Resolution of a fluorosis case through the association of minimally invasive techniques
microabrasion and tooth bleaching
Color changes may interfere with smile balance and they represent a clinical challenge to dentists. Dental fluorosis originates from intrinsic factors and it is a disorder of enamel formation during the phase of teeth development, resulting in the change of enamel color. This clinical case report aimed to present the resolution of a case of dental fluorosis through the association of minimally invasive techniques, namely microabrasion and tooth bleaching. A 27-year-old male patient sought the dental clinic of the School of Dentistry of Piracicaba (FOP - UNICAMP, Brazil) presenting striped and symmetrical white stains and generalized chromogenic biofilm. After anamnesis and clinical examination, the patient was diagnosed with fluorosis stains. Initially, adequacy of the oral environment was performed with prophylaxis and supragingival scraping. Then, the enamel microabrasion technique was performed with 6% hydrochloric acid associated with silicon carbide (Whiteness RM - FGM) and supervised at-home bleaching was performed with 16% carbamide peroxide (Whiteness Simple 16% - FGM). In conclusion, the treatment performed reestablished the aesthetics and harmony of smile color with minimally invasive procedures without causing tooth sensitivity.
Wang Y, Sa Y, Liang S, Jiang T. Minimally invasive treatment for esthetic management of severe dental fluorosis: a case report. Oper Dent. 2013 Jul-Aug;38(4):358-62. doi: 10.2341/12-238-S.
Joiner A. Tooth colour: a review of the literature. J Dent. 2004;32 Suppl:3-12. doi:10.1016/j.jdent.2003.10.013.
Gugnani N, Pandit IK, Gupta M, Gugnani S, Soni S, Goyal V. Comparative evaluation of esthetic changes in nonpitted fluorosis stains when treated with resin infiltration, in-office bleaching, and combination therapies. J Esthet Restor Dent. 2017;29(5):317-24. doi: 10.1111/jerd.12312.
Park T-Y, Choi H-S, Ku H-W, Kim H-S, Lee Y-J, Min J-B. Application of quantitative light-induced fluorescence to determine the depth of demineralization of dental fluorosis in enamel microabrasion: a case report. Restor Dent Endod. 2016;41(3):225-30. doi: 10.5395/rde.2016.41.3.225.
Pini NIP, Lima DANL, Sundfeld RH, Ambrosano GMB, Aguiar FHB, Lovadino JR. In situ assessment of the saliva effect on enamel morphology after microabrasion technique. Brazilian J Oral Sci. 2014;13(3):187-92. doi: 10.1590/1677-3225v13n3a05.
Pini NIP, Lima DANL, Sundfeld RH, Ambrosano GMB, Aguiar FHB, Lovadino JR. Tooth enamel properties and morphology after microabrasion: an in situ study. J Investig Clin Dent. 2017 May;8(2):e12212. doi: 10.1111/jicd.12212.
Benbachir N, Ardu S, Krejci I. Indications and limits of the microabrasion technique. Quintessence Int. 2007 Nov-Dec;38(10):811-5.
Donly KJ, O’Neill M, Croll TP. Enamel microabrasion: a microscopic evaluation of the "abrosion effect". Quintessence Int. 1992 Mar;23(3):175-9.
Sundfeld RH, Croll TP, Briso ALF, de Alexandre RS, Sundfeld Neto D. Considerations about enamel microabrasion after 18 years. Am J Dent. 2007 Apr;20(2):67-72.
Sundfeld RH, Komatsu J, Russo M, Holland Junior C, Castro M, Quintella L, et al. [Removal of tooth-enamel white stains: clinical and microscopical study]. Rev Bras Odontol. 1990 May-Jun;47(3):29-34.
Litzenburger F, Heck K, Pitchika V, Neuhaus KW, Jost FN, Hickel R, et al. Inter- and intraexaminer reliability of bitewing radiography and near-infrared light transillumination for proximal caries detection and assessment. Dentomaxillofac Radiol. 2018 Feb 7;47(3):20170292. doi: 10.1259/dmfr.20170292.
Laitala M-L, Piipari L, Sämpi N, Korhonen M, Pesonen P, Joensuu T, et al. Validity of digital imaging of fiber-optic transillumination in caries detection on proximal tooth surfaces. Int J Dent. 2017;2017:1-6. doi: 10.1155/2017/8289636.
Miguéns-Vila R, Martín-Biedma B, Varela-Patiño P, Ruíz-Piñón M, Castelo-Baz P. Vertical root fracture initiation in curved roots after root canal preparation: a dentinal micro-crack analysis with LED transillumination. J Clin Exp Dent. 2017 Oct;9(10):e1218-23. doi: 10.4317/jced.54227.
Sundfeld RH, Sundfeld-Neto D, Machado LS, Franco LM, Fagundes TC, Briso ALF. Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups. J Appl Oral Sci. 2014 Jul;22(4):347-54. doi: 10.1590/1678-775720130672.
Sundfeld R, Franco L, Gonçalves R, de Alexandre R, Machado L, Neto D. Accomplishing esthetics using enamel microabrasion and bleaching — a case report. Oper Dent. 2014 Apr;39(3):223-7. doi: 10.2341/13-002-S.
Sundfeld RH, Rahal V, Croll TP, de Alexandre RS, Briso ALF. Enamel microabrasion followed by dental bleaching for patients after orthodontic treatment - case reports. J Esthet Restor Dent. 2007;19(2):71-7; discussion 78. doi: 10.1111/j.1708-8240.2007.00069.x
Kihn PW. Vital tooth whitening. Dent Clin North Am. 2007 Apr;51(2):319–31, viii. doi: 10.1016/j.cden.2006.12.001.
Basting R, Amaral F, França F, Flório F. Clinical comparative study of the effectiveness of and tooth sensitivity to 10% and 20% carbamide peroxide home-use and 35% and 38% hydrogen peroxide in-office bleaching materials containing desensitizing agents. Oper Dent. 2012 Sep;37(5):464-73. doi: 10.2341/11-337-C.
Moghadam FV, Majidinia S, Chasteen J, Ghavamnasiri M. The degree of color change, rebound effect and sensitivity of bleached teeth associated with at-home and power bleaching techniques: A randomized clinical trial. Eur J Dent. 2013 Oct;7(4):405-11. doi: 10.4103/1305-7456.120655.
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