Abstract
Enamel hypomineralization is a condition that affects the quality of enamel, resulting in a change in its translucency and color. In this case report, a patient with a chief complaint of discolored front teeth, represented a very interesting case as he had combined opaque white, brown discoloration, and pitted enamel well distributed over the entire facial surfaces of enamel, especially his anterior teeth. It was also found that tooth #10 was protruded in relation to the adjacent teeth. The patient’s main concern was to improve his aesthetic appearance. Despite being a typical clinical picture of fluorotic lesion, fluoride was excluded as the cause of his lesions as the patient’s history indicated a lack of exposure to fluoride. A combined minimally invasive treatment, consisted of teeth bleaching, microabrasion, and resin infiltration were performed to address these esthetic problems. Minimum tooth reduction plus resin composite placement was done to solve the problem of the protruded tooth. All materials used was placed according to the manufacturer's instructions. Intraoral photographs were taken directly after each treatment to document any change in the appearance of the case. Six months follow up of the case was documented. The result was acceptable for the patient, and he was satisfied as more aggressive treatments were avoided.
Highlights
Hypomineralization defects are considered one of the most common reasons patients seek esthetic dental treatment
The initial treatment plan for the hypomineralization defects was presented to the patient, this included in-office bleaching with 35% hydrogen peroxide to target the brown discolorations, followed by resin infiltration to mask the white spot areas with Icon (DMG Germany, 220343)
Most clinical reports aimed at conservative management of those defects have incorporated different interventions such as teeth bleaching, enamel macroabrasion, microabrasion, and resin infiltration in their treatment plans
Summary
Hypomineralization defects are considered one of the most common reasons patients seek esthetic dental treatment. The initial treatment plan for the hypomineralization defects was presented to the patient, this included in-office bleaching with 35% hydrogen peroxide (polaoffice in-office Tooth Whitening System, SDI Australia, 7700031) to target the brown discolorations, followed by resin infiltration to mask the white spot areas with Icon (DMG Germany, 220343). It was decided at this moment that a change in the initial treatment plan would have to occur, and that teeth microabrasion (Opalustre, Ultradent USA, 555) was going to be carried out before resin infiltration to selectively target those resistant stains The disappearance of those resistant stains was evident immediately after the microabrasion session (Figure 4). After the resin composite shade was selected and minimal tooth reduction (0.5 mm) of the mesio-incisal aspect was carried out as previously mentioned, enamel was etched with 37.5% phosphoric acid gel (Kerr, Italia, 31297) for 15 seconds, rinsed with water for.
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