Evaluation of penetration depth of a commercially available resin infiltrate into artificially created enamel lesions: An in vitro study

An in vitro evaluation of Icon resin infiltrant penetration into demineralized enamel lesions using an indirect staining technique with confocal laser scanning microscope analysis in dual fluorescence mode

Context

White spot lesion is the first clinical sign of a caries lesion and represents mineral loss from the enamel subsurface.

Aim

The aim of this study was to evaluate the penetration depth (PD) of Icon resin infiltrant into artificially demineralized enamel lesions using confocal laser scanning microscope (CLSM) analysis in dual fluorescence mode.

Settings and Designs

The design of the study was an in vitro study.

Materials and Methods

22 extracted human permanent maxillary central incisor teeth were collected, and enamel sections were obtained from the coronal middle third. All enamel specimens were exposed to demineralization and remineralization solutions for 14 days. On positive confirmation of enamel demineralization by scanning electron microscope analysis, 20 specimens were then subjected to Icon resin infiltration following manufacturer instructions. Specimens were processed with indirect staining technique using rhodamine B and sodium fluorescein dyes and examined under CLSM at ×10 magnification in dual fluorescence mode using ImageJ software to evaluate PD of resin infiltrant into demineralized enamel lesions.

Statistical Analysis Used

Obtained data were analyzed using an independent t-test. P ≤0.05 was considered statistically significant.

Results

The maximum depth of demineralized enamel lesion was 590 μm, and the mean depth was 290.78 ± 14.80 μm. The maximum depth of resin infiltrant penetration was 580 μm, and the mean depth was 279.08 ± 13.88 μm; P = 0.006. The percentage penetration of resin infiltrant was 95.99%.

Conclusion

Icon resin infiltrant was highly effective in its depth of penetration into demineralized enamel lesions. The use of indirect staining and CLSM analysis in dual fluorescence mode is more reliable and accurate technique to evaluate the PD of resin infiltrant.

Management of permanent incisors affected by Molar-Incisor-Hypomineralisation (MIH) using resin infiltration: a pilot study

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.

Efficacy of microabrasion and resin infiltration techniques for masking of fluorotic white spot lesions: A randomized clinical study

Aim

The aim of the study was to compare the esthetic treatment outcome and quantification of tooth color changes using microabrasion and resin infiltration techniques of fluorotic white spot lesions (WSLs).

Subjects and Methods

Sixty-six teeth with fluorotic small opaque white areas involving 25%-50% (very mild/mild fluorosis) of the surface were randomly assigned into two groups for microabrasion and resin infiltration techniques. To quantify tooth color changes, depicted by Delta E (DE), photographic analysis was performed using Adobe Photoshop CS5 Extended version by measuring Commission Internationale de l'Eclairage L*a*b* values of each tooth at two points, i.e. one at WSL and the other one at sound adjacent enamel.

Statistical Analysis Used

Data were analyzed with t-test using SPSS software version 23.

Results

L*value (decrease in whiteness) of posttreatment WSL decreased in both groups but was higher in the resin infiltration group, which was statistically significant. There were no statistically significant changes observed in a* and b* values of WSL in both groups. DE value difference of pre and postoperative was higher in the resin infiltration group, which was statistically significant which indicated the stability of color obtained by the resin infiltration group.

Conclusions

Resin infiltration technique is more efficient in the immediate elimination of fluorotic WSL than microabrasion.

Effect of bleaching on color and surface topography of teeth with enamel caries treated with resin infiltration (ICON®) and remineralization (casein phosphopeptide-amorphous calcium phosphate)

Background

Dental bleaching is not recommended on teeth with enamel caries.

Aim

The study aimed to assess the efficacy of in-office bleaching on demineralized enamel managed by resin infiltration (RI) as well as casein phosphopeptide-amorphous calcium phosphate (CPP-ACP).

Methodology

Forty-eight sound enamel specimens were divided into four groups based on the surface treatment performed before in-office bleaching. Group I consisted of no caries and no treatment (NT); Group II had artificial caries (AC) and NT; Group III had AC treated with RI, and Group IV had AC remineralized with CPP-ACP. Pre- and postbleaching teeth color and surface topography were evaluated using spectrophotometer and scanning electron microscope (SEM), respectively.

