Samenvatting

Proefschrift van Janneke Scheerman:
Fixed orthodontic treatment
Orthodontics is the branch of dentistry concerned with facial growth and the development of the dentition, and with occlusion and the prevention and correction of occlusal anomalies [1]. Approximately 53-57% of Dutch 12-year olds undergo orthodontic treatment—some 100,000 patients each year [2]. Most of these patients
are treated using fixed orthodontic appliances (orthodontic brackets), which are used to correct a wide range of dental and skeletal malocclusions and to align teeth. These appliances are fixed to the teeth, forces being applied by the archwires or auxiliaries attached to them [1]. Such is usually performed during adolescence, when the
eruption of permanent teeth is complete but craniofacial growth is still progressing. This combines advantages in terms of tooth movement, correction of malocclusion and the maintenance of favorable facial growth [3].
The main objectives of orthodontic treatment are to achieve pleasant smile aesthetics with a stable occlusal relationship and healthy masticatory function [1]. The improvements brought by orthodontics to a patient’s facial and dental appearance can also have mental health benefits, as they increased the patient’s psychosocial
well-being and sense of self-esteem and self-confidence [1,4]. As the ideal alignment of the teeth simplifies oral hygiene, it is also supposed to reduce dental caries and periodontal diseases.
White spot lesions
Individuals with malocclusions typically have many retention sites to which oral bacteria can adhere. The irregularities of the teeth make it easier for dental plaque or a biofilm to form. Bonding attachments such as fixed orthodontic appliances to the teeth also create retention sites on surfaces that are not generally susceptible to caries. As these appliances make it difficult to clean the regions surrounding the bracket, they hamper the maintenance of oral hygiene, explaining why biofilm-related complications such as periodontal inflammation and dental caries formation are common during fixed orthodontic therapy [5-7].