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


Yetkiner, Enver; Wegehaupt, Florian; Wiegand, Annette; Attin, Rengin; Attin, Thomas (2014). Colour improvement and stability of white spot lesions following infiltration, micro-abrasion, or fluoride treatments in vitro. European Journal of Orthodontics, 36(5):595-602.

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.

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.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic of Conservative and Preventive Dentistry
04 Faculty of Medicine > Center for Dental Medicine > Clinic for Orthodontics and Pediatric Dentistry
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Orthodontics
Language:English
Date:October 2014
Deposited On:25 Nov 2014 15:52
Last Modified:23 Oct 2022 06:06
Publisher:Oxford University Press
ISSN:0141-5387
Additional Information:This is a pre-copy-editing, author-produced PDF of an article accepted for publication in The European Journal of Orthodontics following peer review. The definitive publisher-authenticated version is available online at:DOI: 10.1093/ejo/cjt095
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1093/ejo/cjt095
PubMed ID:24385411
  • Content: Accepted Version
  • Content: Published Version
  • Language: English
  • Description: Nationallizenz 142-005