Journal of Oral Health and Community Dentistry

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VOLUME 17 , ISSUE 2 ( May-August, 2023 ) > List of Articles

CASE REPORT

Infiltrating Resins, Noninvasive Treatment of White Spot Lesions: A Case Report

Rubén Darío Miranda-Carreño, Jacqueline Adelina Rodríguez-Chávez, Abigailt Flores-Ledesma

Keywords : Case report, Infiltrating resins, Minimal invasive dentistry, White-spot lesions

Citation Information : Miranda-Carreño RD, Rodríguez-Chávez JA, Flores-Ledesma A. Infiltrating Resins, Noninvasive Treatment of White Spot Lesions: A Case Report. J Oral Health Comm Dent 2023; 17 (2):75-79.

DOI: 10.5005/jp-journals-10062-0165

License: CC BY-NC 4.0

Published Online: 29-08-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Demineralization of tooth enamel causes milky, opaque white-spot lesions (WSL). Aim: The aim was to use infiltrating resin as a noninvasive technique on the removal of WSL. Case description: An 18-year-old female patient presented to a dental consultation complaining about “the spots in her front teeth”; the patient had recently finished her orthodontic treatment. The clinical examination identified WSL on the vestibular surfaces of teeth 11, 21, and 22. A minimally invasive treatment was selected with infiltrating resin (ICON Smooth surface, DGM, Germany). After absolute isolation of the upper anterior sector, the teeth with the WSL were conditioned with 15% hydrochloric acid for 2 minutes and rinsed with abundant profuse water for 30 seconds. Ethanol was applied for 30 seconds and volatilized with oil-free air for 20 seconds. The infiltrating resin was placed and left to act for 3 minutes to allow infiltration in the previously etched area. The excess resin was removed, and light cured for 40 seconds with a LED light-curing lamp (Bluephase N® MC, Ivoclar Vivadent, 800 mW/cm2, 430–490 nm). Conclusion: The WSL were successfully removed, stopping the demineralization process. The use of infiltrating resins is an excellent noninvasive treatment to eliminate WPL timely with excellent clinical results. Clinical significance: One of the challenges in dental esthetics are visible WSL in the anterior region. Considering the minimally invasive treatments, the use of infiltrating resins is indicated to treat these WSL, as an indication of an initial caries or certain degrees of fluorosis.


