Poster IADR 2012 Sealant Infiltration penetration fluorosis final

Folia medica, 2020

Dental fluorosis changes the colour and/or structure of enamel, leading to an unaesthetic appearance. One of the main goals in the treatment is aesthetic improvement of the affected teeth. Two clinical cases of patients with white spot fluorosis lesions on frontal teeth are presented. All treated teeth are infiltrated with low-viscous light-curing resin (ICON, DMG). A significant improvement in the aesthetic appearance of all the treated tooth surfaces is visible immediately after resin infiltration, and in most of the teeth - a complete disappearance of the white spots. Resin infiltration is an alternative micro-invasive approach for treatment of white spot lesions of different origin. It allows a quick and natural recovery of the affected teeth.

Journal of South Asian Association of Pediatric Dentistry

Background: Dental fluorosis is the hypomineralization of tooth enamel due to excessive fluoride, resulting in opaque white areas or discoloration of teeth. The available treatment modalities to improve the esthetics affected due to fluorosis include non-invasive and invasive methods. Nowadays, a newer non-invasive treatment that is resin infiltration (RI) is gaining increasing popularity. The present study evaluated and compared the clinical success in esthetic improvement (EI) and changes in white/brown opacities/stains (SC) of RI on non-pitted fluorosis stains. Materials and methods: A total of 18 patients in the age range of 6-12 years with the unesthetic appearance of upper anterior teeth due to non-pitted fluorosis were randomly selected and subjected to an RI procedure. Evaluation for EI and changes in white/brown opacities/stains (SC) was done on the visual analog scale (VAS). Results: The results were statistically highly significant (p < 0.01) for the mean VAS score values of EI (p = 0.001) and SC (p = 0.001) between the follow-up time intervals with the highest values at time interval 6 months followed by 3 months, 1 month, and least at immediate postoperative. Furthermore, inter-grade comparison of fluorosis showed a highly significant difference (p < 0.01) for the VAS scores for both EI and SC with the highest mean VAS score values in a very mild degree of fluorosis, followed by mild and moderate degrees. Conclusion: Resin infiltration is a promising procedure that demonstrated remarkably successful EI in mild to moderate non-pitted fluorosis with a stable long-term positive outcome.

2016

Purpose: The goal of this split-mouth, randomized, prospective clinical trial was to evaluate radiographically the effectiveness of resin infiltration as an adjunct to standard-of-care preventative measures (fluoride application, oral hygiene instruction, and diet counseling) compared to standard-of-care preventative measures alone in controlling the progression of nonadjacent, incipient, enamel proximal carious lesions (E1 and E2) in primary molars after six and 12 months of treatment. Materials and Methods: A total of 45 healthy children aged 5-8 years old who had been diagnosed radiographically by at least two trained and calibrated examiners to have at least two non-adjacent, incipient, enamel proximal carious lesions in primary molars (total of 90 lesions) were included in the study. The lesions were randomly allocated to either case or control group. Case group lesions were treated using resin infiltration followed by topical fluoride (5% NaF) application versus only topical fluoride (5% NaF) in the control group lesions. All subjects were given oral hygiene instruction, diet counseling and flossing instructions including the proximal areas at the baseline, at the six-month and 12-month follow-ups. Other recorded variables included: (1) Date of birth; (2) gender; (3) race; (4); dmft (decayed, missing, filled primary teeth due to caries) at the treatment day; (5) Caries risk assessment (CAT). To provide standardization, individual bite registration was taken during the initial baseline visit and used at the follow-up appointments. The radiographic evaluation was performed after six and 12 months by two blinded, trained and calibrated examiners using pair-wise reading to determine whether lesions had progressed or not. A p-value of < 0.05 was considered statistically significant. Results: After six months of treatment, one of the subjects failed to come to this appointment; thus only 44 lesion pairs could be compared radiographically. Lesions treated with TABLE OF CONTENTS Abstract ….……….…………………….……………………………………. Dedication ….……….…………………….……………………………………. Acknowledgments ….……….…………………….……………………………. Introduction ….……….…………………….……………………………………. Dental Caries ….……….…………………….……………………………. White spot lesions ….……….…………………….……………………. Clinical diagnosis of proximal white spot lesions ……………………… Radiographic diagnosis of proximal white spot lesions ……………… Treatment of proximal white spot lesions ….……….………………….. Conventional treatment of proximal white spot lesions ……………… Noninvasive treatment for proximal white spot lesions ……………… 1-Fluoride varnish ……………………………………………………… 2-Sealing proximal white spot lesions ……………………………… 3-Resin infiltration for proximal white spot lesions ……………………… Clinical significance of the study ……………………………………………… Aims and Objectives ……………………………………………………………… Hypothesis ……………………………………………………………………… Research Design and Methods ……………………………………………… Experimental Design ……………………………………………………… Screening and Baseline Radiographs ……………………………………… Treatments ……………………………………………………………… Follow-up appointments ……………………………………………… Radiographic evaluation ……………………………………………… Sample size calculation ……………………………………………………… Statistical Analysis ……………………………………………………………… Randomization ………………………………………………………………

