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Informationen aus Orthodontie & Kieferorthopädie 2024; 56(03): 153-158
DOI: 10.1055/a-2331-3354
Übersichtsartikel

White-Spot-Läsionen, Zahnwurzelresorptionen und Medikamente im Rahmen einer kieferorthopädischen Therapie

White Spot Lesions, Dental Root Resorption and Medications during Orthodontic Therapy
Friederike Wiedemeyer
1   Poliklinik für Kieferorthopädie, Zentrum für Zahn-, Mund- und Kieferheilkunde, Universitätsklinikum Bonn, Deutschland
,
Christian Kirschneck
1   Poliklinik für Kieferorthopädie, Zentrum für Zahn-, Mund- und Kieferheilkunde, Universitätsklinikum Bonn, Deutschland
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Zusammenfassung

White-Spot-Läsionen (WSL) und Zahnwurzelresorptionen zählen zu den häufigsten Nebenwirkungen im Rahmen einer kieferorthopädischen Therapie und gefährden oft ein ansonsten gutes Therapieergebnis. Sind sie erst einmal aufgetreten, sind die Wahrscheinlichkeit einer Spontanremission gering und die therapeutischen Möglichkeiten begrenzt. Aus diesem Grund muss der Prävention von WSL und Zahnwurzelresorptionen im Rahmen einer kieferorthopädischen Behandlung ein großer Stellenwert eingeräumt werden. Immer mehr Patientinnen und Patienten mit Bedarf bzw. Wunsch nach einer kieferorthopädischen Therapie, v. a. in der Erwachsenenbehandlung, stehen unter dem Einfluss von Medikamenten und entsprechenden, oft chronischen systemischen Erkrankungen, zu deren Therapie diese regelmäßig eingenommen werden. Deren mögliche Auswirkungen auf die kieferorthopädische Zahnbewegung und Begleiterscheinungen wie Zahnwurzelresorptionen werden jedoch meist anamnestisch im klinischen Praxisalltag nur wenig berücksichtigt, obwohl sie einen wesentlichen Einfluss auf den Therapieverlauf nehmen können. Im vorliegenden Artikel werden neben einer epidemiologischen Einordnung die ätiologischen und pathogenetischen Hintergründe von WSL, deren klinisches Erscheinungsbild und diagnostische Möglichkeiten sowie präventive und therapeutische Optionen basierend auf der verfügbaren wissenschaftlichen Evidenz näher beleuchtet, um daraus klinische Empfehlungen zum Umgang mit diesen Entitäten ableiten zu können. Zudem werden bekannte Wirkungen von Medikamenten auf die kieferorthopädische Zahnbewegung dargelegt und klinische Empfehlungen für den Umgang mit diesen Patienten gegeben.

Abstract

White spot lesions (WSL) and dental root resorptions are among the most common side effects of orthodontic therapy and often endanger an otherwise good treatment result. Once they have occurred, the likelihood of spontaneous remission is low and therapeutic options are limited. For this reason, great importance must be given to the prevention of WSL and dental root resorptions as part of orthodontic treatment. More and more patients, who need or desire orthodontic therapy, especially in adult treatment, are under the influence of medications and corresponding often chronic systemic diseases, for which drugs are regularly taken as a therapeutic measure. However, their possible effects on orthodontic tooth movement and accompanying symptoms such as dental root resorption are usually given little consideration in everyday clinical practice, although they can have a significant impact on the course of therapy. In this article, in addition to an epidemiological overview, the etiological and pathogenetic background of WSL, their clinical characteristics and diagnostic possibilities as well as preventive and therapeutic options based on the available scientific evidence will be examined in more detail to be able to derive clinical recommendations for dealing with these entities. In addition, known effects of medications on orthodontic tooth movement are presented and clinical recommendations for the management of patients under medication are given.

Schlüsselwörter

White-Spot-Läsionen - Zahnwurzelresorption - Medikamente - Erkrankungen - Review

Keywords

White spot lesions - tooth root resorption - medication - diseases - review


Publication History

Article published online:
27 September 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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