Caries Infiltration Research Articles

Equivalence study of the resin-dentine interface of internal tunnel restorations when using an enamel infiltrant resin with ethanol-wet dentine bonding

This preregistered ex vivo investigation examined the dentinal hybrid layer formation of a resinous infiltrant (Icon), with reference to both thickness (HLT) and homogeneity when combined with modified tunnel preparation (occlusal cavity only) and internal/external caries infiltration. The adhesives Syntac and Scotchbond MP were used as controls (Groups 1 and 3) or in combination with Icon (Groups 2 and 4). A split-tooth design using healthy third molars from 20 donors resulted in 20 prepared dentine cavities per experimental group. The cavity surfaces (n = 80) were etched (37% H3PO4), rinsed, and air-dried. Rewetting with ethanol was followed by application of the respective primers. After labeling with fluorescent dyes, either Syntac Adhesive/Heliobond or Scotchbond MP Adhesive was used alone or supplemented with Icon. HLT, as evaluated by scanning electron microscopy, did not significantly differ (P > 0.05), and confocal laser scanning microscopy revealed homogeneously mixed/polymerized resin-dentine interdiffusion zones in all groups. Icon can be successfully integrated into an ethanol-wet dentine bonding strategy, and will result in compact and homogeneous hybrid layers of comparable thickness considered equivalent to the non-Icon controls, thus allowing for preservation of the tooth’s marginal ridge and interdental space in the case of internal/external infiltration of proximal caries.

Resin infiltration versus fluoride varnish for visual improvement of white spot lesions during multibracket treatment. A randomized-controlled clinical trial

AimsThis study aimed to evaluate the visual improvement of resin infiltration of white spot lesions (WSL) during orthodontic treatment with the multibracket appliance (MBA) compared to fluoride varnish.MethodsPatients aged 12–17 years with at least one WSL with an International Caries Detection and Assessment System (ICDAS) score of 1–2 during an active MBA treatment were included and randomized to receive either resin infiltration (Icon) or fluoride application (Flairesse). Standardized digital images were obtained before, one-day, one-week, one-month, three-months and six-months after treatment using a DSLR camera and a matching polarization filter. A grey reference card was used for color standardization. A Matlab routine was used to measure the color difference between adjacent healthy enamel and treated WSL. The independent-samples t-test was used for intergroup and paired-samples t-test for intragroup comparison.ResultsImages of 116 teeth from 36 patients were analyzed. The ΔE for the “Icon” treated WSL was smaller (T1ICON = 5.0 ± 1.4) than in the fluoride group (T1Fluoride = 8.4 ± 3.2). Caries infiltration significantly improved the aesthetic appearance of WSL (p < 0.001), which remained satisfactory at six months (T5ICON = 5.2 ± 1.6).ConclusionWSL infiltration management during orthodontic treatment was superior to topical fluoridation in not only arresting the enamel lesions but also significantly improving the aesthetic appearance of demineralized regions around the brackets.Clinical relevanceWSL treatment in orthodontic patients is usually initiated after debonding. Research has shown that the earlier WSL is treated, the better the aesthetic outcome. There is limited data on the efficacy of resin infiltration of WSL during orthodontic treatment.

Integrated approach to the study of biodegradation of composite materials for the restoration of hard dental tissues

