Белые пятна эмали при ортодонтическом лечении: комплексный обзор распространенности, этиологии, факторов риска и стратегий ведения

ЦЕЛЬ. Белые пятна эмали (white spot lesions, WSLs) представляют собой начальные кариозные поражения, характеризующиеся деминерализацией эмали, и часто выявляются у пациентов с несъемной ортодонтической аппаратурой. Целью данного исследования является обобщение и анализ существующих научных данных о распространенности, причинах, факторах риска, профилактике и методах лечения WSLs у ортодонтических пациентов.

МАТЕРИАЛЫ И МЕТОДЫ. Проведен комплексный обзор литературы с использованием баз данных PubMed, Embase и Cochrane Library. В обзор включены исследования, опубликованные на английском языке, выполненные с участием людей и посвященные проблеме белых пятен эмали в контексте ортодонтического лечения.

РЕЗУЛЬТАТЫ. Частота возникновения WSLs у ортодонтических пациентов варьирует в широких пределах (8–97 %), что обусловлено применяемыми диагностическими методами и демографическими характеристиками пациентов. Ключевыми факторами риска являются неудовлетворительная гигиена полости рта, высокое потребление сахара, снижение слюноотделения и конструктивные особенности несъемных ортодонтических аппаратов. Эффективные профилактические и лечебные подходы включают использование фторсодержащих средств, казеинфосфопептида – аморфного фосфата кальция (CPP-ACP), а также методику инфильтрации смолами.

ВЫВОДЫ. Своевременное выявление и индивидуализированные профилактические мероприятия имеют ключевое значение для снижения частоты и выраженности белых пятен эмали. Перспективные исследования должны быть направлены на совершенствование минимально инвазивных методов лечения и оценку долгосрочной эффективности профилактических стратегий.

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