Microabrasion Technique Research Articles

TREATMENT OF TRAUMATIC AMELOGENESIS IMPERFECTA THROUGH MICRO-ABRASION TECHNIQUE: A CASE REPORT

In recent decades, several ultra-conservative techniques have been employed for the treatment of amelogenesis imperfecta, primarily based on non-invasive procedures. In this article, we will shed light on the technique of microabrasion, its indications, advantages, and limitations. Subsequently, we will illustrate the steps of the technique with a clinical case. Finally, we will discuss the short-term and long-term outcomes. The microabrasion technique has proven effective as a non-invasive alternative among the array of proposed treatments for white and brown enamel lesions.

Effectiveness of the dental microabrasion technique as a minimally invasive clinical approach for the aesthetic treatment of dental fluorosis. Case report

Introduction: Dental fluorosis represents one of the most commonly observed enamel defects in the Ecuadorian population; certain provinces, especially those located in the central area of the inter-Andean region of Ecuador, are highly affected. The cases of two female patients are presented, aged 25 and 29 respectively, treated in a private dental clinic in the Francisco Pacheco Parish, Portoviejo canton during the period May 2023 – September 2023, with clinical diagnosis and photographic of dental fluorosis in a mild degree according to the Dean indexFor which the dental microabrasion technique was performed as a minimally invasive clinical approach, obtaining satisfactory results that eliminated the stains present in the tooth enamel. Conservative treatment options should be the first choice when defining the actions to follow, always prioritizing the patient's well-being. It is recommended to consider the possibility of combining them when circumstances justify it. Additional follow-ups are necessary to verify the effectiveness of these treatments. Treatment with dental microabrasion is demonstrated as an effective minimally invasive technique to treat mild dental fluorosis

Microabrasion of teeth with fluorosis: A minimally invasive solution to unaesthetic smile

Dental hypomineralization like dental fluorosis leads to a less aesthetic appearance of the teeth visible in the vicinity. Dental fluorosis results from excessive fluoride intake during enamel formation, which may lead to color abnormalities or defects in the tooth surface. Microabrasion is the preferred treatment for aesthetic improvement of stains in mild to moderate cases. In this procedure, trapped stains are removed with the help of the abrasive agent and HCL acid which is directly applied to the stained enamel surface. Casein phosphopeptide - Amorphous calcium phosphate (CPP-ACP) applied topically after microabrasion, improving remineralization and preventing post-operative sensitivity. This case report illustrates the microabrasion technique for the management of mild to moderate dental fluorosis in maxillary incisors to eliminate stains from the enamel surface in a single session, followed by remineralization with CPP - ACP paste and a further one-year follow-up was done to check the long-term effect of the treatment.

"Comparative Evaluation of Three Different Microabrasion Techniques in Esthetic Management of Fluorosis": An In Vivo Study.

"Comparative evaluation of three different microabrasion techniques in esthetic management of fluorosis"-an in vivo study. A total of 48 permanent incisors in children between the age-groups of 8-12 years with Dean's fluorosis index modified criteria 1, 2, and 3 were included. The patients were randomly divided into three groups; each group included 16 samples. Group I-phosphoric acid and pumice microabrasion (37% phosphoric acid and pumice as abrasive), group II-opalustre microabrasion [6.6% hydrochloric (HCL) acid and silicon dicarbide (SiC2)], and group III-icon etch microabrasion (15% HCL acid gel as icon etch, pumice, and resin infiltrate). Preoperative sensitivity and pulp vitality of each tooth were evaluated. Standardized preoperative photographs were captured for the evaluation of color parameters L1, a1, and b1 by Adobe Photoshop 7 software and an assessment of color enhancement was carried out. Preoperative surface roughness was evaluated with two methods like, cellulose acetate replicating tape and confocal microscope, and Epoxy resin replica obtained from the preoperative impression of teeth using additional silicone and contact profilometer. Microabrasion was done accordingly. Postoperative values of all the parameters were evaluated. Phosphoric acid and pumice showed the best color change, followed by icon etch resin infiltrate. Opalustre (6.6% HCL acid and SiC2) and was unsuccessful as it had less concentration and was more abrasive. Phosphoric acid and pumice showed the best color enhancement, followed by icon etch resin infiltrate and opalustre. Icon etch resin infiltrate showed minimal surface roughness followed by phosphoric acid and pumice and opaluster group. Reddy VN, Nagar P, Lakhotia R, et al. "Comparative Evaluation of Three Different Microabrasion Techniques in Esthetic Management of Fluorosis": An In Vivo Study. Int J Clin Pediatr Dent 2023;16(4):572-581.

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.

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.