Objective. To study the stress-strain state of demineralized tooth enamel after its impregnation with a low-viscosity composite in a long-term period of functioning in the oral cavity in a series of equivalent cyclic tests; to study the correlation of the experimental results with clinical observations of the treatment of enamel caries using a modified infiltration technique. Materials and methods. The parameters of laser holographic interferometry and atomic force microscopy, reflecting the timing, type and severity of deformation defects in samples of demineralized tooth enamel were analyzed in a series of equivalent cyclic tests. During the experiment the samples underwent classical infiltration with composite using ICON technology (main group) and a 2-stage enamel caries treatment technique, including carrying out a time-modified conditioning of classical infiltration and the final stage (stages) of enamel coating with a bioactive hybrid glass ionomer (comparison group). Results. The first signs of the deformation defects generation in demineralized enamel filtered on the classical method (the appearance of perifocal microcracks) were recorded in 11.2 % of the tested samples after 0.9 · 106 cycles (equivalent to 9 months of functioning of a tooth with treated enamel caries in the oral cavity), during further cyclic tests the percentage of samples with local defects increased progressively. Signs of a violation of the stress-strain state in the enamel after combined treatment (samples of the comparison group) were revealed in cycles corresponding to 2–3 years of being in an artificial environment of the oral cavity. Experimental data correlated with the clinical observations both in time and frequency of complications (secondary/recurrent caries) in the long term after treatment of enamel caries by various methods. Conclusions. In the process of equivalent cyclic tests, heterogeneous elastic-plastic deformations develop in the thickness of a section of demineralized enamel impregnated with a flowing composite and along its perifocal zones, most pronounced at the interface between intact and treated enamel, which leads to the development of local defects, delaminations, cracks, and destruction of the structurally heterogeneous environment of tooth enamel. According to the results of the comparative analysis, the most favorable results in terms of the timing of development, frequency and severity of deformation defects were obtained in samples of demineralized enamel after its treatment using a modified caries infiltration technique followed by coating with a bioactive hybrid glass ionomer.

Aesthetic caries infiltration – Long-term masking efficacy after 6 years

ObjectivesThis study aimed to evaluate the masking efficacy of caries infiltration technique of initial caries lesions (ICL) six years after debonding and single treatment. MethodsIn 10 adolescents, 74 ICL (ICDAS 2) in 74 teeth were treated by resin infiltration (Icon, DMG) at a mean (SD) of 1.2 (1.2) months after bracket removal. The etching procedure was performed up to 3 times. Standardized digital images were taken before treatment (T0), seven days (T7) and 6 years (T2190) after treatment. Outcomes included the evaluation of the color differences between carious and healthy enamel at T0, T7 and T2190 by quantitative colorimetric analysis (ΔE), ICDAS scores, quantitative light-induced fluorescence (QLF; ΔF,ΔQ,WS Area) and qualitative visual evaluation (5-point Likert-scale [deteriorated (1), unchanged (2), improved, but not satisfying (3), improved and no further treatment required (4), completely masked (5)). ResultsThe median color difference ΔΕ0 (25th/75th percentiles) at T0 was 10.3 (8.56/13.0). At T7 a significant decrease was observed (ΔΕ7=3.7 (2.0/5.8); p<0.001; Friedmann-test; ICDAS p<0.001; Chi-square test). No significant changes based on ΔΕ (p=0.972; Friedmann-test) and ICDAS grading (p=0.511, chi-square test) were observed between T7 and T2190 (ΔΕ2190=2.9 (1.8/4.2)). Furthermore, at T2190 four experienced dentists classified 50% and 37% of the lesions as “improved and no further treatment required” and “completely masked”, respectively (Fleiss kappa: T2190: 0.782 (substantial agreement)). ConclusionAesthetic caries infiltration can effectively mask post-orthodontic initial caries lesions for at least 6 years. These results for most of the teeth could not only be observed by quantitative but also by qualitative analysis. Clinical significanceResin infiltration efficaciously masks post-orthodontic initial carious lesions. The optical improvement can be observed directly after treatment and remains stable for at least six years.

