Underlying Resin Infiltration and Direct Composite Veneers for the Treatment of Severe White Color Alterations of the Enamel: Case Report and 13-Month Follow-Up

Combined Minimally Invasive Esthetic Rehabilitation of Dental Fluorosis-5-year Follow-up: Case Report

Dental fluorosis (DF) is a specific esthetic issue characterized by a persistent condition in which there is a disruption in enamel development, leading to the formation of hypomineralized enamel. The resulting unusual appearance varies in intensity, presenting as mildly white and opaque to dark brown, and significantly impacts individuals' esthetic features and self-confidence. The objective of this case report was to assess the efficacy of microabrasion, dental whitening, and resin infiltration in terms of resolving lesions, tracking the sensitivity of teeth, and evaluating patient satisfaction over a period of time. A minimally invasive treatment approach in a 27-year-old woman with severe DF is detailed. The treatment plan involved enamel microabrasion, in-office bleaching, and two weeks of at-home bleaching, followed by resin infiltration for the affected tooth under rubber dam isolation. After a 5-year follow-up, the assessment of the patient's esthetic appearance indicated a successful treatment of teeth affected by DF.

Effect of shade and opacity on color differences and translucency of resin composite veneers over lighter and darker substrates

To evaluate color differences (ΔE00) and translucency parameters (TP) from mono, bi, and trilayer resin composite veneers using different opacities and shades of resin composite over lighter and darker simulated tooth-colored substrates. Mono, bi, and trilayer veneers (1.5 mm) (n = 12) were made using two shades (A1 and A2) and three opacities (enamel, body, and dentin) of resin composite over simulated lighter (A1) and darker (C4, and C4+) tooth-colored substrates. CIEDE2000 formula was used to calculate ΔE00 considering simulated tooth-colored substrate versus opacities in distinct mono, bi, and trilayer combinations of resin composite over the simulated tooth-colored substrate. The TP was calculated using color coordinates measured over standard white and black backgrounds. Differences in ΔE00 and TP values were calculated with a Three-way Analysis of Variance followed by Tukey's post-hoc test. A1E and A1B monolayer veneers showed similar TP values. Significantly higher ΔE00 values were observed over darker (C4 and C4+), and lower over lighter (A1) simulated tooth-colored substrate. Bilayer and trilayer veneers using dentin opacity provided similar ΔE00 values over the darker tooth-colored substrate. Distinct shades and opacities of resin composite layer combinations over lighter and darker tooth-colored substrates significantly affected TP and ΔE00 values. A1 shade and dentin opacity of monolayer resin composite veneers yielded higher ΔE00 values over darker tooth-colored substrates.

Aesthetic impact of resin infiltration and its mechanical effect on ceramic bonding for white spot lesions

BACKGROUND

Treating white spot lesions (WSLs) with resin infiltration alone may not be sufficient, raising questions about its compatibility with other treatments amid controversial or incomplete data. Therefore, this study aimed to assess the aesthetic feasibility of resin infiltration combined with bleaching, as well as its potential mechanical effect on ceramic bonding to WSLs.

METHODS

One hundred and fifty flat enamel surfaces of bovine incisors were prepared. Ninety specimens were deminerailized and randomly assigned to three groups(n = 30): post-bleaching resin infiltration (Bl-R), pre-bleaching resin infiltration (R-Bl), and only resin infiltration (R). Color, surface roughness and microhardness were assessed in immediate, thermocycling and pigmentation tests. The remaining sixty samples were randomly assigned to three groups (n = 20): control (Ctrl), bonding (Bo), pre-bonding resin infiltration (R-Bo). Shear bonding strength, failure mode, micro-leakage depth and interface morphology were evaluated after ceramic bonding. The Tukey test and analysis of variance (ANOVA) were used for statistical analysis.

RESULTS

For the effect of resin infiltration and bleaching on WSLs, the R-Bl group showed the worst chromic masking ability, with the highest |ΔL|, |Δa|, |Δb|, and ΔE values after treatment. Compared with those in the Bl-R group, the R-Bl and R groups showed significant time-dependent staining, which is possibly attributed to their surface roughness. For the effect of resin infiltration on the adhesive properties of WSLs, resin infiltration reduced the staining penetration depth of WSLs from 2393.54 ± 1118.86 μm to 188.46 ± 89.96 μm (P < 0.05) while reducing WSLs porosity in SEM observation.

