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Kabeel DG, Nour KA, Sedky RA. The Effect of Resin Infiltration Technique on the Calculated Color Change of Demineralized Lesions of Different Severities. Oper Dent 2024; 49:443-454. [PMID: 38978312 DOI: 10.2341/23-126-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVE To assess the color change of demineralized enamel lesions of different severities after resin infiltration using both clinical spectrophotometry and digital photography. METHODS AND MATERIALS Sixty sound human premolars were randomly divided into 3 groups according to the demineralization level. All the teeth were immersed in a demineralizing solution of a pH adjusted to 4.4 at 37°C. Three levels of demineralization were obtained (D1 shallow, D2 moderate, D3 deep) according to the demineralization time. The demineralized area was then infiltrated by low-viscosity resin (ICON, DMG, Germany). Two instrumental methods were utilized to assess the color difference, a clinical spectrophotometer and digital photography at three time points (sound, demineralized, and infiltrated enamel) to calculate the color difference between sound and demineralized enamel (ΔE1) and between sound and infiltrated enamel (ΔE2). Statistical analysis was performed by ANOVA, followed by Tukey's post hoc test. The correlation was analyzed using linear regression. RESULTS Two-way ANOVA showed statistically significant differences for both levels of the study (p≤0.05). The color change (ΔE1) and (ΔE2) for different demineralization levels showed statistically significant differences between all groups. For both clinical spectrophotometry and digital photography, D3 showed the highest difference followed by D2 and then D1. As for (ΔE1) calculations, digital photography had a significantly higher difference than spectrophotometry for the D1 group (5.47±0.93 vs 2.78±0.58). As for (ΔE2) digital photography had a statistically significantly lower difference than spectrophotometry (5.55±1.05 vs 6.48±0.76) for the D3 group. CONCLUSIONS Color correction after resin infiltration is affected by the demineralization level of enamel. Clinical spectrophotometry and digital photography can detect similarly the color change of demineralized enamel after resin infiltration in shallow and moderate demineralization. However, in deep demineralization clinical spectrophotometry tends to exaggerate the color change compared to digital photography.
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Affiliation(s)
- D G Kabeel
- *Dina Gamal Kabeel, BDS, MDSc, assistant lecturer, Operative Dentistry, Faculty of Dentistry, Ain-Shams University, Abbasyia, Cairo, Egypt
| | - K A Nour
- Khaled Aly Nour, BDS, MSc, PhD, associate professor, Operative Dentistry, Faculty of Dentistry, Ain-Shams University, Abbasyia, Cairo, Egypt
| | - R A Sedky
- Rana A Sedky, BDS, MDSc, DDSc, lecturer, Operative Dentistry, Faculty of Dentistry, Ain-Shams University, Abbasyia, Cairo, Egypt
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Sinanovic AL, Messer-Hannemann P, Samadi M, Schwendicke F, Effenberger S. Effect of Bleaching on Resin-Infiltration-Masked Artificial White Spots In Vitro. J Funct Biomater 2024; 15:125. [PMID: 38786636 PMCID: PMC11122313 DOI: 10.3390/jfb15050125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 04/30/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024] Open
Abstract
Resin infiltration is an effective method to mask vestibular white spots. If needed, external bleaching is usually recommended before infiltration, whilst in clinical practice, this sequence may not always be feasible. This in vitro study evaluated the effect of bleaching after resin infiltration regarding surface roughness and color using bovine incisors. Unlike for the untreated specimens (control, n = 25), artificial caries lesions were created within the test group (n = 25) using a demineralization solution at 37 °C for five days (pH = 4.95). The lesions were subsequently infiltrated using a resin infiltrant (Icon, DMG, Hamburg, Germany), followed by polishing. Afterwards, all specimens were bleached with a 10% carbamide peroxide gel (Opalescence, Ultradent, South Jordan, UT, USA) for 8 h/day over a ten-day period. Between bleaching treatments, specimens were stored in an opaque container with moistened paper tissues at 37 °C. Surface roughness was measured using a profilometer, and color in the L*a*b* space was assessed spectrophotometrically before and after bleaching. Bleaching increased the L*-values of both infiltrated (mean ± SD; ΔL* = 3.52 ± 1.98) and untreated (control) specimens (ΔL* = 3.53 ± 2.30) without any significant difference between the groups (p = 0.983). Bleaching also induced a significant increase in the mean surface roughness of both infiltrated (p < 0.001) and untreated (p = 0.0134) teeth. In terms of clinical relevance; it can be concluded that bleaching resin-infiltrated enamel is as effective as bleaching sound enamel.
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Affiliation(s)
- Alan Leon Sinanovic
- Clinical Research, DMG Dental-Material Gesellschaft mbH, 22547 Hamburg, Germany
- Department Biotechnology, University of Applied Sciences Hamburg, 21033 Hamburg, Germany
| | | | - Mariam Samadi
- Clinical Research, DMG Dental-Material Gesellschaft mbH, 22547 Hamburg, Germany
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians University Munich, 80336 Munich, Germany
| | - Susanne Effenberger
- Clinical Research, DMG Dental-Material Gesellschaft mbH, 22547 Hamburg, Germany
- Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians University Munich, 80336 Munich, Germany
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Alghawe S, Raslan N. Management of permanent incisors affected by Molar-Incisor-Hypomineralisation (MIH) using resin infiltration: a pilot study. Eur Arch Paediatr Dent 2024; 25:105-116. [PMID: 38285169 DOI: 10.1007/s40368-024-00861-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/15/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE To compare the aesthetic improvement of Molar-Incisor-Hypomineralisation (MIH) opacities treated by applying Icon-Etch for three cycles with the opacities treated by Icon-Etch for once, in the course of resin infiltration technique. METHODS Thirty incisors were sorted based on the colour of the opacities and then distributed according to the number of Icon-Etch cycles using a randomisation table into the groups: (1) White/Creamy one cycle, (2) White/Creamy three cycles, (3) Yellow/Brown one cycle, (4) Yellow/Brown three cycles. The primary outcomes of applying the resin infiltration to the opacities were compared amongst groups according to the parents' satisfaction, the amount of coverage, and the colour matching with the surrounding sound enamel. The stability of the results after 3 months was evaluated using a spectrophotometer. RESULTS The colour of the opacity pre-treatment affected the outcomes significantly (p < 0.05), compared according to the method of application (p > 0.05) in terms of parents' satisfaction. Whilst the multiple applications for Icon-Etch cycles showed more coverage amount in White/Creamy opacities than the application ones (p < 0.05); in colour matching, there was no statistically significant difference between the two methods (p > 0.05). For yellow/brown opacities, some negative results occurred with the single Icon-Etch cycle. CONCLUSION In MIH opacities, it is possible to rely on the resin infiltration as a minimally invasive method to achieve acceptable results, especially with multiple Icon-Etch cycles applications in the white/creamy opacities. The colour stability has not been affected by either the colour of the opacity or the number of cycles.
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Affiliation(s)
- S Alghawe
- Department of Paediatric Dentistry, Tishreen University, Lattakia, Syria.
| | - N Raslan
- Department of Paediatric Dentistry, Tishreen University, Lattakia, Syria
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Ibrahim DFA, Venkiteswaran A, Hasmun NN. Esthetic Effects and Color Stability of Resin Infiltration on Demineralized Enamel Lesions: A Systematic Review. J Int Soc Prev Community Dent 2023; 13:273-286. [PMID: 37876578 PMCID: PMC10593370 DOI: 10.4103/jispcd.jispcd_29_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/21/2023] [Accepted: 06/23/2023] [Indexed: 10/26/2023] Open
Abstract
Aims and Objectives The aim of this study was to systematically review the ability of resin infiltration to conceal demineralized enamel lesions to normal enamel translucency and to maintain color stability. Materials and Methods A literature search of PubMed, MEDLINE, Web of Science, and Scopus databases and a manual search of articles from 2009 to 2021 for randomized controlled trials (RCTs) and clinical efficacy trials (nonrandomized) were performed. Methodological quality and risk of bias (RoB) of included papers was assessed using Cochrane Collaboration Risk of Bias Tool 2.0 for RCTs and ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) tool for nonrandomized studies. Results A total of 352 titles and abstracts were reviewed. Eight RCTs and three clinical efficiency studies were included in this review. The masking effects of the demineralized enamel lesion were reported immediately after resin infiltration, and the color stability of this material was up to 24 months, with no adverse effects noted. For RCTs, four studies were classified as "some concerns" and four were as "low RoB." For nonrandomized studies, all of the studies presented an overall moderate RoB. Conclusion Resin infiltration achieves the best esthetic outcomes compared with microabrasion and remineralization therapy. Color stability was achieved with this material for up to 24 months and no adverse effects were noted. Factors contributing to the esthetic outcomes of the resin include the elimination of the hypermineralized surface layer, the homogeneity of the resin itself, and polishing after resin infiltration. Longitudinal follow-up and improved control of confounding variables should characterize future high-quality systematic reviews.
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Affiliation(s)
- Dayang Fadzlina Abang Ibrahim
- Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA Campus Sungai Buloh, Sungai Buloh, Selangor, Malaysia
| | | | - Noren Nor Hasmun
- Department of Oral Science, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Wierichs RJ, Abou-Ayash B, Kobbe C, Esteves-Oliveira M, Wolf M, Knaup I, Meyer-Lueckel H. Evaluation of the masking efficacy of caries infiltration in post-orthodontic initial caries lesions: 1-year follow-up. Clin Oral Investig 2023; 27:1945-1952. [PMID: 36627531 PMCID: PMC10160188 DOI: 10.1007/s00784-022-04843-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 12/26/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This study aimed to qualitatively and quantitatively assess the masking efficacy and color stability of resin infiltration on post-orthodontic ICL after 1 year. MATERIALS AND METHODS In 17 adolescents, 112 ICL (ICDAS-1: n = 1; ICDAS-2: n = 111) in 112 teeth were treated by resin infiltration (Icon, DMG) 3 to 12 months after bracket removal. The etching procedure was performed up to 3 times. Standardized digital images were taken before treatment (T0), 7 days (T7) and 12 months (T365) after treatment. Outcomes included the evaluation of the color differences between infiltrated and healthy enamel at T0, T7, and T365 by quantitative (colorimetric analysis (ΔE), ICDAS scores) and qualitative methods (5-point Likert scale (deteriorated (1), unchanged (2), improved, but not satisfying (3), improved and no further treatment required (4), completely masked (5)).) Differences between time points were analyzed by using Friedman test (ΔΕ) and chi-square tests (ICDAS). RESULTS The median color difference (25th/75th percentiles) between carious and healthy enamel at baseline (ΔΕ0) was 10.2(7.7/13.6). A significant decrease was observed 7 days after treatment (ΔΕ7 = 3.1(1.8/5.0); p < 0.001; ICDAS; p < 0.001). No significant changes based on ΔΕ (p = 1.000), and ICDAS grade (p = 0.305) were observed between T7 and T365 (ΔΕ12 = 3.4 (1.8/4.9)). Furthermore, at T365 four experienced dentists classified 55% and 39% of the lesions as "improved and no further treatment required" and "completely masked," respectively (Fleiss kappa: T365 = 0.851 (almost perfect)). CONCLUSION Resin infiltration efficaciously masked post-orthodontic ICL 7 days and 12 months after treatment. These results for most of the teeth could not only be observed by quantitative but also by qualitative analysis. CLINICAL RELEVANCE Resin infiltration efficaciously masks post-orthodontic initial carious lesions. The optical improvement can be observed directly after treatment and remains stable for at least 12 months.
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Affiliation(s)
- R J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - B Abou-Ayash
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - C Kobbe
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - M Esteves-Oliveira
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - M Wolf
- Department of Orthodontics, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - I Knaup
- Department of Orthodontics, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - H Meyer-Lueckel
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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Nicholas LS, Yew Christopher QE, Fei Frank LK. Conservative esthetic management of brown enamel fluorosis using combination therapy: A clinical report. J Conserv Dent 2023; 26:349-354. [PMID: 37398859 PMCID: PMC10309132 DOI: 10.4103/jcd.jcd_632_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/22/2022] [Accepted: 03/25/2022] [Indexed: 12/12/2022] Open
Abstract
Dental fluorosis is caused by ingestion of excessive fluoride during tooth development resulting in hypomineralization of the enamel and can present as white or brown intrinsic lesions. This case report describes a combination of minimally invasive techniques: microabrasion, bleaching, and resin infiltration to address brown enamel fluorosis present on the maxillary anterior teeth of a young patient. Before resin infiltration, air microabrasion was targeted at subsurface lesions located on the maxillary central and lateral incisors, and chairside bleaching was done with 37% hydrogen peroxide (Opalescence). After which, hypoplastic lesions on the buccal surfaces were etched before being treated with two sessions of resin infiltration (ICON and DMG). Following treatment, satisfactory esthetic outcomes were achieved. Accurate diagnosis, depth of lesions, and understanding the effectiveness and limitations of each technique are essential to select the appropriate type of treatment to obtain the best esthetic outcome. In conclusion, the conservative management of varying severity of dental fluorosis may require the appropriate use of combination treatment modalities, such as microabrasion, bleaching and resin infiltration, when clinically indicated, to address the treatment needs and achieve a desired outcome.