Evaluation of the masking efficacy of caries infiltration in post-orthodontic initial caries lesions: 1-year follow-up

ObjectivesThis study aimed to qualitatively and quantitatively assess the masking efficacy and color stability of resin infiltration on post-orthodontic ICL after 1 year.Materials and methodsIn 17 adolescents, 112 ICL (ICDAS-1: n = 1; ICDAS-2: n = 111) in 112 teeth were treated by resin infiltration (Icon, DMG) 3 to 12 months after bracket removal. The etching procedure was performed up to 3 times. Standardized digital images were taken before treatment (T0), 7 days (T7) and 12 months (T365) after treatment. Outcomes included the evaluation of the color differences between infiltrated and healthy enamel at T0, T7, and T365 by quantitative (colorimetric analysis (ΔE), ICDAS scores) and qualitative methods (5-point Likert scale (deteriorated (1), unchanged (2), improved, but not satisfying (3), improved and no further treatment required (4), completely masked (5)).) Differences between time points were analyzed by using Friedman test (ΔΕ) and chi-square tests (ICDAS).ResultsThe median color difference (25th/75th percentiles) between carious and healthy enamel at baseline (ΔΕ0) was 10.2(7.7/13.6). A significant decrease was observed 7 days after treatment (ΔΕ7 = 3.1(1.8/5.0); p < 0.001; ICDAS; p < 0.001). No significant changes based on ΔΕ (p = 1.000), and ICDAS grade (p = 0.305) were observed between T7 and T365 (ΔΕ12 = 3.4 (1.8/4.9)). Furthermore, at T365 four experienced dentists classified 55% and 39% of the lesions as “improved and no further treatment required” and “completely masked,” respectively (Fleiss kappa: T365 = 0.851 (almost perfect)).ConclusionResin infiltration efficaciously masked post-orthodontic ICL 7 days and 12 months after treatment. These results for most of the teeth could not only be observed by quantitative but also by qualitative analysis.Clinical relevanceResin infiltration efficaciously masks post-orthodontic initial carious lesions. The optical improvement can be observed directly after treatment and remains stable for at least 12 months.

In-vivo colour stability of enamel after ICON® treatment at 6 years of follow-up: A prospective single center study.

ObjectivesThis in-vivo clinical study provides subjective and objective documentation on colour stability of enamel after resin infiltration at a mean observation time of six years after treatment. Methods76 teeth previously treated with ICON® due to hypomineralized lesions of enamel were recalled for a follow-up at the 1st Observation Unit of the Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome (Italy). Colour stability was assessed: i) subjectively by patients using FDI-colour matching criteria; ii) objectively by calculating CIEDE2000 colour differences between the affected/treated and sound enamel in each tooth at T0 (baseline), T1 (one year) and T2 (six years) based on spectrophotometric data. Analysis of correlation between FDI and CIEDE2000 data was performed. ResultsTwo teeth were lost to follow-up prior to 72 months. No unwanted effects were reported by patients. Number of FDI scores 1 and 2 were 13.5%, 90.6% and 93.2% at T0, T1 and T2, respectively. ΔE00 was evaluated at 6.8 (SD3.8) at T0. ΔE00 was 5.8 (SD3.1) between T0 and T1 and 1.3 (SD0.6) between T1 and T2. ΔE00 reduction (T1-T0) was significantly but only fairly correlated with FDI scores at any follow-up. ConclusionsThis study shows that caries infiltration satisfactorily masks aesthetically relevant lesions after longer follow-up. Subjective and objective outcomes showed a fair correlation mainly for the initial masking effect. Clinical SignificanceThis prospective clinical trial demonstrates the excellent subjective and objective colorimetric stability of enamel treated with ICON® 6 years after treatment.

Application of Selected Biomaterials and Stem Cells in the Regeneration of Hard Dental Tissue in Paediatric Dentistry-Based on the Current Literature.

