BACKGROUND: Resin infiltration proved to be effectiveon enamel hypomineralized lesion of various etiologies, asdescribed by Paris et al. White spot post orthodontic lesions,early enamel carious lesion, developmental defects of enameland mild fluorosis can be treated with good prognosis byIconâ. On the other hand, when a deeper configuration ofthe lesion is found, as in severe fluorosis and post-traumaticlesions, an experimental approach has been described by Attalet al. The aim of this study was to present the clinical reportof deep infiltrative technique with a mixed approach of liquidand solid resin in a patient presenting with a post traumaticlesion.METHODS: The study was performed at SapienzaUniversity, Rome, Italy. The patient, a 12 years old female,who was found with a hypomineralized lesion of traumaticorigin on the upper right central incisor. Photographic images(Nikon D7100, 105 mm Macro lens, R1C1 Macro flash) weretaken before and after treatment, in order to document thecolourimetric outcome after treatment. Icon Etch (15% HCl)is applied up to three times (2 minutes X 3) and after eachrinsing and drying the lesion is still visible. Also, the finaldrying with Icon Dry (Ethanol) does not reveal masking ofthe spot. The application of Icon Etch is not recommendedmoreover, after three repetitions. After the three cycles oferosion-rising-drying, milling is performed. Application ofIcon Etch is repeated up to three times again. When the enameltranslucency is reached, the infiltration can be performed.Icon Infiltrant is applied on the pre-treated surface and leftin place for 3 minutes. The excess is removed then from theinterproximal areas by dental floss and with air spray andlight cured for 40 seconds. The infiltration is repeated anothertime with a penetration time of 60 seconds and the light curingfor additional 40 seconds. After the first step of the procedurethe result is of an optimal enamel translucency recoveryand of a substance loss visible in the lateral view intra-oral photographs. The subsequent step of the procedure is directrestoration of the volume lost by the erosion and milling, withbonding of a small and sufficient resin quantity. In this case,we have used the Admira Fusion (Voco) A2 shade.RESULTS: The photographic images show the pleasant aestheticoutcome of the treated lesion, observed on the centraland incisal tooth section of the right upper incisor. 15% HCleliminates 0.2 to 0.3 mm of the outer enamel layer and whenthe lesion has a deeper configuration, clinically appears to bemarkedly opaque. In traditional dentistry, it would be impossibleto hide the opacity at this stage using composite in sucha thin layer. Milling is necessary to reach the ceiling of thelesion and to recover the enamel translucency by subsequentrepeated infiltration.CONCLUSIONS: Icon procedure combined with direct resinrestoration and milling can be performed when clinical indicationfor lesions presenting a deeper configuration are ceramicveneers. This clinical case reports on the efficacy of deep resininfiltration performed on enamel hypomineralized lesion oftraumatic origin.
Resin infiltration and direct resin reconstruction in a post-traumatic enamel defect: a case report
D. Corridore;
2018-01-01
Abstract
BACKGROUND: Resin infiltration proved to be effectiveon enamel hypomineralized lesion of various etiologies, asdescribed by Paris et al. White spot post orthodontic lesions,early enamel carious lesion, developmental defects of enameland mild fluorosis can be treated with good prognosis byIconâ. On the other hand, when a deeper configuration ofthe lesion is found, as in severe fluorosis and post-traumaticlesions, an experimental approach has been described by Attalet al. The aim of this study was to present the clinical reportof deep infiltrative technique with a mixed approach of liquidand solid resin in a patient presenting with a post traumaticlesion.METHODS: The study was performed at SapienzaUniversity, Rome, Italy. The patient, a 12 years old female,who was found with a hypomineralized lesion of traumaticorigin on the upper right central incisor. Photographic images(Nikon D7100, 105 mm Macro lens, R1C1 Macro flash) weretaken before and after treatment, in order to document thecolourimetric outcome after treatment. Icon Etch (15% HCl)is applied up to three times (2 minutes X 3) and after eachrinsing and drying the lesion is still visible. Also, the finaldrying with Icon Dry (Ethanol) does not reveal masking ofthe spot. The application of Icon Etch is not recommendedmoreover, after three repetitions. After the three cycles oferosion-rising-drying, milling is performed. Application ofIcon Etch is repeated up to three times again. When the enameltranslucency is reached, the infiltration can be performed.Icon Infiltrant is applied on the pre-treated surface and leftin place for 3 minutes. The excess is removed then from theinterproximal areas by dental floss and with air spray andlight cured for 40 seconds. The infiltration is repeated anothertime with a penetration time of 60 seconds and the light curingfor additional 40 seconds. After the first step of the procedurethe result is of an optimal enamel translucency recoveryand of a substance loss visible in the lateral view intra-oral photographs. The subsequent step of the procedure is directrestoration of the volume lost by the erosion and milling, withbonding of a small and sufficient resin quantity. In this case,we have used the Admira Fusion (Voco) A2 shade.RESULTS: The photographic images show the pleasant aestheticoutcome of the treated lesion, observed on the centraland incisal tooth section of the right upper incisor. 15% HCleliminates 0.2 to 0.3 mm of the outer enamel layer and whenthe lesion has a deeper configuration, clinically appears to bemarkedly opaque. In traditional dentistry, it would be impossibleto hide the opacity at this stage using composite in sucha thin layer. Milling is necessary to reach the ceiling of thelesion and to recover the enamel translucency by subsequentrepeated infiltration.CONCLUSIONS: Icon procedure combined with direct resinrestoration and milling can be performed when clinical indicationfor lesions presenting a deeper configuration are ceramicveneers. This clinical case reports on the efficacy of deep resininfiltration performed on enamel hypomineralized lesion oftraumatic origin.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