Statistical Analysis Used

One-way analysis of variance and Tukey's post hoc test were performed for inter-group comparisons.

Results

The color change postbleaching was the least in Group IV; and this was significantly less than Group I (P < 0.05) and Group II (P < 0.001). The bleaching efficiency in Group III was not significantly different from the control group. In addition, the enamel topographic changes were less in the surface-treated group.

Conclusion

RI can be considered a treatment modality for teeth with enamel caries requiring tooth whitening as the bleaching efficiency was like that of sound enamel.

Roughness and Microhardness of Demineralized Enamel Treated with Resinous Infiltrants and Subjected to an Acid Challenge: An in vitro Study

Background:

Resinous infiltrating has proven effective in arresting incipient caries lesions.

Objective:

This study aimed to assess the penetration depth of an experimental resin-infiltrant (75% - TEGDMA, 25% - Bis-EMA, 1% - EDAB, 0.5% camphorquinone), compare it with commercial infiltrant Icon®, and analyze the surface-roughness and microhardness of the resin-materials infiltrated into tooth specimens, before and after pH cycling.

Methods:

To assess penetration depth, sound third molar specimens were submitted to ten de-remineralization cycles for incipient carious lesion induction and were then randomly divided into 2 groups (n=3): (I) Experimental Infiltrant (EI) and (II) Commercial Infiltrant Icon (CI). After resin infiltration into specimens, qualitative Confocal Fluorescence Microscopy images were captured. For roughness and microhardness assessment, new specimens were demineralized, then randomly divided into two groups (n=20): (I) Experimental Infiltrant (EI) and (II) Commercial Infiltrant Icon (CI) and submitted to roughness and microhardness readouts at the following time-intervals: (T1) sound tooth, (T2) white-spot caries lesion, (T3) resin material that infiltrated, and (T4) resin material that infiltrated and was exposed to pH-cycling. In statistical analyses, generalized linear models of repeated measures in time were applied, with a significance level of 5%.

Results:

The experimental infiltrant penetrated the carious lesion and exhibited lower roughness values after its application, even after pH cycling, similar to the CI. The microhardness value of the EI group was significantly lower in the last three-time intervals evaluated compared to CI.

Conclusion:

Experimental resin infiltrant was efficient in penetrating white spot lesions and reducing surface roughness; however, it did not increase surface microhardness.

Impact of Dentistry Materials on Chemical Remineralisation/Infiltration versus Salivary Remineralisation of Enamel-In Vitro Study

The aim of this study is to evaluate salivary remineralisation versus chemical remineralisation/infiltration of enamel, using different dentistry materials. The enamel changes were studied using confocal laser scanning microscopy (CLSM), and the depth of lesions and demineralisation/remineralisation/infiltration percentage were calculated. Additionally, the macro elemental composition of the teeth was performed using atomic absorption spectroscopy (AAS). Two studies were performed: (i) demineralisation of enamel in 3% citric acid and infiltration treatment with infiltration resin (Icon, DMG), remineralisation with Fluor Protector (Ivoclar Vivadent) and artificial saliva pH 8; and (ii) enamel demineralisation in saliva at pH 3 and remineralisation at salivary pH 8. The results showed that, firstly, for the remineralisation of demineralised enamel samples, Fluor Protector (Ivoclar Vivadent) was very effective for medium demineralised lesions followed by saliva remineralisation. In cases of deep demineralisation lesions where fluoride could not penetrate, low viscosity resin (Icon, DMG, Hamburg) effectively infiltrated to stop the demineralisation process. Secondly, remineralisation in salivary conditions needed supplementary study over a longer period, to analyse the habits, diet and nutrition of patients in detail. Finally, demineralisation/remineralisation processes were found to influence the macro elemental composition of enamel demineralisation, with natural saliva proving to be less aggressive in terms of decreasing Ca and Mg content.

Assessment of Wettability and Contact Angle of Bonding Agent with Enamel Surface Etched by Five Commercially Available Etchants: An In Vitro Study

Background

The quantity and quality of the etching pattern produced by acids play a significant role in the wettability and contact angle of the adhesive with the enamel surface in orthodontics. The better the etch pattern, the more the surface energy of the enamel, better the penetration of the adhesive, which ultimately results in better bond strength. The present study aimed to evaluate the contact angle of the bonding agent with the enamel surface etched by five commercially available etchants and check if any difference existed between the five.

