"Superficial infiltration to treat white hypomineralized defects of enamel: clinical trial with 12-month follow-up

Hypomineralization represents one of the most common defects in tooth crowns. Thanks to a wide understanding of aesthetics, patients request a treatment to resolve these defects. Different techniques are available, such as crowns/veneers, traditional restorative treatments, microabrasion, whitening, remineralizing agents and infiltration technique. The objective of this trial is to assess the effectiveness of superficial infiltration with Icon (DMG, Hamburg, Germany) on the attenuation of crown hypomineralized lesions of various etiological origins with a 12-month follow-up. Seventeen patients with white defects of enamel in the aesthetic sector were selected. The infiltration procedure was carried out following the manufacturer's instructions. Intraoral photographs were taken before and directly after treatment in order to document the immediate change in colour. Check-ups were performed 1 and 12 months later. All the defects which were treated showed a degree of attenuation. The teeth affected by molar incisor hypomineralization (MIH) showed partial attenuation in 8 cases, and only in one case the defect disappeared. Regarding the post-trauma cases, 6 were partially attenuated and 2 disappeared. The post orthodontic defects disappeared in 6 cases and were attenuated in 5. All incipient caries defects were completely hidden. Four out of 6 cases of fluorosis disappeared. Diagnosis plays a key role in guiding the dental clinical selection of treatment. While it has always been possible to achieve a high level of attenuation in cases of fluorosis and lesions of caries origin, cases of MIH should probably be treated using more invasive techniques. Post-trauma lesions should be infiltrated with caution, and only after having informed the patient of the possible ineffective outcome.