Enamel changes resulting from the use of fixed orthodontic appliances

The monograph describes procedures that influence the occurrence of enamel damage during and after fixed orthodontic appliances treatment. The authors provide a detailed overview of all relevant factors that may contribute to enamel damage, including enamel conditioning methods, types of adhesives and brackets, bracket design and size, as well as tooth-related changes that may affect the strength of the bond between the bracket and the tooth, and the potential consequent enamel damage. Particular attention is given to enamel changes occurring in the final phase of fixed orthodontic appliance treatment, which are crucial for understanding the procedures applied in several steps during the debonding phase. In clinical practice, this phase of treatment is often neglected, although it is frequently associated with numerous complications. All protocols for bracket and adhesive removalare described in detail, as well as their potential impact on the enamel surface.The authors emphasize the importance of cooperation between the orthodontist and the dental disease specialist, who must timely recognize and treat initial enamel changes in order for orthodontic treatment to be successful. Initial enamel changes are systematically described, with emphasis on white spot lesions and initial caries, which occur during and after the completion of fixed orthodontic appliance therapy.Modern approaches based on the use of fluoride-containing preparations and ICON materials are also discussed and explained. These represent a contemporary approach to the treatment not only of white spot lesions but also of initial carious lesions resulting from the use of fixed orthodontic appliances.