Materials and Methods

Twenty-five human maxillary and mandibular central incisors and premolars extracted for orthodontic or dental purposes were used in this study as samples. The teeth were allocated into five groups based upon the etchant used to etch the enamel surface. After the samples were etched, a hard tissue microtome was used to create thin slices of the enamel surface. The samples were then exposed to bonding agent Ormco Enlight. The bonding agent was released in the form of droplets onto the enamel slices mounted on a contact angle goniometer. The contact angle values were tabulated, and statistical analysis using the one-way ANOVA test was carried out.

Results

The contact angle measurements of the etchant group, DPI, were the lowest, while D-tech has the highest contact angle values. However, statistical analysis revealed no statistically significant difference between the contact angle measurements of the five groups included in the study.

Conclusion

No statistically significant difference existed between the five etchant groups included in the study. However, commercially available etchant DPI showed lesser contact angle and thus better wettability in comparison to other groups. Further elemental analysis and surface analysis are required to validate these results.

Resin infiltration in white spot lesions caused by orthodontic hypomineralisation: a minimally invasive therapy

Objective White spot lesions are characterised by the presence of clinically detectable opaque lesions due to enamel demineralisation. These frequently present in patients following fixed orthodontic treatment, mostly due to the prolonged accumulation of bacterial plaque on the dental surface. When remineralisation is not achieved through good oral hygiene and prophylaxis with fluoride products, the infiltration of lesions with low-viscosity photopolymerised resin has proved to be a valid micro-invasive alternative compared to traditional conservative therapy.Clinical considerations A case series will be presented, where the chosen approach was resin infiltration, a micro-invasive and aesthetic technique.Clinical significance Infiltrative resin therapies are single-session procedures that reduce the need for more invasive therapies such as the use of rotary instruments for greater patient comfort. The need for periodic fluoride applications is also avoided. This approach increases the durability of the infiltrated lesion without compromising its mechanical properties and impedes the development of recurrent or secondary caries.Conclusions Resin infiltration might be considered as a routine procedure in the treatment of post-eruptive hypomineralised lesions. This follows the line of thought of minimally invasive dentistry, is an excellent treatment option and prevents the lesion's progression.

Assessment of the Potential Ability to Penetrate into the Hard Tissues of the Root of an Experimental Preparation with the Characteristics of a Dental Infiltratant, Enriched with an Antimicrobial Component-Preliminary Study

Infiltration is a method of penetration with a low viscosity resin that penetrates deep into demineralised tooth tissue and fills the intergranular spaces, hence reducing porosity. Carious lesions initially located at the enamel–cement junction are usually found in elderly patients. Those spots are predisposed to bacterial adhesion originating both from biofilm and from gingival pocket bacteria. The aim of this study was to evaluate the penetration of an experimental preparation, which has the characteristics of a dental infiltrant, enriched with an antibacterial component, into the decalcified root cement tissues of extracted human teeth in elderly patients. An experimental preparation with the characteristics of a dental infiltrant was prepared, applied, and polymerised on the surface of extracted, previously decalcified human teeth. The control sample was Icon (DMG, Hamburg, Germany). The ability of the preparations to penetrate deep into the root cement was evaluated using scanning electron and light microscopy. The study showed that an experimental preparation could potentially be used for treatment of early carious lesions within the tooth root in elderly patients, among others, as it penetrates deep into demineralised tissues. More research is needed.

A comparative evaluation of penetration depth and surface microhardness of Resin Infiltrant, CPP-ACPF and Novamin on enamel demineralization after banding: an in vitro study

Background

The field of dentistry has been revolutionized by various concepts. Minimal invasive dentistry is the preferred treatment approach in the present era; therefore, various techniques have been advocated to arrest caries lesions at an early stage on the grounds of better understanding of the dynamic nature of dental caries. Thus, study was conducted to compare and evaluate the penetration depth and enamel microhardness of Resin Infiltrant, CPP-ACPF and Novamin on artificial demineralized enamel surface after orthodontic banding.