Currently, the development of the use of biomaterials and their application in medicine is causing rapid changes in the fields of regenerative dentistry. Each year, new research studies allow for the discovery of additional possibilities of dental tissue restoration. The structure and functions of teeth are complex. They consist of several diverse tissues that need to act together to ensure the tooth’s function and durability. The integrity of a tooth’s enamel, dentin, cementum, and pulp tissue allows for successful mastication. Biomaterials that are needed in dentistry must withstand excessive loading forces, be biocompatible with the hosts’ tissues, and stable in the oral cavity environment. Moreover, each tooth’s tissue, as well as aesthetic qualities in most cases, should closely resemble the natural dental tissues. This is why tissue regeneration in dentistry is such a challenge. This scientific research focuses on paediatric dentistry, its classification of caries, and the use of biomaterials in rebuilding hard dental tissues. There are several methods described in the study, including classical conservative methods such as caries infiltration or stainless-steel crowns. Several clinical cases are present, allowing a reader to better understand the described methods. Although the biomaterials mentioned in this work are artificial, there is currently ongoing research regarding clinical stem cell applications, which have a high potential for becoming one of the most common techniques of lost dental-tissue regeneration in the near future. The current state of stem cell development is mentioned, as well as the various methods of its possible application in dentistry.

Proximal caries infiltration – Pragmatic RCT with 4 years of follow-up

ObjectivesEfficacy of proximal caries infiltration to arrest lesion progression has been shown in university settings, but only once in a practice-based pragmatic design with a follow-up of 18 months. The aim of this randomized split-mouth placebo-controlled study was to follow-up this cohort for 3 years and those with high caries risk for 4 years. MethodsOriginally, in 87 children and young adults pairs of 238 proximal caries lesions, radiographically extending into inner half of enamel (E2) or outer third of dentin (D1), were randomly allocated to two groups: infiltration (Icon; DMG) or mock (control) treatment by five dentists in four private practices. All subjects received risk-related instructions for diet, flossing and fluoridation. The primary outcome was radiographic lesion progression (pairwise comparison) evaluated by two evaluators independently being blinded to treatment allocation. ResultsAfter 36 months [mean (SD): 1152 (166) days] 165 lesion pairs in 64 patients as well as after 48 months [mean (SD): 1496 (121) days] 71 lesion pairs in 20 high caries risk patients could be re-evaluated clinically as well as radiographically using individualized bitewing holders as at baseline. No adverse events could be observed. After 36 months, progression was recorded in 23/165 test (14%) and 64/165 control lesions (39%) [McNemar/Obuchowski test; p<0.001; relative risk reduction (CI95%): 64 (45–77%)]. After 48 months lesion progression was recorded in 13/71 test (18%) and 34/71 control lesions (48%) [p = 0.003; relative risk reduction (CI95%): 62 (34–78%)] of high caries risk patients. ConclusionsIt can be concluded that also in a practice-setting proximal caries infiltration is more efficacious in reducing lesion progression compared with individualized non-invasive measures alone over a period of four years.

Do bleaching gels affect the stability of the masking and caries-arresting effects of caries infiltration\u2014in vitro

ObjectivesThe aim of this study was to evaluate the influence of different bleaching gels on the masking and caries-arresting effects of infiltrated and non-infiltrated stained artificial enamel caries lesions.Materials and methodsBovine enamel specimens (n = 240) with each two sound areas (SI and SC) and each two lesions (DI and DC) were infiltrated (DI and SI), stained (1:1 red wine-coffee mixture,70 days), and randomly distributed in six groups to be bleached with the following materials: 6%HP (HP-6), 16%CP (CP-16), 35%HP (HP-35), 40%HP (HP-40), and no bleaching (NBl,NBl-NBr). Subsequently, specimens were pH-cycled (28 days, 6 × 60 min demineralization/day) and all groups except NBl-NBr were brushed with toothpaste slurry (1.100 ppm, 2×/day, 10 s). Differences in colorimetric values (ΔL, ΔE) and integrated mineral loss (ΔΔZ) between baseline, infiltration, staining, bleaching, and pH cycling were calculated using photographic and transversal microradiographic images.ResultsAt baseline, significant visible color differences between DI and SC were observed (ΔEbaseline = 12.2; p < 0.001; ANCOVA). After infiltration, these differences decreased significantly (ΔEinfiltration = 3.8; p < 0.001). Staining decreased and bleaching increased ΔL values significantly (p ≤ 0.001). No significant difference in ΔΔE was observed between before staining and after bleaching (ΔEbleaching = 4.3; p = 0.308) and between the bleaching agents (p = 1.000; ANCOVA). pH-cycling did not affect colorimetric values (ΔEpH-cycling = 4.0; p = 1.000). For DI, no significant change in ΔZ during in vitro period was observed (p ≥ 0.063; paired t test).ConclusionsUnder the conditions chosen, the tested materials could satisfactorily bleach infiltrated and non-infiltrated stained enamel. Furthermore, bleaching did not affect the caries-arresting effect of the infiltration.Clinical relevanceThe present study indicates that bleaching is a viable way to satisfactorily recover the appearance of discolored sound enamel and infiltrated lesions.

