sodium-hypochlorite and Dental-Enamel-Hypoplasia

In this 2nd part, the current treatment of white spot lesions by erosion/infiltration is presented, beginning with a reminder of the principle of superficial infiltration, which enables most early carious lesions, fluorosis and post-traumatic lesions to be treated. However, this technique has met with frequent failures in cases of MIH or deep lesions of traumatic origin or those associated with fluorosis. For this reason a new deep infiltration technique is proposed: thanks to its global treatment concept, this enables all white spots to be treated. The place of whitening in these treatment options is discussed, with explanations of the main reasons for its failures.

Topics: Acid Etching, Dental; Composite Resins; Dental Caries; Dental Enamel; Dental Enamel Hypoplasia; Dental Materials; Dental Restoration, Permanent; Enamel Microabrasion; Ethanol; Fluorosis, Dental; Humans; Light-Curing of Dental Adhesives; Resins, Synthetic; Sodium Hypochlorite; Tooth Bleaching; Tooth Discoloration; Tooth Injuries

To ascertain whether deproteinization pretreatment of molar-incisor hypomineralization (MIH) enamel affects resin sealant infiltration.. Thirty one extracted MIH teeth were divided into three sections and randomly allocated into the Control (etch and FS), Treatment 1 (5% NaOCl, etched and fissure sealed), and Treatment 2 (5% NaOCl and fissure sealed with no etch) groups. Two hundred seventy nine sealant tag/enamel grade observations were recorded by scanning electron microscopy.. Control and Treatment 1 were similar in their outcomes, and Treatment 2 was markedly different. There was no statistical evidence to suggest that there was any difference between Treatment 1 and the Control Treatment (95% CI, 0.52, 1.51; P = 0.6). There was a marked difference between Treatment 2 and the Control Treatment (95% CI, 0.07, 0.25; P < 0.001). All treatments also demonstrated a high-predicted probability of obtaining 'poor' sealant tags (Control = 47%, Treatment 1 = 49%, and Treatment 2 = 40%).. The findings suggest that there was no significant difference in the tag quality between the conventional technique (Control) and the 'bleach-etch-seal' technique (Treatment 1). There was no benefit in pre-treating with NaOCl alone (without etch) before sealing. This research also showed that there was a high-predicted probability of obtaining 'poor' sealant tags in MIH enamel, regardless of which of the three treatments was used.

Topics: Acid Etching, Dental; Child; Composite Resins; Dental Bonding; Dental Enamel; Dental Enamel Hypoplasia; Dental Enamel Permeability; Dental Leakage; Drug Therapy, Combination; Humans; Pit and Fissure Sealants; Single-Blind Method; Sodium Hypochlorite; Surface Properties; Tooth Bleaching Agents