Material and methods

Eighty extracted sound premolars were banded. The bands were cemented with type 1 GIC and further divided into – Group I: Resin Infiltrant, Group II: CCP-ACPF, Group III: Novamin and Group IV: Control. The samples were incubated for 30 days and then thermocycled. A window of 4 mm × 4 mm was prepared on the buccal surface of samples and artificially demineralized for 4 weeks. A single application was made for Resin Infiltrant, while Novamin and CCP-ACPF were applied twice daily. These samples were otherwise immersed in artificial saliva, and this was protocol was observed for 14 days. For the evaluation of penetration depth, 10 samples from each group were bucco-lingually sectioned and immersed in methylene blue dye solution for 24 h and then evaluated under stereomicroscope. For the enamel surface microhardness, remaining 10 samples from each group were embedded in acrylic resin with outer buccal surface exposed and were tested by a using digital Micro-Vickers hardness tester.

Results

All groups showed a significant difference in the depth of dye penetration and surface microhardness compared to the control group. As compared to the other tested groups, Resin Infiltrant exhibited the highest significant reduction in demineralization and increased microhardness. Novamin had a deeper penetration and increase in microhardness as compared to CCP-ACPF.

Conclusion

Resin Infiltrant exhibited the highest potential to impede caries and constitutes a competent aerosol free micro-invasive strategy for combating non cavitated lesions approaching the outer layer dentine which are too advanced for remineralizing agents but do not necessarily require any drilling of tooth.

Comparing Impact of Two Resin Infiltration Systems on Microhardness of Demineralized Human Enamel after Exposure to Acidic Challenge

AIM: This study compared the impact of two resin infiltration systems on microhardness of demineralized enamel before and after an acidic challenge. MATERIALS AND METHODS: A total of forty human maxillary molar teeth were used in this study. Each tooth has 4 groups (four standardized windows onto each tooth). Group A1: Untreated sound enamel surface (positive control), Group A2: Artificially demineralized enamel surface (negative control), Group A3: Icon resin infiltrating to demineralized enamel, while Group A4: Single bond universal adhesive applied to the demineralized enamel surface. All teeth were immersed in a demineralizing solution. The groups (A3 and A4) were further subdivided into two subgroups according to acidic ethanol challenge Subgroup B1: Specimens tested before an acidic challenge and B2: Specimens tested after an acidic challenge. Vickers microhardness test was done for all groups. One-way analysis of variance (ANOVA) was used to study the difference between tested groups on mean microhardness within each group. Tukey’s post-hoc test was used for pair-wise comparison between the means when ANOVA test was performed, and the significance level was set at p ≤ 0.05. RESULTS: Icon resin infiltration and single bond universal adhesive showed significantly higher mean microhardness than negative control, but significantly lower mean microhardness than positive control. However, insignificant difference was found between icon and single bond universal adhesive. After the acidic challenge, icon resin infiltration showed significantly higher mean microhardness than negative control. However, single bond universal adhesive showed insignificant difference as compared to the negative control. CONCLUSION: After an acidic challenge, icon resin infiltration was more successful than single bond universal total-etch adhesive system in microhardness. RECOMMENDATION: Icon resin infiltration technique is a promising, noninvasive approach that prevents the progress of the carious lesion.

Remineralization Potential and Shear Bond Strength of Surface Treated Hypomineralized Enamel in Bonding of Orthodontic Brackets: An In Vitro Study

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.

Experimental self-etching resin infiltrants on the treatment of simulated carious white spot lesions

OBJECTIVES

To evaluate the penetration depth (μm) of experimental resin infiltrants containing different percentages of triethylene glycol dimethacrylate (TEGDMA) and phosphoric acid 2-hydroxyethyl methacrylate ester (PAM) in artificial carious white spot lesions (WSL).

METHODS

WSL were produced in 65 bovine flat enamel specimens by pH cycling protocol, which were treated with either Icon (control) or experimental acidic infiltrants based on different percentages of TEGDMA and PAM monomers (acidic), and their association or not with previous acid-etching with phosphoric acid. Ten readings using Confocal Laser Scanning Microscopy were conducted on each specimen and the penetration depth was calculated from the surface until the deepest point with the fluorescent dye Rhodamine B (0.02 mg/mL). The pH and the viscosity of the experimental infiltrants were also tested. Data were statistically analyzed with two-way ANOVA and Tukey tests (α < 0.05).

