Indagine conoscitiva sull’approccio alle lesioni bianche dello smalto post-ortodontiche

OBJECTIVES White enamel lesions (WSLs) are an increasingly present clinical occurrence, not infrequently ob-served at the end of orthodontic treatment. Their presence ob-served during the removal of or-thodontic devices raises perplexi-ties of an aesthetic nature and puts clinicians in front of the doubt on how to intervene from a thera-peutic point of view since it seems no standardized protocols still ex-ist. Consequently, aim of this work was to evaluate the knowledge, therapeutic and informative ap-proach of the dental team on WSLs after orthodontic treatment. MATERIALS AND METHODS An electronic survey (Qualtrics) of 21 multiple choice questions was sent via email and social networks (Facebook, WhatsApp) to various professionals usually involved in the management of WSLs, includ-ing general dentists, pedodontists, orthodontists and hygienists. Par-ticipation was voluntary, anony-mous and unpaid. The survey was divided into four macro-sections: 1) demography; 2) vocational training; 3) knowledge of WSLs; 4) methods of treatment (therapeutic and informative). RESULTS Of the 248 who completed the in-terview, 81% were female and aged between 22-50 years, with a prevalence between 22-35 years. Of these, 38% were hy-gienists, 26% students, 20% den-tists practicing orthodontics, 8% dentists specializing in orthodon-tics, 6% pedodontists and 2% general dentists not practicing or-thodontics. Most of the clinicians interviewed (73%) stated that a diagnosis of WSLs was made at the end of the orthodontic treat-ment. Inadequate home oral hy-giene, incorrect diet, quality and quantity of saliva, susceptibility and age have been considered the risk factors that can most in-fluence their onset. 33% of the clinicians interviewed believed that the identification/manage-ment of these lesions is the task of hygienists. 57% of those inter-viewed tend to inform patients/ parents/guardians about the pos-sibility of developing WSLs during orthodontic treatments, against 16% who are not in the habit of informing patients about these important side effects of the ther-apy. The most widely used thera-peutic approach for the treatment of WSLs involves regular remind-ers of professional oral hygiene, treatment with toothpaste or fluo-ride varnishes and instructions on an adequate diet. Only 4% of those interviewed used resin infil-tration or microabrasion to reduce the aesthetic problem associated with WSLs, considered by many therapy professionals to be unpre-dictable or of which they report lack of adequate knowledge. CONCLUSIONS WSLs are an ever-present topic. The results of the study showed that there is no one-way line for the management of this clinical even-tuality, requiring greater collaboration between all healthcare profes-sionals involved in the treatment of the orthodontic patient. Due to an incomplete familiarity with some therapeutic approaches (such as resin infiltration and microabra-sion), these are not considered for the treatment of WSLs, possibly limiting operative practices. CLINICAL SIGNIFICANCE Greater attention must be paid to the interception of WSLs by all professionals involved in the man-agement of the orthodontic pa-tient. This provides for more ade-quate communication between the various operators and pushes for the establishment of a com-mon operating protocol.