2019

Introduction: Severe Enamel Fluorosis is frequently found in young adolescents with aesthetic concerns. Colourimetric alterations could vary from diffuse opacities to demarcated brown and white areas. Material and methods: One young patient with a severe fluorosis was treated by a combined use of at-home bleaching and at-office resin infiltration. Results: In all the affected teeth, existing aesthetic enamel alterations, were successfully treated by the combined use of bleaching and Icon® resin application. Given the minimal substance loss due to the erosion infiltration procedure, the patient was extremely satisfied with the results. Conclusions: Our case report show the capability of treating severe fluorosis with bleaching and subsequent Icon® resin infiltration. Longer observation periods in studies with larger patients population are needed to validate the clinical significance found in this case report.

Objective: Our study aims to evaluate the effect of mineralizing fluorine varnish on the progression of initial caries of enamel in temporary dentition by laser fluorescence. Material and Methods: Object of observation. 1 group-100 children aged 3, 4, 5 and 6 years treated with Clinpro ™ White Varnish with TCP (Tri-Calcium phosphate) (3M) – CV. Two groups-100 children aged 3, 4, 5 and 6 years without treatment with varnish CV. Location of the study-University Medical Dental Center Varna, Clinical Halls for Children's Dentistry, Faculty of Dental Medicine – Varna. Units of observation: Temporary teeth, Caries lesions at level d1 and d2. After processing the results and determination of the highlights was conducted by actual survey data processing package for mathematical and statistical analysis SPSS v 20.0. Results: The analysis of the results of temporary central incisors in six-year-old children showed a significant difference in the three study groups, the control group values being significantly higher than those in the treatment-treated group (t = 3.44, p<0.01) and those after treated with treatment with Clinpro White Varnish, TCP (t = 5.31, p<0.001). A significant difference showed the use of CV varnish, which showed improvement after treatment (t = 2.81, p<0.01). Results before and after treatment of lesions in the treated group also showed a significant difference, but better values were observed in temporary lateral incisors (t = 6.25, p<0.001 for temporary lateral incisors and t = 5.93, p<0.001 for temporary canines). The results in the study group before and after treatment also showed a significant difference in the provisional first and second molars (t = 7.53, p< 0.001 and t = 6.32, p< 0.001). Conclusion: 1. All reversible lesions may regress or stagnate by reducing the accumulated pathology above this diagnostic level. 2. After the first week, DIAGNOdent pen scores improved from less than three steps for d1b and d2 lesions and improved by two steps for d1a lesions. 3. Increased therapeutic efficacy of dental agents for non-invasive treatment is achieved by enhancing them with fluorides.

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

The advances in scientific developments in dentistry have led to the emergence of innovative technologies for early diagnosis, prevention, interception, and therapeutic strategies for the preservation of tooth structure loss due to carious destruction or tooth decay arresting the carious lesions in order to preserve the tooth structure loss. Minimal intervention techniques to replace, repair, and remove as little tissue as possible is gaining significant importance over traditional techniques, as the emphasis is given on the preservation of the original tooth structure. White spot lesions are a form of enamel demineralisation which usually occurs due to dental fluorosis or postorthodontic treatment, compromising the aesthetics and self-esteem of the patient. The resin infiltration technique is a reliable treatment option advocated for the treatment of white spot lesions and non cavitated carious lesions. It is a microinvasive intervention performed without drilling or sacrificing th...

