الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Enamel decalcification appearing as white spot lesion (WSL) is a common side effect of fixed orthodontic appliance therapy that can adversely affect the patient’s satisfaction. Orthodontic patients have a significantly greater risk of WSLs than non-orthodontic patients as orthodontic attachments and the bonding materials encourage biofilm retention. The presence of brackets, bands, arch wires, ligatures and other orthodontic devices can complicate conventional oral hygiene measures leading to prolonged plaque accumulation. As a result of increased plaque deposition, the amount of cariogenic bacteria in the oral cavity is elevated. Consequently the low pH of the plaque accumulated on the enamel surface around the brackets hinders the remineralization process, and as a result ; decalcification takes place1. Preventive treatment of WSLs is important for the integrity of teeth as well as for esthetics. One of the objectives of modern orthodontic treatment is early prevention of WSLs owing to challenges associated with treating patients once WSLs manifests itself clinically. Overall management of WSLs involves both preventing demineralization and biofilm formation and encouraging remineralization of existing lesions2. Considering the low efficacy of patient‑applied measures, preventive measures that don’t depend on the patient’s cooperation have been implemented to prevent enamel demineralization around orthodontic brackets. These include fluoride releasing adhesives, topical applications of preventive agents as fluoride varnishes and casein phosphopeptide-amorphous calcium phosphate(CPP-ACP), fluoride releasing elastomeric chains ,antibacterial agents incorporated in the adhesive resin , etc.