Cost-effectiveness of Artificial Intelligence for Proximal Caries Detection

Artificial intelligence (AI) can assist dentists in image assessment, for example, caries detection. The wider health and cost impact of employing AI for dental diagnostics has not yet been evaluated. We compared the cost-effectiveness of proximal caries detection on bitewing radiographs with versus without AI. U-Net, a fully convolutional neural network, had been trained, validated, and tested on 3,293, 252, and 141 bitewing radiographs, respectively, on which 4 experienced dentists had marked carious lesions (reference test). Lesions were stratified for initial lesions (E1/E2/D1, presumed noncavitated, receiving caries infiltration if detected) and advanced lesions (D2/D3, presumed cavitated, receiving restorative care if detected). A Markov model was used to simulate the consequences of true- and false-positive and true- and false-negative detections, as well as the subsequent decisions over the lifetime of patients. A German mixed-payers perspective was adopted. Our health outcome was tooth retention years. Costs were measured in 2020 euro. Monte-Carlo microsimulations and univariate and probabilistic sensitivity analyses were conducted. The incremental cost-effectiveness ratio (ICER) and the cost-effectiveness acceptability at different willingness-to-pay thresholds were quantified. AI showed an accuracy of 0.80; dentists’ mean accuracy was significantly lower at 0.71 (minimum–maximum: 0.61–0.78, P < 0.05). AI was significantly more sensitive than dentists (0.75 vs. 0.36 [0.19–0.65]; P = 0.006), while its specificity was not significantly lower (0.83 vs. 0.91 [0.69–0.98]; P > 0.05). In the base-case scenario, AI was more effective (tooth retention for a mean 64 [2.5%–97.5%: 61–65] y) and less costly (298 [244–367] euro) than assessment without AI (62 [59–64] y; 322 [257–394] euro). The ICER was −13.9 euro/y (i.e., AI saved money at higher effectiveness). In the majority (>77%) of all cases, AI was less costly and more effective. Applying AI for caries detection is likely to be cost-effective, mainly as fewer lesions remain undetected. Notably, this cost-effectiveness requires dentists to manage detected early lesions nonrestoratively.

Monitoring enamel caries on resin-treated occlusal surfaces using quantitative light-induced fluorescence: an in vitro study.

The aim of this study is to evaluate the ability of quantitative light-induced fluorescence (QLF) to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant. Sixty extracted permanent teeth had one occlusal site selected and were categorized according to the International Caries Detection and Assessment System (ICDAS) criteria. The teeth were divided into three groups (n = 20): ICDAS 1, ICDAS 2, and ICDAS 3. The teeth were assessed by a trained examiner using QLF in two phases: (A) before and (B) after treatment with resin infiltrant. The caries lesions were evaluated using the following QLF parameters: area (mm2); ΔF, fluorescence loss (%); and ΔQ, fluorescence loss integrated over the lesion area (%*mm2). The resin infiltrant (Icon™) was applied on the occlusal surface following the manufacturer's recommendations. The teeth were then sectioned and prepared for polarized light microscopy analysis. The penetration of resin infiltrant was measured with ImageJ. The groups showed a statistically significant difference in all QLF parameters before and after caries infiltration, with the reduction of fluorescence values posttreatment (p < 0.05). Infiltrant penetration was observed in all groups, with a statistical difference between all groups (p < 0.05). The reduction in QLF parameters after resin infiltration suggests that QLF is able to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant.

