The use of transillumination in mapping demarcated enamel opacities in anterior teeth: A cross-sectional study.

BACKGROUND: Despite intensive efforts for categorizing demarcated enamel opacities, often related to molar incisor hypomineralization (MIH), there is a lack of descriptive criteria aiming to describe them physically outside the scope of color and size. This is most likely due to the indices focusing on molar, not anterior, teeth. AIM: To map and classify demarcated lesions on permanent anterior teeth using reflected and transilluminated light. The association between classification and related lesion characteristics was also examined. DESIGN: Permanent anterior teeth with demarcated opacities related to MIH were selected. For each tooth, standardized photographs were taken using transmitted and reflected light. Each lesion was mapped and classified according to its color, lesion size, surface integrity, and type. The data were analyzed using the chi-square and Fisher's exact tests. A logistic regression analysis was performed to identify the risk of PEB. RESULTS: There were significant relationships between lesion size, color, and type with surface integrity. Lesion type and size were more important than lesion color for assessing the risk of PEB. There was also a significant relationship between lesion size and lesion color. CONCLUSIONS: Lesion size and type are significant clinical parameters for assessing the risk of PEB on enamel opacities related to MIH.

The influence of lesion characteristics on application time of an infiltrate applied to MIH lesions on anterior teeth: An exploratory in vivo pilot study.

OBJECTIVES: To evaluate the factors that influences the kinetics of resin infiltration of molar incisor hypomineralisation (MIH) lesions on permanent anterior teeth. METHODS: Demarcated MIH lesions with homogeneous and heterogeneous lesion body appearance, Types 1 (n = 14) and 2 (n = 18), respectively, were selected. After removal of the lesion surface layer using a tapered diamond finishing bur, the lesions were etched and ethanol was applied to the lesions and it was determined if the lesion was still visible or not. Images were taken just prior infiltrant (Icon; DMG) application (T0), during the infiltration process (Tx) and when infiltration had ceased progressing or opacity disappearance was clinically apparent (Tmax). Surface-area measurements of the opacity and infiltrated area were calculated and the infiltration proportion (IPx) was calculated over the infiltration time. RESULTS: Type 1 and positive ethanol test lesions showed significantly lower mean Tmax (3.4 min) in comparison with Type 2 and negative ethanol test lesions (9.9 min) [Student t-test/Fisher's exact test; p < .01]. A non-linear correlation was observed (R2 = 0.88) indicating that the IPx was rapid at the beginning of resin application, decreasing over time. CONCLUSION: In comparison with Type 1 and positive ethanol test lesions, Type 2 and negative ethanol test lesions require longer application time to infiltrate. CLINICAL SIGNIFICANCE: MIH-lesion type and the 'ethanol test' were reliable predictive factors for the application time required for infiltrating MIH lesions on permanent anterior teeth.

Transillumination-aided infiltration: A diagnostic concept for treating enamel opacities.

OBJECTIVE: Esthetic management of enamel opacities related to molar-incisor hypomineralization is recognized as an unpredictable procedure when resin infiltration is used. The use of transillumination during this procedure may increase its predictability. The aim of this paper is to describe a new transillumination-based concept for treating enamel opacities with resin infiltration. CLINICAL CONSIDERATIONS: This report describes a case of enamel opacities affecting the maxillary central incisors related to molar-incisor hypomineralization where transillumination-aided infiltration was used for treating these lesions. Pre-operatively, the lesion depth is assessed using transillumination, which shows the presence of enamel surface layer covering the lesion. The mandatory removal of this layer is also monitored using transillumination as the lesion is progressively exposed and brought into the surface. Then, the classic protocol of resin infiltration is followed. Transmitted light was also efficient in monitoring the progression of resin-infiltration. CONCLUSION: The appearance of the lesions' edges in transillumination was the main clue in indicating their depth and eventually their exposure into the surface. Transillumination was also reliable in monitoring the progression of the infiltration until complete saturation of the porous enamel. CLINICAL SIGNIFICANCE: The use of the proposed concept may help the dental practitioner in obtaining predictable results when enamel opacities related to molar-incisor hypomineralization are treated with resin infiltration. Besides, transillumination can be used as a diagnostic tool during the lesion transformation as well as its infiltration.

The use of transillumination in detecting subclinical extensions of enamel opacities.

OBJECTIVE: Accurate detection of enamel opacities in reflected light is limited in terms of discriminating between affected and unaffected enamel. The aim of this study was to compare the ability of transilluminated photography in distinction between healthy and unhealthy enamel in comparison with reflected photography. MATERIALS AND METHODS: Patients presenting enamel opacities were selected during their regular dental visits and for each tooth, standardized photographs were taken in transmitted and reflected light. For each lighting condition, the ratio of the opacity surface area to the entire buccal enamel area was calculated. The difference in the ratio of the opacity surface area to the entire buccal enamel area was compared using the Wilcoxon paired test. RESULTS: The results of this study showed that the ratio of the opacity surface area to the entire buccal enamel area calculated in transilluminated photography is significantly higher in comparison with its calculation in reflected photography. The means ratios (SD) of the opacity to the entire buccal enamel area are in transmitted light and reflected light respectively 18% (12) and 15% (11). CONCLUSIONS: In comparison with reflected photography, transilluminated photography significantly increases the ratio of the opacity surface area to the entire buccal enamel area. Transilluminated photography allows better detection of enamel opacities on anterior teeth by aiding clinical discrimination between healthy an unhealthy enamel. CLINICAL SIGNIFICANCE: Being simple, noninvasive, painless and without any risk to the patient, transillumination represents a promising imaging method for detecting enamel opacities and for discriminating healthy and unhealthy enamel.