Efficacy of 4-year treatment of icon infiltration resin on postorthodontic white spot lesions

Abstract

White spot lesions are defined as enamel surface and sub surface demineralisation, although these lesions can be reversed and do not form cavities. Infiltration using fluid resin proved to be a valid micro-invasive alternative compared with traditional conservative therapy. This has allowed treatment without any trauma (no use of local anaesthesia and cavity preparation) of numerous lesions in only one session with stable clinical (mechanical stability, enamel hardness, conservation of sound tissue) and aesthetic results (disappearance of lesions) over the time. The present report evaluates the effectiveness of Icon infiltration resin on postorthodontic white spots at 6 months, 1 and 4 years.

Dental Treatment of White Spots and a Description of the Technique and Digital Quantification of the Loss of Enamel Volume

“…Due to the high concentration, the technique produced satisfactory results, but given the risk of destroying the enamel, reports of the treatment were not published. In 1941, Raper was the first to describe the technique of fluorosis stain removal, who did so using HCl at a lower concentration than used by Kane to ensure safety; 18% HCl was applied with a cotton wool swab, was left on the enamel for 10 min, and was followed by an application of sodium bicarbonate to neutralize the effect of the acid [37]. In 1989, a micro-abrasion technique was described by Croll that involved using a solution that combined chemical erosion with 18% HCl and mechanical abrasion using a pumice stone, thus eliminating the surface layer of the enamel and the white spots within it [38].…”

“…Erosion using 15% HCl-based products and subsequent infiltration of the intercrystalline spaces with low viscosity resin without milling the affected surface is a minimally invasive treatment that camouflages white spots, since the infiltration resin has a similar refractive index (I.R: 1.52) to hydroxyapatite. The refraction of light falling on the resin makes the human eye perceive the tooth color as unaltered in white spot areas [33][34][35][36][37]. As the HCl-based products used in this technique work through the erosion of the enamel, the site of application to the tooth's vestibular surface should be considered carefully in relation to the product's erosive capacity.…”

A minimally invasive treatment for white spots on teeth

“…ICON has shown in cases that aesthetic results can be delivered on white spots in a minimally invasive way. 3,4,5,6 This technique Molar incisor hypomineralisation (lack of enamel development during its maturation stage, which affects the molar and incisor teeth) Decalcification of enamel due to fixed braces (inadequate oral hygiene around the plaque retentive orthodontic brackets).…”

“…The clear resin flows into the demineralised enamel, and has similar optical properties (similar refractive index) to the enamel, therefore reflecting light to match the the tooth's natural shade. 3,4,5 What is a white spot? White spot lesions are white opacities seen on teeth after the subsurface layer of enamel on a tooth becomes demineralised, often due to poor oral hygiene and plaque, bacteria and The flow chart in Figure 1, produced by DMG Dental, outlines the process for ICON.…”

Pediatric Dentists’ Educational Experiences, Attitudes, and Professional Behavior Concerning Resin Infiltration: Implications for Dental Education

“…The result is a blockage of cariogenic acids and the arrest of lesion progression 10 . While research showed that RI creates a significantly rougher surface than healthy enamel, clinical trials with a split‐mouth design found that RI was effective 11‐13 . For example, in 2010, Ekstrand et al.’s study on primary molars in high caries risk children found, based on radiographs, that only 23.1% of infiltrated lesions in primary molars had carious lesion progression, while in the control group 61.5% of lesions had progressed during a 12‐month period 14 .…”