Monitoring the results of enamel demineralization treatment with the caries infiltration method (according to laser fluorescence value)

Relevance. In the actual dentistry a special place takes opportune diagnosis of early stages of dental caries and effective non-surgical treatment. In the recent times new approaches, technologies and methods for diagnosing focal demineralization of tooth enamel have been developed, among which the laser fluorescence method is widely used. Purpose. To study the results of local enamel demineralization treatment with the caries infiltration method according to laser fluorescence value. Materials and methods. The method of caries infiltration was applied in 99 permanent teeth with local enamel demineralization in 15 children aged 10-16 years. Laser fluorescence method was used for enamel demineralization assessment before and immediately after the treatment, after 6, 12 and 18 months. Three study groups were formed according to laser fluorescence value before the treatment: the first one – values 14-20 (initial enamel demineralization), the second one – values 21-29 (deep enamel demineralization), the third one – values ≥ 30 (enamel and dentine demineralization). Proportions (%), mean-values and standard errors (M±m) were calculated, significance (p) of differences was assessed according to Students’ criteria (t) at p &lt; 0.05. Results. During 18 months after caries infiltration caries cavities forming were not revealed. The mean-values of laser fluorescence were in the first group before the treatment 17.38 ± 0.27, after the treatment 5.00±0.82, after 18 months – 4.82 ± 0.79; in the second group 25.42 ± 0.38, 15.25 ± 0.78 and 13.96 ± 0.75, in the third group 33.08 ± 0.69, 22.54 ± 1.39 and 20.77 ± 1.44 respectively. The differences between the values before and after the treatment were significant statistically (p &lt; 0,001) in all groups. After 18 months the laser fluorescence values corresponding to healthy enamel were revealed in 94.1% cases in the first group, in 50.0% cases in the second group, and in 7.7% cases in the third group.Conclusions. Local enamel demineralization treatment of permanent teeth in children with the caries infiltration method prevented caries cavity forming. Monitoring laser fluorescence values revealed that the results of the treatment with the caries infiltration method depended on the depth of dental hard tissue demineralization.

Seven-year-efficacy of proximal caries infiltration – Randomized clinical trial

ObjectivesWe report efficacy of resin infiltration to arrest progression of caries lesions as compared with non-invasive measures and oral hygiene education alone after a mean observation time of seven years. Materials and methodsThis randomized split-mouth placebo-controlled clinical trial included 22 young adults having 29 pairs of interproximal non-cavitated caries lesions with radiographic extensions into inner half of enamel (E2) or outer third of dentin (D1). Lesion pairs were randomly allocated to two treatment groups: infiltration (Icon, pre-product; DMG) or mock (control) treatment. All subjects received risk-related instructions for diet, flossing and fluoridation. The primary outcome was radiographic (digital subtraction radiography) lesion progression after seven years. Secondly, Kaplan-Meier-analyses were applied to analyze time-to-failure additionally including patients followed up for less than 54 months as well. ResultsTwo lesion pairs were excluded due to invasive treatment decision by another dentist, five lesion pairs were lost to follow-up prior to 54 months but included in the survival analysis. No unwanted effects could be observed. For the primary outcome in 17 patients followed up in mean for 84 months 2/22 infiltrated lesions (9 %) compared with 10/22 control lesions (45 %) progressed (p = 0.018). The relative risk reduction for test in relation to control was 80 % (CI 95 % = 19–95 %). For the survival analysis within a mean (SD) observation time of 73 (25) months mean failure rates of 1.3 % and 7.8 % could be observed for test and controls, respectively. Hazard risk (95 % CI) for caries progression was 6.6 (2–22) for the control compared with the test lesions (p = 0.002). ConclusionsWe conclude that resin infiltration of proximal caries lesions extending radiographically around the enamel dentin junction is efficacious to reduce lesion progression after a mean observation time of seven years. Clinical significanceThis randomized clinical trial proves that caries infiltration is highly efficacious compared with non-invasive measures and oral hygiene education alone after a considerably longer observation time of 7 years than studied so far before.

