Clinical investigation of enamel demineralization during clear aligner treatment

Objective To investigate the incidence and severity of enamel demineralization during clear aligner treatment and provide reference for clinical medical nursing work. Methods A total of 151 patients(3 507 teeth)undergoing clear aligner treatment in our hospital from 2015 to 2022 were collected. The enamel demineralization before and after treatment was compared, and the enamel demineralization index(EDI) was calculated to evaluate the severity of demineralization. The incidence and severity of enamel demineralization were analyzed statistically, and the differences among different genders, ages and dental positions were compared. Results Enamel demineralization occurred in 84 patients during treatment, with an incidence rate of 55.63%. Gender and treatment time had no effect on the incidence, and the incidence of adolescent patients was higher than that of adult patients. Among the investigated 3 507 teeth, 601 teeth had enamel demineralization, and the incidence rate was 17.14%. The incidence of maxillary anterior teeth and mandibular posterior teeth was higher; the incidence of right teeth was significantly higher than that of left teeth, and the incidence of teeth with adhesive attachments was also significantly increased. 88% of the enamel demineralization lesions were 1-2 degrees, and the degree of enamel demineralization was similar in male and female patients. But the degree in adolescents was significantly higher than that in adult patients. The average EDI value of maxillary anterior teeth was significantly higher than that of mandible, but that of maxillary posterior teeth was significantly lower than that of mandible. The average EDI value of right teeth was significantly higher than that of left. Conclusion The incidence of enamel demineralization is high in the process of clear aligner treatment, and teenagers are susceptible to it. The demineralization of teeth is significantly different among different tooth positions, and adhesive attachments will increase the risk of enamel demineralization. Therefore, medical staff should take active and effective measures in the prevention and treatment of enamel demineralization.