{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:10:34Z","timestamp":1789470634690,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015401","name":"Key Research and Development Projects of Shaanxi Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015401","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthod Craniofacial Res"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study was aimed to clarify the incidence, severity, and clinical risk factors for white spot lesions (WSLs) in adolescent patients treated with clear aligners.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pre\u2010treatment and post\u2010treatment intraoral photographs of 203 adolescent patients undergoing clear aligner therapy were retrospectively evaluated to assess the occurrence and severity of WSLs. Information on patients' general oral condition and orthodontic treatment was collected from clinical medical documents, retrospective questionnaires, and ClinCheck\u00ae software. Independent risk factors and model performance were determined by multivariate logistic regression and receiver operating characteristic curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010five percent of adolescent patients developed WSLs during clear aligner treatment. Logistic regression analysis revealed that the presence of WSLs before treatment (OR 2.484, 95% CI 1.245\u20104.957), frequency of drinking carbonated beverages (OR 1.508, 95% CI 1.045\u20102.177), and number of anterior attachments (OR 2.192, 95% CI 1.502\u20103.198) were risk factors for the occurrence of WSLs in adolescent patients treated with clear aligners (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05), whereas the number of times they brushed each day (OR 0.656, 95% CI 0.454\u20100.947) and frequency of aligner cleaning after eating while wearing them (OR 0.611, 95% CI 0.433\u20100.861) were protective factors against WSLs (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The incidence of WSLs was high in adolescent patients treated with clear aligners. Few brushings each day, pre\u2010treatment WSLs, a high frequency of drinking carbonated beverages, a low frequency of aligner cleaning after eating while wearing them, and a high number of anterior attachments are strongly associated with the development of WSLs in adolescent patients treated with clear aligners.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ocr.12791","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T09:44:46Z","timestamp":1713347086000},"page":"704-713","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Incidence, severity, and risk factors for white spot lesions in adolescent patients treated with clear aligners"],"prefix":"10.1111","volume":"27","author":[{"given":"Qian","family":"Liu","sequence":"first","affiliation":[{"name":"State Key Laboratory of Oral &amp; Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology The Fourth Military Medical University  Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixin","family":"Song","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oral &amp; Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology The Fourth Military Medical University  Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2319\/062523-440.1"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/2231-0762.167719"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.2319\/051710-262.1"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2010.04.001"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2021.04.018"},{"issue":"7","key":"e_1_2_12_7_1","article-title":"Evaluation of the prevalence of white spot lesions during fixed orthodontic treatment among patients reporting for correction of malocclusion: a prevalence study","volume":"15","author":"Jha AK","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/cjz045"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.12013"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCIDE.S190893"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ocr.12692"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345221129806"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40510-022-00404-9"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2018.12.018"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11914-022-00723-0"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/cju083"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1119616"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2020.01.004"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S257814"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.2319\/073118-553.1"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0889-5406(89)90327-2"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-014-1382-3"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sodo.2016.05.006"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejwf.2017.07.001"},{"issue":"1","key":"e_1_2_12_25_1","first-page":"49","article-title":"Posteruptive age dependency of cariogenic changes in enamel of permanent teeth of children","volume":"18","author":"W\u00f6ltgens JH","year":"1990","journal-title":"J Biol Buccale"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejwf.2022.03.003"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.2319\/071712-584.1"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2009.06.037"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2018.11.017"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.4207"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2019.04.003"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.2319\/012413-75.1"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2021.10.015"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/cjq126"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40510-016-0158-5"}],"container-title":["Orthodontics &amp; 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