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Affiliation(s)
| | - Quek Eng Yew Christopher
- Senior Lecturer, Department of Endodontics, Operative Dentistry and Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore
| | - Lee Kong Fei Frank
- Senior Lecturer, Department of Endodontics, Operative Dentistry and Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore
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Zhou Y, Huang X, Wu L, Liang Y, Huang Y, Huang S. Microleakage, microgap, and shear bond strength of an infiltrant for pit and fissure sealing. Heliyon 2023; 9:e16248. [PMID: 37229157 PMCID: PMC10205491 DOI: 10.1016/j.heliyon.2023.e16248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
Objectives This study aimed to evaluate the potential clinical application of an infiltrant with different etchants as pit and fissure sealants and to compare them with a conventional resin-based sealant. Materials and methods Seventy-five molars were randomly divided into three groups (n = 25): phosphoric acid etchant + conventional resin-based sealant (Group A); 15% hydrochloric acid etchant + infiltrant (Group B); phosphoric acid etchant + infiltrant (Group C). Fifteen teeth in each group were subjected to pit and fissure sealing procedures. After 500 thermocycling and methylene blue dye penetration, ten specimens were sectioned and the pencentages of dye penetration were measured under a stereomicroscope. Another five teeth in each group were sectioned and the microgaps between materials and enamel surface were measured using electron microscope scanning. Ten teeth in each group were used to measure shear bond strength and the failure mode was analyzed. Results The results showed that infiltrant exhibited significantly less microleakage and microgap than resin-based sealant, no matter which echant was used. Although there was no significant difference betweern the three groups, infiltrant applied with 15% hydrochloric acid etching showed higher shear bond strength than resin-based sealant etching with 35% phosphoric acid. Conclusions The infiltrant has significant advantages in reducing the degree of microleakage and microgap. Moreover, the infiltrant could achieve the same bonding strength as conventional resin-based sealant. Although, manufacturers do not currently recommend the infiltrant for fissure sealing, the potential clinical application would be an off-label use.Clinical relevance This report provides a theoretical basis for the potential clinical application of the infiltrant as a pit and fissure sealant, and provides a new perspective for selecting pit and fissure sealants.
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8
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Puleio F, Di Spirito F, Lo Giudice G, Pantaleo G, Rizzo D, Lo Giudice R. Long-Term Chromatic Durability of White Spot Lesions through Employment of Infiltration Resin Treatment. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040749. [PMID: 37109707 PMCID: PMC10146668 DOI: 10.3390/medicina59040749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/01/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: White spot lesions (WSLs) denote regions of subsurface demineralization on the enamel that manifest as opaque and milky-white regions. Treatment for WSLs is essential for both clinical and aesthetic reasons. Resin infiltration has been identified as the most efficacious solution for alleviating WSLs, but studies with long-term monitoring are scarce. The aim of this clinical study is to assess the color change stability of the lesion after four years of implementing the resin infiltration technique. Materials and Methods: Forty non-cavity and unrestored white spot lesions (WSLs) were treated with the resin infiltration technique. The color of the WSLs and adjacent healthy enamel (SAE) was assessed using a spectrophotometer at T0 (baseline), T1 (after treatment), T2 (1 year after) and T3 (4 years after). The Wilcoxon test was utilized to determine the significance of the variation of color (ΔE) between WSLs and SAE over the observed time periods. Results: When comparing the color difference ΔE (WSLs-SAE) at T0-T1, the Wilcoxon test demonstarated a statistically significant difference (p < 0.05). For ΔE (WSLs-SAE) at T1-T2 and T1-T3, the color variation was not statistically significant (p = 0.305 and p = 0.337). Conclusions: The study's findings indicate that the resin infiltration technique is an effective solution for resolving the appearance of WSLs, and the results have demonstrated stability for a minimum of four years.
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Affiliation(s)
- Francesco Puleio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy
| | - Federica Di Spirito
- Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, 84084 Baronissi, Italy
| | - Giuseppe Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy
| | - Giuseppe Pantaleo
- Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, 84084 Baronissi, Italy
| | - David Rizzo
- Independent Researcher, 98124 Messina, Italy
| | - Roberto Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy
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Adel SM, El-Harouni N, Vaid NR. White Spot Lesions: State of the Art Biomaterials and Workflows used in Prevention, Progression and Treatment. Semin Orthod 2023. [DOI: 10.1053/j.sodo.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Resin Infiltration of Non-Cavitated Enamel Lesions in Paediatric Dentistry: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121893. [PMID: 36553336 PMCID: PMC9776437 DOI: 10.3390/children9121893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
The resin infiltration (RI) technique was introduced as one of the minimal intervention dentistry strategies in addressing dental caries among the paediatric population. This technique used the low-viscosity resin monomer to infiltrate the non-cavitated carious lesion and other developmental enamel porosities, thus allowing the conservation of the tooth structure. This narrative review aims to explore the value of RI in Paediatric Dentistry. Through our search of the literature, the development of the material, their clinical applications and shortcomings, as well as the innovation that has been carried out to improve the current RI, were discussed. There are number of high-level evidence supporting the use of RI in arresting non-cavitated proximal caries lesions in primary and permanent teeth, but its efficacy in managing anterior white spot lesions is still unclear. Limited penetration depth, not radiopaque and questionable long-term colour and material stability were among the limitation of the material. Various laboratory-based studies have been conducted to improve the current properties of RI. Nevertheless, RI has emerged as one of the important micro-invasive techniques in addressing non-cavitated and anterior white-spot enamel lesions in children and adolescents with great success.
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Knaup I, Kobbe C, Ehrlich EE, Esteves-Oliveira M, Abou-Ayash B, Meyer-Lueckel H, Wolf M, Wierichs RJ. Correlation of quantitative light-induced fluorescence and qualitative visual rating in infiltrated post-orthodontic white spot lesions. Eur J Orthod 2022; 45:133-141. [PMID: 36179095 DOI: 10.1093/ejo/cjac051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The aim of this prospective, clinical single-centre study was to evaluate the masking efficacy of post-orthodontic resin infiltration after 12-month follow-up and correlate quantitative and qualitative outcome measures. METHODS Patients with completed fixed orthodontic treatment and the presence of one or more vestibular active non-cavitated white spot lesion/s (WSL) [ICDAS 1 or 2 (International Caries Detection and Assessment System)] were provided with resin infiltration 3-12 months after bracket removal. All patients (n = 31) participating before (t0) intervention were invited again and examined after 12 months (t2). Enamel demineralization was scored using quantitative light-induced fluorescence [QLF (DeltaF[flourescence], DeltaQ[lesion volume], White Spot Area)] and qualitative visual rating [11-point Likert-scale from 0 (no lesions visible on any tooth) to 10 (all teeth affected on the entire vestibular surface)]. RESULTS In 17 patients (7 female and 10 male) 112 WSL (ICDAS 1: n = 1; ICDAS 2: n = 111) in 112 teeth were (re)examined. Before treatment (t0) a significant, weak (DeltaF), and moderate (DeltaQ, White Spot Area) correlation was observed between the quantitative and the qualitative rating (P < 0.002) [median DeltaF: -7.31 (-10.4/-6.58)%; DeltaQ:-2.25 (-10.8/-0.41)% mm2; White Spot Area: 0.34 (0.05/1.16) mm2; visual rating:3.7 ± 1.2]. Resin infiltration led to significantly increased fluorescence and decreased visual scores (P < 0.001) 7 days (t1) and 12 months (t2) after treatment. No significant changes based on DeltaF [-6.55 (-7.29/-6.08)%] and on visual ratings [1.0 ± 1.0] were observed between t1 and t2 (P = 1.000). After 7 days (t1) the correlation between the quantitative and the qualitative ratings remained significant, weak to moderate (P < 0.002). After 12 months (t2) the correlation was (non-)significant and weak for DeltaF, DeltaQ, and White Spot Area (P ≤ 0.097). LIMITATIONS Since the overall masking efficacy of resin infiltration has been shown previously, an untreated control group was omitted. CONCLUSIONS When assessing the masking efficacy of infiltrated post-orthodontic WSL only a weak to moderate correlation was found between QLF values and visual ratings. Furthermore, over time this correlation decreased. Thus, it remains unclear if QLF is a viable method to assess and quantify infiltrated post-orthodontic WSL over time. TRIAL REGISTRATION German Clinical Trials Register (DRKS-ID:DRKS00005067).
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Affiliation(s)
- Isabel Knaup
- Department of Orthodontics, RWTH Aachen University Hospital, Germany
| | - Celine Kobbe
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Switzerland
| | - Eva-Elaine Ehrlich
- Department of Orthodontics, RWTH Aachen University Hospital, Germany.,Private Orthodontic Office, Goch, Germany
| | | | - Bedram Abou-Ayash
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Switzerland
| | - Hendrik Meyer-Lueckel
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Switzerland
| | - Michael Wolf
- Department of Orthodontics, RWTH Aachen University Hospital, Germany
| | - Richard J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Switzerland
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12
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Patient Satisfaction with Resin Infiltration Treatment for Masking Noncavitated White Spot Lesions on Anterior Maxillary Teeth: Two Case Reports. Case Rep Dent 2022; 2022:9180553. [PMID: 36117932 PMCID: PMC9481409 DOI: 10.1155/2022/9180553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/04/2022] [Accepted: 07/22/2022] [Indexed: 12/02/2022] Open
Abstract
Aim We assessed patient satisfaction with resin infiltration treatment outcomes for masking postorthodontic treatment noncavitated white spot lesions on anterior maxillary teeth. Background White spot lesions (WSLs) are opaque white areas of demineralization. The lesion may remineralize over time, but the opaque color usually remains, retaining the undesirable tooth color. Case Description: Resin infiltration (RI) was administered to two patients with a total of 10 anterior maxillary teeth diagnosed with noncavitated WSLs. Immediately after treatment, patients were asked about their comfort during the RI treatment and their level of satisfaction with treatment outcomes. Two weeks post-treatment, the two patients were asked again about their level of treatment outcome satisfaction and if they thought they needed a second treatment. Both reported that they were comfortable during the treatment and were extremely satisfied with the achieved treatment outcomes immediately and two weeks after the treatment and did not feel that they would need to seek further treatment to reach the desired outcome. Conclusion Resin infiltration is a comfortable, conservative treatment option providing satisfactory outcomes in masking noncavitated WSLs on anterior maxillary teeth after orthodontic treatment. Clinical Significance. Resin infiltration is a conservative treatment option to mask noncavitated WSLs after orthodontic treatment.
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Saccucci M, Corridore D, Di Carlo G, Bonucci E, Cicciù M, Vozza I. Assessment of Enamel Color Stability of Resins Infiltration Treatment in Human Teeth: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11269. [PMID: 36141540 PMCID: PMC9517161 DOI: 10.3390/ijerph191811269] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 06/16/2023]
Abstract
(1) The evolution of techniques and materials used in dentistry has led to the introduction of a technique known as micro-infiltration, using ICON infiltrating resin. The purpose of this study was to evaluate whether the resin infiltrant can remain stable in the enamel color of human teeth over time or if it causes discoloration and review current knowledge on color stability based on the literature selected solely on studies performed on human teeth and to provide a perspective on the methods proposed by clinicians in the infiltration procedure; (2) Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement; (3) Results: Twelve studies were selected for this review. The study results suggest that the device content is sufficiently comprehensive. The reviewers expressed strong support for the device's content for assessing the quality of reviews. The paper summarizes current reports regarding the color stability assessment of enamel treated by in- filtration resin confirmed in in vitro and in vivo studies; (4) Conclusions: Based on these considerations, the resin infiltration method can be recommended to improve the appearance of enamel lesions. The infiltrated lesions remained chromatically stable, showing no significant color changes in the long term.