CONCLUSIONS

Post-bleaching resin infiltration proved to be advantageous in the aesthetic treatment of WSLs. Resin infiltration did not compromise bonding strength but it did reduce microleakage and enhance marginal sealing. Overall, resin infiltration can effectively enhance the chromatic results of treated WSLs and prevent long-term bonding failure between ceramics and enamel. Based on these findings, the use of post-bleaching resin infiltration is recommended, and resin infiltration before ceramic bonding is deemed viable in clinical practice.

Management of Enamel Defects with Resin Infiltration Techniques: Two Years Follow Up Retrospective Study

Background: Developmental Defects of Enamel (DDE) represent an aesthetic, functional, and often psychological problem, especially in young patients. Infiltrative treatment with resin (Icon-DMG, Hamburg, Germany) is a minimally invasive technique based on the infiltration of high viscosity resin inside the hypomineralized enamel, modifying its optical properties. The aim of this paper is to evaluate the clinical efficacy of superficial infiltration in the treatment of white enamel defects of the anterior sector with pre-eruptive etiology and its stability over time. Methods: Thirty-three patients affected by DDE associated with mild and moderate Molar Incisor Hypomineralization (MIH), mild and moderate fluorosis, and post-traumatic hypomineralization treated with resin infiltration were retrospectively retrieved. Results: In all cases an improvement in aesthetic appearance was achieved, and the 24-month follow-up confirmed the stability of the results. However, in the cases of traumatic hypomineralization the results were not completely satisfactory. Conclusions: The superficial infiltration technique can be considered a valid minimally invasive alternative to traditional treatment of mild or moderate fluorosis and mild MIH.

In vitro effect of resin infiltrant on resistance of sound enamel surfaces in permanent teeth to demineralization

OBJECTIVE

To investigate the effect of resin infiltrant on resistance of sound permanent enamel surfaces to demineralization.

METHOD

Eighty healthy premolars were sectioned to obtain enamel blocks from the buccal surface. Specimens with baseline surface microhardness values of 320-370 were selected. The experimental group were treated with resin infiltrant, while the control group was not. Specimens from each group were artificially demineralized and the surface microhardness values were measured again. Confocal laser scanning microscopy was used to measure the depth of demineralization and detect the penetration ability of the resin infiltrant. The specimens were subjected to a simulated toothbrushing abrasion test. Scanning electron microscopy was used to observe changes in the surface morphology of specimens after each of these procedures.

RESULTS

No significant differences between the experimental and control groups were observed in the baseline microhardness values or in the experimental group after resin infiltration compared with the baseline conditions. After artificial demineralization, the microhardness value in the control group was significantly lower than that in the experimental group (266.0 (±34.5) compared with 304.0 (±13.0), P = 0.017). Confocal laser scanning microscopy results showed that the demineralization depth in the control group was significantly deeper than that in the experimental group (97.9 (±22.8) µm vs. 50.4 (±14.3) µm, P < 0.001), and that resin infiltrant completely penetrated the acid-etched demineralized area of the tooth enamel with a mean penetration depth of 31.6 (±9.0) µm. Scanning electron microscopy showed that the surface morphology was more uniform and smoother after simulated toothbrushing. The enamel surface structure was more severely destroyed in the control group after artificial demineralization compared with that of the experimental group.

CONCLUSION

Resin infiltrant can completely penetrate an acid-etched demineralized enamel area and improve resistance of sound enamel surfaces to demineralization. Our findings provide an experimental basis for preventive application of resin infiltrant to sound enamel surfaces to protect tooth enamel against demineralization.

Clinical Performance of Enamel Microabrasion for Esthetic Management of Stained Dental Fluorosis Teeth

CLINICAL RELEVANCE

Enamel microabrasion is an effective first-line esthetic treatment for the removal of tooth stains due to fluorosis, with an improvement in the appearance of teeth that is associated with a high level of patient acceptance.

SUMMARY

Minimally invasive esthetic management of dental fluorosis: a case report

Dental fluorosis is a dental condition caused by excessive intake of fluoride during enamel formation, which can lead to color abnormalities or defects on the tooth surface. The resultant abnormal appearance ranges in severity from mildly white and opaque to dark brown, which substantially affects patients' esthetic characteristics and self-confidence. Treatment methods include tooth whitening or restoration. This clinical report describes the use of a minimally invasive esthetic technique in a 22-year-old woman with moderate dental fluorosis. The treatment plan included enamel microabrasion, at-home bleaching for 2 weeks, and subsequent resin infiltration for each tooth under a rubber dam. After 2 years of follow-up, evaluation of the patient's esthetic appearance revealed that teeth affected by dental fluorosis could be successfully treated with a minimally invasive technique involving microabrasion, at-home bleaching, and resin infiltration.