Hydrolytic degradation of different infiltrant compositions within different histological zones of enamel caries like-lesions.

This study evaluates the effects of resin infiltrant composition and caries histological zone on the hydrolytic degradation of resininfiltrated artificial bovine enamel caries (RI-AEC). Different resin infiltrants were tested (n=26 per group): Icon (G1); TEGDMA 60%, UDMA 20%, and HEMA 20% (TUH); TEGDMA 80% and HEMA 20% (TH); and TEGDMA 75% and Bis-EMA 25% (TB). Following caries infiltration, samples were cut perpendicularly, and transverse microhardness were analyzed (at two histological zones: surface layer and lesion body) before and after 21 days of water immersion. TB presented lower decrease in microhardness (due to hydrolytic degradation) than the other groups, with a large effect size (Hedge's G from 0.83 to 1.19) and high power (84 to 99%). Neither histological zone nor its interaction with resin infiltrant composition significantly affected the outcome. In conclusion, resin composition affected microhardness of RI-AEC upon water immersion, and TB was the least affected.

Caries infiltration

Caries infiltration

A clinical guideline for caries infiltration of proximal enamel lesions with resins.

A clinical guideline for caries infiltration of proximal enamel lesions with resins.

An in vivo study on the durability of resin infiltration technique on color masking of white spot lesions

The caries infiltration technique was introduced with the aim of filling the intercrystalline spaces with a low-viscosity resin, to arrest lesions and treat the esthetic problem of white spot lesions. This study was designed to evaluate the color effect and durability of resin infiltration technique on masking of enamel white spot lesions compared to an ordinary adhesive system. Methods: a total number of 20 patients having 120 not cavitated anterior teeth with white spot lesions were subjected to this study. The six maxillary anterior teeth were isolated with rubber dam. The teeth were divided into two groups, the first group (central incisor, lateral incisor and canine on right side of patient) was treated with hydrochloric acid (Icon-Etch) then ethanol (Icon-Dry) followed with application of resin (Icon-Infiltrate), while the second group: (central incisor, lateral incisor and canine on left side of the same patient) was treated with phosphoric acid (N-Etch) and adhesive (ExciTE F).Evaluation of color was done using VITA Easyshade V (VITA Germany) at the following intervals (pre-operative, immediate, one week, three months, six months and twelve months post-operatively). Results: the highest mean value of color change was found immediately post-operatively for icon resin infiltration group presented as positive (ΔL) and negative (ΔC) that means decrease in the whitish discoloration of teeth. Conclusions: Icon resin infiltration is an effective treatment for deminiralized white spot lesions, while Excite F adhesive can be used for short time sealing of enamel surface to improve the esthetics of white spot lesions.

An in vivo study on the clinical efficacy of resin infiltration technique on treatment of white spot lesions

