International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 12 , ISSUE 2 ( March-April, 2019 ) > List of Articles

Original Article

Testing the Clinical Applicability of Resin Infiltration of Developmental Enamel Hypomineralization Lesions Using an In Vitro Model

Dagmar Schnabl, Viktoria Dudasne-Orosz, Rudolf Glueckert, Stephan Handschuh, Ines Kapferer-Seebacher, Herbert Dumfahrt

Keywords : Cheese molars, Developmental enamel hypomineralization, Laboratory research, Low-viscosity resin, Penetration depth, Resin infiltration

Citation Information : Schnabl D, Dudasne-Orosz V, Glueckert R, Handschuh S, Kapferer-Seebacher I, Dumfahrt H. Testing the Clinical Applicability of Resin Infiltration of Developmental Enamel Hypomineralization Lesions Using an In Vitro Model. Int J Clin Pediatr Dent 2019; 12 (2):126-132.

DOI: 10.5005/jp-journals-10005-1609

License: CC BY-NC 4.0

Published Online: 01-09-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Aim: The aim of this study is to investigate the penetration abilities of a commercially available low-viscosity resin infiltrant into developmentally hypomineralized teeth in vitro. Materials and methods: Four extracted third molars of a 17-year-old patient with signs of developmental enamel hypomineralization (discoloration, increased opacity, and surface roughness) were infiltrated with a low-viscosity resin mixed with a fluorescent dye, according to the manufacturer's standard protocol. Four extracted molars with sound enamel or showing only initial fissure caries were used as a control group. Specimens were embedded in polymethylmethacrylate, and grindings were prepared. High-resolution projectional radiography of the grindings was performed, and, for one specimen, quantitative micro-computed tomography was used to measure hydroxyapatite density in enamel and dentin lesions. After decalcification, the grindings were examined by reflected bright-field microscopy, wide-field fluorescence microscopy, and confocal laser scanning microscopy. Fluorescence micrographs were superimposed on the radiographs and analyzed correlatively. Results: The pattern of hypo-/demineralization in enamel and dentin in developmentally hypomineralized teeth showed a good congruence with the pattern of resin infiltration. Cavitations and dentin tubules up to a depth of 2 mm beyond cavitations were filled by the infiltrant. In control teeth, the penetration of the infiltrant was limited to decalcified enamel areas (initial fissure caries). Conclusions: In vitro infiltration of developmentally hypomineralized enamel was successful. Clinical significance: Resin infiltration might be considered as a routine procedure in the treatment of developmentally hypomineralized teeth. Further investigations with higher sample sizes, different degrees of severity, different stages of lesion extension, and modified treatment protocols are necessary.


