Infiltrante resinoso vs Microabrasão no manejo de lesões de mancha branca: relato de caso / Resin infiltration vs microabrasion in white-spot lesions treatment: case report

Objetivo: Apresentar caso clínico de tratamento estético das lesões de mancha branca após tratamento ortodôntico nos dentes superiores anteriores através de duas técnicas minimamente invasivas usando o sistema de infiltração de resina e microabrasão. Relato de caso: Paciente com 18 anos de idade apresentava lesões de manchas brancas inativas nos dentes 11, 12, 13, 21, 22, 23. O sistema de infiltrante de resina Icon (DMG, Hamburgo, Alemanha) foi utilizado nos dentes 11, 12, 13, enquanto os dentes 21, 22, 23 foram submetidos à microabrasão com Whiteness RM (FGM, Joinville, Santa Catarina, Brasil).Ambos os protocolos foram utilizados de acordo com as recomendações do fabricante.Nos dentes 21 e 22, o produto para microabrasão foi aplicado com espátula que acompanha o kit, enquanto que no dente 23 utilizou-se o mesmo produto aplicado com taça de borracha em baixa rotação, todos os procedimentos executados por um único operador. A microabrasão com taça de borracha proporcionou uma superfície mais lisa e homogênea.Ambos os produtos tiveram resultados satisfatórios na resolução estética das lesões de mancha branca após um ano de acompanhamento. Conclusão: Os dois produtos apresentam bom desempenho e resolutividade para os problemas estéticos de lesões de manchas brancas inativas, entretanto deve-se levar em conta o tempo clínico, toxicidade, a atividade da lesão e a possibilidade de desgaste da estrutura dentária.

Objective: To present a case report of aesthetic treatment of post orthodontic white--spot lesions in the anterior superior teeth through two minimally invasive technique susing resin infiltration system or microabrasion. Case report: Patient 17 years of age had inactive white-spots lesions on teeth 11, 12, 13, 21, 22, 23. The teeth 11, 12, 13 received the resin infiltrating system Icon (DMG, Hamburg, Germany) while the teeth 21, 22, 23were submitted to microabrasion with Whiteness RM (FGM, Joinville, Santa Catarina, Brazil). Both protocols were used according to manufacturer’s recommendations. In the teeth 21 and 22, the product of the microabrasion was applied with a spatula that accompanied the kit, while the tooth 23 received the same product applied with a rubbercup at low speed turbine, all by a single operator. The microabrasion with rubber cupoccasioned a more smooth and homogeneous surface. Both products had satisfactory results in aesthetic resolution of the white-spots lesions, for a 1-year follow-up. Conclusion:Although both products are able to resolve aesthetic problems of inactive white-spots lesions, it should be taken into account the clinical time, toxicity, the activity ofthe lesion and the possibility of wear of the tooth structure.

Evaluation of the effect of different methods of microabrasion and polishing on surface roughness of dental enamel.

Description of the Technique: The microabrasion technique of enamel consists of selectively abrading the discolored areas or causing superficial structural changes in a selective way. Objective: In microabrasion technique, abrasive products associated with acids are used, and the evaluation of enamel roughness after this treatment, as well as surface polishing, is necessary. This in-vitro study evaluated the enamel roughness after microabrasion, followed by different polishing techniques. Settings and Design: Roughness analyses were performed before microabrasion (L1), after microabrasion (L2), and after polishing (L3).Thus, 60 bovine incisive teeth divided into two groups were selected (n=30): G1- 37% phosphoric acid (37%) (Dentsply) and pumice; G2- hydrochloric acid (6.6%) associated with silicon carbide (Opalustre – Ultradent). Thereafter, the groups were divided into three sub-groups (n=10), according to the system of polishing: A – Fine and superfine granulation aluminum oxide discs (SofLex 3M); B – Diamond Paste (FGM) associated with felt discs (FGM); C – Silicone tips (Enhance - Dentsply). A PROC MIXED procedure was applied after data exploratory analysis, as well as the Tukey-Kramer test (5%). Results: No statistical differences were found between G1 and G2 groups. L2 differed statistically from L1 and showed superior amounts of roughness. Differences in the amounts of post-polishing roughness for specific groups (1A, 2B, and 1C) arose, which demonstrated less roughness in L3 and differed statistically from L2 in the polishing system. Conclusion: All products increased enamel roughness, and the effectiveness of the polishing systems was dependent upon the abrasive used.

Influence of microabrasion on shear bond strength of composite resin to dentin

The purpose of this study was to determine the influence of microabrasion on shear bond strength of composite resin to dentin. Ninety noncarious recently extracted human molars were selected. The occlusal surface of teeth was ground, exposing flat dentin surface to accommodate bonded restorative material. The teeth were divided into nine groups of 10 teeth each. The dentin surfaces of the first group were conditioned with Total Etch for 10 seconds, then washed and dried to serve as control. Air abrasion conditioning of the remaining 8 groups was accomplished with "Micro Prep Director+" air abrasion device using 0.4mm nozzle tip perpendicular to sample surface and 1cm away from it. Surface abrasion was performed using a 27 micro m aluminum oxide particle stream at 60 psi for 10 seconds in two groups, and for 20 seconds in another two groups. Air pressure was then increased to 120 psi to abrade surfaces of another two groups for 10 seconds, and for 20 seconds in the remaining two groups. Additional conditioning with Total Etch was performed to the surfaces of the last four groups combined with air abrasion treatment. Three teeth from each of the nine groups were mounted in a profilometer and three Ra values were recorded for dentinal surface roughness before and after surface treatment. Remaining samples were prepared for bonded composite restorations, and shear bond strengths were determined using a testing machine. Results revealed significantly higher roughness of etched surface than air abraded dentin. Meanwhile acid etching created bond strengths to dentin that were almost twice as high as those achieved by air abrasion. It could be, thus, suggested that cavities prepared by air abrasion should also be acid etched to achieve adequate bonding with resinous materials