Enamel Microabrasion Research Articles

A global overview of enamel microabrasion for white spot lesions: a bibliometric review.

This study aimed to identify and analyze articles on enamel microabrasion for the treatment of white spot lesions. A search was conducted on the Web of Science. The following parameters were recorded and analyzed: number of citations, year, journal, impact factor, study design, theme, country and continent, institution, authors, and keywords. Data was analyzed using VOSviewer software. The initial search resulted in 1,126 documents, of which 94 articles were included. The highest number of citations an article received was 65. The oldest article was published in 1975, and the most recent in 2023. The most frequent study design was case report (n = 42). Regarding the themes, it was observed that the main objective of the studies was to evaluate the clinical performance of enamel microabrasion (n = 75), primarily using Opalustre (Ultradent Products Inc., South Jordan, UT, USA) (n = 37) for treating white stains caused by dental fluorosis (n = 41). Most articles originated from Latin America (n = 31), mainly from Brazil (n = 26). The most frequent author was Sundfeld RH (n = 10). This study reveals research trends in the field of enamel microabrasion. The publications were mainly case reports/series using Opalustre for the removal of fluorosis stains.

Restoration of Anterior Teeth Using Minimal Invasive Esthetic Techniques with Opalusture and Composite Restoration: A Clinical Technique

Discoloration is one of the important reasons for restoration of anterior teeth in esthetic zone. Dental fluorosis is among common discoloration. Main reason for fluorosis is that concerned person residing in area with high fluoride content in community drinking water supply. In this case report, a 45year old male patient reported with esthetic concern due to discoloration in anterior teeth which was in turn diagnosed to be fluorosis and eventually treated with minimal invasive techniques including combination of microabrasion ,macroabrasion and direct composite veneers. KEYWORDS: Fluorosis,Tooth discoloration,Enamel microabrasion,Dental veneers

BASIC DIRECTIONS IN FLUOROSIS TREATMENT

The territory of Poltava region belongs to the Buchatsky hydrogeological province, whose groundwater is characterized by an elevated fluorine level content. The cause of endemic dental fluorosis particularly in the children’s population of the region is water consumption with surplus concentration of this chemical element. Also, having fluorosis a condition that develops from a high fluoride concentration in drinking water- causes disorder of hard tooth tissues maturing, mineralizationand teeth germ development. This, in turn, has a negative influence on enamel amelogenin synthesis and violation of the crystals maturing, determines a surface porosity. The chalky spots, brown pigmentation, and enamel erosion destruction lesions are characterized the different severity manifestation of the fluorosis.
 The purpose of our research was to conduct a thorough analysis of all the material we found on this topic, gather all possible information on new trends in recent years in the treatment of dental fluorosis: what are the methods, their origins, indications for use, clinical stages and advantages.
 Dental enamel fluorosis requires different approaches to treatment depending on the severity of clinical manifestations. Obviously, as the leading method is remineralizing therapy. One of the method is offered by Nikolishina E.V. etc. [6], which is carried out in the following way: after carry out of the professional hygiene procedure, next step, individual caps were made of transparent silicone filled with 10% solution «Poltavsky Bishofit» and applied on the fluorosis teeth, daily course consist with 30 minutes and 10-20 procedures.
 Enamel microabrasion is the first minimally invasive treatment method of mild and moderate dental fluorosis using to removes opaque brown spots and surface roughness smoothing, providing a flat and shinier surface. The microabrasion technique involves etching with mild acid in combination with application of abrasive components. Resin infiltration has also become a popular treating dental fluorosis technique without loss of hard tissue.
 Resin infiltration is based on the application of hydrochloric acid to the hard tissues of the tooth and subsequent coating with a low-viscosity resin that penetrates into the microspaces of the tooth enamel. The cloaking effect is based on the refractive index. The optical properties of the affected enamel change and it looks like a healthy enamel surrounding. The indication to dental fluorosis treatment of severity forms in permanent teeth with mature roots is restoration of teeth, veneers, orthopedic crowns, if the microabrasive method hasn’t aesthetic effect efficiency.
 Thus, in cases of aesthetic changes due to fluorosis, minimally invasive restorative approaches that preserve dental hard tissue such as microabrasion method, external bleaching or resin infiltration should be considered before invasive restorative procedures. More invasive treatments may be considered if the results remain unsatisfactory.

