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32 I I industry report _ Opalescence Treswhite Ortho as Streptococcus mutants and Lactobacillus are responsible for the white spot lesions caused by enamel demineralisation. Both types of bacteria areanaerobic,meaningthattheyneedadark,warm and oxygen-free environment to survive, because their organisms are unable to eliminate or detoxify in the presence of oxygen radicals.10 Conversion of H2O2 to nascent oxygen causes tissue and oral environment oxygenation, and subsequently cre- ates an inadequate environment for bacteria growth and reproduction. _Overcoming reluctance Many young and adult patients are reluctant to wear fixed orthodontic brackets because of their unattractive aesthetic appearance. Adequate oral hygiene is more difficult to achieve when wearing these devices, and after months or years of treatment, patients’ teeth usually become dark or pigmented, thus increasing patient rejection of orthodontic treatments. The use of pre-medicated, adaptable and malleable trays for home or in-office treatment is an excellent and easy way to offer patients the opportunity to have sparkling white teeth during orthodontic treatment.11 Treswhite Ortho whiten- ing power has a predictable benefit. H2O2 has a low molecularweightof32mg/m,whichallowsitseasy diffusion through enamel to dentine.12 Once it spreads to the dentine, oxygen molecules act upon the dark pigments rotating and fragmenting them, creating a whitening effect in the dental struc- ture.13 Inaddition,TreswhiteOrthoH2O2 conversion to oxygen is highly beneficial for eliminating gin- givitis,owingtotheabilitytoprovidetheextraoxy- genrequiredduringthehigh-oxygenconsumption by the inflamed gingival tissues.12,14 H2O2 whitenspoly-directionallyinsidetheteeth, even underneath places covered by orthodontic devices such as brackets, making it possible to ob- tain homogeneous whitening on patients wearing orthodontic devices.12 Patients are very receptive and keen to use this whitening product. Addition- ally, dental whitening increases the responsibility for maintaining a good oral hygiene. An 18-year-old patient is more receptive to a treatment based on a dental whitening product than to brushing with fluoride toothpaste or using anti-plaquemouthrinses.Thisisquiteevidentwhen removing the soft Treswhite Ortho tray, since teeth mustbevigorouslybrushedtoremovetheremnants of the viscous H2O2-based whitening gel. The result is chemical and mechanical removal of filaments and bacteria from the teeth surface and brackets. As oral health professionals, we desperately seek to increase patients’ awareness of functional, healthy and aesthetic orthodontic treatments. Treswhite Ortho is effective in removing bacteria and achieving enamel hardness, leaving patients with bright and sparkling teeth. But more impor- tantly, it leaves teeth healthy and free of fissures. This type of result must form the basis for our new maintenance and care methodology for modern orthodontic therapies._ Editorial note: A complete list of references is available fromthepublisher. cosmeticdentistry 3_2010 Fig. 13_Colour matching using the VITA Classical (Lumin Vacuum). Fig. 14_Final result after ten days’ use of Treswhite Ortho and brackets removal. Fig. 15_Patient smile shows uniform colour in all the anterior teeth. Dr Enrique Jadad is a specialist in Oral Rehabilitation andAssociate Professor at the University of Cartagena and Santiago de Cali University in Colombia.He is also an international visiting professor atViña del Mar University,Chile. He can be contacted at ejadad@gmail.com. Dr Jaime Montoya is an orthodontic specialist in private practice in Barranquilla,Colombia. He can be contacted at jamontoya72@gmail.com. Prof Gonzalo Arana is a Professor at Santiago de Cali University,and a researcher in aesthetics and biomaterials who leads the BEO Research Group. He can be contacted at gonzalo.arana@usc.edu.co. cosmeticdentistry _about the authors Fig. 13 Fig. 14 Fig. 15