A simple microabrasion technique as aesthetic approach on fluorosis of anterior teeth

ABSTRACT Dentistry treatment is not only focused on restoring the function of mastication but also onthe aesthetic problem. Fluorosis is one of the aesthetic problems caused by excessive fluoride intakeduring email formation and produced color changes on the surface of the email. Fluorosis was notaffected by the aesthetics but also influenced the confidence of the patient. The Microabrasion techniqueis an option for fluorosis because it is conservative treatment with good results. A 20-year-old womanwho came to the Dental Conservation clinic complained that she wants to remove the brown color andwhite spots seen on the front teeth, which significantly interfere with her appearance. Based on clinicalexamination, many cavities were found in the back teeth of the upper and lower jaw. The results of thehistory and clinical study revealed that the patient had fluorosis in her teeth. Microabrasion was carriedout using Opalustre (ultradent). This material was applied to the tooth surface and rubbed using anapplicator (opal bristle) for 60 seconds. Then applied fluoride gel paste with finishing cup opal.Treatment results showed changes in tooth color, brown and white patches disappeared. Microabrasionis the first choice for aesthetic treatment in fluorosis and has shown satisfying results to restore thepatient's aesthetics problem. KEYWORDS: Fluorosis, microabrasion technique

Microabrasion plus resin infiltration in masking white spot lesions.

Enamel opacities or white spot lesion is a result of enamel demineralization due to cariogenic activity or fluorosis, or enamel hypo-plastic/hypo-mineralized, which are an esthetic concern. A recent evidence base of dentistry has been focused on the Minimal Invasive Dental (MID) approach for treating such lesions. The aim of the study is to evaluate the esthetic improvement of white spots lesion using microabrasion and resin infiltration in upper permanent incisors, immediately and up to six months follow-up. For the present case with enamel opacities, the minimal invasive therapy resin infiltration was chosen, preceded by microabrasion technique, to improve the teeth aesthetic appearance of the affected teeth. An excellent improvement in 11 and 21 teeth esthetic. However, we still found good outcome in the enamel surfaces after six months follow-up, which became hard to detect, except in the near inspection. The patient was delighted with the well-defined enhancement in his esthetics smile and was mentioned no postoperative sensitivity immediately or in the recall evaluation. The resin infiltration showed significant teeth esthetic improvement immediately and good follow-up outcome for six months, preceded by microabrasion. More high-quality and long-term clinical studies are needed to verify durability and factors that may affect treatment quality.

MICROABRASÃO DO ESMALTE

Enamel defects are described as changes in its structure characterized by local decrease or loss of its translucency from fluorosis, hypocalcifications, hypoplasias and inactive carious lesions with superficial and medium depth. The microabrasion of enamel selectively promotes the removal of its surface layer that presents color or structure modification through a mixture of abrasive and erosive agents mechanically. The association of these agents exposes a sub-layer of enamel with normal characteristics. This procedure can be used alone or associated with one or more aesthetic treatments, such as tooth whitening and composite resin restorations. Objective: to approach the microabrasion technique applied in dental enamel with changes in color and structure. Methodology: a non-systematic review of the scientific literature, published from 2009 to 2019, was carried out in the Virtual Health Library and in the academic Google. The inclusion criteria were articles in Portuguese and English, published in the last 10 years, that addressed the proposed theme. Conclusion: Dental microabrasion is a good alternative for aesthetic treatment for changes in the superficial structure of dental enamel, fluorosis and hypoplasia, because it wears little dental structure, restores aesthetics, does not cause damage to the pulp or periodontal tissues, requires little treatment time, does not require cavitary preparation, nor restorative material and is low cost. Aesthetic dissatisfaction is a concern of patients of all ages and the diagnosis of dental fluorosis should be the result of careful anamnesis and it should be taken into account that the etiology may be of various origins.

Systematic Review on White Spot Lesions Treatments

The difference in refractive index between the healthy enamel and the demineralized area generates a lesion with a milky white opaque appearance, clearly distinguishable from the surrounding healthy enamel. The aim of this systematic review was to evaluate if the infiltration technique is the most efficient treatment to resolve a white spot lesion when compared with remineralization and microabrasion techniques. The Population/Intervention/Comparison/Outcome question investigated: “in enamel WS lesion, the infiltration treatment compared to remineralization or microabrasion treatments is more or less effective in the camouflage effect?.” The research was performed on electronic databases, including Ovid MEDLINE, PubMed, and web of science. The search was conducted up to April 1, 2020. The scientific search engines produced 324 results. Only 14 were screened after screening. Based on the articles analyzed in this systematic review, the resin infiltration technique seems to be the most effective and predictable treatment for the aesthetic resolution of WSLs.