VITAL BLEACHING AND ENAMEL MICROABRASION FOLLOWED BY DIRECT COMPOSITE VENEERS FOR THE MANAGEMENT OF FLUOROSIS STAINS: A CASE REPORT

Fluorosis stains can signicantly impact the esthetic appearance of teeth. In this case report, we describe the management of uorosis stains in a 15-year-old male patient through a combination of vital bleaching, enamel microabrasion, and direct composite veneers. Vital bleaching using hydrogen peroxide was employed to decolorize the stains, followed by enamel microabrasion using Opalustre containing 6.6% HCl acid and silicon carbide abrasive particles to remove the remaining supercial bands. Direct composite veneers were done to the central incisors to further improve the esthetic outcome. This case demonstrates the efcacy of this treatment approach in the management of uorosis stains.

Minimally Invasive Aesthetic Management of Dental Fluorosis

Dental fluorosis is a developmental disturbance of enamel caused by the intake of excessive fluoride, which leads to pathological changes to ameloblasts that interfere with the formation of normal hydroxyapatite crystals. The resultant appearance ranges from white opaque to dark brown colour and pitting and chipping of teeth which affects the aesthetic characteristics and self-confidence of the patients. The treatment methods to improve the appearance of dental fluorosis include microabrasion, bleaching, resin infiltration, composite restoration, placement of veneers or full crowns and a combination of the above. This case report describes minimally invasive aesthetic management in a 22-year-old female patient with moderate dental fluorosis. The treatment plan included enamel microabrasion followed by in-office bleaching. After 16 months of follow-up, an evaluation of the patient’s aesthetics revealed that teeth affected by dental fluorosis could be successfully treated with a minimally invasive technique involving micro-abrasion and in-office bleaching.

Effect of microabrasion on the staining susceptibility of enamel: An in vitro study.

Background. Enamel microabrasion can eliminate enamel irregularities and discoloration. This study evaluated the staining susceptibility of enamel after microabrasion using different clinical protocols. Methods. A total of 210 extracted bovine incisors were used in this study. The teeth were randomly divided into five groups of 42 teeth each (n=42), including group 1: control (no treatment), group 2: microabrasion, group 3: microabrasion + fluoride polishing, group 4: macroabrasion (fine-grit diamond bur) + microabrasion, and group 5: macroabrasion (finegrit diamond bur) + microabrasion + fluoride polishing. The groups were then randomly divided into two subgroups for discoloration procedures: coffee and distilled water (n=21). A spectrophotometric evaluation was carried out at baseline and on the 1st, 7th, 14th, and 28th days of the staining period. Statistical analyses were performed using repeated-measures ANOVA and the post hoc Bonferroni test at a significance level of 0.05. Results. The greatest color change was observed in group 2 specimens, which were immersed in coffee solutions. The color change values for groups 3, 4, and 5 specimens, which were immersed in distilled water, were higher than those in group 1 specimens (P<0.05). The fluoride polishing + enamel microabrasion treatment groups (groups 3 and 5) exhibited greater resistance to color changes than the matched non-fluoride-polished groups (groups 2 and 4) (P<0.05). Conclusions. The teeth that underwent enamel microabrasion treatment and were polished with fluoride gel became more resistant to color changes. Our findings confirm that enamel microabrasion treatment is a conservative method for localized discoloration.