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Affiliation(s)
- Matteo Saccucci
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Denise Corridore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Gabriele Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Elisa Bonucci
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy
| | - Iole Vozza
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
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Warner C, Hasmun NN, Elcock C, Lawson JA, Vettore MV, Rodd HD. Making white spots disappear! Do minimally invasive treatments improve incisor opacities in children with molar-incisor hypomineralisation? Int J Paediatr Dent 2022; 32:617-625. [PMID: 34797015 DOI: 10.1111/ipd.12940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/05/2021] [Accepted: 11/12/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children with molar-incisor hypomineralisation (MIH) frequently seek aesthetic treatment for incisor opacities. Surprisingly, few studies have evaluated the clinical success of such interventions. AIM To quantify the effectiveness of minimally invasive treatments in reducing enamel opacity visibility in children with MIH. DESIGN This in vitro study used digital clinical images of 23 children aged 8-16 years with MIH who underwent microabrasion and/or resin infiltration for the management of incisor opacities. Standard images were taken pre-treatment and 6 months post-treatment. Image software (Image-Pro Plus® V7) was employed to convert 24-bit RGB images to 16-bit greyscale and 145× magnification. Measurement repeatability was assessed using intra-class correlation coefficients (ICCs). Post-treatment changes in visible opacity area (mm2 ) and brightness (greyscale value) were tested using the Wilcoxon signed-rank test for related samples. RESULTS The mean total opacity surface area significantly reduced from 14.3 mm2 (SD = 7.5) to 9.4 mm2 (SD = 9.0) post-treatment. The proportion of tooth surface affected by the opacity also significantly reduced from 22.5% (SD = 10.5) to 14.7% (SD = 12.7). The mean maximum opacity brightness significantly reduced from 53 066 greyscale value (SD = 4740) to 49 040 (SD = 3796). ICC was good/excellent (0.75-1.0). CONCLUSION Minimally invasive treatment is effective in reducing the size and brightness of discrete incisor opacities. Future research should compare objective findings with patient-reported outcomes.
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Affiliation(s)
- Claire Warner
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Noren N Hasmun
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Claire Elcock
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Jennifer A Lawson
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Mario V Vettore
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Helen D Rodd
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
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Athayde GDS, Reis PPGD, Jorge RC, Americano GCA, Fidalgo TKDS, Soviero VM. Impact of masking hypomineralization opacities in anterior teeth on the esthetic perception of children and parents: A randomized controlled clinical trial. J Dent 2022; 123:104168. [PMID: 35643218 DOI: 10.1016/j.jdent.2022.104168] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the impact of treating demarcated opacities in anterior teeth on the esthetic perception of children and their parents. Additionally, the masking effect was evaluated quantitively and qualitatively. METHODS Thirty-nine patients, 8-18 years-old, presenting white-creamy opacity in permanent incisors were randomly allocated to test or control group. Test received resin infiltration and control received a placebo. The questionnaire Child's and Parent's Questionnaire about Teeth Appearance was used. The masking effect was quantitatively analyzed using the Lab System to calculate the color difference (ΔE) between the opacity and the surrounding enamel in Photoshop. Fisher's, Chi-square, Wilcoxon, Mann-Whitney tests and Spearman's correlation were applied to data analysis. RESULTS In the test group, a significant impact on physical and psychological domains in parents' and in social domain in parents' and children's perception was observed (p<0.05). Significant difference in ΔE between test and control groups was seen from 15 min of application onwards (p<0.05). After treatment, the mean ΔE was 4.07 (SD=3.07) in the test and 7.35 (SD=3.54) in the control group (p<0.01). One month later, the mean ΔE was 4.22 (SD=2.96) in the test and 6.06 (SD=2.52) in the control group (p<0.01). Total masking was seen only in the test group (p<0.01). CONCLUSION Aesthetic treatment of hypomineralization opacities in anterior teeth with resin infiltration impacted positively on parents and children. Resin infiltration reduced the color difference between opacities and sound enamel significantly after an application time of at least fifteen minutes. CLINICAL SIGNIFICANCE Opacities in anterior teeth impact the self-image of children and parents negatively. This study demonstrated that 15 min resin infiltration can mask opacities in permanent incisors and recover social wellbeing. This minimally invasive approach can be offered to MIH children who report dissatisfaction with their incisors.
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Affiliation(s)
- Glaucia Dos Santos Athayde
- Department of Preventive and Community Dentistry, Dental School, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; Dental School, Centro Universitário Serra dos Órgãos, Teresópolis, Brazil
| | - Patrícia Papoula Gorni Dos Reis
- Department of Preventive and Community Dentistry, Dental School, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; Dental School, Centro Universitário Arthur Sá Earp Neto, Petrópolis, Brazil
| | - Roberta Costa Jorge
- Department of Preventive and Community Dentistry, Dental School, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; Dental School, Centro Universitário Arthur Sá Earp Neto, Petrópolis, Brazil
| | | | - Tatiana Kelly da Silva Fidalgo
- Department of Preventive and Community Dentistry, Dental School, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vera Mendes Soviero
- Department of Preventive and Community Dentistry, Dental School, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; Dental School, Centro Universitário Arthur Sá Earp Neto, Petrópolis, Brazil.
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16
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Mathias P, Farias JO, Cunha MA, Martins V. Microinvasive esthetic approach for deep enamel white spot lesion. Dent Res J (Isfahan) 2022. [DOI: 10.4103/1735-3327.340114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Lygidakis NA, Garot E, Somani C, Taylor GD, Rouas P, Wong FSL. Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH): an updated European Academy of Paediatric Dentistry policy document. Eur Arch Paediatr Dent 2022; 23:3-21. [PMID: 34669177 PMCID: PMC8926988 DOI: 10.1007/s40368-021-00668-5] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 12/16/2022]
Abstract
AIM To update the existing European Academy of Paediatric Dentistry (EAPD) 2010 policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with Molar-Incisor-Hypomineralisation (MIH).' METHODS Experts, assigned the EAPD, worked on two different topics: (A) Aetiological factors involved in MIH, and (B) Treatment options for the clinical management of MIH. The group prepared two detailed systematic reviews of the existing literature relevant to the topics and following a consensus process produced the updated EAPD policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH).' The GRADE system was used to assess the quality of evidence regarding aetiology and treatment which was judged as HIGH, MODERATE, LOW or VERY LOW, while the GRADE criteria were used to indicate the strength of recommendation regarding treatment options as STRONG or WEAK/CONDITIONAL. RESULTS (A) Regarding aetiology, it is confirmed that MIH has a multifactorial aetiology with the duration, strength and timing of occurrence of the aetiological factors being responsible for the variable clinical characteristics of the defect. Perinatal hypoxia, prematurity and other hypoxia related perinatal problems, including caesarean section, appear to increase the risk of having MIH, while certain infant and childhood illnesses are also linked with MIH. In addition, genetic predisposition and the role of epigenetic influences are becoming clearer following twin studies and genome and single-nucleotide polymorphisms analyses in patients and families. Missing genetic information might be the final key to truly understand MIH aetiology. (B) Regarding treatment options, composite restorations, preformed metal crowns and laboratory indirect restorations provide high success rates for the posterior teeth in appropriate cases, while scheduled extractions provide an established alternative option in severe cases. There is great need for further clinical and laboratory studies evaluating new materials and non-invasive/micro-invasive techniques for anterior teeth, especially when aesthetic and oral health related quality of life (OHRQoL) issues are concerned. CONCLUSIONS MIH has been studied more extensively in the last decade. Its aetiology follows the multifactorial model, involving systemic medical and genetic factors. Further focused laboratory research and prospective clinical studies are needed to elucidate any additional factors and refine the model. Successful preventive and treatment options have been studied and established. The appropriate choice depends on the severity of the defects and the age of the patient. EAPD encourages the use of all available treatment options, whilst in severe cases, scheduled extractions should be considered.
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Affiliation(s)
- N A Lygidakis
- Private Paediatric Dental Clinic, 2 Papadiamantopoulou Street, 11528, Athens, Greece.
| | - E Garot
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - C Somani
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - P Rouas
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - F S L Wong
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent 2022; 23:39-64. [PMID: 34110615 PMCID: PMC8927013 DOI: 10.1007/s40368-021-00635-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, 'What are the treatment options for teeth in children affected by molar incisor hypomineralisation?' METHODS An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers. RESULTS Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed. CONCLUSION The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.
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19
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Comparison of bleaching effects when applied to white-spot lesions before or after resin infiltration: An in vitro study. J Am Dent Assoc 2021; 153:39-49. [PMID: 34763817 DOI: 10.1016/j.adaj.2021.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The purpose of this study was to compare color alterations (ΔE) of white-spot lesions (WSLs) bleached before versus after resin infiltration (RI). METHODS Using the facial surfaces of bovine maxillary incisors, WSLs were created and the teeth were allocated into 2 groups (n = 45/group): bleach then RI (B-RI group) and RI then bleach (RI-B group). To determine ΔE, Commission Internationale de l'Eclairage L∗ a∗ b∗ (L∗ represents lightness, ranging from black to white [0-100]; a∗ represents green to red chromaticity [-150-+100]; and b∗ represents blue to yellow chromaticity [-100-+150]) measurements were obtained at baseline, after WSL formation, and after RI and bleaching. Representative specimens were evaluated by means of scanning electron microscopy. Statistical analyses included the Mann-Whitney U and Wilcoxon signed rank tests (P ≤ .0016) and repeated measures analysis of variance (P ≤ .05). RESULTS No differences in ΔE were found comparing B-RI with RI-B groups or when the B-RI group was compared with bleached enamel. A statistically significant difference was found when the RI-B group was compared with bleached enamel (ΔE, 0.81; P < .001), but the difference was deemed not clinically significant. Scanning electron microscopy revealed that bleaching after RI increased surface roughness of the resin. CONCLUSIONS There were no clinically significant differences in ΔE of WSLs when bleach was applied before or after RI; however, applying bleaching agent after RI roughened the surface of the resin material. PRACTICAL IMPLICATIONS Results indicate that ΔE were not clinically significantly different between WSLs bleached before versus after RI, although it is best to sequence bleaching before RI therapy, as bleaching after RI roughened the restoration's surface.
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20
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Marouane O, Manton DJ. The influence of lesion characteristics on application time of an infiltrate applied to MIH lesions on anterior teeth: An exploratory in vivo pilot study. J Dent 2021; 115:103814. [PMID: 34543698 DOI: 10.1016/j.jdent.2021.103814] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate the factors that influences the kinetics of resin infiltration of molar incisor hypomineralisation (MIH) lesions on permanent anterior teeth. METHODS Demarcated MIH lesions with homogeneous and heterogeneous lesion body appearance, Types 1 (n = 14) and 2 (n = 18), respectively, were selected. After removal of the lesion surface layer using a tapered diamond finishing bur, the lesions were etched and ethanol was applied to the lesions and it was determined if the lesion was still visible or not. Images were taken just prior infiltrant (Icon; DMG) application (T0), during the infiltration process (Tx) and when infiltration had ceased progressing or opacity disappearance was clinically apparent (Tmax). Surface-area measurements of the opacity and infiltrated area were calculated and the infiltration proportion (IPx) was calculated over the infiltration time. RESULTS Type 1 and positive ethanol test lesions showed significantly lower mean Tmax (3.4 min) in comparison with Type 2 and negative ethanol test lesions (9.9 min) [Student t-test/Fisher's exact test; p < .01]. A non-linear correlation was observed (R2 = 0.88) indicating that the IPx was rapid at the beginning of resin application, decreasing over time. CONCLUSION In comparison with Type 1 and positive ethanol test lesions, Type 2 and negative ethanol test lesions require longer application time to infiltrate. CLINICAL SIGNIFICANCE MIH-lesion type and the 'ethanol test' were reliable predictive factors for the application time required for infiltrating MIH lesions on permanent anterior teeth.
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Affiliation(s)
- Omar Marouane
- Restorative Dentistry and Endodontics, Private Practice, Oralys Dental Clinic Tunis, Tunisia.
| | - David John Manton
- Paediatric Dentistry and Cariology, Centrum voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen, Groningen, the Netherlands.
