Effect of Caries Infiltration Technique and Fluoride Therapy on Microhardness of Enamel Carious Lesions

Abstract

Enamel white spot subsurface lesions compromise esthetics and precede cavitation; therefore, they must be halted. The aim of this study was to evaluate the effect of a caries infiltration technique and fluoride therapy on the microhardness of enamel carious lesions. Subsurface carious lesions were produced in 60 bovine specimens with polished enamel surfaces. The specimens were divided into four groups (n=15), according to the treatment used: CON, control-immersion in artificial saliva; DF, daily 0.05% fluoride solution; WF, weekly 2% fluoride gel; and IC, resin infiltration (Icon). The specimens were kept in artificial saliva and evaluated for microhardness at five points: baseline, after caries production, after four and eight weeks of treatment, and a final evaluation after being submitted to a new acid challenge. The repeated-measures analysis of variance showed significant differences according to the type of treatment (TREAT; p=0.001) and time of evaluation (EV; p=0.001). The results of the Tukey test were TREAT: CON = 45.18 (±29.17)a, DF = 107.75 (±67.38)b, WF = 83.25 (±51.17)c, and IC = 160.83 (±91.11)d. Analysis of correlation between the TREAT and EV factors showed no significant differences for DF (138.63 ± 38.94) and IC (160.99 ± 46.13) after the new acid challenge. The microhardness results in decreasing order after eight weeks were IC > DF > WF > CON. It was concluded that the microhardness of carious lesions increased with the infiltration of resin, while the final microhardness after a new acid challenge was similar for DF and IC.

Effect of resin infiltration on enamel surface properties and <i>Streptococcus mutans</i> adhesion to artificial enamel lesions

“…Some clinical studies have reported that micro-invasive caries treatment with resin infiltration was an effective and safe approach to arrest initial caries lesions and preserve demineralized enamel [27][28][29] . Findings of this study agreed with those reported by Torres et al 6) and Paris et al 13) , in that the microhardness of carious lesions was significantly improved with resin infiltration. Taher et al 14) also indicated that enamel surfaces treated with an infiltrant showed significantly higher surface hardness than treatment with a fissure sealant.…”

“…From biomedical engineering standpoint, surface hardness is an important property because resistance to wear by either friction or erosion increases with hardness. Several studies have confirmed that resin infiltration significantly increased the microhardness of initial enamel carious lesions 6,13,14) . When the micropores of infiltrated lesions are filled with resin, cariogenic acids are blocked from entering these carious lesions, causing caries progression to slow down or even be arrested 1) .…”

“…Different methods are available for the arrestment of white spot lesions: resin infiltration 4) , conventional resin bonding 5) , remineralization of enamel subsurface lesions with the use of topical agents such as fluorides 6) and amorphous calcium phosphates (ACP) 7) , microabrasion 8) , and various types of veneers 9) . The use of topically applied fluoride on enamel surfaces, shown to be both safe and effective, has played a major role in markedly reducing caries incidence and prevalence.…”

Color Masking of Developmental Enamel Defects: A Case Series

“…13,14 In addition, as the subsurface lesions are filled with resin, a positive effect regarding color masking of the whitish lesions can be observed; therefore, this technique has been used in esthetically compromised areas. 3,15 These masking effects were initially observed in enamel carious lesions, with satisfactory outcomes demonstrated in both in vitro investigations 16,17 and clinical cases.…”

Resin Infiltration Technique for Proximal Caries Lesions in the Permanent Dentition: A Contrarian Viewpoint

“…Subsequent to 2-minute etch treatment, resin infiltration initially increased the microhardness of caries lesions in bovine enamel; however, there was a reduction in microhardness following acid challenge, likely due to either resin shrinkage or dissolution of the remaining mineral within the body of the lesion. 17 Definitive restorations, though seemingly more drastic, may therefore be more pragmatic than resin infiltration since longitudinal caries data (birth to 32 years of age) have shown caries rate to be constant over the years. 18 Robinson, who pioneered the resin infiltration technique in the 1970s, reported in a 2011 review that the contemporary technique lacked resolution of some methodological concerns and therefore recommended that it be restricted to ''accessible and relatively superficial lesions.''…”