RESULTS

The material factor and the interaction material*acid-etching were statistically significant. The lowest penetration depth was observed for the samples treated with the commercial infiltrant after etching with 15% hydrochloric acid. When specimens were pre-treated with PA, highest penetration was seen for specimens treated with 100% TEGDMA, which differed from all other groups. The lowest penetration was seen for those treated with 50:50 TEGDMA:PAM infiltrants. When specimens were not previously etched, highest penetration was seen for Icon, which differed only from those treated with 25% TEGDMA 75% PAM, where the lowest values were seen. The values of viscosity increased and the pH decreased with the addition of PAM in the infiltrant formulations.

CONCLUSION

the association between TEGDMA and PAM seems to allow similar infiltration depth reached by Icon infiltrant without acid etching the enamel surface.

Evaluation of color changes of white spot lesions treated with three different treatment approaches: an in-vitro study

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.

Spectrophotometric Evaluation of Color Change in Tooth Enamel Defects Using Resin Infiltrate: An In Vivo Study

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.

Effect of Conditioning Protocols and Ultrasonic Application of an Infiltrant Resin in White Spot Lesions

The aim of this study was to evaluate different conditioning protocols and sonic/ultrasonic application of an infiltrant resin (IR) in artificial white spot lesions (AWSL). the V/L surfaces of 48 molars were induced to an AWSL and divided in 6 groups, according to the conditioning protocols and application technique: 15% hydrochloric acid (HA) + manual application of the IR; HA + 37% phosphoric acid (PA) + manual application of the IR; HA + ultrasonic application (U) of the IR; HA + sonic application (S) of the IR; PA+HA+S; and PA+HA+U. For the Penetration Depth (PD), the crowns were etched with HA for 120s. The IR Icon® (DMG) was applied according to the manufacturer`s instructions. The crowns were dye penetrated (0.1% red fluorophore rhodamine B isothiocyanate for 12h) and bleached with 30% hydrogen peroxide for 12 h. The discs were immersed in a 50% ethanol solution, containing 100 µM of sodium fluorescein. The PD (in µm) was measured using confocal laser scanning microscopy (20x). The bond strength (BS) was performed by michoshear test (0.5 mm/min). Data were submitted to 2-way ANOVA and Tukey (α=0.05). For BS, the interaction was not significant (p>0.05). For PD, the main factors were significant (application - p<0.001; conditioning technique - p=0.003). The ultrasonic application showed the highest PD values. PA+HA presented higher results than HA. The sonic/ultrasonic applications and the use of phosphoric acid prior to hydrochloric acid improved PD of the infiltrant resin. Conditioning protocols or application techniques did not influence BS values.

Resin Infiltration of Artificial Enamel Lesions: Evaluation of Penetration Depth, Surface Roughness and Color Stability

Aim

To evaluate the penetration depth, surface roughness, and color stability of resin infiltration restoration of artificial enamel lesions induced in primary and permanent teeth.

Materials and methods

Primary (group I, n = 30) and permanent (group II, n = 30) extracted non-carious human anterior teeth were subjected to demineralization for four days after creating a window of 5 mm × 5 mm on the labial surfaces. Demineralized area was infiltrated with the low viscosity resin. Ten samples from each group were evaluated for penetration depth, surface roughness, and color stability, respectively. Penetration depth was determined using a stereomicroscope at 80× magnification. Surface roughness of sound and infiltrated enamel was recorded using a profilometer. The color stability was assessed at 2, 4, and 8 weeks along with baseline values using vita easy shade spectrophotometer.

Results

Data were analyzed using the student “t” test and Friedman test. The degree of resin penetration was observed to be higher in primary teeth (32.6 ± 15.72 μm) compared to permanent teeth (24.23 ± 6.85 μm), but no significant difference was found (p = 0.138). Surface roughness values of resin infiltrated enamel is similar to that of sound enamel in both primary (p = 0.617) and permanent teeth (p = 0.234). The mean color stability scores immediately after resin infiltration at 2, 4, and 8 weeks intervals showed no statistically significant difference in primary (p = 0.998) and permanent teeth (p = 0.213).

