Clinical Evaluation of Enamel Microabrasion for the Aesthetic Management of Mild‐to‐Severe Dental Fluorosis

Introduction Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar‐incisor hypomineralization (MIH), amelogenesis imperfecta and dental fluorosis (DF) are examples of such defects. Objective To evaluate the effectiveness of the treatments applied to the different forms of dental hypomineralization. Materials and Methods PubMed, Scopus, Cochrane Library, Web of Science, and Embase were screened. The research was limited to studies published in English, Spanish, and Portuguese, until May 30, 2018. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. The quality of the methodology of each article was evaluated employing the Cochrane Handbook for Systematic Reviews. Results From the initial research, 7895 references were obtained, of which 33 were included in the systematic review. The following treatments were reported: desensitizing and remineralizing products, resin infiltration, restorations, fissure sealants, tooth bleaching, enamel microabrasion and calcium, and vitamins supplements. Conclusions Although the results are suggestive, there is a clear need for a greater uniformity of the methodologies, thus allowing for the development of clinical guidelines. Nevertheless, it was possible to identify several effective treatments for teeth with MIH (arginine pastes or fluoride varnishes) and DF (tooth bleaching and/or enamel microabrasion). Clinical Significance Because MIH, amelogenesis imperfecta, and DF are commonly seen in dental daily practice, it is extremely important to analyze the literature regarding its treatment.

Section: Resultsmentioning

confidence: 99%

Dental hypomineralization treatment: A systematic review

Coelho

Mata²,

Lino

et al. 2018

“…Subjective evaluation parameters used in our study included scoring for “Change in esthetics” and “improvement in brown stains/opaque white areas” on a Visual Analog Scale. These VAS scales were adopted from similar studies done for evaluating the esthetic improvements in fluorosis patients . Similar VAS scales have also been used by other researchers for fluorosis and other stain removal studies …”

Section: Discussionmentioning

confidence: 99%

“…Celik et al reported that this scale can truly quantify the overall improvement in the appearance of the mottled surface and a quantitative evaluation of Δ E only on fluorotic area of the tooth may not be sufficient …”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of esthetic changes in nonpitted fluorosis stains when treated with resin infiltration, in‐office bleaching, and combination therapies

Gugnani

Pandit

Gugnani

et al. 2017

White and brown opacities due to fluorosis have always been a concern for esthetics. In our study, resin infiltration technique with tailored etching times and increased infiltration time exhibited best immediate esthetic improvement for nonpitted fluorotic opacities and stains. These esthetic outcomes reaffirm the applicability of RI technique for nonpitted fluorosis, which was originally advocated only for white spot lesions due to early caries. This will in turn help the dentists to plan the esthetic management of nonpitted fluorosis in a micro-invasive manner.

“…Even though the esthetic perception of enamel mottling is variable across patients, this may have considerable psychosocial effects on many patients and impact their quality of life . Therefore, considerable efforts have been put in identifying an effective means to treat fluorotic stains that might be chosen according to lesion severity .…”

Section: Introductionmentioning

confidence: 99%

Interventions for dental fluorosis: A systematic review

Giovanni

Eliades

Papageorgiou

2018

For this systematic review, which was registered beforehand in PROSPERO (CRD42016053492), we synthesized evidence from existing randomized clinical trals on humans to see which treatment is most effective for the esthetic rehabilitation of dental fluorosis, the prevalence of which is seeing a worldwide steady increase. We found that resin infiltration seems to be the most effective treatment approach for lesions of mild to moderate severity, followed by bleaching, and finally microabrasion. Our study's strengths are its a priori registration, wide search, quality check according to Cochrane guidelines, and the use of a new robust analytic method to provide valid clinical recommendations according to the principles of evidence-based medicine.