HOME - Clinical cases - Restorative dentistry
 
 
23 January 2019

Which therapy is more effective for the treatment of fluorosis?

Simona Chirico


INTRODUCTION 
Dental fluorosis is a chronic condition due to excessive ingestion of fluoride. This leads to a disturbed enamel formation characterized by hypomineralization of tooth enamel, seen as diffuse, symmetrical, discolored white opaque stains and striations. Enamel surface lesions, such as pitting, porosity, and brownish areas often occur in the more severe forms of fluorosis. These clinical signs depend on the amount of fluoride uptake, duration of fluoride exposure and stage of amelogenesis. A wide range of interventions have been proposed to treat fluorotic enamel, such as:

  • microabrasion: based on the application of an etching gel (mostly HCl) followed by pumicing with slow rotation handpiece;
  • external bleaching:  based on the application of acids (mostly H2O2) that produces peroxide ions to penetrate enamel and dental tubules;
  • enamel infiltration with low viscosity light-cured resins: to hide fluorotic stains, because of the resin’s similar to enamel refractive index.

Which of these is the best? A review published on the 2018 Journal of Esthetic and Restorative Dentistry compared all these treatments to give an answer. 

MATERIALS AND METHODS 
The authors searched from nine database only randomized clinical trials from 2016. Only six studies were included, with a total of 348 patients (40% male and 60% female) with a mean age of 17,7 years. They were divided into three groups and treated with bleaching, microabrasion or resin infiltration. All the groups were compared by calculating: mean differences (MD), relative risks (RR) and the corresponding 95% confidence intervals (CI). 

RESULTS
Bleaching was adopted as a reference intervention, because it contributed with the largest number of trials.
Compared to no treatment, bleaching improved all colorimetric aspects,
even if fewer bleached fluorotic areas tended to have discernable color differences from healthy enamel (RR = 0.68; 95% CI = 0.43-1.08).
In the comparison between microabrasion and bleaching, microabrasion resulted in smaller esthetic improvement compared to bleaching (MD: -2,9; 95% CI: -3,4 to -2,5).
In the comparison between resin infiltrations and bleaching, resin infiltrations had a greater esthetic improvement compared to bleaching (MD: 3,6; 95% CI: 2,7 to 4,6). 

CONCLUSIONS
Based on current evidence, resin infiltrations seems to be the most effective treatment for dental fluorosis, followed by bleaching and microabrasion.


For additional informations:
Interventions for dental fluorosis: A systematic review

Related articles

Author: A. Colella

Thanks to the introduction of new technologies and more performing materials, in recent years Restorative Dentistry has focused on a less invasive clinical...


Dentists must regularly determine the best adhesive cementation protocol for glass-ceramic restorations on posterior teeth. A few in vivo follow-up...


38-year-old male patient with negative medical history, who comes for a visit many years after the last dental check-up. He reports difficulty in removing food residues in the interproximal areas, in...


38-year-old male patient with negative medical history, who comes for a visit many years after the last dental check-up. He reports difficulty in removing food...


Restoration of teeth with insufficient coronal tooth structure due to deep caries, resorption or traumatic injury with fracture line extended under gingival...


Read more

USA     18 June 2021 - 30 November 0001

ADHA Annual Conference 2021

June 18-20, 2021. Phoenix, Arizona.

As the largest event dedicated to dental hygienists, this meeting is just for you! 


The treatment of palatal displaced canines (PDCs) is one of the most challenging treatments in orthodontic dental care. The invasive and long-lasting treatment often requires interceptive extraction...


Recorded webinar - Oral Surgery - Prof. Testori

Sinus elevation surgery has become a sought-after part of implant dentistry. Procedures have evolved over the last 25 years to a point where sinus grafting surgery is considered one of the most...


Dental billing platform company, Vyne Dental, has acquired patient communications company, Operability, LLC. The acquisition also includes Operability’s OperaDDS platform, which launched in 2011 to...


Authors: Monica Giani, Umberto Pagliaro, Lorenzo Franchi, Roberto Rotundo, Michele Nieri

Purpose. The aim of this randomized clinical trial with blinded examiner was to compare the efficacy of four different methods of enhancing oral hygiene motivation in: (i) reducing the full-mouth...


 
 
 
 
 
 

Most popular

 
 

Events

 
 

Copyright © 2021 - All Rights Reserved
ISSN 2767-1178

Top