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  1. Machiulskiene V, Campus G, Carvalho JC, et al. Terminology of dental caries and dental caries management: Consensus report of a workshop organized by ORCA and Cariology Research Group of IADR. Caries Res 2020;54(1):7–14. DOI: 10.1159/000503309.
  2. Roberts WE, Mangum JE, Schneider PM. Pathophysiology of demineralization, Part II: enamel white spots, cavitated caries, and bone infection. Curr Osteoporos Rep 2022;20(1):106–119. DOI: 10.1007/s11914-022-00723-0.
  3. Bourouni S, Dritsas K, Kloukos D, et al. Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis – A systematic review and meta-analysis. Clin Oral Investig 2021;25(8):4711–4919. DOI: 10.1007/s00784-021-03931-7.
  4. Flynn LN, Julien K, Noureldin A, et al. The efficacy of fluoride varnish vs a filled resin sealant for preventing white spot lesions during orthodontic treatment: A randomized clinical trial. Angle Orthod 2022;92(2):204–212. DOI: 10.2319/052521-418.1.
  5. Michaelis J, Yu Q, Lallier T, et al. Quantifying the degree of white spot lesions on enamel caused by different commercial beverages using the canary caries detection system: An in vitro study. J Dent Res Dent Clin Dent Prospects 2022;16(1):29–34. DOI: 10.34172/joddd.2022.005.
  6. Iheozor-Ejiofor Z, Worthington HV, Walsh T, et al. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 2015;2015(6):CD010856. DOI: 10.1002/14651858.CD010856.pub2.
  7. DenBesten P, Li W. Chronic fluoride toxicity: Dental fluorosis. Monogr Oral Sci 2011;22:81–96. DOI: 10.1159/000327028.
  8. Saldarriaga A, Rojas-Gualdrón DF, Restrepo M, et al. Clinical changes in the severity of dental fluorosis: A longitudinal evaluation. BMC Oral Health 2021;21(1):366. DOI: 10.1186/s12903-021-01729-3.
  9. Banerjee A, Frencken JE, Schwendicke F, et al. Contemporary operative caries management: Consensus recommendations on minimally invasive caries removal. Br Dent J 2017;223(3):215–222. DOI: 10.1038/sj.bdj.2017.672.
  10. Abdullah Z, John J. Minimally invasive treatment of white spot lesions – A systematic review. Oral Health Prev Dent 2016;14(3):197–205. DOI: 10.3290/j.ohpd.a35745.
  11. Cedillo Valencia J de J, Cedillo Felix JE. Resinas Infiltrantes, una novedosa opción para las lesiones de caries no cavitadas en esmalte. Revista ADM 2012;69(1):38–45. Available from: https://www.medigraphic.com/pdfs/adm/od-2012/od121j.pdf.
  12. Goyal A, Verma M, Toteja G, et al. Validation of ICMR index for identification of dental fluorosis in epidemiological studies. Indian J Med Res 2016;144(1):52–57. DOI: 10.4103/0971-5916.193283.
  13. Son J-H, Hur B, Kim HC, et al. Management of white spots: Resin infiltration technique and microabrasion. J Korean Acad Conserv Dent 2011;36(1):66–71. DOI: 10.5395/JKACD.2011.36.1.66.
  14. Schwendicke F, Splieth C, Breschi L, et al. When to intervene in the caries process? An expert Delphi consensus statement. Clin Oral Investig 2019;23(10):3691–3703. DOI: 10.1007/s00784-019-03058-w.
  15. Ramírez Barrantes JC. Minimally invasive restoration in anterior teeth affected by enamel hypoplasia: Clinical case report. Odovtos Int J Dent Sci 2019;21(3):99–113. DOI: 10.15517/ijds.v0i0.36764.
  16. Giray F, Durhan MA, Haznedaroglu E, et al. Resin infiltration technique and fluoride varnish on white spot lesions in children: Preliminary findings of a randomized clinical trial. Niger J Clin Pract 2018;21(12):1564–1569. DOI: 10.4103/njcp.njcp_209_18.
  17. Philip N. State of the art enamel remineralization systems: The next frontier in caries management. Caries Res 2019;53(3):284–295. DOI: 10.1159/000493031.
  18. Indrapriyadharshini K, Madan Kumar P, Sharma K, et al. Remineralizing potential of CPP-ACP in white spot lesions – A systematic review. Indian J Dent Res 2018;29(4):487–496. DOI: 10.4103/ijdr.IJDR_364_17.
  19. Thierens LAM, Moerman S, van Elst C, et al. The in vitro remineralizing effect of CPP-ACP and CPP-ACPF after 6 and 12 weeks on initial caries lesion. J Appl Oral Sci 2019;27:e20180589. DOI: 10.1590/1678-7757-2018-0589.
  20. Aref NS, Alrasheed MKh. Casein phosphopeptide amorphous calcium phosphate and universal adhesive resin as a complementary approach for management of white spot lesions: An in-vitro study. Prog Orthod 2022;23(1):10. DOI: 10.1186/s40510-022-00404-9.
  21. Oliveira GMS, Ritter AV, Heymann HO, et al. Remineralization effect of CPP-ACP and fluoride for white spot lesions in vitro. J Dent 2014;42(12):1592–1602. DOI: 10.1016/j.jdent.2014.09.004.
  22. Arnold WH, Haddad B, Schaper K, et al. Enamel surface alterations after repeated conditioning with HCl. Head Face Med 2015;11:32. DOI: 10.1186/s13005-015-0089-2.
  23. Nahuelhuaiqye Fuentealba P, Díaz Melendez J, Sandoval Vidal P. Resin infiltration: An effective and minimally invasive treatment for the treatment of non-cavitated white lesions. Narrative review. Av Odontoestomatol 2019;33(3):121–126. Available from: https://scielo.isciii.es/pdf/odonto/v33n3/original3.pdf.
  24. Perdigão J. Resin infiltration of enamel white spot lesions: An ultramorphological analysis. J Esthet Restor Dent 2020;32(3):317–324. DOI: 10.1111/jerd.12550.
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