Citation Information :
Garg I, Kumar A. Resin Infiltration for Esthetic Improvement of Mild to Moderate Non-pitted Fluorosis Stains in 6–12-year-old Children: A Randomized 6-month Interventional Study. J South Asian Assoc Pediatr Dent 2021; 4 (2):96-103.
Background: Dental fluorosis is the hypomineralization of tooth enamel due to excessive fluoride, resulting in opaque white areas or discoloration of teeth. The available treatment modalities to improve the esthetics affected due to fluorosis include non-invasive and invasive methods. Nowadays, a newer non-invasive treatment that is resin infiltration (RI) is gaining increasing popularity. The present study evaluated and compared the clinical success in esthetic improvement (EI) and changes in white/brown opacities/stains (SC) of RI on non-pitted fluorosis stains.
Materials and methods: A total of 18 patients in the age range of 6–12 years with the unesthetic appearance of upper anterior teeth due to non-pitted fluorosis were randomly selected and subjected to an RI procedure. Evaluation for EI and changes in white/brown opacities/stains (SC) was done on the visual analog scale (VAS).
Results: The results were statistically highly significant (p < 0.01) for the mean VAS score values of EI (p = 0.001) and SC (p = 0.001) between the follow-up time intervals with the highest values at time interval 6 months followed by 3 months, 1 month, and least at immediate postoperative. Furthermore, inter-grade comparison of fluorosis showed a highly significant difference (p < 0.01) for the VAS scores for both EI and SC with the highest mean VAS score values in a very mild degree of fluorosis, followed by mild and moderate degrees.
Conclusion: Resin infiltration is a promising procedure that demonstrated remarkably successful EI in mild to moderate non-pitted fluorosis with a stable long-term positive outcome.
Molina-Frechero N, Nevarez-Rascón M, Nevarez-Rascón A, et al. Impact of dental fluorosis, socio-economic status and self-perception in adolescents exposed to a high level of fluoride in water. Int J Environ Res Public Health 2017;14(1):73. DOI: 10.3390/ijerph14010073.
Gupta A, Dhingra R, Chaudhuri P, et al. A comparison of various minimally invasive techniques for the removal of dental fluorosis stains in children. J Indian Soc Pedod Prev Dent 2017;35(3):260–268. DOI: 10.4103/JISPPD.JISPPD_138_16.
Gugnani N, Pandit IK, Gupta M, et al. Comparative evaluation of esthetic changes in non-pitted fluorosis stains when treated with resin infiltration, in-office bleaching, and combination therapies. J Esthet Restor Dent 2017;29(5):317–324. DOI: 10.1111/jerd.12312.
Auschill TM, Schmidt KE, Arweiler NB. Resin infiltration for esthetic improvement of mild to moderate fluorosis: a six-month follow-up case report. Oral Health Prev Dent 2015;13(4):317–322. DOI: 10.3290/j.ohpd.a32785.
Russell AL. The differential diagnosis of fluoride and non fluoride enamel opacities. J Public Health Dent 1961;21(4):143–146. DOI: 10.1111/j.1752-7325.1961.tb00373.x.
Den-Besten P, Li W. Chronic fluoride toxicity: dental fluorosis. Monogr Oral Sci 2011;22:81–96.
Loguercio AD, Correia LD, Zago C, et al. Clinical effectiveness of two microabrasion materials for the removal of enamel fluorosis stains. Oper Dent 2007;32(6):531–538. DOI: 10.2341/06-172.
Price RB, Loney RW, Doyle MG, et al. An evaluation of a technique to remove stains from teeth using microabrasion. J Am Dent Assoc 2003;134(8):1066–1071. DOI: 10.14219/jada.archive.2003. 0320.
Celik EU, Yildiz G, Yazkan B. Clinical evaluation of enamel microabrasion for the aesthetic management of mild-to-severe dental fluorosis. J Esthet Restor Dent 2013;25(6):422–430. DOI: 10.1111/jerd.12052.
Cocco AR, Lund RG, Torre E, et al. Treatment of fluorosis spots using a resin infiltration technique: 14-month follow-up. Oper Dent 2016;41(4):357–362. DOI: 10.2341/14-335-S.
Owda R, Sancakli HS. Resin infiltration as a minimal invasive esthetic treatment for a mild fluorosis case. Stoma Edu J 2018;5(3):184–188. DOI: 10.25241/stomaeduj.2018.5(3).art.7.
Garg SA, Chavda SM. Color masking white fluorotic spots by resin infiltration and its quantitation by computerized photographic analysis: a 12-month follow-up study. Oper Dent 2020;45(1):1–9. DOI: 10.2341/17-260-T.
Ontiveros JC. Commentary: alternative esthetic management of fluorosis and hypoplasia stains: blending effect obtained with resin infiltration techniques. J Esthet Restor Dent 2013;1(1):40–41. DOI: 10.1111/j.1708-8240.2012.00528.x.
Meyer-Lueckel H, Paris S, Mueller J, et al. Influence of the application time on the penetration of different dental adhesives and a fissure sealant into artificial subsurface lesions in bovine enamel. Dent Mat 2006;22(1):22–28. DOI: 10.1016/j.dental.2005.03.005.
Robinson C, Brookes SJ, Kirkham J, et al. In vitro studies of the penetration of adhesive resins into artificial caries-like lesions. Cari Res 2001;35(2):136–141. DOI: 10.1159/000047445.
Attal JP, Atlan A, Denis M, et al. White spots on enamel: treatment protocol by superficial or deep infiltration (part 2). Inter Orthod 2014;12(1):1–31. DOI: 10.1016/j.ortho.2013.12.011.
Shawkat ES, Shortall AC, Addison O, et al. Oxygen inhibition and incremental layer bond strengths of resin composites. Dent Mat 2009;25(11):1338–1346. DOI: 10.1016/j.dental.2009.06.003.
Thylstrup A, Fejerskov O. Clinical appearance of dental fluorosis in permanent teeth in relation to histologic changes. Community Dent Oral Epidemiol 1978;6(6):315–328. DOI: 10.1111/j.1600-0528.1978.tb01173.x.
Paris S, Meyer-Lueckel H. Masking of labial enamel white spot lesions by caries infiltration-a clinical report. Quintessence Int 2009;40(9):713–718.