The caries infiltration technique was introduced with the aim of filling the intercrystalline spaces with a low-viscosity resin, to arrest lesions and treat the esthetic problem of white spot lesions. This study was designed to evaluate the effect and clinical efficacy of resin infiltration technique on masking of enamel white spot lesions compared to an ordinary adhesive system. Methods: A total number of 20 patients having 120 not cavitated anterior teeth with white spot lesions were subjected to this study. After scaling, polishing and oral hygiene measures, the six maxillary anterior teeth were isolated with rubber dam. The teeth were divided into two groups, the first group (central incisor, lateral incisor and canine on right side of patient) was treated with hydrochloric acid (Icon-Etch) then ethanol (Icon-Dry) followed with application of resin (Icon-Infiltrant), while the second group: (central incisor, lateral incisor and canine on left side of the same patient) was treated with phosphoric acid (N-Etch) and adhesive (ExciTE F).Durability of used resins were clinically assessed by six of the FDI World Dental Federation criteria which were selected to be suitable for the current study (Surface luster, Surface Staining, Postoperative hyper-sensitivity, Recurrence of caries, Adjacent mucosa, and Patient’s view), Each property has five grades from excellent to poor. Results: Both of treated groups showed improved surface luster, decreased postoperative hypersensitivity, diminished recurrent caries and increased patient satisfaction. Icon resin infiltration was more durable than Excite F adhesive after one year follow up. Both groups showed no initial surface staining, but with timesurface stainingbeing more with icon infiltrated group. Both materials have no effect on adjacent mucosa at different aging times. Conclusions: Icon resin infiltration is an effective treatment for deminiralized white spot lesions but with frequent repolishing to overcome surface staining for long lasting esthetic outcome. Excite F adhesive can be used only for short time sealing of enamel surface to improve the esthetics of white spot lesions and control of caries progression.

Effect of caries infiltration technique (icon) on the remineralization and color stability of enamel white spot lesions

This research was designed to evaluate the effect of resin infiltration material (Icon) and remineralizing agents (fluoride, CPP-ACP) on remineralization and color stability of enamel white spot lesion. A total number of 120 sound non-carious human anterior teeth were collected. The teeth were divided into two main groups (60 teeth each); Group R: for assessment of enamel remineralization and Group S: for assessment of color stability. Each main group was further divided into four equal subgroups (15 teeth each) according to the treatment applied as follows: Subgroup (A): control, Subgroup (P): CPP-ACP, Subgroup (I): ICON Subgroup (F): Fluoride. Each subgroup was further subdivided into three equal division (5 teeth each) according to the storage period in artificial saliva; one week (1W), four weeks (4W) and six weeks (6W). For assessment of remineralization; the enamel white spot lesion specimens in the four different subgroups were examined three times (after one week, four weeks and six weeks from the first time of treatment application) by (SEM/EDX). The results of remineralization revealed that the subgroup (P) group was provided the highest ca/p ratio mean value, followed by subgroup (F), then subgroup (I) while subgroup (A) showed the lowest ca/p ratio mean value. For assessment of color stability; the enamel white spot lesion specimens in the three different subgroups were examined three times (after one week, four weeks and six weeks from the first time of treatment application) by a portable Reflective spectrophotometer. The results of color stability revealed that the subgroup (F) was provided the highest color variation mean value, followed by subgroup (P) group while subgroup (I) showed the lowest color variation mean value.

Modern conceptions of initial dental caries treatment

Quick and efficient initial caries treatment (a spot stage) is an important and burning issue of the modern practical dentistry. At the spot stage, cariosity is reversible and thus, the scientists direct their attention to the techniques development for the restoration of the enamel crystal structure. Technique of a minimally invasive caries infiltration makes it possible to remove white spots on the teeth after a single visit. The objective is to analyse a specialized medical literature devoted to modern techniques and medicines for early dental caries treatment. The article represents data on the modern medicines for remineralization of the early caries focuses such as nanohydroxyapatite, silver diamine fluoride, casein phosphopeptide. Particular attention is paid to the analysis of literature data on the recently developed amino acid analogue of the human enamel proteins called amelogenin and its first user experience. New data on the minimally invasive technique of infiltration have been revealed. Conclusions. A wide range of modern medicines and techniques for initial caries treatment enables the dentist to make the correct choice in each specific clinical situation. Further studies on the latest developments are required to confirm their clinical efficiency.