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21
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Bourouni S, Dritsas K, Kloukos D, Wierichs RJ. Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis - a systematic review and meta-analysis. Clin Oral Investig 2021; 25:4711-4719. [PMID: 34106348 PMCID: PMC8342329 DOI: 10.1007/s00784-021-03931-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/30/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The present review systematically analyzed clinical studies investigating the efficacy of resin infiltration on post-orthodontic or non-post-orthodontic, white spot lesions (WSL), or fluorosis. MATERIALS Five electronic databases (Central, PubMed, Ovid MEDLINE, Ovid EMBASE, LILACS) were screened. Article selection and data abstraction were done in duplicate. No language or time restrictions were applied. Outcomes were visual-tactile or DIAGNOdent measurements. RESULTS Eleven studies with 1834 teeth being affected in 413 patients were included. Nine studies were randomized control trials, one a prospective cohort study, and one had an unclear study design. Meta-analysis could be performed for "resin infiltration vs. untreated control," "resin infiltration vs. fluoride varnish," and "resin infiltration without bleaching vs. resin infiltration with bleaching." WSL being treated with resin infiltration showed a significantly higher optical improvement than WSL without any treatment (standard mean difference (SMD) [95% CI] = 1.24 [0.59, 1.88], moderate level of evidence [visual-tactile assessment]) and with fluoride varnish application (mean difference (MD) [95% CI] = 4.76 [0.74, 8.78], moderate level of evidence [DIAGNOdent reading]). In patients with fluorosis, bleaching prior to resin infiltration showed no difference in the masking effect compared to infiltration alone (MD [95% CI] = - 0.30 [- 0.98, 0.39], moderate level of evidence). CONCLUSION Resin infiltration has a significantly higher masking effect than natural remineralization or regular application of fluoride varnishes. However, although the evidence was graded as moderate, this conclusion is based on only very few well-conducted RCTs. CLINICAL RELEVANCE Resin infiltration seems to be a viable option to esthetically mask enamel white spot lesions and fluorosis.
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Affiliation(s)
- S Bourouni
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - K Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - D Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - R J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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Divyameena B, Sherwood A, Rathna Piriyanga S, Deepika G. Clinical Performance of Enamel Microabrasion for Esthetic Management of Stained Dental Fluorosis Teeth. Oper Dent 2021; 46:15-24. [PMID: 32926733 DOI: 10.2341/19-248-c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2020] [Indexed: 11/23/2022]
Abstract
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
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23
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Nogueira VKC, Mendes Soares IP, Fragelli CMB, Boldieri T, Manton DJ, Bussaneli DG, Cordeiro RDCL. Structural integrity of MIH-affected teeth after treatment with fluoride varnish or resin infiltration: An 18-Month randomized clinical trial. J Dent 2020; 105:103570. [PMID: 33385533 DOI: 10.1016/j.jdent.2020.103570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/28/2020] [Accepted: 12/19/2020] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To evaluate the influence of fluoride varnish (FV) therapies or resin infiltration (RI) to maintain the structural integrity of Molar Incisor Hypomineralization (MIH) -affected teeth. METHODS Fifty-one children aged 6-12 years with at least one incisor and one first permanent molar with yellow/brown MIH opacities were included. Patients were randomly allocated into three groups: FV - Fluoride Varnish (Duraphat); FV+etch - Fluoride Varnish (Duraphat) after enamel etching with 37% phosphoric acid; or RI - Resin Infiltration system (Icon). Opacities were monitored for 18 months. The primary outcome was the loss of integrity due to post-eruptive enamel breakdown (PEB). Covariables included sex, age, DMFT index, opacity colour, plaque index, number of MIH-affected teeth, and number of MIH-affected surfaces. Fisher's Exact was used to test the association of treatments with PEB, the Kaplan-Meyer method analysed the survival rates and Cox-regression determined which covariables would predict failure (α=0.05). RESULTS From a total of 235 teeth, the PEB rate for RI (6.1%) was significantly lower (p<0.05) than FV (17.9%; OR 3.0, 95%CI 1.07, 8.48) and FV+etch (17.3%; OR 3.1, 95%CI 1.13, 8.73). DMFT index >3, brown opacities, cusp involvement, and age between 6-8 years predicted PEB (p<0.05). CONCLUSIONS Resin infiltration positively influenced the structural integrity maintenance of MIH-affected teeth by decreasing the risk of enamel breakdown over18 months follow-up. Registry of Clinical Trials (RBR-8wwk3n). CLINICAL RELEVANCE Resin infiltration proved to be a more efficacious intervention to maintain the structural integrity of MIH-affected teeth than fluoride varnish therapies.
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Affiliation(s)
- Vinícius Krieger Costa Nogueira
- Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
| | - Igor Paulino Mendes Soares
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University (UNESP). Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
| | - Camila Maria Bullio Fragelli
- Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
| | - Talita Boldieri
- Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
| | - David John Manton
- Melbourne Dental School, The University of Melbourne, Victoria, 3010, Australia; Cariology and Paediatric Dentistry, Centrum voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen.
| | - Diego Girotto Bussaneli
- Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
| | - Rita de Cássia Loiola Cordeiro
- Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
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Enan E, Tawfik MA, Mehesen R, Basha S. Remineralization Potential and Shear Bond Strength of Surface Treated Hypomineralized Enamel in Bonding of Orthodontic Brackets: An In Vitro Study. JOURNAL OF ADVANCED ORAL RESEARCH 2020. [DOI: 10.1177/2320206820977734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: To investigate the effect of different conditioning methods on remineralization potential of hypomineralized enamel and its shear bond strength (SBS) to orthodontic brackets. Materials and Methods: An in vitro study was conducted at Mansoura University, Egypt. Eighty premolars were collected and randomly classified into four groups ( n = 20 each) as follows: Group 1. Control (sound teeth), Group 2. Demineralized, Group 3. Demineralized and treated with nanohydroxyapatite (nano-HA) varnish, Group 4. Demineralized and treated with casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) paste. To detect the rate of remineralization on the surface of treated specimens, energy dispersive X-ray (EDX) analysis was used in conjunction with the scanning electron microscope (SEM). The SBS was measured with a universal testing machine. One-way ANOVA test was carried out to analyze differences between the tested groups. Result: SE micrographs of Group 3 and Group 4 specimens showed smoother and less porous enamel surface than that of the Group 2 specimens. EDX analysis showed highest calcium (Ca) (25.47%) and phosphorous (P) (12.76%) values for Group 4 while Group 2 showed the lowest Ca and P values (16.96%) and (10.20%), respectively ( P < .001). Demineralized enamel showed lowest (3.70 MPa) SBS mean value compared to sound (10.69 MPa) and remineralized enamel (Group 3—9.90 MPa, Group 4—10.32 MPa) ( P < .001). Conclusion: Nano-HA and CPP–ACP have equal remineralizing effect on hypomineralized enamel lesions and positive influence on SBS.
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Affiliation(s)
- EnasTawfik Enan
- Department of Dental Biomaterials, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Marwa Ali Tawfik
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Rabab Mehesen
- Department of Conservative Dentistry, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Sakeenabi Basha
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
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Sampson V, Sampson A. Diagnosis and treatment options for anterior white spot lesions. Br Dent J 2020; 229:348-352. [PMID: 32978577 DOI: 10.1038/s41415-020-2057-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Indexed: 11/10/2022]
Abstract
White spot lesions on teeth present as white opacities due to enamel surface and/or subsurface demineralisation. Unfortunately, dentistry has seen a marked jump in prevalence and severity of white spot lesions over the past decade. In response to the rise in white spot lesions, the dental industry has been pushed to create less invasive alternatives for the removal of these lesions, particularly when located anteriorly. There are numerous different causes of white spot lesions that influence how the enamel substructure is affected and which treatment option is selected. Once, the only treatment option for white spot lesions was drilling the defects away, but with a better understanding of the science and the aetiology, we have now been able to create minimally invasive, preventive alternatives. It is vital that the cause, size and depth of the white spot lesions are ascertained before providing treatment options to a patient, as treatment results will vary depending on the enamel substructure available. This paper will explore the main causes of white spot lesions and the recommended treatments for them.
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Affiliation(s)
| | - Ariane Sampson
- Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Department of Oral and Maxillofacial Surgery and Orthodontics, UK
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Klaisiri A, Janchum S, Wongsomtakoon K, Sirimanathon P, Krajangta N. Microleakage of resin infiltration in artificial white-spot lesions. J Oral Sci 2020; 62:427-429. [PMID: 32830164 DOI: 10.2334/josnusd.19-0321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study examined the effectiveness of resin infiltration in inhibiting microleakage from artificial white-spot lesions (AWL) in enamel. Fifty sound extracted premolars were selected and randomly divided into five groups (n = 10 each). Group 1 included sound teeth. In contrast, an AWL was created in all specimens in groups 2 to 5, as follows-Group 2: AWL with no treatment; Group 3: AWL treated with resin infiltration; Group 4: AWL treated with resin infiltration and 5,000 cycles of thermocycling; Group 5: AWL treated with resin infiltration and 10,000 cycles of thermocycling. All specimens were then coated with nail varnish, except for a 4 × 4 mm2 area on the buccal surface (the measurement area), immersed in 2% methylene blue solution, and sectioned buccolingually. Microleakage was evaluated with a stereomicroscope. Data were analyzed by using the Kruskal-Wallis test and Bonferroni post-hoc correction. Application of resin infiltrant reduced microleakage in AWL. No microleakage was seen in Group 3, and differences between Groups 3, 4, and 5 were not significant (P > 0.05). The resin infiltration technique appears to aid in sealing enamel AWL and may help provide long-term protection against microleakage in enamel AWL.
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Affiliation(s)
- Awiruth Klaisiri
- Division of Operative Dentistry, Faculty of Dentistry, Thammasat University
| | | | | | | | - Nantawan Krajangta
- Division of Operative Dentistry, Faculty of Dentistry, Thammasat University
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Sadyrin E, Swain M, Mitrin B, Rzhepakovsky I, Nikolaev A, Irkha V, Yogina D, Lyanguzov N, Maksyukov S, Aizikovich S. Characterization of Enamel and Dentine about a White Spot Lesion: Mechanical Properties, Mineral Density, Microstructure and Molecular Composition. NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E1889. [PMID: 32967152 PMCID: PMC7560001 DOI: 10.3390/nano10091889] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/10/2020] [Accepted: 09/17/2020] [Indexed: 11/17/2022]
Abstract
The study focuses on in vitro tracing of some fundamental changes that emerge in teeth at the initial stage of caries development using multiple approaches. The research was conducted on a mostly sound maxillary molar tooth but with a clearly visible natural proximal white spot lesion (WSL). Values of mineral density, reduced Young's modulus, indentation hardness and creep as well as the molecular composition and surface microstructure of the WSL and bordering dentine area were studied. The results obtained were compared to those of sound enamel and dentine on the same tooth. A decrease of mechanical properties and mineral density both for the WSL and bordering dentine was detected in comparison to the sound counterparts, as well as increase of creep for the enamel WSL. Differences in molecular composition and surface microstructure (including the indenter impressions) were found and described. WSL induces a serious change in the state of not only the visually affected enamel but also surrounding visually intact enamel and dentine in its vicinity. The results provide the basis for future studies of efficacy of minimal invasive treatments of caries.
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Affiliation(s)
- Evgeniy Sadyrin
- Research and Education Center “Materials”, Don State Technical University, Gagarin Square 1, 344000 Rostov-on-Don, Russia; (M.S.); (B.M.); (A.N.); (V.I.); (S.A.)
| | - Michael Swain
- Research and Education Center “Materials”, Don State Technical University, Gagarin Square 1, 344000 Rostov-on-Don, Russia; (M.S.); (B.M.); (A.N.); (V.I.); (S.A.)
- Biomaterials and Bioengineering department, Faculty of Dentistry, The University of Sydney, Camperdown, Sydney NSW 2006, Australia
| | - Boris Mitrin
- Research and Education Center “Materials”, Don State Technical University, Gagarin Square 1, 344000 Rostov-on-Don, Russia; (M.S.); (B.M.); (A.N.); (V.I.); (S.A.)
| | - Igor Rzhepakovsky
- Institute of Life Sciences, North Caucasus Federal University, Pushkin Street 1, 355009 Stavropol, Russia;
| | - Andrey Nikolaev
- Research and Education Center “Materials”, Don State Technical University, Gagarin Square 1, 344000 Rostov-on-Don, Russia; (M.S.); (B.M.); (A.N.); (V.I.); (S.A.)
| | - Vladimir Irkha
- Research and Education Center “Materials”, Don State Technical University, Gagarin Square 1, 344000 Rostov-on-Don, Russia; (M.S.); (B.M.); (A.N.); (V.I.); (S.A.)