PDF Share
  1. Meyer-Lueckel H, Paris S. Improved resin infiltration of natural caries lesions. J Dent Res 2008 Dec;87(12):1112–1116. DOI: 10.1177/154405910808701201.
  2. Kielbassa AM, Muller J, et al. Closing the gap between oral hygiene and minimally invasive dentistry: a review on the resin infiltration technique of incipient (proximal) enamel lesions. Quintessence Int 2009 Sep;40(8):663–681.
  3. Kielbassa AM, Ulrich I, et al. An updated review on the resin infiltration technique of incipient proximal enamel lesions. Med Evol 2010;16(4):3–15.
  4. Meyer-Lueckel H, Paris S. Infiltration of natural caries lesions with experimental resins differing in penetration coefficients and ethanol addition. Caries Res 2010 Aug;44(4):408–414. DOI: 10.1159/000318223.
  5. Paris S, Hopfenmuller W, et al. Resin infiltration of caries lesions: an efficacy randomized trial. J Dent Res 2010 Aug;89(8):823–826. DOI: 10.1177/0022034510369289.
  6. Paris S, Meyer-Lueckel H. Inhibition of caries progression by resin infiltration in situ. Caries Res 2010 Jan;44(1):47–54. DOI: 10.1159/000275917.
  7. Paris S, Schwendicke F, et al. Masking of white spot lesions by resin infiltration in vitro. J Dent 2013 Nov;41(5):e28–e34. DOI: 10.1016/j.jdent.2013.04.003.
  8. Knösel M, Eckstein A, et al. Durability of esthetic improvement following Icon resin infiltration of multibracket-induced white spot lesions compared with no therapy over 6 months: a single-center, split-mouth, randomized clinical trial. Am J Orthod Dentofacial Orthop 2013 Jul;144(1):86–96. DOI: 10.1016/j.ajodo.2013.02.029.
  9. Borges AB, Caneppele TM, et al. Is resin infiltration an effective esthetic treatment for enamel development defects and white spot lesions? A systematic review. J Dent 2017 Jan;56:11–18. DOI: 10.1016/j. jdent.2016.10.010.
  10. Paris S, Lausch J, et al. Comparison of sealant and infiltrant penetration into pit and fissure caries lesions in vitro. J Dent 2014 Apr;42(4):432–438. DOI: 10.1016/j.jdent.2014.01.006.
  11. Lausch J, Paris S, et al. Resin infiltration of fissure caries with various techniques of pretreatment in vitro. Caries Res 2015;49(1):50–55. DOI: 10.1159/000366082.
  12. Muñoz MA, Arana-Gordillo LA, et al. Alternative esthetic management of fluorosis and hypoplasia stains: blending effect obtained with resin infiltration techniques. J Esthet Restor Dent 2013 Feb;25(1):32–39. DOI: 10.1111/j.1708-8240.2012.00527.x.
  13. Torres CR, Borges AB. Color masking of developmental enamel defects: a case series. Oper Dent 2015 Jan-Feb;40(1):25–33. DOI: 10.2341/13-346-T.
  14. Wang Y, Sa Y, et al. Minimally invasive treatment for esthetic management of severe dental fluorosis: a case report. Oper Dent 2013 Jul-Aug;38(4):358–362. DOI: 10.2341/12-238-S.
  15. Contaldo M, Di Stasio D, et al. Non-invasive in vivo visualization of enamel defects by reflectance confocal microscopy (RCM). Odontology 2015 May;103(2):177–184. DOI: 10.1007/s10266-014-0155- 4.
  16. Crombie FA, Manton DJ, et al. Characterisation of developmentally hypomineralised human enamel. J Dent 2013 Jul;41(7):611–618. DOI: 10.1016/j.jdent.2013.05.002.
  17. Jälevik B, Norén JG. Enamel hypomineralization of permanent first molars: a morphological study and survey of possible aetiological factors. Int J Paediatr Dent 2000 Dec;10(4):278–289. DOI: 10.1046/j.1365-263x.2000.00210.x.
  18. Lygidakis NA, Wong F, et al. Best Clinical Practice Guidance for clinicians dealing with children presenting with Molar-Incisor- Hypomineralisation (MIH): An EAPD Policy Document. Eur Arch Paediatr Dent 2010 Apr;11(2):75–81. DOI: 10.1007/BF03262716.
  19. Crombie F, Manton D, et al. Aetiology of molar- incisor hypomineralization: a critical review. Int J Paediatr Dent 2009 Mar;19(2):73–83. DOI: 10.1111/j.1365-263X.2008.00966.x.
  20. Garg N, Jain AK, et al. Essentiality of early diagnosis of molar incisor hypomineralization in children and review of its clinical presentation, etiology and management. Int J Clin Pediatr Dent 2012 Sep;5(3):190–196. DOI: 10.5005/jp-journals-10005-1164.
  21. Salanitri S, Seow WK. Developmental enamel defects in the primary dentition: aetiology and clinical management. Aust Dent J 2013 Jun;58(2):133–140. DOI: 10.1111/adj.12039.
  22. Crombie F, Manton D, et al. Resin infiltration of developmentally hypomineralised enamel. Int J Paediatr Dent 2014 Jan;24(1):51–55. DOI: 10.1111/ipd.12025.
  23. Pitts NB, Ekstrand KR. ICDAS Foundation: International Caries Detection and Assessment System (ICDAS) and its International Caries Classification and Management System (ICCMS) - methods for staging of the caries process and enabling dentists to manage caries. Community Dent Oral Epidemiol 2013 Feb;41(1):e41–e52. DOI: 10.1111/cdoe.12025.
  24. http://www.zentrale-ethikkommission.de/page.asp?his=0.1.21.
  25. Belli R, Rahiotis C, et al. Wear and morphyology of infiltrated white spot lesions. J Dent 2011 May;39(5):376–385. DOI: 10.1016/j.jdent.2011.02.009.
  26. Kim S, Kim EY, et al. The evaluation of resin infiltration for masking labial enamel white spot lesions. Int J Paediatr Dent 2011 Jul;21(4): 241–248. DOI: 10.1111/j.1365-263X.2011.01126.x.
  27. Gugnani N, Pandit I, et al. Comparative evaluation of esthetic changes in nonpitted fluorosis stains when treated with resin infiltration, in-office bleaching, and combination therapies. J Esthet Restor Dent 2017 Sep;29(5):317–324. DOI: 10.1111/jerd.12312.
  28. Kumar H, Palamara JEH, et al. An investigation into the effect of a resin infiltrant on the micromechanical properties of hypomineralized enamel. Int J Paediatr Dent 2017 Sep;27(5):399–411. DOI: 10.1111/ipd.12272.
  29. Anderson P, Elliott JC, et al. A comparison of the mineral content of enamel and dentine in human premolars and enamel pearls measured by X-ray microtomography. Arch Oral Biol 1996 Mar; 41(3):281–290. DOI: 10.1017/0003-9969(95)00122-0.
  30. Chay PL, Manton D, et al. The effect of resin infiltration and oxidative pre-treatment on microshear bond strength of resin composite to hypomineralised enamel. Int J Paediatr Dent 2014 Jul;24(4):252–267. DOI: 10.1111/ipd.12069.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.