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Objective <p>To compare the incidence, severity, and regional distribution of white spot lesions (WSLs) between clear aligner therapy (CAT) and fixed appliance therapy (FAT) using standardized intraoral photographs supported by digital scans.</p> Materials and methods <p>This retrospective comparative study included pre- (T0) and posttreatment (T1) records of 100&#xa0;patients treated with CAT or FAT. Enamel demineralization was assessed using the Enamel Decalcification Index (EDI; 0–3). All evaluations were performed by two calibrated, blinded examiners. Statistical analyses were conducted using SPSS (<i>p</i> &lt; 0.05; version 21.0, IBM, Armonk, NY, USA).</p> Results <p>Posttreatment WSL counts were significantly lower in the maxillary and mandibular anterior regions in the CAT group, with no significant differences in the posterior regions. Although WSLs increased in both groups, the increase was lower after CAT. Total WSL counts were also significantly lower after CAT. In the FAT group, lesion development was more pronounced in the mandibular anterior region.</p> Conclusion <p>CAT was associated with lower WSL burden and fewer newly developed lesions than FAT, particularly in the anterior regions. However, given the observational design, findings should be interpreted as associations rather than causal effects.</p>

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Incidence and distribution of white spot lesions after clear aligner versus fixed appliance therapy

  • 期刊论文

  • 发表日期：

    2026年6月15日

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  • Nursezen Kavasoğlu,
  • Abdurrahman Yalçın,
  • Seda Kotan

摘要

Objective

To compare the incidence, severity, and regional distribution of white spot lesions (WSLs) between clear aligner therapy (CAT) and fixed appliance therapy (FAT) using standardized intraoral photographs supported by digital scans.

Materials and methods

This retrospective comparative study included pre- (T0) and posttreatment (T1) records of 100 patients treated with CAT or FAT. Enamel demineralization was assessed using the Enamel Decalcification Index (EDI; 0–3). All evaluations were performed by two calibrated, blinded examiners. Statistical analyses were conducted using SPSS (p < 0.05; version 21.0, IBM, Armonk, NY, USA).

Results

Posttreatment WSL counts were significantly lower in the maxillary and mandibular anterior regions in the CAT group, with no significant differences in the posterior regions. Although WSLs increased in both groups, the increase was lower after CAT. Total WSL counts were also significantly lower after CAT. In the FAT group, lesion development was more pronounced in the mandibular anterior region.

Conclusion

CAT was associated with lower WSL burden and fewer newly developed lesions than FAT, particularly in the anterior regions. However, given the observational design, findings should be interpreted as associations rather than causal effects.