ABSTRACT
Orthodontic treatment with fixed appliances significantly increases the risk of white spot lesions and enamel demineralization around the orthodontic attachments. White spot lesions and enamel decalcification are attributed to prolonged accumulation and retention of dental plaque on the enamel surface adjacent to the orthodontic attachments. A clinical trial was conducted to determine whether ligating orthodontic brackets with fluoride releasing elastic ligatures [FREL] reduce white spot formation compared with conventional elastic ligatures [CEL]. Twenty patients were incorporated into the study [age range 13-15 years]. All the twenty patients showed a class t malocclusion with a problem of crowding requiring extraction of four first premolars. Full fixed orthodontic therapy was performed for all the twenty patients. Each of the twenty patients had eight FREL, eight CEL placed in a cross quadrant fashion on their orthodontic attachments from second premolar to second premolar in both maxillary and mandibular arches, accordingly 16 elastic ligatures were placed per patient. The elastic ligatures were changed every four weeks throughout the course of the study. At the end of the active orthodontic treatment, the teeth were dried and scored for decalcification. Enamel decalcification was noticed in four teeth of the FREL group [2.5%] and in 16 teeth of the CEL group [10%]. These results were significant at the 5% level of significance [p<0.05] Results showed that, FREL might offer significant caries protection around bonded brackets independent of patient cooperation