Case Reports, 2013

World Journal of Dentistry

Aim: Analysis of masking potential of the resin infiltration technique with dental milestones guaranteed caries infiltration concept (DMG ICON) on nonpitted white spot lesions due to fluorosis in newly erupted permanent maxillary incisors for better esthetics and psychological wellbeing in children. Materials and methods: This prospective interventional study was conducted on 60 newly erupted maxillary central incisors with mild, nonpitted white spot lesions of fluorosis till grade IV of the Thylstrup and Fejerskov (TF) index. The resin infiltration technique with DMG ICON (DMG, Hamburg, Germany) was used to mask lesions along with the analysis for color change using Euclidean distance, i.e., the ∆E (Delta E) unit of the CIE L*a*b* color space formula where ∆E = (∆L 2 + ∆a 2 + ∆b 2) ½ using the image-analyzing software. Data were analyzed statistically by the SPSS software. Results: Fifty-one tooth samples (85%) showed complete masking of white spot lesions of fluorosis postoperatively to resin infiltration with net ∆E values less than or equal to 3.7 whereas lesions in nine tooth samples (15%) were not masked completely with net ΔE > 3.7. Statistically highly significant results were obtained with the Wilcoxon signed-ranks test (p value < 0.001). Conclusion: The minimally invasive resin infiltration technique using DMG ICON is highly efficient and satisfactory for masking of nonpitted white spot lesions of dental fluorosis in newly erupted permanent central incisors as per the analysis for color change using the image-analyzing software. Clinical significance: The outcome of masked and blended white spot lesions of fluorosis with the sound enamel in the smile zone with the resin infiltration technique was found to be a child-friendly, noninvasive, single-sitting approach with stabilized results in follow-up visits.

Journal of Esthetic and Restorative Dentistry, 2012

Statement of Problem: New light-polymerized resin composites optimized for rapid infiltration of enamel lesions with resin light curing monomers are commercially available today to prevent enamel lesions from further demineralization and provide a highly conservative therapy. In addition, this technique has proved to be effective treatment for blending white spot lesions because the microporosities of infiltrated lesions are filled with resin. Purpose: This clinical report presents and describes cases in which the minimally invasive infiltrant resin technique was used for blending different microporous lesions, mild-to-moderate fluorosis, and hypoplasia stains related to traumatic dental injuries. The fluorosis stain showed visually perceptual improvements. In the cases of hypoplasia, stains were not completely blended. However, the general clinical outcomes of these cases were considered successful and recovered the patients' self-esteem. Based on the results obtained, it could be concluded that the resin infiltration technique shows promising results and could be considered a minimally invasive procedure for mild-to-moderate fluorosis and hypoplasia stains. This case study allows a better understanding of the concept of the resin infiltration technique applied in other types of porous lesions, increasing its use as a therapeutic alternative for esthetic purposes in the philosophy of minimally invasive dentistry.

Advances in dental research, 1994

International Journal of Clinical Pediatric Dentistry

Original research disintegration of the matrix proteins during the maturation phase. 5,7 Consequently, the degradation of matrix proteins is delayed. 5 The occurrence of fluoride-induced retention of enamel matrix protein leads to compromised crystal growth. 5,8 Maxillary permanent incisors are teeth that are at risk of fluorosis if the child is exposed to excessive fluoride between the age-groups of 20−30 months. 9 Conservative nonrestorative treatments, such as microabrasion and bleaching, have been advocated in the management of demineralization defects and intrinsic stains of teeth due to fluorosis. Enamel microabrasion is a significant technique in the elimination of intrinsic discoloration or texture modification to the IntroductIon Esthetic dentistry is an evolving branch of dentistry concerned with enhancing dental esthetics. Esthetic dentistry includes many procedures, such as conservative restorative treatments, smile corrections and designing, orthodontic procedures, veneers, depigmentation of the gingiva, microabrasion, and so on. In this part, our line of treatment for microabrasion is efficient in the management of fluorosis. Dental fluorosis is a significant oral condition that may affect oral esthetics. Hence it is generally believed that a widely prevalent esthetic disturbance may be significant for children's perception of well-being. 1 Impaired esthetic disturbances in permanent dentition are of the greatest concern in dental fluorosis and are more predisposed to affect children who are extremely exposed to fluoride present in water between 20 and 30 months of age of the child. The critical period for fluoride over-exposure is between 1 and 4 years old only, and not be at risk during the older years. 2 Dental fluorosis is an oral health condition described as a developmental disturbance of enamel due to excessive exposure to fluoride. 3 During tooth development, a high concentration of fluoride exposure will affect the enamel-forming cell, ameloblast, particularly in the process of enamel development. 4 Subsequent changes happening in the enamel occur due to the changes of developing enamel mineral matrix and ameloblast. 5,6 Due to increased fluoride existence during the mineralization of enamel, there is a decrease in the free calcium ion concentration in the mineralizing matrix, which inhibits enzyme proteinases from the

