Comparison between phosphoric acid and hydrochloric acid in microabrasion technique for the treatment of dental fluorosis

Abstract

Purpose:To compare the effectiveness of phosphoric acid (H3PO4)-pumice compound with conventional hydrochloric acid (HCl)-pumice compound in treating different severities of dental fluorosis with the microabrasion technique.Materials and Methods:Sixty-seven anterior teeth from seven patients with different severities of dental fluorosis were treated. In each patient, half of the teeth were treated with HCl-pumice compound and the other half with H3PO4-pumice compound (split-mouth design). Both treatment compounds were applied for 30-second periods and treatment continued up to 10 minutes. Before and after treatment, standardized photographs were taken. The photographs were compared by two experienced observers unaware of the modality of treatment. Two indices of aesthetics, improvement in appearance (IA) and degree of stain removal (DSR), were determined according to a visual analog scale. The inter- and intra-correlation coefficients were made; then, statistical analyses were calculated using Mann-Whitney and t-test.Results:There were no significant differences in interobserver evaluation. Improvements in aesthetic indices were observed in all fluorotic teeth by both compounds; however, the mean treatment time with HCl-pumice was significantly lower than H3PO4-pumice.Conclusion:The H3PO4-pumice compound improved aesthetic indices in fluorotic teeth similar to the HCl-pumice compound.

Dental hypomineralization treatment: A systematic review

“…The location and depth of the stain or spot are the most important factors for a successful treatment. As so, this procedure should be restricted to more superficial enamel and deeper lesions may require additional treatment …”

“…Although hydrochloric acid is presently used as a component of microabrasion pastes in concentrations up to 18%, its use at 36% as suggested by Chandra and Chawla is not currently advocated given the loss of tooth structure caused by high concentrations of hydrochloric acid …”

“…As so, this procedure should be restricted to more superficial enamel and deeper lesions may require additional treatment. [101][102][103] Although hydrochloric acid is presently used as a component of microabrasion pastes in concentrations up to 18%, its use at 36% as suggested by Chandra and Chawla 57 is not currently advocated given the loss of tooth structure caused by high concentrations of hydrochloric acid. 102 Loguercio et al 64 resorted to enamel microabrasion with 10% hydrochloric acid, comparing it with the application of the same product at 6.6%.…”

Evaluation of color changes of white spot lesions treated with three different treatment approaches: an in-vitro study

“…The improvement in esthetics of WSLs may be attributed to light reflection through this new surface, which is thought to act differently than light reflected from an untreated enamel surface. 29 However, to obtain this improvement, a relatively important layer of enamel has to be removed, and since the depth of WSLs can reach one third of the enamel thickness, this may not be accepted, because modern dentistry aims at maximal tissue preservation. Also, some studies showed that even if up to 360 µm are removed from the enamel surface during microabrasion, the WSL may still be visible in the end.…”

Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups

“…Both phosphoric acid (H 3 PO 4 )-pumice and (HCl)-pumice compounds presented effectiveness in treating different severities of dental fluorosis by using the microabrasion technique, however, the mean treatment time with the HCl-pumice was significantly lower than the one with H 3 PO 4 -pumice 4 . In addition, clinically, we have noted that stains are routinely removed with unrecognizable alterations.…”