Caries Intensity and Structural-Functional Acid Resistance of Tooth Enamel in Children with Orthodontic Pathology

Abstract

The purpose of the study was to analyze the indices of caries intensity and the structural-functional acid resistance of tooth enamel in children with orthodontic pathology during its treatment with fixed equipment. Materials and methods. 53 children aged 14 to 17 years old with orthodontic pathology were examined. The state of oral hygiene was assessed by the OHI-S index, the intensity of carious lesions of the teeth – by the index of carious, filled and removed teeth, and the structural-functional acid resistance of tooth enamel – according to the enamel resistance test with an assessment by a computer program. The children were given measures for sanitation and professional oral hygiene. Orthodontic pathology was treated using the vestibular bracket systems. A year later, the indices and the increase in the intensity of caries were determined again. Results and discussion. The average index of the structural-functional acid resistance of tooth enamel was 4.40 ± 0.26 points, while 15 children (28.3%) had a high level (the enamel resistance test index 1.92 ± 0.24 points), in 26 children (49.1%) the level was average (the enamel resistance test value 4.35 ± 0.10 points), 9 children (17.0%) and 3 children (5.7%) had low (6.36 ± 0.15 points) and very low (8.33 ± 0.33 points) levels. The index of carious, filled and removed teeth in all children was 3.87 ± 0.29. In children with a high level of the structural-functional acid resistance of enamel, the initial index of carious, filled and removed teeth was significantly (p<0.05) the lowest and amounted to 2.23 ± 0.47, in children with an average level – 4.04 ± 0.39, with a low level – 4.7 ± 0.54, with very low – 6.33 ± 1.45. A year later, the overall rate of caries intensity significantly (p<0.05) increased to 5.55 ± 0.43. In children with a high level of the structural-functional acid resistance of enamel, the index of carious, filled and removed teeth was again significantly (p<0.05) the lowest and amounted to 2.93 ± 0.43, with an average level of structural-functional acid resistance it was 5.15 ± 0.38, with a low and very low level – 9.22 ± 0.52 and 11.00 ± 1.53. The indices of the increase in the intensity of the carious lesion was respectively 0.47; 1.12; 4.33 and 4.67. Only 4 children (7.5%) had a high level of the structural-functional acid resistance, that is, the number of children with such level decreased by 3.8 times, 23 children (43.4%) had an average level of the structural-functional acid resistance, at the same time low and very low level of structural-functional acid resistance was established in 20 (37.7%) and 6 children (11.3%), which, respectively, is by 2.2 and 2 times higher than the primary values. According to the repeated enamel resistance test in children with a high level of the structural-functional acid resistance, this index was 1.75 ± 0.48 points, with an average level – 4.17 ± 0.08 points, with low and very low – 6.35 ± 0.11 and 8.50 ± 0.22 points. Conclusion. The results of the study indicate a high risk of developing dental caries in children under the conditions of treatment of orthodontic pathology with fixed equipment and the need to search for caries prevention measures depending on the level of the structural-functional acid resistance of tooth enamel