Aesthetic management of fluorosis

With increasing awareness and aesthetic concerns, the number of people seeking professional dental help for improvement in the appearance of their dentitions and for smile makeovers are on rise. Dental fluorosis, tetracycline staining, localised and chronological hypoplasia, and both amelogenesis and dentinogenesis imperfecta can all produce a cosmetically unsatisfactory dentition. The aetiology of intrinsic discolouration of enamel may sometimes be deduced from the patient's history, and one factor long associated with the problem has been a high level of fluoride intake. Optimal use of topical fluorides leads to a decrease in the caries prevalence but may show an increase in the prevalence of fluorosis staining because of metabolic alterations in the ameloblasts, causing a defective matrix formation and improper calcification. A 28 yr female patient was screened at the Department of Conservative Dentistry and Endodontics at desh bhagat dental college, mandi gobindgarh, Punjab. She wanted us to remove and/or minimise the noticeable brown/yellow staining of his teeth. She requested the least invasive and most cost-effective treatment to change his smile. Various treatment modalities are present for the treatment of fluorosis stains. This report discusses the microabrasion technique in the patient having dental fluorosis.

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.

Clinical Efficacy of Resin Infiltration Technique Alone or in Combination with Micro Abrasion and In-Office Bleaching in Adults with Mild-To-Moderate Fluorosis Stains

Background:The present study was conducted to evaluate the clinical efficacy of resin infiltration technique alone or in combination with microabrasion and in-office bleaching in adults with mild-to-moderate fluorosis stains on permanent maxillary anterior teeth at the end of 1 month.Materials and Methods:A total of 30 patients with nonpitted fluorosis stains on maxillary anterior were classified as mild (n = 15) and moderate (n = 15). Each grade is subdivided into three groups as Group A, Group B, and Group C. Group 1: Mild (score 2), Subgroup A: Resin infiltration (n = 5 patients), Subgroup B: Microabrasion followed by resin infiltration (n = 5 patients), Subgroup C: Microabrasion and bleaching followed by resin infiltration after 2 weeks (n = 5 patients). Group 2: Moderate (score 3), Subgroup A: Resin infiltration (n = 5 patients), Subgroup B: Microabrasion followed by resin infiltration (n = 5 patients), and Subgroup C: Microabrasion and bleaching followed by resin infiltration after 2 weeks (n = 5 patients). Microabrasion was performed with the opalustre kit from Ultradent according to the manufacturer's instructions. Pola office bleaching from SDI and Icon infiltrant was performed. Stain score, improvement in appearance score, need for further treatment, patient satisfaction score, tooth sensitivity immediately after treatment, 24 h and 72 h were recorded.Results:The mean appearance score in Group 1A was 73.60, in Group 1B was 72.87, in Group 1C was 65.27, in Group 2A was 68.00, in Group 2Bwas 72.93 and in Group 2C was 84.73. The mean need for further treatment score in Group 1A was 72.80, in Group 1B was 78.40, in Group 1C was 68.73, in Group 2A was 71.20, in Group 2B was 79.53 and in Group 2C was 88.73. The mean patient satisfaction score in Group 1A was 91.40, in Group 1B was 95.20, in Group 1C was 98.00, in Group 2A was 90.20, in Group 2B was 99.40 and in Group 2C was 100.00. There was a significant difference in mean tooth sensitivity immediately after treatment between Groups 1A, 1B, 1C, 2A, 2B, and 2C. There was a significant difference in mean tooth sensitivity after 24 h between Groups 1A, 1B, 1C, 2A, 2B, and 2C.Conclusion:Resin infiltration technique in combination with bleaching and microabrasion technique found to be effective in the management of dental fluorosis.

Minimally Invasive Dentistry for Pre-Eruptive Enamel Lesions—A Case Series

Pre-eruptive enamel lesions occur during tooth formation and include fluorosis, traumatic hypomineralization, and molar incisor hypomineralization. Minimally invasive treatment approaches, such as microabrasion, should be considered for these cases. This article presents a case series of three patients with pre-eruptive enamel defects in esthetically compromised tooth regions which were treated with the microabrasion technique: two fluorosis cases, moderate and advanced, and one hypomineralization case of traumatic etiology. In Cases 1 and 3, there was a significant improvement in esthetics with a total resolution of the enamel defects. However, a slight yellowish coloration may be detected at close observation. In Case 2 (advanced fluorosis), although there was no full resolution of the white spots, there was a clear improvement in esthetics. Microabrasion is a safe and effective, minimally invasive treatment for pre-eruptive enamel lesions. It does not require local anesthesia, it is less destructive than restorative interventions, and allows good esthetic outcomes with no significant postoperative sensitivity. Its efficacy is directly related to the lesions’ severity and depth. Although there are some limitations, further improvement can be achieved with dental bleaching. More invasive treatments might be considered if results are still unsatisfactory.

