{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:55:14Z","timestamp":1781744114375,"version":"3.54.5"},"reference-count":52,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the susceptibility of enamel to white spot lesion formation following the application of two orthodontic bonding protocols: a conventional three-step adhesive system and a two-step self-adhesive system with primer integrated into the resin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      Thirty extracted premolars were randomly allocated to two groups: Transbond XT (three-step system) and GC Ortho Connect (two-step self-adhesive system). After 7-day pH cycling, demineralization was assessed using Witec a300R confocal Raman microscopy. Phosphate intensity at 960 cm\n                      <jats:sup>\u22121<\/jats:sup>\n                      was measured along a 130-\u00b5m enamel profile and normalized.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Measurements by two operators showed high intraoperator and interoperator reliability (intraclass correlation coefficient = 0.82\u20130.92). GC samples exhibited a continuous decline in phosphate intensity, indicating extensive demineralization, while XT samples showed a midenamel plateau, suggesting mineral preservation. Spline modeling confirmed significantly higher phosphate retention in the XT group at middepth (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), with both groups showing surface demineralization near 130 \u00b5m (\n                      <jats:italic>P<\/jats:italic>\n                      = .005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The three-step adhesive system (Transbond XT) showed greater resistance to subsurface enamel demineralization than the self-adhesive system (GC Ortho Connect). These results suggest that using a separate primer may better protect enamel beyond the immediate bracket interface.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/062725-527.1","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T03:21:22Z","timestamp":1771989682000},"page":"444-451","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of conventional and self-adhesive orthodontic bonding systems in white spot lesion formation: an in vitro confocal Raman microscopy analysis"],"prefix":"10.2319","volume":"96","author":[{"given":"Marwan","family":"El Helou","sequence":"first","affiliation":[{"name":"Associate Professor, Department of Orthodontics, School of Dentistry, University Clermont Auvergne, Clermont-Ferrand; and PhD Candidate in Health Biology, University of Montpellier, Montpellier, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"Albaret","sequence":"additional","affiliation":[{"name":"Resident, Department of Orthodontics, School of Dentistry, University Clermont Auvergne, Clermont-Ferrand, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Nicolas","sequence":"additional","affiliation":[{"name":"Professor and Dean, School of Dentistry, University Clermont-Auvergne, Clermont-Ferrand, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Boutin","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Biostatistics, University of Montpellier, Montpellier, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Younes","sequence":"additional","affiliation":[{"name":"Postdoctoral Research Fellow in Neuroscience, Laboratory of Bioengineering and Nanosciences, University of Montpellier, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Cuisinier","sequence":"additional","affiliation":[{"name":"Professor and Head, Laboratory of Bioengineering and Nanosciences, Faculty of Dentistry, University of Montpellier, Montpellier, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Barth\u00e9lemi","sequence":"additional","affiliation":[{"name":"Professor, Vice Dean and Head, Department of Orthodontics, Faculty of Dentistry, University of Montpellier, Montpellier, France."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"issue":"4","key":"i1945-7103-96-4-444-b01","series-title":"Angle Orthod","first-page":"641","article-title":"Prevalence of white spot lesion formation during orthodontic treatment","volume":"83","author":"Julien","year":"2013","unstructured":"Julien KC,\nBuschang PH,\nCampbell PM. 