„Biofilm control in orthodontic patients – an old problem with new solutions“
Abstract
The development of white enamel lesions during orthodontic treatment with fixed appliances remains an unwanted clinical problem with a reported incidence of 15-85%. As such lesions have limited ability to improve after bracket removal the final aesthetical result may be severely impaired. The first part of the lecture will review the oral microbiota and the ecological stress that may shift a stable and diverse biofilm to a cariogenic community, causing enamel net mineral loss. The second part will examine the quality of evidence for the prevention of white enamel lesions adjacent to brackets during treatment and discuss the management of post-orthodontic lesions. There is evidence of moderate quality that regular exposure to high-fluorides during active treatment can prevent enamel lesions, partly by hampering the metabolic activity of the oral biofilm. On the other hand, there is evidence of limited quality to re-mineralize post orthodontic lesions with low-fluoride exposure and/or mineralizing agents. Novel and emerging technologies will also be addressed.
Svante Twetman, DDS, PhD, Odont. Dr.
Svante Twetman, DDS, PhD, Odont. Dr.
Dr. Twetman is licensed specialist in pediatric dentistry and professor of Cariology at the Faculty of Health and Medical Sciences, University of Copenhagen, Denmark and consultant at the Maxillo-facial unit at Halland Hospital, Halmstad, Sweden. He graduated from dental school 1974 and holds the Odont Dr Degree from the Karolinska Institute, Stockholm, Sweden. The current research interests are risk assessment and prevention of oral diseases, focused on oral and microbial ecology with special emphasis on fluoride, antibacterial agents, sugar-substitutes, and pre- and probiotic bacteria. The research has to a large extent been performed in clinical settings and he has encouraged and led research teams for further studies in the laboratories. He has also made a substantial contribution to the knowledge in cariology and pediatric dentistry through lectures world-wide in developed, as well as in developing countries. Dr. Twetman is author and co-author of several textbooks and more than 200 scientific articles. He is an active member of The Swedish Council on Health Technology Assessment performing systematic reviews and mapping knowledge gaps. Among several awards, he received the IADR Distinguished Scientist Award in 2010 and the IADR Borrow Award in 2011.