Background and Aim: Development of fluorosis is increasing due to the higher consumption of fluoride. Microabrasion is the most conservative technique for the management of this disorder. The present study assessed the esthetic improvement of fluorotic teeth after microabrasion with office bleaching.Materials and Methods: This clinical trial was carried out on 20 fluorotic teeth. Microabrasion was performed for 10 minutes followed by office bleaching. Digital images were obtained of all stages of the treatment. The esthetic improvement was determined by visual analogue scale along with the color parameters of L*a*b* and (DE) after microabrasion (M), microabrasion plus office bleaching (MO) and one week later the data were subjected to One-way analysis of variance (ANOVA) for repeated measures, LSD and Friedman tests.Results: No significant differences were found between fluorotic areas and non-fluorotic areas of the teeth after different stages of (M) regarding L*a*b* and DE parameters. The mean DE was estimated to be 10.05, 14.51 and 20.28 for M, MO and one week later, respectively. Significant differences were observed between these stages (p<0.001). In addition, the mean visual analogue scores for these stages were 4.15, 5.22 and 6.36, respectively, which were significantly different (p<0.0001).Conclusion: This study showed that the microabrasion technique significantly improved the esthetic appearance of fluorotic teeth at all stages of treatment. The most improvement was observed with (MO) after one week and the least was related to (M), while immediate results of (MO) were moderate.

Background: Enamel microabrasion can eliminate enamel irregularities and discoloration. This study evaluated the staining susceptibility of enamel after microabrasion using different clinical protocols. Methods: A total of 210 extracted bovine incisors were used in this study. The teeth were randomly divided into five groups of 42 teeth each (n = 42), including group 1: control (no treatment), group 2: microabrasion, group 3: microabrasion + fluoride polishing, group 4: macroabrasion (fine-grit diamond bur) + microabrasion, and group 5: macroabrasion (finegrit diamond bur) + microabrasion + fluoride polishing. The groups were then randomly divided into two subgroups for discoloration procedures: coffee and distilled water (n = 21). A spectrophotometric evaluation was carried out at baseline and on the 1st, 7th, 14th, and 28th days of the staining period. Statistical analyses were performed using repeated-measures ANOVA and the post hoc Bonferroni test at a significance level of 0. 05. Results: The greatest color change was observed in group 2 specimens, which were immersed in coffee solutions. The color change values for groups 3, 4, and 5 specimens, which were immersed in distilled water, were higher than those in group 1 specimens (P < 0. 05). The fluoride polishing + enamel microabrasion treatment groups (groups 3 and 5) exhibited greater resistance to color changes than the matched non-fluoride-polished groups (groups 2 and 4) (P < 0. 05). Conclusions: The teeth that underwent enamel microabrasion treatment and were polished with fluoride gel became more resistant to color changes. Our findings confirm that enamel microabrasion treatment is a conservative method for localized discoloration.

Statement of the Problem: Demineralization of enamel adjacent to orthodontic appliances frequently occurs, commonly due to insufficient oral hygiene.Purpose: The aim of this study was to compare two microabrasion techniques on improving the white spot lesions as well as subsequent enamel discoloration.Materials and Method: Sixty extracted premolar teeth without caries and hypoplasia were selected for this study. White spot lesions were artificially induced on the buccal surface of each tooth. Teeth were randomly assigned to three treatment groups, each treated with pumice powder as the control, microabrasion with 18% HCl, and microabrasion with 37% H3PO4. Subsequently, the three groups were daily immersed for five minutes in a tea-coffee solution for a period of one week. Colorimetric evaluation was done before and after formation of white spot lesions, after microabrasion, and after immersion in the colored solution; then the color differences (DE) were calculated. Statistical analysis was performed by multiple measurement analysis and the Tukey’s test.Results: This study showed that ΔE between the stages of white spot formation and microabrasion for H3PO4 was more than other groups and for the pumice powder group it was less than the others. Furthermore, there was a significant difference between DE of the three study groups (p= 0.017). Additionally, DE after placing the teeth in the colored solution and microabrasion was the highest for the HCl group and the lowest for the pumice powder group. There was also a significant difference between the three groups (p= 0.000).Conclusion: Pumice powder alone had similar effects as 18% HCl on removing the white spot lesions. Nevertheless, 18% HCl makes the enamel susceptible for subsequent color staining more than the other microabrasion methods.