Conclusion

Resin penetration into enamel lesions was more in primary teeth enamel compared to permanent. The early enamel lesions, when treated with resin infiltration, showed surface characteristics similar to sound enamel and also exhibited acceptable color up to 8 weeks duration.

Clinical significance

Resin infiltration can be considered as an effective and predictable treatment option for the restoration of early enamel lesions owing to its deeper penetration, provision of better surface characteristics, and reliable masking of white spot lesions in both primary and permanent dentitions.

How to cite this article

Aswani R, Chandrappa V, Uloopi KS, et al. Resin Infiltration of Artificial Enamel Lesions: Evaluation of Penetration Depth, Surface Roughness and Color Stability. Int J Clin Pediatr Dent 2019;12(6):520–523.

Is Resin Infiltration a Microinvasive Approach to White Lesions of Calcified Tooth Structures?: A Systemic Review

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.

Microhardness and Penetration of Artificial White Spot Lesions Treated with Resin or Colloidal Silica Infiltration

INTRODUCTION

Infiltration of early enamel lesions by materials having remineralizing capacity seems to improve aesthetics and arrests caries progression.

AIM

To evaluate and compare the surface microhardness and penetration depth of a low viscosity resin and colloidal silica nanoparticle infiltrates into artificially created white spot lesions.

MATERIALS AND METHODS

Forty extracted human central incisors were embedded in acrylic resin blocks exposing the labial surfaces of the crowns. The specimens were immersed in demineralizing solution for 96 hours to create white spot lesions on labial surfaces. The samples were then divided into two groups (n=20 each), where in Group 1-resin infiltration (ICON DMG, Hamburg, Germany) and Group 2-colloidal silica infiltration (Arrow Fine chemicals, Rajkot, Gujarat, India) was done. Samples were subjected to vicker's microhardness testing at baseline, after demineralization and after treatment with resin or colloidal silica infiltrates. Then, the crowns were sectioned longitudinally and penetration depth of the infiltrants was measured using confocal laser scanning microscope and compared the readings to lesion depth. All the collected data was subjected to statistical analysis using t-test.

RESULTS

Resin infiltration group showed significantly greater increase in microhardness compared to colloidal silica infiltration (p=0.001). The percentage of penetration of the resin group was 67.14% and that of colloidal silica group was 54.53% indicating significant difference between the two.

CONCLUSION

Resin infiltrates performed better in regaining the baseline microhardness and penetrating deep into the porous white spot lesions, when compared to colloidal silica infiltrates.

Evaluation of staining and color changes of a resin infiltration system

OBJECTIVE

To analyze the staining and color changes of a resin infiltrant system used for management of white spot lesions (WSLs).

MATERIALS AND METHODS

WSLs were artificially created on left buccal halves of 48 extracted human teeth. These sites were then treated with resin infiltration (RI) while the right halves of the teeth remained as nonresin (NRI) areas. Six groups were formed (n = 8 teeth/group) and were exposed to the following: red wine, coffee, orange juice, combined staining agents, accelerated aging, and distilled water for 1 week. The teeth were then polished with a prophy cup and polishing paste. Color properties were assessed using a spectrophotometer at baseline (T0), after each exposure (T1), and after polishing (T2). Color difference (ΔE*) was calculated between each time point for both halves of the teeth (RI and NRI). Data were analyzed with a two-way analysis of variance with presence of resin infiltration and staining agents as the main effects for each time point pair. Multiple comparisons were made with a Bonferroni post hoc test. The level of significance was set at P < .05.

RESULTS

The red wine and combined staining agent groups caused the greatest color change between all intervals (P < .05). Significant interactions were recorded between resin infiltration application and staining agents at all time periods (P < .05). The presence of resin infiltration as a main effect did not affect color change between T0 and T2 (P > .05).

CONCLUSIONS

RI areas showed higher staining susceptibility than did NRI areas. However, prophylaxis had a strong effect on reversing the discoloration of both RI and NRI areas.