- Federal Research Centre The Southern Scientific Centre of the Russian Academy of The Sciences, Chehova Street 41, 344006 Rostov-on-Don, Russia
| | - Diana Yogina
- Department of dentistry, Rostov State Medical University, Nakhichevansky Lane 29, 344022 Rostov-on-Don, Russia; (D.Y.); (S.M.)
| | - Nikolay Lyanguzov
- Faculty of Physics, Southern Federal University, Bolshaya Sadovaya Street 105/42, 344090 Rostov-on-Don, Russia;
| | - Stanislav Maksyukov
- Department of dentistry, Rostov State Medical University, Nakhichevansky Lane 29, 344022 Rostov-on-Don, Russia; (D.Y.); (S.M.)
| | - Sergei Aizikovich
- Research and Education Center “Materials”, Don State Technical University, Gagarin Square 1, 344000 Rostov-on-Don, Russia; (M.S.); (B.M.); (A.N.); (V.I.); (S.A.)
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Gaglianone LA, Pfeifer CS, Mathias C, Puppin-Rontani RM, Marchi GM. Can composition and preheating improve infiltrant characteristics and penetrability in demineralized enamel? Braz Oral Res 2020; 34:e099. [PMID: 32785474 DOI: 10.1590/1807-3107bor-2020.vol34.0099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 06/09/2020] [Indexed: 11/22/2022] Open
Abstract
The composition of infiltrants can influence their physical properties, viscosity and depth of penetration (DP). Strategies are used to increase the DP, such as the addition of diluents or the use of heat. This study aimed to evaluate the effect of preheating and composition on physical properties and DP of infiltrants in demineralized enamel. The groups were assigned, and the following experimental formulations were made: 25%BisEMA +75%TEGDMA; 25%BisEMA +65%TEGDMA +10%ethanol; 25%BisEMA +65%TEGDMA +10%HEMA; 100%TEGDMA; 90%TEGDMA +10%ethanol; 90%TEGDMA +10%HEMA. The samples were photoactivated at two temperatures (25°C and 55°C). Degree of conversion (DC) was performed using an infrared spectrophotometer. Elastic modulus (E), flexural strength (FS) and contact angle (CA) tests were also performed. The DP of an infiltrant in demineralized enamel was determined by confocal laser scanning microscopy (CLSM) using an indirect labeling technique. The data were analyzed by two-way ANOVA and Tukey's test. DC increased after preheating in all the groups; however, 90%TEGDMA+10%ethanol showed the lowest DC for both temperatures, and the lowest E. Preheating did not influence E or FS. The CA increased at 55°C for most groups, but decreased for groups containing HEMA. Temperature did not seem to influence DP, and Icon showed the lowest DP values. The 100%TEGDMA composition showed more homogeneous penetration, whereas Icon showed heterogeneous and superficial penetration. The preheating technique does not improve all properties in all the material compositions. The composition of a material can influence and improve its properties.
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Affiliation(s)
- Livia Aguilera Gaglianone
- Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Carmem Silvia Pfeifer
- Division of Biomaterials and Biomechanics, School of Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Caroline Mathias
- Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Regina Maria Puppin-Rontani
- Department of Pediatric Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Giselle Maria Marchi
- Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
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Enamel around orthodontic brackets coated with flash-free and conventional adhesives. J Orofac Orthop 2020; 81:419-426. [PMID: 32696069 DOI: 10.1007/s00056-020-00241-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 05/12/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate enamel roughness and color after debonding flash-free adhesive precoated brackets and brackets coated with conventional orthodontic adhesives using nonbonded enamel as control. MATERIALS AND METHODS A total of 80 extracted human premolars were divided into the following four groups: group I: APCTM Flash-Free adhesive precoated brackets; group II: APCTM PLUS adhesive precoated brackets; group III: noncoated brackets, which were coated manually at the time of bonding (all three brackets were ClarityTM Advanced ceramic brackets [3M Unitek, Monrovia, CA, USA]); group IV: nonbonded enamel (control). Bonded premolars were subjected to demineralization, and then brackets were debonded. Each group was then divided into two subgroups to assess enamel around the debonded brackets, and also enamel in the control group, using an atomic force microscope and spectrophotometer. In addition, 12 samples were used to assess the bracket/adhesive/enamel junction with a scanning electron microscope. RESULTS Mean values of root mean square roughness (Rq) and maximum profile valley depth (Rv) for APCTM Flash-Free, APCTM PLUS, and ClarityTM Advanced groups were 140 nm and 482 nm, 210 nm and 727 nm, and 447 nm and 1243 nm, respectively. All three groups showed higher roughness and depth values than the control enamel. Spectrophotometer results yielded ∆E* of 3.7 ± 0.6, 5.1 ± 0.4, and 7.1 ± 0.6 for APC™ Flash-Free, APC™ PLUS, and ClarityTM Advanced groups respectively. Color coordinates showed progressively higher L* and b* values and progressively lower a* values from group I to group III. CONCLUSIONS Under the same demineralization conditions, enamel around debonded APC™ Flash-Free adhesive precoated brackets showed less roughness and color changes compared to the other two groups.
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Lo Giudice R, Lipari F, Puleio F, Alibrandi A, Lo Giudice F, Tamà C, Sazonova E, Lo Giudice G. Spectrophotometric Evaluation of Enamel Color Variation Using Infiltration Resin Treatment of White Spot Lesions at One Year Follow-Up. Dent J (Basel) 2020; 8:E35. [PMID: 32290119 PMCID: PMC7344573 DOI: 10.3390/dj8020035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 11/29/2022] Open
Abstract
The aim of this study is to evaluate the color changes and the stability at a 1-year follow-up of white spot lesions (WSLs) treated with an infiltrating technique by using etching and TEGDMA resin. The color of 22 white spot lesions and the sound adjacent enamel (SAE) were assessed with a spectrophotometer at T0 (baseline), T1 (after treatment), and T2 (1 year after). The color change ΔE (WSLs-SAE) at T0 vs. T1 were compared to evaluate the camouflage effect efficiency, and at T1 vs. T2 to assess the stability of outcomes. To evaluate the effect on the treatment outcome of gender, the presence or not of previous orthodontic treatment, WSLs onset more/less than 10 years, the age of the patient, and the ΔE WSL (T0 vs. T1) was analyzed. The difference between ΔE (WSLs-SAE) at T0 and T1 resulted in statistical significance (p < 0.01). No statistical difference was found between ΔE (WSLs-SAE) at T1 vs. T2. The variables considered showed no statistical differences in treatment outcomes. The results of our investigation show that the technique used is immediately effective and the camouflage effect keeps up and steady one year after treatment. Such results do not appear to be influenced by analyzed clinical variables.
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Affiliation(s)
- Roberto Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy
| | - Frank Lipari
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Francesco Puleio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Angela Alibrandi
- Department of Economics, Section of Statistical and Mathematical Sciences, Messina University, 98100 Messina, Italy;
| | - Fabrizio Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Cristina Tamà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Evgenia Sazonova
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Giuseppe Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
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Hammad SM, El-Wassefy NA, Alsayed MA. Evaluation of color changes of white spot lesions treated with three different treatment approaches: an in-vitro study. Dental Press J Orthod 2020; 25:26-27. [PMID: 32215474 PMCID: PMC7077944 DOI: 10.1590/2177-6709.25.1.27.e1-7.onl] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 08/27/2018] [Indexed: 11/21/2022] Open
Abstract
Objective: To qualitatively and quantitatively assess the color changes effect and the color stability of the resin infiltrant on white spot lesions (WSLs), in comparison with nano-hydroxyapatite (nano-HA) toothpaste and microabrasion. Methods: WSLs were artificially created on sixty human premolars enamel surfaces and randomly assigned to equal four groups (n = 15 each): nano-HA toothpaste, microabrasion (Opalusture), resin infiltrant (Icon) treatment, or artificial saliva (control group). The color change (ΔE) of each specimen was measured by dental spectrophotometer (Vita Easyshade) at different time points: baseline, after WSLs’ creation, after application of treatments, one month, three and six months after treatments application. Results: The ΔE value did not differ significantly for the four groups at baseline measurement before treatment (p> 0.05). Icon resin infiltrant improved the color of WSLs significantly immediately after its application, giving the lowest ΔE value (3.00 ± 0.59), when compared to other treatments (p< 0.001). There were no significant changes in ΔE (p> 0.05) for all groups during the follow up intervals (one month, three and six months after treatments application). Conclusion: Resin infiltrant can improve the color of WSLs and restore the natural appearance of enamel better than nano-HA toothpaste and microabrasion.
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Affiliation(s)
- Shaza M Hammad
- Mansoura University, Faculty of Dentistry, Department of Orthodontics (Mansoura, Egypt)
| | - Noha A El-Wassefy
- Mansoura University, Faculty of Dentistry, Department of Dental Biomaterials (Mansoura, Egypt)
| | - Mohamed A Alsayed
- Mansoura University, Faculty of Dentistry, Department of Orthodontics (Mansoura, Egypt)
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de Oliveira Correia AM, Bühler Borges A, Torres CRG. Color masking prediction of posterior white spot lesions by resin infiltration in vitro. J Dent 2020; 95:103308. [PMID: 32112912 DOI: 10.1016/j.jdent.2020.103308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/22/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To investigate parameters that could predict the color masking effect (ME) of white spot lesions (WSLs) after resin infiltration (RI). METHODS Sixty extracted human teeth with natural WSLs were selected (28 premolars, 29 molars and 3 incisors). At baseline, the laser fluorescence (LF) of surrounding sound enamel (SE) and the WSLs were analyzed with DIAGNOdent. Standardized photographs were obtained under D65 and UV illuminants, from which the CIE L*a*b* color coordinates and natural fluorescence (NF) of the WSLs and SE were obtained. The color difference (ΔE00) and differences of NF and LF between the SE and WSLs were calculated. The lesion dimensions (area, perimeter, width, and height) were determined. After RI, the assessments were repeated. ME was considered as the reduction of ΔE00 values after RI. One-way ANOVA and the Tukey tests were used to analyze the absolute means of the LF and NF values. The t test was used to compare the ΔE00 values and lesion dimensions before and after infiltration. The correlations between all parameters at baseline and ME were analyzed. RESULTS The absolute mean values of LF at the baseline (B) and after infiltration (I) were SE/B-3.98a, WSL/B-13.28c, SE/I-3.36a, WSL/I-7.95b (p = 0.001). The mean values for NF were SE/B-7.93a; WSL/B-6.29b, SE/I-7.93a, WSL/I-7.27a (p = 0.001). The results for ΔE00 were B-11.74a, I-8.66b (p = 0.001). RI significantly reduced lesion dimensions. No correlations were observed between the baseline parameters and the ME. CONCLUSIONS The WSLs presented higher LF and smaller NF than SE, which were respectively reduced and increased after RI. Prediction of the masking effect by the parameters evaluated at baseline was not possible, which could be due to the choice of mainly caries lesions in posterior teeth. Nonetheless, infiltration was found suitable to mask most of the WSL. CLINICAL SIGNIFICANCE The color masking effect of white spot lesions after resin infiltration cannot be predicted by a previous analysis of fluorescence, color, or dimensions of the lesion.
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Affiliation(s)
- Ayla Macyelle de Oliveira Correia
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
| | - Alessandra Bühler Borges
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
| | - Carlos Rocha Gomes Torres
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
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Bhandari R, Thakur S, Singhal P, Chauhan D, Jayam C, Jain T. In vivo Comparative Evaluation of Esthetics after Microabrasion and Microabrasion followed by Casein Phosphopeptide-Amorphous Calcium Fluoride Phosphate on Molar Incisor Hypomineralization-Affected Incisors. Contemp Clin Dent 2020; 10:9-15. [PMID: 32015635 PMCID: PMC6975009 DOI: 10.4103/ccd.ccd_852_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Molar incisor hypomineralization (MIH) is an esthetic setback for the patient as well as for the dentist, treatment options for MIH includes minimally invasive techniques like microabrasion which has a limited literature of its effect. Furthermore, the effect of remineralizing such as casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) agent on MIH-affected teeth is minimally studied. Aim: Comparative evaluation of the esthetic after microabrasion and microabrasion followed by Tooth Mousse Plus on hypomineralized incisors of MIH-affected patients. Settings and Design: The study was a randomized clinical trial. Materials and Methods: The study comprised Grade I MIH patients in the age strata of 7–16 years having lesions on incisors. As per inclusion criteria, 46 lesions were divided into two groups of microabrasion and microabrasion followed by CPP-amorphous calcium fluoride phosphate (ACFP). Photographs were obtained before treatment, just after treatment, and 6 months after treatment. The photographic evaluation was done using the CIE L*a*b* scoring method. Statistical Analysis Used: ANOVA and posthoc Tukey's test were applied to compare the difference in lightness ΔL and total color change ΔE of these two groups. Results: In microabrasion group, the overall change in ΔL of white tooth discoloration came −0.9 standard deviation (SD) 7.3. In microabrasion followed by CPP-ACFP group, statistically significant difference was found between both these groups with P value of P ≤ 0.001. Conclusions: Microabrasion followed by the remineralizing agent can improve the esthetics of white tooth discoloration with time.