Esthetic treatments for white and yellow/brown enamel stains

In order to solve the dental aesthetic pattern of a patient, who has dental stains on the enamel surface, we carried out this case report where are presented the steps employed for bleaching of teeth with superficial yellow/brown enamel stains with carbamide peroxide and micrometric removal of hard white enamel stains using the enamel microabrasion technique. The worn of dental surface during enamel microabrasion technique was measured with a digital analysis, using a intraoral scanner. It was observed a surprisingly esthetic outcome as the superficial enamel stains were camouflaged by the at-home dental bleaching. Only the superficial white enamel stains that remained evident were removed by enamel microabrasion technique with a minimal average wear of 118 um of the dental enamel on all anterior teeth, showing to be a conservative technique. Dental bleaching can solve the discoloration of vital teeth, such as the superficial yellow/brown hard enamel stains, as well as can mask the superficial white enamel stains. But when necessary, enamel microabrasion technique is an effective minimally-invasive option that can also be adopted.

Comparative Evaluation of Esthetic Improvement of Resin Infiltration (RI), In-office Bleaching (B), Enamel Microabrasion (M) and Resin Infiltration with Double Application of Infiltrant (2RI) on Non-pitted Fluorosis Stains: A Randomized Six-month Interventional Study.

BackgroundNewer minimally invasive treatment options for improvement in appearance of dental fluorosis stains are gaining popularity in recent years.ObjectiveTo evaluate and compare the clinical success in esthetic improvement of resin infiltration, in-office bleaching with 35% hydrogen peroxide, enamel microabrasion, and resin infiltration with double infiltrant application on nonpitted fluorosis stains.Materials and methodsSeventy two patients aged between 6 and 12 years with nonpitted dental fluorosis stains on the upper anterior teeth were randomly selected and divided into four interventional groups: group 1- resin infiltration (RI), group 2- in-office bleaching using 35% hydrogen peroxide (B), group 3- enamel microabrasion (M), and group 4- resin infiltration with double infiltrant application (2RI). In each group, standardized photographs were taken preoperatively, immediate postoperatively and after 1, 3, and 6 months time interval postoperatively to assess the esthetic improvement (EI) and changes in white/brown surface opacities/stains (SC) using a Visual Assessment Scale (VAS).ResultsRI and 2RI showed statistically significant results (p ≤0.05) followed by microabrasion and bleaching, for both the evaluation criteria (EI and SC) at all the follow-up intervals.ConclusionResin infiltration is a promising procedure that demonstrated remarkable clinical success for improvement in esthetics of nonpitted fluorosis stains with stable long-term positive outcome.How to cite this articleGarg I, Kumar A, Kumar A. Comparative Evaluation of Esthetic Improvement of Resin Infiltration (RI) In-office Bleaching (B) Enamel Microabrasion (M) and Resin Infiltration with Double Application of Infiltrant (2RI) on Non-pitted Fluorosis Stains: A Randomized Six-month Interventional Study. Int J Clin Pediatr Dent 2022;15(1):20-34.

Developmental defect of email in children and adolescent: a review

ABSTRACT Developmental defect of enamel (DDE) is a defect on the surface of the enamel layer thatoccurs during tooth development due to various genetic and environmental factors. Defects that occurresult in changes in color and texture on the enamel surface so that it interferes with aesthetics. Thedefect level that happens can be classified based on the DDE index to determine the option of a casetreatment plan consisting of enamel microabrasion, conservative aesthetic restoration, and bleaching.This review aims to analyze and review studies related to DDE in primary and permanent teeth. Anelectronic search was conducted through PubMed/Medline, Google Scholar, Semantic Scholar,SpringerLink, and Wiley Online Library using the keywords “defect email”, “developmental defectemail”, and “defect on primary teeth” for research published between January 2011 and April 2020, thesame article was eliminated, the initial search resulted in a total of 55 articles. The exclusion of articleswas carried out based on the title and abstract so that finally, 45 relevant articles were obtained. Threestudies were included in this review for qualitative analysis. The results show that Enamel (DDE)Developmental defects can occur in both primary and permanent teeth with the same prevalence rate. KEYWORDS: Developmental Defect of Email (DDE), DDE Index, defect to primary teeth, defect topermanent teeth

Effects of microabrasion association to at-home bleaching on hydrogen peroxide penetration and color change.

