Treatment of various degrees of white spot lesions using resin infiltration—in vitro study

Abstract

BackgroundThis 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.ResultsIn 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.ConclusionsAs 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.

Color Stability of Artificial White Spot Lesions treated with Resin Infiltration

“…The rest of the enamel surface was protected by two coats of acidresistant nail varnish (Revlon Consumer Products Corporation, New York, USA). 17,18 Specimens were immersed in a demineralizing solution containing 2.2 mM CaCl2, 2.2 mM KH2PO4, and 50 mM Acetic Acid at 37 o C for 4 days. 19 Two milliliters of demineralizing solution was used per each mm 2 of the exposed enamel area of each specimen.…”

Can composition and preheating improve infiltrant characteristics and penetrability in demineralized enamel?

“…This tells us that it is important to study how the materials perform during penetration of the lesion. 9 The optical effect that allows the altered enamel to look like the adjacent healthy enamel is related to the similarity between the infiltrating refractive index and the healthy enamel, in comparison with porous enamel, filled with air or water. 10,11 Thus, the addition of diluents is a strategy that can be used to reduce the viscosity of the infiltrant and to increase the depth of penetration.…”

Color evaluation of white spot lesions treated with resin infiltration after water or grape juice storage

“…Resin infiltration is currently indicated to mask defects in enamel staining, such as white spot lesions. In this case, ICON can prevent the progression of non-cavitated enamels caries 5,12,25 . This material improves the esthetic aspects of the lesion due to monomer infiltration through porosities of white spot lesions, decreasing their opacity 5 .…”

“…In this case, ICON can prevent the progression of non-cavitated enamels caries 5,12,25 . This material improves the esthetic aspects of the lesion due to monomer infiltration through porosities of white spot lesions, decreasing their opacity 5 . The present study was designed to evaluate the color stability of bovine teeth with artificial white spot lesions treated with remineralization (Flugel, DFL Indústria e Comércio SA) or resin infiltration (ICON, DMG) using two different application techniques.…”

“…In addition, the introduction of resinous materials to seal pits and grooves and to infiltrate white spot lesions brought the advantage of being an immediate treatment. However, studies with infiltrant in anterior teeth have questionable esthetic in masking white spot lesions in the long-term [5][6][7] .…”