photographs of the patients were examined to determine lesion development. The labial surface of each tooth was scored with a standardized system based on the *International Caries Determination and Assessment System II*. The independent variables were collected by chart abstraction. In the second study, 100 extracted human premolars were allocated randomly to five groups (N = 20). Brackets were bonded with ACP-cement

XT (Control), Transbond XT followed by application of fluoride varnish (Vanish), resin sealer (Pro-seal) and CPP-ACP paste (MI Paste). All teeth were pH cycled for 15 days in demineralization solution and artificial saliva. The extent of demineralization in each group was assessed using Quantified Light-induced Fluorescence (QLF) and Confocal Laser Scanning Microscopy (CLSM). The incidence of patients who developed at least one new white-spot lesion during treatment was 73%. Treatment length was associated significantly with new white-spot lesion development. The independent variables of gender, age and extraction/non-extraction were not associated with lesion development. Fluorescence loss and lesion depth measurements demonstrated that the Pro-seal and Vanish groups had the least amount of demineralization. The control group showed the most demineralization. Although the MI Paste and Aegis-Ortho groups experienced less demineralization than controls, neither was significant statistically. Only the Pro-seal and Vanish groups had significantly smaller lesions than the control group for both QLF and CLSM. Thus, the development of new lesions appeared to be related to treatment duration and, to a lesser degree, to initial oral hygiene score. Light-cured filled sealer (Pro-seal) and the fluoride varnish (Vanish) have the potential to prevent enamel demineralization adjacent to

**1. Introduction** 

(Aegis-Ortho), Transbond

orthodontic brackets exposed to cariogenic conditions.

Airton O. Arruda, Scott M. Behnan and Amy Richter

**Incidence and Prevention** 

*University of Michigan,* 

*USA* 

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