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

*Department of Orthodontics, University of Ege, Izmir, Turkey,
**Clinic for Preventive Dentistry, Periodontology and Cariology, University of Zurich, Switzerland,
***Department of Preventive Dentistry, Periodontology and Cariology, University of Göttingen, Germany and
****Clinic for Orthodontics and Pediatric Dentistry, University of Zurich, Switzerland

Correspondence to: Enver Yetkiner, Faculty of Dentistry, Department of Orthodontics, University of Ege, 35100, Bornova, Izmir, Turkey. E-mail:[email protected]

European Journal of Orthodontics 36(5):p 595-602, October 2014. | DOI: 10.1093/ejo/cjt095

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.