Thursday, April 25, 2013

Masking of white spot lesions by resin infiltration in vitro

I have done some successful white spot lesion reversals using Icon along with GC's MI Paste and Voco's ReminPro. They all work but the depth of the lesion is unknown and can influence the results. MJ
Available online 11 April 2013

Abstract

Objectives

The aim of this in vitro study was to evaluate the ability of one commercial and five experimental infiltrating resins (infiltrants) to camouflage enamel white spot lesions immediately after resin infiltration and after a staining period.

Methods

In each of 120 bovine enamel samples, two artificial caries lesions were created (windows A, C; pH = 4.95, 50 days), whereas two windows were protected serving as sound controls (B, D). After etching windows C and D (37% phosphoric acid), specimens were randomly allocated to 6 groups. Either one of 5 experimental infiltrants or a commercial infiltrant (Icon, DMG) (refractive indices 1.50-1.55) was applied and light cured. After half of each specimen was polished, samples were remineralised (pH = 7.0) and stained with tea and red wine for 50 days. Photographic images after various treatment steps were obtained. Colour differences (ΔE) of untreated (A) and treated lesions (C) as well as infiltrated sound enamel (D) were compared with untreated enamel (B).

Results

All infiltrants showed significantly better colour match with sound enamel (median ΔE [25th/75th percentile]: 2.2 [1.5/3.1]) than untreated controls (9.3 [8.0/10.9]) (p < 0.001, Wilcoxon, post-hoc Bonferroni). Moderate correlation between refractive index and ΔE of infiltrated lesions was demonstrated (R2 = 0.43, p > 0.05). Staining was significantly reduced for polished infiltrated lesions compared to untreated or infiltrated unpolished lesions (p < 0.001).

Conclusions

Resin infiltration is suitable to mask artificial white spot lesions. Polished infiltrated lesions are resistant to staining in vitro.

Clinical Significance

Resin infiltration is a micro-invasive approach to camouflage post-orthodontic white spot lesions.

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