Objective: To investigate the use of image analysis for diagnosis and quantification of artificial white spot lesions on digital photographs before and after removal of orthodontic brackets.
Materials and Methods: Enamel demineralization was artificially induced on the labial surface of 20 teeth bonded with orthodontic brackets. Standardized digital photographs were taken at angles of 90° and 110° to the labial surface, before and after bracket removal. All images were analyzed by two observers using image-processing software, and the area of the white spot lesion was calculated. Reproducibility was assessed by the Pearson correlation coefficient for interobserver reliability and by the paired t-test for differences between observers. Differences between the known and the measured demineralization area were tested using the t-test. Differences between both stages and angles were assessed by application of the paired t-test.
Results: Reproducibility was very good for all measurements. For the photographs taken at an angle of 110°, there was a statistically significant but clinically irrelevant difference between the observers. The difference between the surface measured and the true surface was dependent on the stages and angles but was always <1 mm2.
Conclusion: Image analysis is a reproducible and reliable method for quantification of artificial enamel demineralization around orthodontic brackets.
