Korean J Orthod.  2014 Jul;44(4):195-202. 10.4041/kjod.2014.44.4.195.

Modification of surface pretreatment of white spot lesions to improve the safety and efficacy of resin infiltration

• Yim HK
• Min JH
• Kwon HK
• Kim BI

• KMID: 2273276
• DOI: http://doi.org/10.4041/kjod.2014.44.4.195

Abstract

OBJECTIVE
A low-viscosity resin (infiltrant) was used to inhibit the progression of white spot lesions (WSLs) and resolve associated esthetic issues. An alternative pretreatment was explored to increase the pore volume of the surface layer of the WSLs. Also, the penetration effects of the infiltrant were evaluated for various pretreatments.
METHODS
Sixty two artificial lesions were fabricated on bovine teeth. As a positive control, 15% HCl gel was applied for 120 seconds. Further, 37% H3PO4 gel was applied for 30 seconds using three methods. The samples were divided as follows: H3PO4 only group, H3PO4 sponge group, and H3PO4 brush group. The acid was gently rubbed with the applicators (i.e., a sponge or brush) throughout the application time. To compare the effects of resin infiltration, twenty paired halves of specimens were treated with an infiltrant (ICON(R)).
RESULTS
Thicknesses of the removed surface layers and infiltrated areas were evaluated by confocal laser scanning microscope. The positive control and the 37% H3PO4 brush group failed to show significant differences in the removed thickness (p > 0.05); however, the mean percentage of the infiltrated area was higher in the 37% H3PO4 brush group (84.13 +/- 7.58%) than the positive control (63.51 +/- 7.62%, p < 0.001). Scanning electron microscope observations indicate higher pore volumes for the 37% H3PO4 brush group than for the positive control.
CONCLUSIONS
Application of 37% H3PO4 with a brush for 30 seconds increased the pore volume of WSL surface layers and the percentage of infiltrated areas in comparison to the use of 15% HCl for 120 seconds.

Keyword

White spot lesions (WSLs); Resin infiltration; Surface layer; 37% Phosphoric acid; 15% Hydrochloric acid

MeSH Terms

Dental Caries*
Porifera
Tooth

Figure

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  Figure 1 Confocal laser scanning microscope images of the removed surfaces (magnification ×400). A, Positive control showing lesion treated with 15% HCl gel for 120 seconds; B, lesion treated with 37% H3PO4 gel using the brush applicator for 30 seconds. Baseline, unetched lesion surface.

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  Figure 2 Scanning electron microscope images of the lesion surfaces after acid treatment (magnification ×5,000). A, Baseline showing unetched lesion surface; B, lesion surfaces treated with 15% HCl gel for 120 seconds; C, 37% H3PO4 gel using the sponge applicator for 30 seconds; and D, 37% H3PO4 gel using the brush applicator for 30 seconds.

• 

  Figure 3 Confocal laser scanning microscope images of the lesions treated with infiltrant (magnification ×100). The lesion surfaces were pretreated with either A, 15% HCl for 120 seconds; or B, 37% H3PO4 using the brush applicator for 30 seconds. In the lesions, the infiltrated area (IA) as well as the sound enamel is displayed as dark areas and the lesion area (LA) is displayed in green. White arrows indicate the boundaries of LAs and IAs. LD, Lesion depth; E, enamel; D, dentin.

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