Background: Endemic fluorosis is the most common generalized dental discoloration in several parts of Iran. The improvement of appearance in different degrees of dental fluorosis (mild, moderate and severe) was evaluated in vivo.Materials & Methods: In this study, 281 fluorotic permanent teeth from 45 patients were divided in to 3 categories: mild (62), moderate (150) and severe (62). Standardized intraoral slides were taken prior and after treatment. The pastes of pumice- HCl (18%) were rubbed on the labial surfaces of stained teeth (after isolation) with no webbed rubber cup. A treatment was defined as five application of the paste, with each application lasting 30 sec (total 21/2 min).Treatment were terminated when there were no visible stains or after maximum of 10 minutes. Slides were randomized and viewed independently by two standardized observes and rated for area of white spot lesions (WS), stain amount (SA) and stain intensity (SI), before and after treatment.Results: The Wilcoxan's signed rank test indicated a significant difference in the area of WS and SA and SI (p<0.0001) from pretreatment to successive rating. Kruskal- Wallis analysis revealed no significant differences among the moderate and severe fluorotic teeth in SA and SI (p=0.58). Significant difference revealed in WS between 3 groups. The area of WS in severs group reduced more than moderate and mild groups. Relapse of discoration after 7 days was not seen in any patient.Conclusion: Mildly fluorotic teeth had the best esthetic results. In moderately and severely stained teeth brown and yellow stains completely removed but white spots continue to demonstrate.

Objective: Removal of enamel superficial layer during microabrasion treatments may adversely affect sealing ability of the restorative materials. The aim of this study was to measure the effect of different periods of enamel microabrasion on the microleakage of class V glass-ionomer restorations.Methods: This in vitro experimental study was conducted on 96 Class V cavities which had been prepared on the buccal and lingual surfaces of 48 sound human premolars. After conditioning with 10% polyacrylic acid (GC, Tokyo, Japan) one half of the cavities were restored with the conventional glass-ionomer (Fuji II GC, Tokyo, Japan) and another half with resin-modified glassionomer (Fuji II LC GC, Tokyo, Japan). Finishing and polishing were performed after 24 hours and the teeth incubated for 2 weeks (37oC and 100% humidity).Then the teeth were classified into eight groups (n=12). Microabrasion treatment was performed with Opulster (Ultradent product Inc, South Jordan, UT, USA) in 0 (control no treatment), 60, 120 and 180 seconds. Then teeth were thermocycled between 5oC-55oC (×1000), immersed in 0.5% basic-fushin solution (24h) and sectioned longitudinally in bucco-lingual direction (n=192). Dye penetration was examined with stereomicroscope (×40). Microleakage scores were statistically analyzed by Kruskal-Wallis test while the paired comparisons were done using Mann-Whitney U test.Results: The mean microleakage scores were significantly increased following increased microabrasion times in occlusal margin in FU II (p<0.009) and FU II LC (p<0.02) and in gingival margin in resin-modified glass-ionomer (p<0.04).Conclusion: In Fuji II restorations after microabrasion in occlusal margins, microleakage increased up to 120s but in gingival margins no significant difference were seen. In Fuji II LC restorations after microabrasion in occlusal margin, microleakage from 60s up to 180s was significantly increased. In gingival margin with increasing the time up to 180s microleakage increased.

Background and Aims: The purpose of this study was research on a new herbal compound (Seidlitzia Rosmarinus) made by Traditional Medicine Research Group, University of shahed to find a safer alternative to HCL-Pumice compound technique.Materials and Methods: In this randomized clinical trial seventy two teeth from 9 patients were divided in to three groups according to fluorosis severity: mild (34 teeth), moderate (14 teeth), and sever (24 teeth). In each patient, half of the teeth were treated with “Shahed” compound and other half treated with HCL-Pumice compound. Before and after treatment, photographs were taken in both groups. HCL-Pumice treatment compound was applied for 30 seconds periods and continued for 10 minutes if necessary. In case of herbal Shahed compound the time was determined by clinical symptoms or when labial contour was dismissed, If the result was not esthetistically acceptabale for the patient, HCL-Pumice compound was applied on teeth. NaF was applied after mouth washing. The photographs of the teeth before and after treatment were reviewed by two experienced observer unaware of the treatment modality. The results were analyzed using willcoxon wallis, kruskal and scheffe' test. Results: There was over 81.3% acceptance between two observers and no significant differences in intraobservers evaluation (P>0.05). Improvement in beauty indexes were observed in all degrees of dental fluorosis by 18% with HCL-Pumice compound application, but “Shahed” herbal compound induced significant reduction in the amount of white spots in mild fluorosis and stain intensity of moderate fluorosis (P<0.05), While the reduction in the severity of discoloration in group 2, these two techniques were statistically equivalent but in the remainder, HCL-Pumice compound was more significantly effective (P<0.05).Conclusion: HCL-Pumice compound reduces the severity of the discoloration of the teeth. Shahed herbal compound cannot reduces the discoloration like as HCL-Pumice compound.

