Abstract
BACKGROUND: Dental fluorosis is a condition of enamel hypomineralization due to the effects of excessive fluoride on ameloblasts during enamel formation. Delayed degradation of enamel matrix proteins or inhibited protein removal results in impaired and incomplete crystal growth, producing hypomineralized and porous enamel. Severely fluorosed teeth may undergo post-eruptive surface breakdown and post-eruptive dark brown to black staining. METHODS: A 13 year old girl presented with severely discoloured maxillary central incisors. Initial aesthetic management of these teeth was conservative, including in-office tooth whitening, microabrasion and take-home whitening. RESULTS: Dark brown to black staining of the teeth was reduced successfully without the need for gross mechanical preparation of the enamel. Further improvement of aesthetics was achieved with composite veneers. CONCLUSIONS: Conservative treatment options such as tooth whitening and microabrasion can dramatically improve severely discoloured fluorosed teeth. This can provide a satisfactory interim outcome or minimize the removal of discoloured enamel and dentine prior to the provision of composite veneers. The use of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) may enhance remineralization and decrease postoperative sensitivity following tooth whitening and microabrasion procedures in hypomineralized teeth.
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A randomized CIE L*a*b* evaluation of external bleaching therapy effects on fluorotic enamel stains
OBJECTIVE: To evaluate the effect of external bleaching on the color and luminosity of fluorotic stains and adjacent, normally mineralized enamel areas by means of CIE L*a*b* colorimetry. METHOD AND MATERIALS: Eighteen adolescents with mild to moderate fluorotic stains were randomly assigned to either bleaching group A (n = 9)
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Aesthetic management of dental fluorosis
Significant numbers of patients visiting the paediatric dental clinics have aesthetically objectionable brown stains and desire treatment for them. Intrinsic tooth discolouration can be a significant aesthetic, and in some instances, functional, problem. Dental fluorosis, tetracycline staining, localised and chronological hypoplasia, and both amelogenesis and dentinogenesis imperfecta can all produce
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Alternative esthetic management of fluorosis and hypoplasia stains: blending effect obtained with resin infiltration techniques
STATEMENT OF PROBLEM: New light-polymerized resin composites optimized for rapid infiltration of enamel lesions with resin light curing monomers are commercially available today to prevent enamel lesions from further demineralization and provide a highly conservative therapy. In addition, this technique has proved to be effective treatment for blending white spot
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Minimally invasive treatment for esthetic management of severe dental fluorosis: a case report
Dental fluorosis is a developmental disturbance of enamel caused by excessive fluoride on ameloblasts during enamel formation. Patients often present to the dentist with a main goal of improving their esthetic appearance. This case report describes a minimally invasive technique for treating a severe case of enamel fluorosis with brown
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Comparison between phosphoric acid and hydrochloric acid in microabrasion technique for the treatment of dental fluorosis
PURPOSE: To compare the effectiveness of phosphoric acid (H(3)PO(4))-pumice compound with conventional hydrochloric acid (HCl)-pumice compound in treating different severities of dental fluorosis with the microabrasion technique. MATERIALS AND METHODS: Sixty-seven anterior teeth from seven patients with different severities of dental fluorosis were treated. In each patient, half of the
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Severe Dental Fluorosis: Perception and Psychological Impact
[caption id="attachment_8879" align="aligncenter" width="550"] Severe fluorosis - Photograph by David Kennedy, DDS[/caption] In its severe forms, dental fluorosis causes highly disfiguring brown and black staining of the teeth, which can cause chronic embarrassment and social anxiety for the impacted child. In 1984, a panel from the National Institute of Mental Health (NIMH) warned
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Diagnostic Criteria for Dental Fluorosis: The Thylstrup-Fejerskov (TF) Index
The traditional criteria (the "Dean Index") for diagnosing dental fluorosis was developed in the first half of the 20th century by H. Trendley Dean. While the Dean Index is still widely used in surveys of fluorosis -- including the CDC's national surveys of fluorosis in the United States -- dental
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Dental Fluorosis Is a "Hypo-mineralization" of Enamel
Teeth with fluorosis have an increase in porosity in the subsurface enamel ("hypomineralization"). The increased porosity of enamel found in fluorosis is a result of a fluoride-induced impairment in the clearance of proteins (amelogenins) from the developing teeth. Despite over 50 years of research, the exact mechanism by which fluoride impairs amelogin
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Moderate/Severe Dental Fluorosis
In its "moderate" and severe forms, fluoride causes a marked increase in the porosity of the enamel. After eruption into mouth, the porous enamel of moderate to severe fluorosis readily takes up stain, creating permanent brown and black discolorations of the teeth. In addition to extensive staining, teeth with moderate to severe fluorosis are more prone to attrition and wear - leading to pitting, chipping, and decay.
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Mechanisms by Which Fluoride Causes Dental Fluorosis Remain Unknown
When it comes to how fluoride impacts human health, no tissue in the body has been studied more than the teeth. Yet, despite over 50 years of research, the mechanism by which fluoride causes dental fluorosis (a hypo-mineralization of the enamel that results in significant staining of the teeth) is not
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