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Affiliation(s)
- Ranu Bhandari
- Department of Pedodontics, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Seema Thakur
- Department of Pedodontics, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Parul Singhal
- Department of Pedodontics, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Deepak Chauhan
- Department of Pedodontics, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Cheranjeevi Jayam
- Department of Pedodontics, H.P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Teerthesh Jain
- School of Dental Medicine, University of Colorado, Denver, Colorado, USA
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Krasniqi S, Sejdini M, Stubljar D, Jukic T, Ihan A, Aliu K, Aliu X. Antimicrobial Effect of Orthodontic Materials on Cariogenic Bacteria Streptococcus mutans and Lactobacillus acidophilus. Med Sci Monit Basic Res 2020; 26:e920510. [PMID: 31959737 PMCID: PMC6993557 DOI: 10.12659/msmbr.920510] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND White spot lesions (WSLs) are a common complication after orthodontic treatment. The aim of this study was to characterize and compare the antimicrobial properties of selenium-containing vs. fluoride-containing orthodontic materials. MATERIAL AND METHODS Antibacterial efficacy of orthodontic materials (SeLECT Defense bonding agent, Adhesive agent, Band Cement, Transbond Plus SEP bonding agent, Transbond Plus Adhesive agent, Fuji I Band cement, Fuji Ortho LC Adhesive agent, Ortho Solo Bonding agent, Transbond XT bonding agent, and Transbond XT primer) was tested with the inhibition of 2 bacterial strains: S. mutans (ATCC 10449) and L. acidophilus (ATCC 4356). The antimicrobial efficacy of the materials was measured by agar diffusion test. The diameters of inhibition zones around each disk were measured in millimeters (mm). RESULTS Materials containing selenium and fluoride showed significant differences from the negative control (both p<0.001). Orthodontic materials containing fluoride as a potential antimicrobial agent showed larger zones of inhibition in total (9.1±2.6 mm), the selenium group was the second-most effective (4.7±4.9 mm), and the group without any potential antimicrobial agent showed the least antimicrobial effect (0.9±1.0 mm). Materials from the group with no antibacterial agent were not significantly different from the negative control group (p>0.05). CONCLUSIONS Materials containing selenium carried the most significance when comparing microorganisms with the agent, since they were the only ones showing difference between the 2 microorganisms. They showed statistically significant difference in efficacy against S. mutans, and poor antimicrobial effect against L. acidophilus. These data suggest that orthodontic materials containing selenium might have the potential to prevent WSLs due to their antimicrobial properties.
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Affiliation(s)
- Sokol Krasniqi
- Faculty of Medicine, University of Pristina, Pristina, Kosovo
| | - Milaim Sejdini
- Faculty of Medicine, University of Pristina, Pristina, Kosovo
| | - David Stubljar
- Department of Research and Development, In-Medico, Metlika, Slovenia
| | - Tomislav Jukic
- Department of Internal Medicine, History of Medicine and Medical Ethics, Faculty of Medicine, Osijek, Croatia
| | - Alojz Ihan
- Medical Faculty, Institute of Microbiology and Immunology, Ljubljana, Slovenia
| | - Kaltrina Aliu
- Faculty of Medicine, University of Pristina, Pristina, Kosovo
| | - Xhevdet Aliu
- Faculty of Dentistry, University for Business and Technology, Pristina, Kosovo
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Sekundo C, Frese C. 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. Oper Dent 2020; 45:10-18. [PMID: 31373889 DOI: 10.2341/18-242-l] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Pronounced white color alterations due to structural anomalies of the enamel are often insufficiently masked by bleaching techniques or resin infiltration procedures alone. This frequently leads to the choice of more invasive prosthetic restorations in order to correct tooth color and form. This article describes a minimally invasive treatment option for esthetic and functional rehabilitation in the case of a 13-year-old female patient with suspected severe fluorosis and misalignment of the anterior teeth. The restorations were performed using underlying resin infiltration to homogenize the tooth shade. In a second step, direct composite veneers were applied on top to attain a natural tooth color and adjust tooth alignment and form. By joining the two minimally and noninvasive techniques, this treatment option combines the directive for preservation of hard tooth structure while treating adolescents with the benefits of easy adaptation and repair when the occlusion is still in adjustment.
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Dogra S, Goyal V, Gupta A, Joshi S, Kataria V, Saini J, Nagpal M, Narula P. Spectrophotometric Evaluation of Color Change in Tooth Enamel Defects Using Resin Infiltrate: An In Vivo Study. Int J Clin Pediatr Dent 2020; 13:150-154. [PMID: 32742092 PMCID: PMC7366758 DOI: 10.5005/jp-journals-10005-1727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim To analyze the comparative change in pretreatment and posttreatment La*b* values of color in initial nonpitted white spot lesions of fluorosed teeth after resin infiltration with DMG-Icon spectrophotometrically with VITA easy shade. Materials and methods A total of 30 maxillary and mandibular permanent anterior teeth with mild, nonpitted white spot lesions (atleast one) of fluorosis [till grade IV of Thylstrup and Fejerskov (TF) index] in patients between 6 years and 14 years of age were included in the present study. Shade of selected tooth and its white spot lesion area was recorded using VITA 3D shade guide, both pre and postoperatively, i.e., after application of DMG Icon. This was followed by recording the change in corresponding La*b* values of tooth shade and white spot lesion spectrophotometrically using VITA Easy Shade. Results obtained were analyzed statistically. Results ΔE value of color change was found to be less than 3.7 in most of samples after resin infiltration and esthetically color change to naked eye was statistically significant (p value < 0.00001) postoperatively. Conclusion Resin infiltration with DMG Icon can improve the color of non-cavitated white spot lesions. The esthetic effect of this treatment was evident immediately after treatment. Moreover, no cavitation occurred after etching, even when the surface layer had been eroded completely. Clinical significance Achievement of esthetic results without loss of tooth structure and postoperative sensitivity. How to cite this article Dogra S, Goyal V, Gupta A, et al. Spectrophotometric Evaluation of Color Change in Tooth Enamel Defects Using Resin Infiltrate: An In Vivo Study. Int J Clin Pediatr Dent 2020;13(2):150–154.
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Affiliation(s)
- Shikha Dogra
- Department of Pedodontics and Preventive Dentistry, SGT University, Gurugram, Haryana, India
| | - Virinder Goyal
- Department of Pediatric and Preventive Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
| | - Anil Gupta
- Department of Pedodontics and Preventive Dentistry, SGT University, Gurugram, Haryana, India
| | - Sakshi Joshi
- Department of Pedodontics and Preventive Dentistry, SGT University, Gurugram, Haryana, India
| | - Vimanyu Kataria
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Jyotika Saini
- Department of Pedodontics and Preventive Dentistry, SGT University, Gurugram, Haryana, India
| | - Monika Nagpal
- Department of Pedodontics and Preventive Dentistry, SGT University, Gurugram, Haryana, India
| | - Payal Narula
- Department of Pedodontics and Preventive Dentistry, SGT University, Gurugram, Haryana, India
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Perdigão J. Resin infiltration of enamel white spot lesions: An ultramorphological analysis. J ESTHET RESTOR DENT 2019; 32:317-324. [PMID: 31742888 DOI: 10.1111/jerd.12550] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/21/2019] [Accepted: 11/05/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE There is not a clear understanding of the ultramorphology of enamel white spot lesions (WSLs). The purpose of this study is to characterize resin infiltration of enamel WSLs using electron microscopy. MATERIALS AND METHODS Enamel sections with sound enamel and WSLs were sectioned from extracted teeth and assigned to three groups: (a) left untreated; (b) etched with 15% hydrochloric acid (Icon-Etch); (c) restored with the resin infiltration sequence (Icon-Etch, Icon-Dry, and Icon-Infiltrant). Restored specimens were demineralized to obtain replicas. Observations were carried out under a field-emission scanning electron microscope. RESULTS Icon-Etch resulted in an array of pits and funneled holes on the WSL. Replicas of WSLs depicted 0.5-6.0-μm-thick shaggy resin tags up to a depth of 465 μm. Enamel crystallites were enveloped with resin at the bottom of the WSL forming a hybrid layer. CONCLUSIONS The resin infiltrant filled the spaces between the crystallites and resulted in an enamel hybrid layer. CLINICAL SIGNIFICANCE In addition to masking enamel WSLs, resin infiltration is able envelop residual enamel crystallites forming an enamel hybrid layer. This hybridization makes resin-embedded enamel more resistant to acid attack than sound enamel.
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Affiliation(s)
- Jorge Perdigão
- Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota
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Kobbe C, Fritz U, Wierichs RJ, Meyer-Lueckel H. Evaluation of the value of re-wetting prior to resin infiltration of post-orthodontic caries lesions. J Dent 2019; 91:103243. [PMID: 31730787 DOI: 10.1016/j.jdent.2019.103243] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/07/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES Assessment of the influence of colour changes during the re-wetting process as a possible predictor for the final result after resin infiltration to mask post-orthodontic white spot lesions. MATERIALS AND METHODS Resin infiltration (ICON; DMG, Hamburg, Germany) was performed according to the manufacturer's recommendation with the exception of repeated, at maximum three etching procedures based on the subjective decision of the dentist during a so called re-wetting process using ethanol. The masking effect by ethanol as well as after resin infiltration was evaluated by digital images taken before, for nine seconds during re-wetting and one week after treatment using CIE L*a*b* colour space. RESULTS Twenty-nine patients (16 female) with a total of 221 lesions (ICDAS 2) were included (mean age 16 years). Mean time after debonding the orthodontic appliances was ten weeks. Colour changes during re-wetting, evaluated in the first ten patients (71 lesions) showed a significant correlation between the minimum ΔE observed during re-wetting and the final ΔE after resin infiltration (r = 0.65, p < 0.001; Spearman correlation). The main drop in ΔE becomes visible after three seconds when performing the re-wetting process. Regarding the 221 lesions, resin infiltration significantly reduced the colour difference between sound and lesion areas from a baseline ΔE (25th/75th percentiles) of 10.9 (8.2/13.2) to a ΔE of 4 (2.1/5.8) after one week (p < 0.001). The number of etching procedures correlated significantly with baseline ΔE (p < 0.05). CONCLUSIONS The minimum ΔE observed during the re-wetting process seems to be a useful predictor for the final result of resin infiltration of post-orthodontic caries lesions. More prominent lesions with higher ΔE at baseline seem to require more erosion of the surface layer. In general, a significant and considerable clinical reduction of ΔE could be observed. CLINICAL SIGNIFICANCE We corroborate that resin infiltration technique is a very useful method to mask caries lesions having developed during treatment with fixed orthodontic appliances. Colour changes while re-wetting the lesions with ethanol seem to be a valuable indicator for the number of required etching procedures.
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Affiliation(s)
- C Kobbe
- Department of Restorative, Preventive & Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - U Fritz
- Department of Orthodontics, RWTH Aachen University, Aachen, Germany
| | - R J Wierichs
- Department of Restorative, Preventive & Pediatric Dentistry, University of Bern, Bern, Switzerland; Department of Biohybrid & Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - H Meyer-Lueckel
- Department of Restorative, Preventive & Pediatric Dentistry, University of Bern, Bern, Switzerland.
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Revilla-León M, Fountain J, Piedra-Cascón W, Zandinejad A, Özcan M. Silicone Additive Manufactured Indices Performed from a Virtual Diagnostic Waxing for Direct Composite Diastema Closure Combined with Resin Infiltration Technique on White Spot Lesions: A Case Report. J Prosthodont 2019; 28:855-860. [PMID: 31472020 DOI: 10.1111/jopr.13109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2019] [Indexed: 11/28/2022] Open
Abstract
The present article describes the resin infiltration technique to address white spots lesions presented on anterior and premolar teeth of a young patient after orthodontic treatment and the digital workflow for planning a diastema closure on the maxillary anterior teeth using facial photographs, an intraoral scanner, a facially driven diagnostic waxing using a dental computer-aided design (CAD) software, and 3-piece additive manufactured (AM) clear silicone indices. The virtual design of the silicone indices was completed using an open-source CAD software and included a flexible clear buccal piece, flexible clear lingual piece, and rigid clear custom tray. The unique 3-piece index design allows a horizontal path of insertion, controlled uniform thickness of the indices, flexible and rigid material properties combination, accurate translation of the diagnostic waxing into the patient´s mouth, and digital storage of the designs.