This study aimed to quantify the penetration of hydrogen peroxide (HP) inside the pulp cavity and color change with two different concentrations of HP to at-home bleaching associated or not with enamel microabrasion (MA). Forty healthy premolars were randomly divided in four groups (n=10): only HP4%, MA + HP4%, only HP10%, MA + HP10%. The concentration (μg/ml) of HP was assessed using UV-Vis spectrophotometry. The color change (ΔEab , ΔE00 and WID ) was evaluated before and one-week after bleaching. Data were evaluated for a two-way ANOVA and the Tukey's test (α=0.05). The application of MA increased the amounts of HP inside the pulp chamber when compared to without MA, as well as PH10% when compared to PH4% (p < 0.0001). PH10% showed higher WID when compared to PH4%. No significant difference was observed when ΔEab , and ΔE00 were used. The enamel MA before at-home bleaching promotes greater penetration of HP, although this procedure did not significantly affect the color change. Since greater penetration of HP into the pulp chamber was detected when home bleaching was applied immediately after MA, the clinician should not apply home bleaching gels in the same session when MA was performed.

Evaluation of the Effect of Various Antioxidants on the Shear Bond Strength of the Composite Resin to the Bleached Enamel: An In Vitro study

Abstract Objective Various intrinsic and extrinsic stains cause discolored teeth, which is of great concern to patients, which can be treated by bleaching, enamel microabrasion, veneers, and crowns. However, bleaching leads to reduced bond strength if adhesive restorations are performed immediately.Thus, the application of antioxidant agents after bleaching has been recommended, which are proved to act as free radical scavengers, improving the bond strength. Materials and Methods A total of 120 extracted human maxillary incisor teeth were taken. Using a slow-speed diamond saw and a water coolant spray, the roots of all the teeth were removed approximately 2 mm below the cementoenamel junction. With the labial surface facing upward, each sectioned sample was embedded in the acrylic resin. Then, the central portion of the embedded tooth was ground flattened with 600-grit silicon carbide paper such that the labial enamel surface becomes smooth and evenly flat.All 120 samples were divided into two control groups (n = 20), i.e., positive control group (n = 10) and negative control group (n = 10) and five experimental groups (n = 100), such that each experimental group had 20 samples.The enamel surface in both the control groups and groups treated with antioxidants was thoroughly rinsed off with distilled water for 30 seconds and subjected to bonding procedure. Result Significant differences were observed among the experimental groups (p &lt; 0.05). The samples that were treated with 10% sodium ascorbate (group III) demonstrated significantly higher mean shear bond strength than the other experimental groups (p &lt; 0.05).

O que é preciso saber sobre microabrasão

Objective: Having in mind the growing value that is given to esthetic procedures it has been carried out a literature review about the main polemics that goes around Enamel Microabrasion technique. Action mechanism: the microabrasion compound modifies light refraction and reflection indexes producing an optical effect which allows the camouflage of the subsurface stains. Indications: the technique is indicated to remove any stain, since it is restrict to the most superficial layer of enamel. Advantages: immediate and permanent results with minimum loss of dental structure. Technique: with all care steps taken, a mixture of hydrochloric acid or phosphoric acid and pumice is applied to dental surface for 12 to 16 times, during 10 seconds each application. The application can be done manually or with the help of a low rotation hand-piece. Conclusions: the enamel microabrasion is an effective, safe and conservative technique if compared with other alternatives available. However, some authors affirm that it must be very carefully used because of enamel loss and risks of lesion by the acid.

