Clinical
Fig 14 After 21 days of whitening
Fig 15 Erosion procedure begins
Fig 16 Drying step, before the second erosion REFERENCES
1. Atlan A, Denis M, Tirlet G, Attal JP. L’érosion-infiltration, un nouveau traitement des taches blanches de l’émail. Clinic 2012 (Sonderausgabe Ästhetik); 23-29.
2. Attal JP, Tirlet G. Le gradient thérapeutique: un concept médical pour les traitements esthétiques. Info dent 2009, 91 (41/42): 2561-2568.
Fig 17 Resin infiltration procedure is then carried out
3. Carvalho L, Bernardon J, Bruzi G, Andrada M, Vieira L. Hypoplastic Enamel Treatment in Permanent Anterior Teeth of a Child. Oper Dent 2013, Jan 17.
4. Hattab FN et coll. Dental discoloration: an overview. J Esth Dent 1999; 11: 291-300.
5. Meyer-Lueckel H, Paris S. Progression of artificial enamel caries lésions after infiltration with expérimental light curing resins. Caries Res 2008; 42 (2): 117-124.
6. Meyer-Lueckel H, Chatzidakis A, Naumann M, Dôrfer CE, Paris
S.Influence of applica- tion time on pénétration of an infiltrant into natural enamel caries. J Dent 2011; 39 (7): 465-469.
7. Newburn E, Brudevold F. Studies on the physical properties of fluorosed enamel. I. Microradiographic studies. Arch Oral Biol 1960; 12:15-20.
8. Newburn E. Studies on the physical proper- ties of fluorosed enamel. II.Microhardness. Arch Oral Biol 1960; 12:21:00-27.
Fig 18 One year post-treatment shows lasting results Continued »
rinsed for 30 seconds using a water spray (Fig 5) and the surface dried using water-free air. Once the enamel had been eroded, the water that was contained in the microporosities of the fluorosis lesions had to be eliminated (Fig 6) before the resin infiltration was carried out. Effectively, the infiltrating resin (Icon-Infiltrant) is a mixture based on hydrophobic methacrylate resin (TEGDMA). For this reason, the lesions must be desiccated beforehand. This dehydration was accom- plished through the application of a solution of 99 per ceny ethanol (Icon-Dry), for 30 seconds, on the surface of the lesions using a flat-ended needle. Because the whiteness of the lesions did not exhibit any significant decrease when this procedure was performed, it meant that the demin- eralised lesions were not fully accessible. Therefore a second erosion procedure
56 Scottish Dental magazine
was performed for ı20 seconds (Fig 7). This time, after rinsing, drying and a
new application of the ethanol solution, the lesions appeared to be much less bright and had nearly disappeared (Fig 8). Therefore, this time, they were accessible for the resin infiltration. Drying with air was then carried out to evapo- rate the ethanol. After this drying was completed, the lesions appeared to be more pronounced (bright opaque white), which can be explained by the refractive index of air. At this point, infiltration was performed
(Fig 9). The application of TEGDMA- based resin (Icon-Infiltrant) with a refractive index of ı.52, which is close to that of enamel (ı.62), was done using the sponge applicator tip. This resin, which has very a low viscosity and water-resist- ance, uses capillary action to infiltrate the porosities of the lesions for three minutes. Since the resin can be photo-
9. Paris S, Meyer-Lueckel H, Kielbassa AM. Resin inflitration of natural caries lésions. J Dent Res. 2007; 86 (7): 662-666.
10. Paris S, Meyer-Lueckel H. Masking of labial enamel white spot lésions by resin infiltration – a clinical report. Quintessence Int. 2009; 40 (9): 713-718.
11. Robinson C, Brookes SJ, Kirkham J, Wood SR, Shore RC. In vitro studies of the pénétra- tion of adhesive resins into artificial caries-like lésions. Caries Res 2001; 35 (2): 136-141.
12. Serfati R. Reproduction de l’état de surface et polissage des composites. Info dent 2011; 93 (13): 37-39.
13. Tirlet G, Attal JP. L’érosion/infiltration: une nouvelle thérapeutique pour masquer les taches blanches. Info dent 2011; 26 (4): 12-17.
14 Attal JP, Denis M, Altan A, Vennat E, Tirlet G. L’infiltration en profondeur. Un nouveau concept pour le masquage des taches de l’émail - Partie I. Information Dentaire 2013 95 (18/19) : 94-99.
polymerised, this should be done away from light6. The application of acid provides significant surface tension, which also facilitates the infiltration. The resin penetrates more deeply into the enamel than conventional adhesives do5. Solvents were evaporated using the air blower and any excess was
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