Resin infiltration for white spots

13 Jan 2016

The etiology behind hypomineralized enamel can be genetic, acquired and idiopathic, and the extend of the lesions is time dependent. Due to hypomineralization the light behaves differently giving an appearance of white spots and when we are referring to the anterior teeth the smile esthetics is compromised. For the treatment of these anomalies many options are provided and the clinician should always chose the minimal invasive technique. This case is about a 23 year old student visited the graduate program of operative dentistry in Athens seeking for a smile enhancement. Direct resin restoration would be an appropriate treatment plan but it would require enamel removal. Before being subtractive the resin infiltration technique can be used as an ultraconservative approach.

When managing white spots, an ultraconservative approach is needed in order to prevent tooth destruction following the concept of minimal invasive dentistry. The resin infiltration technique is a very promising microinvasive method to preserve enamel tha is demineralized

Fig. 1

Frontal view of the smile where we can see the white spot lesions mainly at #13,12,21.

Fig. 2

Initial smile of the young patient.

Fig. 3

Lateral initial smile smile.

Fig. 4
Fig. 5

The use of rubber dam is essential when adhesive protocols are applied

Fig. 6

Lateral view of the teeth and the isolation

Fig. 7

Lateral view of the teeth and the isolation

Fig. 8

HCL 15% is applied for 2 minutes and spray of water and air is used in order to wash out the acid.

Fig. 9

The application of 99% ethanol follows and helps the water to evaporate from the microcavities of the lesion.

Fig. 10

In this case, repeating the etching step was not necessary, so the process was continued by applying locally on the lesions the infiltration resin

Fig. 11

The resin was left set for 3 minutes and then it was light cured for 40 seconds.

Fig. 12

Immediately after the removal of the rubber dam the rehydration of the anterior teeth is visible.

Fig. 13

Lateral view of the smile immediately post operative.

Fig. 14

Lateral view of the smile immediately post operative.

Fig. 15

Close up view of the teeth without visable white-spots.

Fig. 16

The smile of the patient 30 minutes after dam removal.

Fig. 17

Two weeks after the use of the resin infiltration technique.

Fig. 18

Six months recall of the case