English

The undesirable discoloration or pitting of teeth due to fluorosis or developmental defects like amelogenesis imperfecta or enamel hypoplasia pose a challenge to the clinician to cater to the aesthetic requirements of patients. Fluorosis had been reported way back in 1901. There are treatment options depending upon individual cases as follows: microabrasion / macroabrasion, bleaching, composite restoration, veneers or full crowns. For the aesthetic enhancement of stains associated with mild to moderate fluorosis enamel microabrasion is the preferred treatment. This technique involves removal of entrapped stains by rubbing of slurry containing HCl acid and an abrasive agent on the stained enamel surface. But if the depth of the defect is more then microabrasion can be done in conjunction with bleaching or bonded restorations can be done to achieve optimal aesthetics. Casein phospopeptide - Amorphous calcium phosphate (CPP – ACP) can be topically applied after microabrasion which enhances remineralisation and prevents post-operative sensitivity. The present paper illustrates the management of mild to moderate dental fluorosis by microabrasion to remove stains on the enamel surface followed by remineralisation using CPP - ACP paste. An unaesthetic smile has psychological impact especially on young patients and lowers their confidence.1 Discoloration of the young permanent anterior teeth is mostly seen due to varying developmental defects. This could be due to extrinsic aetiology such as those caused by coffee, tea, red wine and tobacco or due to intrinsic aetiology. The intrinsic stains may be due to pre-eruptive or post-eruptive causes.2 Pre-eruptive causes of intrinsic stains include dentinogenesis imperfecta and fluorosis, whereas post-eruptive causes of intrinsic stains include tetracycline dentine staining or due to injuries.3 The excessive and chronic ingestion of fluoride during amelogenesis leads to fluorosis which can be skeletal or dental depending upon the intake.4,5 Dental fluorosis is characterized by white opaque flecks on teeth or yellow to brown discolorations with pitting on the enamel surface.6,7 The enamel microabrasion is an effective and non-invasive procedure for removing the stains limited to outer enamel layer.7,8 It uses a rubber cup along with abrasive materials and chemical solutions.9,10 Currently, many products are commercially available for enamel microabrasion such as Prema Compound (Premier Dental Products, Norristown, PA, USA) containing 15 % HCl and Opalustre (Ultradent, South Jordan, UT, USA) containing 6.6 % HCl and silicon carbide.7 (Table 1) Since these products are expensive, the prototype paste containing 18 % HCl and pumice, as described by Croll in 1986 is most commonly used in clinical practice.8

Enamel Microabrasion Combined with in-Office Bleaching in Treating with Moderate to Severe Dental Fluorosis: A Randomized Clinical Trial

Dental fluorosis is a special enamel dysplasia caused by excessive intake of fluoride during tooth development and mineralization...

Weight-loss and surface roughness of enamel after microabrasion procedure with different agents

Abstract Introduction Enamel microabrasion is achieved by abrasion of the enamel surface and it is a quick, practical and efficient procedure. Objective It was assessed the weight loss and surface aspect of enamel after microabrasion procedures with commercial and mixtures made in-office. Material and method Eighty bovine incisors were divided into four groups (n=10): OpalustreTM (6.6% HCl + silicon carbide); Whiteness RMTM (6% HCl + silicon carbide); 37% H3PO4 + pumice and 10% HCl + pumice. Treatment was performed by 15 applications of 10s duration. The enamel weight loss was determined by the difference in weight before and after the microabrasion. The surfaces were analyzed by a surface roughness equipment and scanning electron microscopy. Data were submitted to paired-T test, one-way ANOVA and Tukey tests (α=0.05). Result It was observed significantly weight loss for all groups. The difference in weight loss ranged from 0.037±0.012 for group 37% H3PO4 and from 0.054±0.009 for group 6,6% HCl. There was a significant increase in surface roughness for all groups and 10% HCl group showed the lower results (0.65±0.09). It was observed different patterns of enamel morphology by SEM images. Conclusion The in-office mixtures resulted in the lowest enamel structure loss (37% H3PO4) and the lowest surface roughness (10% HCl).

Clinical Performance of Enamel Microabrasion for Esthetic Management of Stained Dental Fluorosis Teeth.

