Impact of clear aligners and different esthetic orthodontic brackets on enamel demineralization (A comparative SEM study)

Abstract

Objective: To evaluate the susceptibility of development and severity of enamel surface demineralization with subsequent development of white spot lesions (WSLs) in patients treated with clear aligners in comparison with those treated with monocrystalline and poly crystalline ceramic brackets (using scanning electron microscope). Methodology: Forty sound permanent premolars were collected from 4 groups of patients (n=10). Group I: patients received no orthodontic treatment (control group), group II: patients treated with polycrystalline ceramic brackets, group III: patients treated with monocrystalline ceramic brackets, group IV: patients treated with clear aligners. The buccal surfaces of teeth were coated with gold and subjected to scanning electron microscope (SEM) surface analysis and Elemental analysis of calcium and phosphorus using energy-dispersive X-ray spectroscopy (EDX).Result: The polycrystalline, monocrystalline and clear aligner groups showed demineralization with significant decrease in both calcium and phosphorus content (P<0.001) accompanied by erosion of enamel surface. Group II was the mostly affected one, while group IV was least affected either in surface morphology or mineral loss. Conclusion: Clear aligners showed less enamel demineralization and surface alteration in comparison with other fixed esthetic orthodontic brackets.