Efeito da apresentação comercial de ácido clorídrico para técnica de microabrasão na perda de estrutura e superfície do esmalte

Introduction: The microabrasion technique can be performed using a commercially available paste, or the dentist can prepare it in his office. Objective: To verify the effect of hydrochloric acid commercial presentation in the handling of microabrasion paste on the enamel surface. Methodology: Bovine incisors were divided into two groups, according to the commercial presentation of 10% hydrochloric acid (liquid or gel). The treatment was carried out through ten applications of 10 s duration each, intercalated with a 10s wash. Twenty teeth (n=10) were used to determine the loss of enamel structure. Each sample was weighed on an analytical balance before and after submission to microabrasion. Another 20 teeth (n=10) were used to determine the average surface roughness (Ra) using a rugosimeter. Three samples from each group of the previous experiment were selected, randomly, and another three additional samples were repared as a control (baseline) for SEM analysis. Results: There was a statistically significant difference between the final and initial mass and the surface roughness of the samples, regardless of the acid commercial presentation. In the SEM images, a regular surface was observed for the control group (baseline). In the other images, there was a surface with considerable irregularity and a slight dissolution of the enamel. Conclusions: The treatment carried out.

Association of Tooth Bleaching and Microabrasion as a Resolution of Intrinsic Staining by Fluorosis: A Case Report

Background: Different treatment protocols for teeth affected by fluorosis have been applied. Among them, microabrasion associated with tooth bleaching has presented satisfactory results in the treatment of intrinsic and/or extrinsic staining. Case Presentation: A 22-year-old female patient attended the Dental Clinic of FOP/UNICAMP, reporting dissatisfaction with her smile due to the presence of white striations contrasting with the yellowish hue of the other teeth. Initially, the adequacy of the oral environment was performed by supragingival scraping and prophylaxis. Due to the characteristics of the staining, fluorosis TF3, the treatment plan consisted of teeth whitening with 35% hydrogen peroxide (Whiteness HP, AutoMixx 35% FGM) and microabrasion (Whiteness RM, FGM). Conclusion: The association of tooth bleaching and microabrasion techniques provided the harmonization of the smile and resolution of the clinical case of the main complaint.

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.

Effectiveness of a microabrasion technique using 16% HCL with manual application on fluorotic teeth: A series of studies.

BACKGROUNDDental fluorosis is caused by excessive fluoride ingestion during tooth formation. As a consequence, there is a higher porosity on the enamel surface, which causes an opaque look.AIMThe aim of this study was to identify a dental intervention to improve the smile in patients with tooth fluorosis. Additional aims were to relate the stain size on fluorotic teeth with the effectiveness of stain removal, enamel loss and procedure time using a manual microabrasion technique with 16% hydrochloric acid (HCL).METHODSAn experimental study was carried out on 84 fluorotic teeth in 57 adolescent patients, 33 females and 24 males, with moderate to severe fluorosis. The means, standard deviations and percentages were analyzed using nonparametric statistics and ArchiCAD 15 software was used for the variables including stain size and effectiveness of stain removal.RESULTSThe average enamel loss was 234 µm and was significantly related to the procedure time categorized as 1-4 min and 4.01-6 min, resulting in a P > 0.000. The microabrasion technique using 16% HCL was effective in 90.6% of patients and was applied manually on superficial stains in moderate and severe fluorosis. Procedure time was less than 6 min and enamel loss was within the acceptable range.CONCLUSIONMicroabrasion is a first-line treatment; however, the clinician should measure the average enamel loss to ensure that it is within the approximate range of 250 µm in order to avoid restorative treatment.

Minimally invasive aesthetic treatment of white spots by dental fluorosis in children: case report

Introduction: The presence of white spots due to dental fluorosis can cause aesthetic discomfort, being one of the factors for a search for dental treatment. Objective: Report a clinical case in which the aesthetic complaint was solved through the association of the dental bleaching to the microabrasion technique. Case report: Male patient, 13 years, attended to the Integrated Clinic of the School of Dentistry of the Federal University of Rio de Janeiro, with fluorosis, mainly in the antero-superior teeth and aesthetic complaint. Initially, it was made an immediate bleaching with hydrogen peroxide at 35%, in 3 sessions of 15 minutes each, to soften the disparity of shades between tooth-stain. The result was insufficient and the dental microabrasion technique was adopted. A pumice paste was applied together with gel of phosphoric acid at 37% under relative isolation, in a total of 8 applications (1 minute each). At the end of each application, it was made an abundant water washing, microengine mounted fine-grained disc polishing and topical application of neutral NaF2 in gel (4 minutes each application) to eliminate possible postoperative sensitivity. Conclusion: The dental bleaching and the microabrasion technique promoted satisfactory immediate clinical results that increased self-esteem of the patient in a minimally invasive way to dental structure.

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.