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White spot lesions in fixed orthodontic treatment: Etiology, pathophysiology, diagnosis, treatment, and future research perspectives. J Orthod Sci. 2024;13:21. doi:10.4103\/jos.jos_205_23"},{"issue":"5","key":"i1945-7103-96-4-444-b05","series-title":"Am J Orthod Dentofacial Orthop","first-page":"592","article-title":"Prevention of enamel demineralization: an in-vitro study using light-cured filled sealant","volume":"128","author":"Hu","year":"2005","unstructured":"Hu W,\nFeatherstone JDB. Prevention of enamel demineralization: an in-vitro study using light-cured filled sealant. Am J Orthod Dentofacial Orthop. 2005;128(5):592\u2013600. doi:10.1016\/j.ajodo.2004.07.046"},{"issue":"5","key":"i1945-7103-96-4-444-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"574","article-title":"Increased susceptibility for white spot lesions by surplus orthodontic etching exceeding bracket base area","volume":"141","author":"Kn\u00f6sel","year":"2012","unstructured":"Kn\u00f6sel M,\nBojes M,\nJung K,\nZiebolz D. Increased susceptibility for white spot lesions by surplus orthodontic etching exceeding bracket base area. Am J Orthod Dentofacial Orthop. 2012;141(5):574\u2013582. doi:10.1016\/j.ajodo.2011.11.017"},{"issue":"5","key":"i1945-7103-96-4-444-b07","series-title":"Angle Orthod","first-page":"836","article-title":"Determinants of enamel decalcification during simulated orthodontic treatment","volume":"81","author":"Hess","year":"2011","unstructured":"Hess E,\nCampbell PM,\nHoneyman AL,\nBuschang PH. 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The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol. 2007;35(3):170\u2013178. doi:10.1111\/j.1600-0528.2007.00347.x"},{"issue":"2","key":"i1945-7103-96-4-444-b03","series-title":"Angle Orthod","first-page":"206","article-title":"Prevalence of white spot lesions during orthodontic treatment with fixed appliances","volume":"81","author":"Tufekci","year":"2011","unstructured":"Tufekci E,\nDixon JS,\nGunsolley JC,\nLindauer SJ. Prevalence of white spot lesions during orthodontic treatment with fixed appliances. 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Prevention of enamel demineralization: an in-vitro study using light-cured filled sealant. Am J Orthod Dentofacial Orthop. 2005;128(5):592\u2013600. doi:10.1016\/j.ajodo.2004.07.046"},{"issue":"5","key":"i1945-7103-96-4-444-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"574","article-title":"Increased susceptibility for white spot lesions by surplus orthodontic etching exceeding bracket base area","volume":"141","author":"Kn\u00f6sel","year":"2012","unstructured":"Kn\u00f6sel M,\nBojes M,\nJung K,\nZiebolz D. Increased susceptibility for white spot lesions by surplus orthodontic etching exceeding bracket base area. Am J Orthod Dentofacial Orthop. 2012;141(5):574\u2013582. doi:10.1016\/j.ajodo.2011.11.017"},{"issue":"5","key":"i1945-7103-96-4-444-b07","series-title":"Angle Orthod","first-page":"836","article-title":"Determinants of enamel decalcification during simulated orthodontic treatment","volume":"81","author":"Hess","year":"2011","unstructured":"Hess E,\nCampbell PM,\nHoneyman AL,\nBuschang PH. Determinants of enamel decalcification during simulated orthodontic treatment. Angle Orthod. 2011;81(5):836\u2013842. doi:10.2319\/121710-726.1"},{"issue":"1","key":"i1945-7103-96-4-444-b08","series-title":"Prog Orthod","first-page":"12","article-title":"In vitro study of the potential protection of sound enamel against demineralization","volume":"16","author":"Montasser","year":"2015","unstructured":"Montasser MA,\nEl-Wassefy NA,\nTaha M. In vitro study of the potential protection of sound enamel against demineralization. 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Accessed May 20, 2025."},{"issue":"5","key":"i1945-7103-96-4-444-b13","series-title":"Angle Orthod","first-page":"531","article-title":"Comparison of three orthodontic bonding systems in white spot lesion development: a randomized clinical trial","volume":"93","author":"Horan","year":"2023","unstructured":"Horan OGA,\nAl-Khateeb SN. Comparison of three orthodontic bonding systems in white spot lesion development: a randomized clinical trial. Angle Orthod. 2023;93(5):531\u2013537. doi:10.2319\/111422-781.1"},{"issue":"1","key":"i1945-7103-96-4-444-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"e17","article-title":"White-spot lesions during multibracket appliance treatment: a challenge for clinical excellence","volume":"140","author":"Enaia","year":"2011","unstructured":"Enaia M,\nBock N,\nRuf S. White-spot lesions during multibracket appliance treatment: a challenge for clinical excellence. 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