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J Dent. 2018 Dec;79:77-84. doi: 10.1016/j.jdent.2018.10.005. Epub 2018 Oct 18.

Power bleaching enhances resin infiltration masking effect of dental fluorosis. A randomized clinical trial.

Author information

1
Department of Operative Dentistry and Periodontology University Hospital of Cologne, Kerpener Str. 32, 50931, Cologne, Germany. Electronic address: christoph.schoppmeier@uk-koeln.de.
2
Department of Operative Dentistry and Periodontology University Hospital of Cologne, Kerpener Str. 32, 50931, Cologne, Germany. Electronic address: sonja.derman@uk-koeln.de.
3
Department of Operative Dentistry and Periodontology University Hospital of Cologne, Kerpener Str. 32, 50931, Cologne, Germany. Electronic address: michael.noack@uk-koeln.de.
4
Department of Operative Dentistry and Periodontology University Hospital of Cologne, Kerpener Str. 32, 50931, Cologne, Germany. Electronic address: michael.wicht@uk-koeln.de.

Abstract

OBJECTIVES:

Patients with moderate dental fluorosis often feel esthetically compromised. Aim of this RCT was to evaluate the objectively and self-assessed masking effect of resin infiltration alone or in combination with in-office bleaching on dental fluorosis in adults.

METHODS:

Twenty-seven patients (9 male, 18 female, 24.81 ± 3.7 yrs) with 410 fluorotic teeth (TF 1-4) were randomly assigned to a treatment (BLI) or control group (NBLI). Patients underwent in-office bleaching (25% H2O2) in the BLI or a placebo bleaching (ACP gel) in the NBLI group followed by resin infiltration after two weeks. Standardized digital photographs were obtained at baseline; after bleaching; before and after resin infiltration and after 1, 3, and 6 months. Color differences (ΔE) between sound and fluorotic areas were calculated and patient satisfaction was evaluated using a VAS (1-10).

RESULTS:

Statistical analysis revealed significant differences in the mean ΔE values 6 months after resin infiltration between the BLI (ΔE = 1.41) and the NBLI group (ΔE = 4.33) (p = 0.024). VAS values increased after resin infiltration (p < 0.05) in both groups. After 3 months patients in the BLI group had higher VAS values than in the NBLI group (p = 0.029).

CONCLUSIONS:

Findings of this study suggest that resin infiltration alone can effectively mask mild to moderate dental fluorosis in young adults. In-office bleaching with 25% H2O2 before resin infiltration provides significantly better masking effects.

CLINICAL SIGNIFICANCE:

Resin infiltration is a safe and efficient treatment option for masking fluorotic opacities. A priori in-office bleaching with 25% H2O2 enhances the masking effect. This controlled clinical trial is registered in the German Clinical Trials Register #DRKS00010465.

KEYWORDS:

Dental fluorosis; Hydrogen peroxide; Opacities; Resin infiltration; Tooth whitening

PMID:
30342902
DOI:
10.1016/j.jdent.2018.10.005
[Indexed for MEDLINE]

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