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Affiliation(s)
- Marta Revilla-León
- College of Dentistry, Texas A&M University, Dallas, TX.,Faculty of Prosthodontics, School of Dentistry, University of Washington, Seattle, WA.,Revilla Research Center, Madrid, Spain
| | | | - Wenceslao Piedra-Cascón
- Complutense University of Madrid, Spain and Researcher at Revilla Research Center, Madrid, Spain
| | | | - Mutlu Özcan
- Dental Materials Unit, Center for Dental and Oral Medicine, University of Zürich, Switzerland
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Yadav P, Desai H, Patel K, Patel N, Iyengar S. A comparative quantitative & qualitative assessment in orthodontic treatment of white spot lesion treated with 3 different commercially available materials - In vitro study. J Clin Exp Dent 2019; 11:e776-e782. [PMID: 31636868 PMCID: PMC6797449 DOI: 10.4317/jced.56044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/30/2019] [Indexed: 12/04/2022] Open
Abstract
Background To comparatively evaluate the esthetic improvement of white-spot lesions (WSLs) treated by: BiominF, CPP-ACP paste with fluoride & ICON resin infiltration, using Spectrophotometer & Diagnodent. Material and Methods The study was done using 72 sound permanent extracted premolars, divided into four groups (18 teeth per group). After taking the ethical approval the study was commenced. WSLs were created on human premolars and randomly assigned to four groups: Group A: Artificial Saliva, Group B: CPP-ACP with fluoride, Group C: BiominF, Group D: Resin infiltration (Icon). The color change (∆E) of each specimen was measured with a Spectrophotometer (VITA Easy Shade Compact), and fluorescence loss (∆Q) was measured by a laser fluorescence device (DIAGNOdent, Kavo, Biberach, Germany), at different time points after treatment: baseline (0 weeks), 2 weeks, 4 weeks, and 6 weeks. Results The ∆E and ∆Q baseline values for the four groups before the treatments did not differ significantly. Icon treatment improved the WSL color significantly and gave the lowest ∆E (5.12± 3.92) & ∆Q (1.64 ±0.72) compared with other treatments at end of 6 weeks (P< .01). In the BiominF and CPP-ACP with fluoride treatment groups, ∆Q & ∆E showed significant recovery compared with the baseline values (P< .05). Conclusions Within the limitations of the study, it can be concluded that all the three remineralizing agents used in the study could effectively remineralize artificial enamel caries and showed improvement in color change and fluoresence as compared to the baseline. Therefore they can be effectively used for the treatment of the white spot lesions. Key words:White spot lesions(WSL), Resin infiltration (ICON), BiominF, CPP-ACP with fluoride.
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Affiliation(s)
- Pooja Yadav
- 3rd Year PG, Department Of Orthodontics & Dentofacial Orthopaedics, Manubhai Patel Dental College & Oral Research Institiute, Vadodara
| | - Hina Desai
- Vice Dean & Head Of Department, Department Of Orthodontics & Dentofacial Orthopaedics, Manubhai Patel Dental College, Vadodara
| | - Kalpesh Patel
- Professor, Department Of Orthodontics & Dentofacial Orthopaedics, Manubhai Patel Dental College & Oral Research Institiute, Vadodara
| | - Nikunj Patel
- Senior Lecturer, Department Of Orthodontics & Dentofacial Orthopaedics, Manubhai Patel Dental College & Oral Research Institiute, Vadodara
| | - Shreya Iyengar
- Senior Lecturer, Department Of Orthodontics & Dentofacial Orthopaedics, Manubhai Patel Dental College & Oral Research Institiute, Vadodara
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Kannan A, Padmanabhan S. Comparative evaluation of Icon® resin infiltration and Clinpro™ XT varnish on colour and fluorescence changes of white spot lesions: a randomized controlled trial. Prog Orthod 2019; 20:23. [PMID: 31204437 PMCID: PMC6571438 DOI: 10.1186/s40510-019-0276-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 05/09/2019] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this trial was to comparatively evaluate Icon® resin infiltration and Clinpro™ XT varnish in restoring aesthetics of white spot lesions (WSLs) present post-orthodontic treatment. Materials and methods Two hundred forty WSLs were detected in 193 teeth of 12 patients. The participants were analysed—before intervention (T0), immediately after intervention (T1), 3 months later (T2) and 6 months later (T3), with a 1:1 allocation ratio for the application of Icon® resin infiltration and Clinpro™ XT varnish. Using a computer-generated allocation sequence, block randomization was done. A spectrophotometer was used to assess the colour of WSLs and the adjacent enamel, while a DIAGNOdent® was used to assess the fluorescence loss. Results Immediately after the intervention, Icon® resin infiltration showed statistically significant better improvement than Clinpro™ XT varnish in restoring the colour (p = 0.000); however, at 3 (p = 0.001) and 6 months (p = 0.000), this was reversed. Except at 3 months, the fluorescence loss sequentially reduced more for Icon® resin infiltration (4.48 ± 1.42 at T0 to 1.48 ± 0.81 at T3) and was not statistically significant. Conclusions Clinpro™ XT varnish showed significantly better improvement than Icon® resin infiltration in restoring the colour and lightness of the WSLs at 3 and 6 months. The fluorescence loss significantly recovered with both intervention methods between immediate application and at 6 months. However, Clinpro™ XT varnish-treated WSLs showed a statistically significant difference compared to the adjacent sound enamel at 6 months.
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Affiliation(s)
- Annapurna Kannan
- Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
| | - Sridevi Padmanabhan
- Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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Cosma LL, Şuhani RD, Mesaroş A, Badea ME. Current treatment modalities of orthodontically induced white spot lesions and their outcome - a literature review. Med Pharm Rep 2019; 92:25-30. [PMID: 30957083 PMCID: PMC6448498 DOI: 10.15386/cjmed-1090] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/17/2018] [Accepted: 09/24/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction White spot lesion is a demineralization of the enamel that appears as a white spot on the surfaces of the tooth. The cause of this spot is determined by the activity of the bacterial plaque and it represents the initial stage of a carious lesion. This lesion is a common side effect for patients with fixed orthodontic appliances mainly because of the brackets' position that favors the accumulation of plaque that ultimately leads to the formation of the white spot. Methods We conducted a search on a single database, PubMed. "Orthodontic", "white spot lesions", "enamel demineralization treatment" and "remineralization" were the search terms used. We found 324 articles, but we took in consideration only the ones from the last 10 years, which resulted in 223 articles. Results The first step after research was article selection: first by scrutinizing the title and secondly by reviewing the abstracts or full texts. The exclusion criteria were: meta-analysis, reviews, original articles regarding prevention of white spot lesions and their prevalence or incidence. We included the articles that seemed relevant for the treatment of white spot lesions, made either on extracted teeth either on orthodontic patients. We found 75 articles to be eligible for this research and we eliminated 5 because of the lack of an abstract or full text and a further 22 were rejected because they did not fit the aforementioned criteria. Conclusion Although some traditional methods for the treatment of white spot lesions seem to have undesirable results, nowadays with new technologies and thorough investigations in nanotechnology, the eradication of the lesion appears to be short term.
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Affiliation(s)
- Lavinia Luminiţa Cosma
- Department of Pediatric Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Raluca Diana Şuhani
- Department of Pediatric Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anca Mesaroş
- Department of Dental Propedeutics and Esthetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mîndra Eugenia Badea
- Department of Prevention in Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Gu X, Yang L, Yang D, Gao Y, Duan X, Zhu X, Yuan H, Li J. Esthetic improvements of postorthodontic white-spot lesions treated with resin infiltration and microabrasion: A split-mouth, randomized clinical trial. Angle Orthod 2019; 89:372-377. [PMID: 30719932 DOI: 10.2319/041218-274.1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To compare the esthetic improvement between postorthodontic white-spot lesions (WSLs) treated by resin infiltration and microabrasion for 12 months. MATERIALS AND METHODS A total of 20 patients with 128 teeth with postorthodontic WSLs were recruited. A simple randomized, split-mouth, positive controlled design was used to allocate patients to resin infiltration or microabrasion groups. The lesion area ratio (R value) was calculated between the area of a WSL and the labial surface of the corresponding tooth based on standardized clinical photographs. The color change (ΔE) of each tooth was measured with a Crystaleye spectrophotometer (Olympus, Tokyo, Japan). Every measurement was taken before treatment (T0) and at different time points after treatment: 1 week (T1), 6 months (T6), and 12 months (T12). RESULTS A total of 16 patients with 108 trial teeth were available at T12. Each group had 54 trial teeth. In both groups, there was a significant decrease in R value and ΔE between T1 and T0 (P < .0001). In the infiltration group, the R value and ΔE had no significant changes over time from T1 to T12. In the microabrasion group, the R value and ΔE decreased significantly from T1 to T6. The R value of resin infiltration was lower when compared with microabrasion at every recall point (P < .001). The ΔE had no significant differences between the two groups at any timepoint. CONCLUSIONS Resin infiltration and microabrasion improved the esthetic appearance of WSLs and showed sufficient durability for 12 months. Resin infiltration showed a better esthetic improvement effect when compared with microabrasion at 12 months.
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Manoharan V, Arun Kumar S, Arumugam SB, Anand V, Krishnamoorthy S, Methippara JJ. Is Resin Infiltration a Microinvasive Approach to White Lesions of Calcified Tooth Structures?: A Systemic Review. Int J Clin Pediatr Dent 2019; 12:53-58. [PMID: 31496574 PMCID: PMC6710943 DOI: 10.5005/jp-journals-10005-1579] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim The treatment of white lesions should aim at arresting the lesion progression of carious lesions and improving the esthetics by diminishing the opacity of the developmental disturbances of a tooth. The objective of this review was to present the scientific basis, the principles of resin infiltration and to discuss its inherent clinical applications. Data sources Data were identified by PubMed searches. Papers published in English between 2010 and 2015 were selected and most up-to-date or relevant references were chosen. Conclusion The resin infiltration technique, while promising, needed more clinical evidence for conclusive findings. However, based on available laboratory and clinical studies, it seems convincing that resin infiltration of enamel lesions should aim at arresting the progression of white spot lesions. Combining this microinvasive approach with a substantial caries remineralization program may provide therapeutic benefits and significantly reduce both long term restorative needs and costs, thus complementing the concept of minimum intervention dentistry. How to cite this article Manoharan V, Kumar AS, et al. Is Resin Infiltration a Micro invasive Approach to White Lesions of Calcified Tooth Structures?: A Systemic Review. Int J Clin Pediatr Dent 2019;12(1):53-58.
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Affiliation(s)
- Vidya Manoharan
- Department of Pedodontics and Preventive Dentistry, Royal Dental College, Palakkad, Kerala, India
| | - S Arun Kumar
- Department of Public Health Dentistry, Educare Institute of Dental Sciences, Malappuram, Kerala, India
| | - Selva B Arumugam
- Department of Paediatric and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Puducherry, India
| | - Vijay Anand
- Department of Pedodontics and Preventive Dentistry, Tagore Dental College, Chennai, Tamil Nadu, India
| | - Santham Krishnamoorthy
- Department of Pedodontics and Preventive Dentistry, Sathyabama Dental College, Chennai, Tamil Nadu, India
| | - John J Methippara
- Department of Pedodontics and Preventive Dentistry, Annoor Dental College, Muvattupuzha, Kerala, India
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Schnabl D, Dudasne-Orosz V, Glueckert R, Handschuh S, Kapferer-Seebacher I, Dumfahrt H. Testing the Clinical Applicability of Resin Infiltration of Developmental Enamel Hypomineralization Lesions Using an In Vitro Model. Int J Clin Pediatr Dent 2019; 12:126-132. [PMID: 31571785 PMCID: PMC6749872 DOI: 10.5005/jp-journals-10005-1609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aim The aim of this study is to investigate the penetration abilities of a commercially available low-viscosity resin infiltrant into developmentally hypomineralized teeth in vitro. Materials and methods Four extracted third molars of a 17-year-old patient with signs of developmental enamel hypomineralization (discoloration, increased opacity, and surface roughness) were infiltrated with a low-viscosity resin mixed with a fluorescent dye, according to the manufacturer's standard protocol. Four extracted molars with sound enamel or showing only initial fissure caries were used as a control group. Specimens were embedded in polymethylmethacrylate, and grindings were prepared. High-resolution projectional radiography of the grindings was performed, and, for one specimen, quantitative micro-computed tomography was used to measure hydroxyapatite density in enamel and dentin lesions. After decalcification, the grindings were examined by reflected bright-field microscopy, wide-field fluorescence microscopy, and confocal laser scanning microscopy. Fluorescence micrographs were superimposed on the radiographs and analyzed correlatively. Results The pattern of hypo-/demineralization in enamel and dentin in developmentally hypomineralized teeth showed a good congruence with the pattern of resin infiltration. Cavitations and dentin tubules up to a depth of 2 mm beyond cavitations were filled by the infiltrant. In control teeth, the penetration of the infiltrant was limited to decalcified enamel areas (initial fissure caries). Conclusions In vitro infiltration of developmentally hypomineralized enamel was successful. Clinical significance Resin infiltration might be considered as a routine procedure in the treatment of developmentally hypomineralized teeth. Further investigations with higher sample sizes, different degrees of severity, different stages of lesion extension, and modified treatment protocols are necessary. How to cite this article Schnabl D, Dudasne-Orosz V, et al. Testing the Clinical Applicability of Resin Infiltration of Developmental Enamel Hypomineralization Lesions Using an In Vitro Model. Int J Clin Pediatr Dent 2019;12(2):126-132.
