Minimally invasive carious spot treatment

Community - Direct anteriors
5 Apr 2016

Minimally invasive treatment methods are nowadays increasingly popular. Many factors, such as primary caries, fluorosis, imperfect enamel formation, dental hypoplasia, can cause superficial enamel alteration. Traditional treatment, that consisted in caries removal followed by sealing with composite resin, often resulted in healthy, intact enamel damage. A minimally invasive way to remove spots is micro abrasion enamel.

Fig. 1

Img 1.- The patient is a 30-year-old male, with brown carious spots located on the cervical enamel surface of all maxillary incisors.

Fig. 2

Img 2.- These alterations have appeared in the last three years.

Fig. 3

Img 3.- For their removal, an enamel micro-abrasion technique was proposed. An enamel microabrasive agent containing a mild concentration of hydrochloric acid (6,6%) and silicon carbide particles (Opalustre) was used.

Fig. 4

Img 4.- After microabrasion of front teeth.

Fig. 5

Img 5.- Application of glass ionomer sealant Clinpro XT Varnish for enamel remineralization.

Fig. 6

Img 6.- After isolation with the rubber dam, pretreatment with a fine-grained diamond bur was performed for 5-10 seconds.

Fig. 7

Img 7.- 1 mm layer of microabrasive compound is applied to the tooth surface for 60 seconds.

Fig. 8

Img 8.- The tooth was treated with micro abrasive compound for 1 minute with a rubber cup (Opal Bristle Cup) with medium and strong pressure and then rinsed with water to check the result. To achieve a good result the procedure was repeated 3 times.

Fig. 9

Img 9.- After microabrasion of tooth 12 0,3 mm enamel were removed.

Fig. 10

Img 10.- The area which was to receive the restoration was etched with 36% orthophosphoric acid for 15 seconds.

Fig. 11

Img 11.- After water rinsing and drying of the tooth surface, the adhesive agent (ScotchBond Universal) was placed on tooth and light cured for 10 seconds.

Fig. 12

Img 12.- Flowable composite resin (Filtek Z350 Flowable A2) was used for restoration.

Fig. 13

Img 13.- Steps are repeated for the other teeth.

Fig. 14

Img 14.- 6 month outcome.