Clinical Oral Investigations, 2011

This in vivo study evaluated the effects of topical fluoride application on enamel by repeated scanning electron microscopy analysis of replicas. Baseline fluid droplets were employed as qualitative indication of enamel permeability. CaF2-like globules were detected in vivo after fluoride application and were not found after professional brushing, ultrasound action, or chemical extraction. Absence of water permeability of enamel was demonstrated even after removal of CaF2-like globules. Droplets reappeared within 1 h in sodium fluoride-treated teeth, but they did not reappear even after 1 week following topical enamel treatment with acidulated phosphate fluoride. Teeth treated with an acidulate fluoride-free solution showed lack of CaF2-like globules and no droplets for at least 1 week as detected in acidulate phosphate fluoride-treated teeth. The caries-preventing action of fluoride may be due to its ability to decrease permeability and diffusion pathways. CaF2-like globules seem to be indirectly involved in enamel protection over time maintaining an impermeable barrier, and phosphoric acid seemed to play an unexpected fluoride-independent preventive role.

Journal of Dental Research, 1988

The purpose of this investigation was to study the intra-oral remineralization of acid-softened enamel by a NaF dentifrice compared with that from a combination of topical F agents. Bovine enamel slabs were demineralized with 0.1 moliL lactic acid at pH 4.0 for 14 hr and then mounted in a removable mandibular appliance. Control slabs were worn for 96 hr by seven adult males who brushed daily with a F-free dentifrice. Test slabs were brushed with a NaF dentifrice 4 x / day or with the same dentifrice 4 x /day and a 0. 02% APF mouthrinse and a 0.4% SnF2 gel which were applied once/day for three days. The natural dentition was also brushed with the NaF dentifrice during both test periods. Microhardness testing was performed on sound enamel, and after acid-softening, intra-oral exposure (IOE), and acid resistance testing (ART) in 0. 01 moliL lactic acid at pH 4. 0 for 24 hr. Control and test slabs were etched with 0.5 mol/L HC104forfrom 15 to 60 sec. The F content was measured with a F electrode and P04 by spectrophotometry. Contact microradiography and image analyses were performed on control and test slabs so that changes in mineral content resulting from treatment could be assessed. Both test groups were significantly harder after both IOE and ART than were controls, but no differences appeared between the effects of the two test groups. The F content of control slabs was significantly less than that of both test groups, and the combination-treated slabs showed greater F than did the dentifrice-treated slabs. Microradiographs revealed a higher mineral content in the basal 2/3 of combinationtreated lesions, while diffuse mineral deposition occurred, especially subjacent to the surface in the dentifrice-treated lesions. Control lesions showed little added mineral. J Dent Res 67(6):954-958,

Archives of Oral Biology, 2009

The morphological characterization of fluorotic rat incisor enamel was carried out. Experimental adult animals received drinking water with 45 mg F/L of fluoride, and the control group received distilled water. Fluoride concentrations found in the control and fluorosis groups were 0.04 and 0.09 μg/mL (plasma), 0.26 and 0.66 μg/mg (whole tibia), and 0.24 and 2.3 μg/mg (tibia surface), with P ≤ 0.001 for all comparisons between the groups. A succession of white and pigmented bands was observed in the fluorotic rat incisors. Under polarizing light microscopy, cross-sections of superficial areas corresponding to the white bands (from the surface to ∼20 μm) showed high positive birefringence. These fluorotic lesions also exhibited the lowest resistance to superficial acid etching. No morphological differences in inner enamel were seen under scanning electron microscopy. In fluorotic enamel, only the surface layer related to the white areas presented lower birefringence compared with the enamel of control teeth and the surface layer of the pigmented areas (normal ones) of fluorotic teeth. In conclusion, the white bands of fluorotic rat enamel represent hypomineralized superficial areas and are not subsurface lesions. The detailed description of these lesions is important to understand dental fluorosis.