Enamel microabrasion is an effective first-line esthetic treatment for the removal of tooth stains due to fluorosis, with an improvement in the appearance of teeth that is associated with a high level of patient acceptance.

White spots on tooth enamel in mixed dentition

Aim: To determine the prevalence, etiological factors of white spots on enamel and to evaluate the treatment by microabrasion technique in schoolchildren. Method: A study was developed in children between the ages of 6 and 12 of both genders, enrolled in 3 municipal public schools. Oral examination of the children was carried out, and for those children in whom white spot lesions were found, dental treatment was provided by the microabrasion technique in the incisors and/ or first permanent molars to prevent the evolution to a caries lesion with cavitation, since the enamel structure was damaged. Results: The most affected age was 10 years with 27.8% (n = 5). In relation to the enamel surface area affected by white patches, the majority had 1% - 24% of the enamel reached. The possible etiological factors of white patches were systemic infections, trauma or caries with pulp involvement in a deciduous tooth. The treatment was effective in 16 children and for the remaining two the restorative treatment was performed. Conclusion: The prevalence of white spot lesions found in enamel was 3.95%, with a higher prevalence in females. The permanent right upper central incisor was the most affected. The treatment proved to be effective in most children possibly because the lesion is located more superficially in the enamel.KeywordsDental enamel; Enamel hypoplasia; Tooth demineralization; Enamel microabrasion.

Influence of newer antioxidants on microtensile bond strength of composite resin to bleached enamel - An in vitro study

The presence of an un-aesthetic discolored tooth is of great concern to patients, which is caused by intrinsic and extrinsic factors and can be treated by bleaching, enamel microabrasion, porcelain veneers, crowns. The application of antioxidant agents after bleaching has been recommended as a way to reduce the waiting period between bleaching and restorative procedure by eliminating the reactive oxygen from the dental substrate. In our study, we found a significant improvement in the bond strength of composite to bleached enamel with the application of antioxidant agents. Keywords: Composite, Aesthetics, Bleaching, Adhesion, Cohesion, Antioxidant

Flowable and Regular Bulk-Fill Composites: A Comprehensive Report on Restorative Treatment.

This article reports a comprehensive restorative treatment using bulk-fill composites and discusses their properties and clinical performance. A 20-year-old man sought dental treatment due to the dark shade of his smile and multiple old amalgam fillings. Based on clinical and radiographic findings, and the patient's demand for tooth-colored fillings, treatment comprised enamel microabrasion and in-office dental bleaching, followed by the replacement of amalgam fillings by bulk-fill composites. Bulk-fill composites exhibit modifications in the filler size and shape or in the chemistry of monomers that allow them to be applied in thicker layers (4 to 5 mm), creating opportunities for simpler, faster, and more-efficient clinical procedures, as seen in the present report.

Comparison of the enamel surface characteristics after orthodontic debonding with and without microabrasion: An in vitro study

Aim: To visually compare, using microscope, two different techniques for removing adhesive remnants after orthodontic bracket debonding. Methods: Twenty healthy third molars were used. One molar did not undergo any procedures and served as a control. After bracket bonding and immersion of the teeth in saline solution for 12 days, the attachments were debonded. One of the molars was not stripped of the attachments, while the others (n=18) were randomly divided into two groups according to the adhesive removal technique: Group 1, use of a high-speed 18-blade bur and a fine-grain sandpaper disc; and Group 2, use of a high-speed 18-blade bur, a fine-grain sandpaper disc, and enamel microabrasion. Tooth fragments were collected for inspection under a field emission scanning electron microscope for a qualitative analysis of the adhesive remnants. Results: A substantial amount of adhesive residue remained on the enamel surface of the molars in Group 1. The procedures performed in Group 2 were more effective in removing the adhesive remnants but resulted in greater enamel wear and ledge formation. Conclusion: The combined use of a multiblade bur and the microabrasion technique was the most effective method of removing adhesive remnants and returning the enamel to its pre-treatment appearance.