Colour improvement and stability of white spot lesions following infiltration, micro-abrasion, or fluoride treatments in vitro

Eur J Orthod. 2014 Oct;36(5):595-602. doi: 10.1093/ejo/cjt095. Epub 2014 Jan 2.

Abstract

Summary background/objectives: White spot lesions (WSLs) are unwelcome side effects of fixed appliances that compromise the treatment outcome. Recently, infiltration of WSLs has been introduced as a viable treatment alternative. The objective was to evaluate the colour improvement of WSLs and their stability against discolouration following infiltration, fluoride, or micro-abrasion treatments in vitro.

Materials/methods: Artificial WSLs were created in bovine enamel (N = 96) using acidic buffer solution (pH 5, 10 days) and were randomly allocated to four groups. Specimens were treated with infiltration (Icon, DMG), fluoride (Elmex Caries Protection, GABA), and micro-abrasion (Opalustre, Ultradent) or remained untreated (control). Groups were discoloured for 24 hours in tea or tea + citric acid. Colour components and visible colour change (L*, a*, b*, ΔE) were measured spectrophotometrically on following time points: baseline, after WSL formation, after treatment, and during discolouration (8, 16, and 24 hours). Data were analysed using Kruskal-Wallis and Mann-Whitney tests.

Results: WSL formation increased (L*) in all groups. Only infiltration reduced this effect to baseline. Highest ΔE improvement was obtained by infiltration and micro-abrasion followed by fluoride. This improvement was stable only for infiltration during discolouration. L*, a*, and b* changed significantly during discolouration in all groups except infiltration. Within the same treatment group, discolouration solutions did not differ significantly.

Limitations: In vitro testing cannot replicate the actual mode of colour improvement or stability but can be used for ranking materials and techniques.

Conclusions/implications: Infiltration and micro-abrasion treatments were capable of diminishing the whitish appearance of WSLs. Only infiltrated WSLs were stable following discolouration challenge.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cariostatic Agents / therapeutic use*
  • Cattle
  • Citric Acid / adverse effects
  • Color
  • Dental Caries / pathology
  • Dental Caries / therapy*
  • Dental Enamel / drug effects
  • Dental Enamel / pathology
  • Diamines / therapeutic use
  • Enamel Microabrasion / methods*
  • Fluorides / therapeutic use*
  • Polyethylene Glycols / therapeutic use
  • Polymethacrylic Acids / therapeutic use
  • Random Allocation
  • Resins, Synthetic / therapeutic use*
  • Spectrophotometry / methods
  • Tea / adverse effects
  • Tooth Discoloration / etiology
  • Tooth Discoloration / pathology
  • Tooth Remineralization / methods

Substances

  • Cariostatic Agents
  • Diamines
  • Polymethacrylic Acids
  • Resins, Synthetic
  • Tea
  • icon infiltrant
  • triethylene glycol dimethacrylate
  • Citric Acid
  • Polyethylene Glycols
  • Olaflur
  • Fluorides