Dental Treatment of White Spots and a Description of the Technique and Digital Quantification of the Loss of Enamel Volume

Abstract

The prevalence of white spots on teeth has increased in recent years. Regardless of their etiology, these lesions are characterized by a reduction in the enamel’s mineral phase, which is replaced by organic fluids. This causes an alteration of its chemical composition that affects its optical characteristics. Subsurface demineralization increases the pore volume of enamel, which in turn changes its optical refraction and results in the opaque color of white spot lesions. Here, we examined a non-invasive clinical technique used for eliminating these white spot lesions from enamel via two HCl-based products at different concentrations (6.6% and 15%). We used a digital method for evaluating the volumetric changes produced in dental enamel by the application of both products, one of which involved chemical erosion and the other, abrasive erosion. The mean volume of the enamel eliminated was −0.042 mm in 15% HCl, and −0.12 mm in 6.6% HCl. Thus, both 15% HCl and 6.6% HCl are capable of eroding the surface of the tooth enamel without reaching dentin. Moreover, 6.6% HCl produced a greater erosion of the dental enamel and left the surface a texture typical of an abrasive chemical-erosive product. The 15% HCl, however, produced an etching pattern typical of an erosive chemical with open enamel prisms prepared for subsequent adhesive procedures and restorers.

White Spot Lesions: Diagnosis and Treatment – a Systematic Review

“…In this way, a large number of clinical studies was obtained after searching the various databases (18,19,20,21,22,23,24,25,26,27,28,29,30,31) . This shows the usefulness and relevance of carrying out a systematic review of this subject.…”

“…SAPP11-4 is also a product that can be used in combination with uorine, not limiting its action and promoting enamel remineralization. This monomeric selfassembling peptide solution can diffuse into carious lesions and promote hydroxyapatite formation, signi cantly reducing the size of buccal white spot lesions (19) .…”

Study on the role of nano antibacterial materials in orthodontics (a review)

“…The development of white spots, sometimes called demineralization, is a common unintended consequence of orthodontic treatment (Figure 1). During active usage of the appliance, acidogenic plaque bacteria, such as lactobacilli and mutans streptococci, might impair the self-cleaning capacity of teeth, change the oral microbiota, and raise the amounts of acidogenic plaque bacteria in saliva and dental biofilm (Roig-Vanaclocha et al, 2020;Kidd and Fejerskov, 2004;Chen et al, 2020). Demineralization or dental decay surrounding orthodontic brackets can be caused by this cariogenic biofilm (Sudjalim et al, 2007;Gorton and Featherstone, 2003).…”

Infiltración de resina y barniz de flúor para el tratamiento de caries interproximales no cavitadas en dentición temporal.

“…• A pesar de que las revisiones sistemáticas no reportan eventos adversos, en el uso de la resina infiltrativa siempre será necesario usar aislamiento absoluto para disminuir el riesgo de complicaciones por el uso del del ácido hidroclorhídrico. Así mismo, algunos autores, considerando los efectos ambientales, recomiendan siempre inactivar el ácido hidroclorhídrico con bicarbonato de sodio inmediatamente después del tiempo de aplicación en la lesión y antes de realizar la succión (16) .…”