Gül DEMIR, Mücahid YILDIRIM, Emire Aybüke ERDUR
Meandros Medical and Dental Journal - 2026;27(1):79-85
Objective: This study aimed to evaluate the effects of fixed appliances (FA), clear aligners (CA), and no treatment on white spot lesion (WSL) formation and the decayed, missing, and filled teeth (DMFT) index. Materials and Methods: A total of 120 patients aged 14-30 years were divided into three groups: FA (n=40), CA (n=40), and control (n=40). The DMFT index and WSL counts were recorded at baseline (T1) and after treatment (T2) using clinical examinations, panoramic radiography, and standardized photographs. All data were analyzed using SPSS with appropriate statistical tests (ANOVA, t-test, chi-square, McNemar-Bowker). Results: The FA group showed significant increases in decayed teeth and DMFT scores (p<0.006), whereas no significant changes were observed in the CA and control groups. The FA group had significantly more decayed teeth at T2 than the other groups (p=0.034). The WSL counts significantly increased in both the FA and CA groups (p<0.018), with the FA group showing significantly higher counts at T2 (p=0.031). The maxillary lateral incisors, maxillary central incisors, and mandibular first molars developed the highest number of new WSLs in the FA group. No significant sex-related differences were observed in any of the groups. Conclusion: FA treatment was associated with a higher incidence of WSLs and caries than CA treatment and no treatment. However, CA treatment also led to a significant increase in WSLs, emphasizing the importance of proper oral hygiene during orthodontic treatment, regardless of appliance type.
