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Restorative Dentistry

Biological & esthetic management of enamel white discoloration:

Erosion infiltration technique Abstract

Hana Sarraj* Post graduate Student

Emna Hidoussi* Assistant Professor

Neila Zokkar Professor

*Both authors contributed equally to this work

Early stage caries (White spots), fluorosis, traumatic hypomineralizations and molar incisor hypomineralization (MIH) all present to differing degree, clinical symptoms involving white marks on the enamel. It can impact patients’ quality of life. The most conservative treatment in such cases is erosion-infiltration. This treatment using Icon® (DMG, Hamburg, Germany) is one of the most conservative and efficient protocols. The Icon® treatment was initially proposed as a simple and minimally invasive alternative for caries treatment of initial proximal lesions, but surprisingly the technique proved a high ability to mask the white spots by modifying the refractive index of the lesion.

The proposed strategy is not based on the elimination of dysplastic enamel, but on masking the lesion by infiltrating the porous subsurface enamel with a hydrophobic resin that has a refraction index closer to that of sound enamel, after permeating the non-porous surface enamel through hydrophobic acid erosion. This article provides an overview of different indications suitable for treatment with the technique of resin infiltration (Icon®, DMG), such as white-spot lesions (WSL), enamel fluorosis, and molar-incisor hypomineralisation (MIH) in different patients. Key words: Infiltration, White spot lesion, Fluorosis, MIH

Introduction Clinically, early carious lesions in enamel is initially seen as a white opaque spot and is characterized by being softer than the adjacent sound enamel. It becomes even whiter when dried with air. These lesions may present a serious aesthetic problem along with the progression of demineralization 1. These white spots can be the result of different factors: early stage caries (due to plaque accumulation and bad oral hygiene) near the gingival line or around orthodontic brackets, fluorosis, medicine intake, molar incisal hypomineralization (MIH) and traumatic hypomineralization 2.

Department of Restorative Dentistr y- Endodontics , Faculty of Dental Medicine, Monastir, Tunisia


Dental News

Management of this type of white spot lesion is generally by means of topical application of Fluoride therapy, Casein-Phospho Peptide-Amorphous Calcium Phosphate pastes, Novamin (calcium sodium phosphosilicate) 3. All these treatment modalities end up in surface remineralization, but the subsurface is still porous. March 2019

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Dental News March 2019