Debonding of orthodontic appliance changes salivary physicochemical properties and favors regression of active caries lesions: A 13-week follow-up study

Aim This prospective cohort study aimed to investigate whether orthodontic appliance removal (OAR) combined with caries-preventive strategies and fluoride varnish treatments alters salivary physicochemical properties, changes the activity of carbonic anhydrase VI (CA VIACT) and alpha-amylase (alpha-AML(ACT)), and favors the regression of active caries lesions (ACL). Design Twenty-two individuals aged between 13 and 24 years were assessed for the presence of visible biofilm, daily sugar exposure, caries activity, salivary flow rate (SFR), pH, buffering capacity (BC), and CA VIACT and alpha-AML(ACT) activity at baseline, and 1, 5, and 13 weeks after OAR. Variables were assessed using repeated-measures analysis of variance, Cochran's Q and McNemar's test, and Pearson's correlation. Results We observed a significant decrease in the number of ACL at the 5-week (29% reduction) and 13-week follow-ups (58% reduction). At the 5- and 13-week follow-ups, the percentage of visible biofilm and sugar exposure decreased, whereas the salivary pH and alpha-AML(ACT) activity significantly increased. BC and CA VIACT remained unchanged throughout the follow-up. Conclusion OAR combined with caries-preventive strategies and fluoride varnish treatments favored the regression of ACL and increased salivary pH and alpha-AML(ACT) activity, whereas BC and CA VIACT remained stable.