Objectives: This study aimed to determine the effect of surface treatments such as tooth reduction and extending the etching time on microtensile bond strength (μTBS) of composite resin to normal and fluorotic enamel after microabrasion.Materials and Methods: Fifty non-carious anterior teeth were classified into two groups of normal and fluorotic (n=25) using Thylstrup and Fejerskov index (TFI=4-6). Teeth in each group were treated with five modalities as follows and restored with OptiBond FL and Z350 composite resin: 1-Etching (30 seconds), bonding, filling (B); 2-Tooth reduction (0.3mm), etching, bonding, filling (R-B); 3-Microabrasion (120 seconds), etching, bonding, filling (M-B); 4- Microabrasion, tooth reduction, etching, bonding, filling (M-R-B); and 5- Microabrasion, etching (60 seconds), bonding, filling (M-2E-B). Ten experimental groups (n=5) were designed; 150 rectangular samples (10 in each group) with a cross-sectional area of 1×1mm2 were prepared for μTBS test. Failure mode was determined under a stereomicroscope and one specimen was selected from each group for scanning electron microscopy (SEM) analysis. Data were analyzed using two-way ANOVA and Tukey’s test.Results: The mTBS to normal enamel was higher than to fluorotic enamel in all groups except for group (R-B). The Maximum and minimum mTBS were noted in the group (normal, reduction, bonding) and (fluorosed, microabrasion, bonding), respectively. Tooth reduction increased μTBS more effectively than extended etching time after microabrasion.Conclusions: Fluorosis may reduce μTBS of composite resin to enamel. Microabrasion reduced the bond strength. Tooth reduction and extended etching time increased μTBS of composite resin to both normal and fluorotic enamel.

Objectives Dental fluorosis is a condition characterized by hypomineralization of tooth structure. It manifests as bilateral white opaque discolorations. Patients with these kinds of staining and discoloration often present to dental offices in young ages, seeking esthetic solutions. Color, shape and structural alterations in the anterior teeth could lead to significant esthetic complications for young patients. There are many cosmetic options to correct the unpleasant appearance of the anterior teeth. Dental bleaching is a conservative treatment for stained or dark-colored teeth. Microabrasion and removal of the outer layer of the tooth is another effective and successful method to treat fluorosis. Resin infiltration can also significantly change the esthetic appearance of such teeth. Case Micro-abrasion followed by tooth bleaching and application of resin infiltrate was used in this study as a minimally invasive and inexpensive approach to treat discolored teeth due to dental fluorosis. Conclusion To treat discolored teeth affected by dental fluorosis, a minimally invasive and inexpensive approach would be micro-abrasion followed by tooth bleaching and resin infiltration. This approach obviates the need for more invasive techniques such as veneers and crowns while it meets the esthetic demands of patients.

Objectives: This study aimed to assess the effect of applying casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) paste, casein phosphopeptide–amorphous calcium phosphate fluoride (CPP-ACPF) paste and sodium fluoride gel on surface microhardness of enamel after microabrasion.Materials and Methods: Thirty freshly extracted human premolars were selected. All samples were subjected to hardness indentations made with the Vickers hardness machine and the average value was recorded as the initial surface microhardness. The specimens were then randomly divided into three groups (n=10) of CPP-ACPF, fluoride and CPP-ACP. The teeth were micro-abraded with Opalustre. Microhardness test was performed to assess the post-abrasion hardness. Three remineralization modalities were performed on samples of each group. The enamel surface microhardness measurements were performed. To compare the difference between groups, the rehardening and softening values were defined. One-way ANOVA and Tukey’s post hoc test at a significance level of 5% were used for statistical analysis.Results: The mean microhardness value (MMV) had a significant decrease after microabrasion from baseline. The MMV had a significant increase after remineralization in all groups. The MMV of CPP-ACPF group was significantly more than that of fluoride group (P=0.027). The rehardening value of fluoride group was significantly more than that of other groups (P<0.001).Conclusion: All the remineralizing agents were effective for rehardening the enamel after microabrasion. The CPP-ACP and CPP-ACPF pastes are effective, but to a lesser extent than neutral sodium fluoride gel in remineralizing enamel surface. Incorporation of fluoride to CPP-ACP formulation does not provide any additional remineralizing potential.