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Affiliation(s)
- Dagmar Schnabl
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, Austria
| | - Viktoria Dudasne-Orosz
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, Austria
| | - Rudolf Glueckert
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Stephan Handschuh
- VetCore Imaging Unit, Veterinary University of Vienna, Vienna, Austria
| | - Ines Kapferer-Seebacher
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, Austria
| | - Herbert Dumfahrt
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, Austria
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Kim J, Shin TJ, Kong HJ, Hwang JY, Hyun HK. High-Frequency Ultrasound Imaging for Examination of Early Dental Caries. J Dent Res 2018; 98:363-367. [PMID: 30412680 DOI: 10.1177/0022034518811642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The extent of dental tissue destruction during the treatment of white spot lesions (WSLs) increases with the severity of the lesion. If the depth and shape of WSLs can be predicted with a noninvasive diagnostic method before dental caries treatment, more conservative interventions can be planned. Given the superiority of high-frequency ultrasound (HFUS) imaging in observing the internal structures of the body, the present study aimed to verify the possibility of HFUS imaging to examine the depth and shape of WSLs. We prepared tooth samples and developed a biomicroscopic system with a HFUS transducer to obtain images of normal and WSL regions. HFUS images were compared with conventional ultrasound images and micro-computed tomography images. HFUS distinctly differentiated demineralization within WSL and normal regions. WSL depth calculated in the micro-computed tomography image was similar to that in HFUS. This study revealed that HFUS imaging has the potential to detect early dental caries and offer information on the invasion depth of early dental caries quantitatively.
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Affiliation(s)
- J Kim
- 1 Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea
| | - T J Shin
- 2 Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - H J Kong
- 3 Department of Biomedical Engineering, College of Medicine, Chungnam National University, and Chungnam National University Hospital, Daejeon, Republic of Korea
| | - J Y Hwang
- 1 Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea
| | - H K Hyun
- 2 Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Silva SN, Reich AM, DeLeon E, Schafer T, Rueggeberg FA, Fortson WM. Staining potential differences between an infiltrative resin and an esthetic, flowable composite. J ESTHET RESTOR DENT 2018; 30:457-463. [PMID: 30284754 DOI: 10.1111/jerd.12415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 06/13/2018] [Accepted: 06/13/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare color change magnitude of an infiltrative resin and a flowable composite resin after immersion in commonly consumed beverages. MATERIALS AND METHODS Disks (1 × 9 mm) of a flowable composite (Filtek Supreme Ultra Flowable) and a resin-infiltrative product (Icon) were made. Specimens were dark-stored in tap water (24 hours). Baseline color parameters (CIE L*a*b*) were obtained using a colorimeter (Easyshade V4, VITA). Specimens were immersed (dark stored, 37°C, 1 week) in commercial beverages: Kool-Aid, coffee, Coca-Cola, and tap water (control). ΔE00 between final and baseline conditions for each material/beverage combination was determined (N = 10/group). Initial analysis of variance indicated significant impact of major factors/interactions on ΔE00 . Subsequently, t-tests between ΔE00 values of restorative materials within each beverage was performed: alpha 0.05. RESULTS Kool-Aid produced the greatest color change for flowable composite, with a ΔE00 significantly greater than the infiltrative product. No significant ΔE00 differences were noted between products immersed in coffee, however color parameters causing these differences were not similar. Water or Coca-Cola immersion showed lowest ΔE00 values for both materials, considered visually imperceptible: ΔE00 values <0.8. CONCLUSIONS Color change potential of infiltrative resin or resin composite was highly dependent on beverage type, with no general trends observed in which material was affected more. CLINICAL SIGNIFICANCE Staining potential of an infiltrative restorative resin differs from that of a filled, flowable composite material on a beverage-by-beverage basis. The potential for color change seems not related to the presence or absence of fillers in the restorative material.
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Affiliation(s)
- Stephanie N Silva
- Second-year Pediatric Dentistry Resident, Dental College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Alena M Reich
- Third-Year Orthodontic Resident, Dental College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Eladio DeLeon
- Department of Orthodontics, Marvin C. Goldstein Chair of Orthodontics, Dental College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Tara Schafer
- Department of Pediatric Dentistry, Dental College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Frederick A Rueggeberg
- Department of Restorative Sciences, Dental College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Weston M Fortson
- Department of Orthodontics, Dental College of Georgia, Augusta University, Augusta, Georgia, USA
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Bhandari R, Thakur S, Singhal P, Chauhan D, Jayam C, Jain T. Concealment effect of resin infiltration on incisor of Grade I molar incisor hypomineralization patients: An in vivo study. J Conserv Dent 2018; 21:450-454. [PMID: 30122830 PMCID: PMC6080169 DOI: 10.4103/jcd.jcd_61_18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Molar incisor hypomineralization (MIH) is a commonly occurring esthetic setback among patients. Depending on the graveness of the lesion, esthetics of MIH can be improved by treatments such as enamel microabrasion, bleaching, composite resin bonding, and the combination of some or all of these techniques. Aim The aim of this study is to evaluate the esthetic results of resin infiltration treatment on incisors with Grade I molar incisor MIH. Materials and Methods A total of 22incisor lesions with MIH were infiltrated with resin. Photographs were captured before infiltration, just after infiltration, and 6 months after infiltration. The photographic evaluation was done by the CIE L*a*b* scoring method. The means of each parameter such as ΔL and ΔE were calculated. Statistical Analysis ANOVA in conjunction with Turkey's post hoc test was used to evaluate the means. Results The total color change observed was equal just after treatment and 6 months after treatment, with no statistically significant difference (P = 0.87) between these two time points. The mean of difference in total color change (ΔE3) of white tooth discoloration was 13.2 SD 6.8, showing an overall color change. Conclusion Infiltration can conceal the white opaque appearance of Grade I MIH lesions, and also reduction in lesion whiteness is seen with time.
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Affiliation(s)
- Ranu Bhandari
- Department of Pedodontics, H. P. Government Dental College, Shimla, Himachal Pradesh, India
| | - Seema Thakur
- Department of Pedodontics, H. P. Government Dental College, Shimla, Himachal Pradesh, India
| | - Parul Singhal
- Department of Pedodontics, H. P. Government Dental College, Shimla, Himachal Pradesh, India
| | - Deepak Chauhan
- Department of Pedodontics, H. P. Government Dental College, Shimla, Himachal Pradesh, India
| | - Cheranjeevi Jayam
- Department of Pedodontics, H. P. Government Dental College, Shimla, Himachal Pradesh, India
| | - Teerthesh Jain
- DDS (ISP-1), School of Dental Medicine, University of Colorado, Denver, USA
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Abbas BA, Marzouk ES, Zaher AR. Treatment of various degrees of white spot lesions using resin infiltration-in vitro study. Prog Orthod 2018; 19:27. [PMID: 30079435 PMCID: PMC6081872 DOI: 10.1186/s40510-018-0223-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 06/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was conducted to evaluate the efficiency of resin infiltration to improve the color of white spot lesions (WSLs) and to estimate the effect of different numbers of etching and resin infiltrant applications on the color change of WSLs with various depths. Ninety-six sound extracted premolars were subjected to acid attack inducing different depths of WSLs. Using a DIAGNOdent, teeth were divided into four main groups according to the depth of the WSLs: shallow enamel, deep enamel, shallow dentine, and deep dentine without cavitation. Then each of the main groups was subdivided into four groups: six teeth each with different protocols of resin infiltration as follows: 1 etching + 1 infiltrant application (EA), 1 etching + 2 infiltrant applications (EAA), 2 etchings + 1 infiltrant application (EEA), 2 etchings + 2 infiltrant applications (EEAA). Spectrophotometric analysis was measured at baseline (T0), after inducing the WSLs (T1), and following resin infiltration application (T2) for each group. RESULTS In shallow enamel, EA produced the least mean color difference (1.62 ± 0.85), with high significant difference (P < 0.001), when compared with the clinically detectable threshold (ΔE = 3.7). While in deep enamel, EAA showed the least mean color change (1.95 ± 0.4), with P < 0.001 when compared with the critical value. Also, in shallow dentine, the least mean change was noticed with EAA (3.0 ± 0.45), with P < 0.001 when compared with the clinical color detection threshold. Furthermore, in deep dentine, EAA had the least mean difference (3.76 ± 0.6) but with no significant difference, when compared with the clinically detectable threshold. CONCLUSIONS As the WSL got deeper, the color of the lesion became more clinically visible. In shallow enamel, the best treatment option was one etching with one resin infiltrant application. For deep enamel and shallow dentine, one etching with two applications of infiltrant gave the best lesion masking. In deep dentine, it is advisable to perform one etching with two infiltration steps, taking in consideration that all deep dentine lesions without cavitation were partially masked, remained clinically detectable, and might require more invasive restorative procedures.
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Affiliation(s)
- Bassant A Abbas
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Azarita, Alexandria, Egypt.
| | - Eiman S Marzouk
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Azarita, Alexandria, Egypt
| | - Abbas R Zaher
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Azarita, Alexandria, Egypt
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Freitas MCCDA, Nunes LV, Comar LP, Rios D, Magalhães AC, Honório HM, Wang L. In vitro effect of a resin infiltrant on different artificial caries-like enamel lesions. Arch Oral Biol 2018; 95:118-124. [PMID: 30099240 DOI: 10.1016/j.archoralbio.2018.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 07/07/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES A resin infiltrant was employed for the treatment of active white spot lesions due to its ability to penetrate into the enamel pores and prevent the progression of the lesion. However, limited information is available about its mechanical effect on different artificial enamel lesions as well as on its resistance to further demineralization. Therefore, this study aimed to evaluate the effects of the Icon® infiltrant on different artificial caries-like enamel lesions and its resistance to new acid challenges. DESIGN Artificial lesions were produced in bovine enamel using three different protocols (demineralization/remineralization cycling, DE-RE; 8% methylcellulose gel, MC; and methyl ethyl diphosphonate solution, MHDP; n = 13). The specimens were treated with Icon® and subjected to a new acid challenge using DE-RE cycling. The surface and cross-sectional hardness were evaluated in sound, demineralized, treated and further demineralized enamel areas. Data were statistically analyzed using ANOVA and Tukey's test (p < 0.05). RESULTS All of the demineralizing protocols produced subsurface artificial caries lesions. The infiltrant was able to partially recover the surface hardness and prevent further surface hardness loss in enamel previously demineralized using the DE-RE and MHDP protocols. In regard to cross-sectional hardness, no positive effect was found. CONCLUSIONS The effect of the infiltrant depends on the type of lesion created in vitro, and its action is limited to the lesion surface.
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Affiliation(s)
- Maria Cristina Carvalho de Almendra Freitas
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil; DeVry FACID, DeVry Education Group, Avenida Rio Poti, 2381, ZIP code: 64999-999, Teresina, PI, Brazil
| | - Larissa Vasconcellos Nunes
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Lívia Picchi Comar
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Collective Health, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Collective Health, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil
| | - Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP code: 17012-901, Bauru, SP, Brazil.
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