Download PDF
CC BY 4.0 · Eur J Dent 2022; 16(01): 41-48
DOI: 10.1055/s-0041-1731931
Review Article

Systematic Review on White Spot Lesions Treatments

Francesco Puleio
1   Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
,
Luca Fiorillo
1   Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
2   Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli,” Naples, Italy
3   Department of Implantology, Faculty of Dentistry, University of Aldent, Tirana, Albania
,
Francesca Gorassini
1   Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
,
Alfredo Iandolo
4   Department of Medicine and Surgery, University of Salerno, Salerno, Italy
,
Aida Meto 
5   Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, Tirana, Albania
,
Cesare D’Amico 
1   Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
,
Gabriele Cervino
1   Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
,
Mirta Pinizzotto
1   Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
,
Giancarlo Bruno
1   Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
,
Marco Portelli
1   Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, Messina, Italy
,
Alessandra Amato
2   Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli,” Naples, Italy
,
Roberto Lo Giudice
6   Department of Clinical and Experimental Medicine, Messina University, Messina, Italy
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

The difference in refractive index between the healthy enamel and the demineralized area generates a lesion with a milky white opaque appearance, clearly distinguishable from the surrounding healthy enamel. The aim of this systematic review was to evaluate if the infiltration technique is the most efficient treatment to resolve a white spot lesion when compared with remineralization and microabrasion techniques. The Population/Intervention/Comparison/Outcome question investigated: “in enamel WS lesion, the infiltration treatment compared to remineralization or microabrasion treatments is more or less effective in the camouflage effect?.” The research was performed on electronic databases, including Ovid MEDLINE, PubMed, and web of science. The search was conducted up to April 1, 2020. The scientific search engines produced 324 results. Only 14 were screened after screening. Based on the articles analyzed in this systematic review, the resin infiltration technique seems to be the most effective and predictable treatment for the aesthetic resolution of WSLs.

Keywords

white spot lesion - resin infiltration - enamel demineralization - aesthetics - enamel remineralization - microabrasion


Publication History

Article published online:
27 August 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Thieme Medical and Scientific Publishers Private Ltd
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Rocha Gomes Torres C, Borges AB, Torres LMS, Gomes IS, de Oliveira RS. Effect of caries infiltration technique and fluoride therapy on the colour masking of white spot lesions. J Dent 2011; 39 (03) 202-207
    CrossrefPubMedGoogle Scholar
  • 2 Gorelick L, Geiger AM, Gwinnett AJ. Incidence of white spot formation after bonding and banding. Am J Orthod 1982; 81 (02) 93-98
    CrossrefPubMedGoogle Scholar
  • 3 Ogaard B, Rølla G, Arends J, ten Cate JM. Orthodontic appliances and enamel demineralization. Part 2. Prevention and treatment of lesions. Am J Orthod Dentofacial Orthop 1988; 94 (02) 123-128
    CrossrefPubMedGoogle Scholar
  • 4 Guzmán-Armstrong S, Chalmers J, Warren JJ. Ask us. White spot lesions: prevention and treatment. Am J Orthod Dentofacial Orthop 2010; 138 (06) 690-696
    CrossrefPubMedGoogle Scholar
  • 5 Richter AE, Arruda AO, Peters MC, Sohn W. Incidence of caries lesions among patients treated with comprehensive orthodontics. Am J Orthod Dentofacial Orthop 2011; 139 (05) 657-664
    CrossrefPubMedGoogle Scholar
  • 6 Pini NI, Sundfeld-Neto D, Aguiar FH. et al Enamel microabrasion: an overview of clinical and scientific considerations. World J Clin Cases 2015; 3 (01) 34-41
    CrossrefPubMedGoogle Scholar
  • 7 Bertoldo C, Lima D, Fragoso L, Ambrosano G, Aguiar F, Lovadino J. Evaluation of the effect of different methods of microabrasion and polishing on surface roughness of dental enamel. Indian J Dent Res 2014; 25 (03) 290-293
    CrossrefPubMedGoogle Scholar
  • 8 Schirrmeister JF, Gebrande JP, Altenburger MJ, Mönting JS, Hellwig E. Effect of dentifrice containing 5000 ppm fluoride on non-cavitated fissure carious lesions in vivo after 2 weeks. Am J Dent 2007; 20 (04) 212-216
    PubMedGoogle Scholar
  • 9 Benson PE, Parkin N, Millett DT, Dyer FE, Vine S, Shah SA. Fluorides for the prevention of white spots on teeth during fixed brace treatment. The Cochrane Collaboration. Wellesley, UK: Wiley & Sons; 2007(3):1–35. Available at: https://www.cochrane.org/CD003809/ORAL_fluorides-preventing-early-tooth-decay-demineralised-lesions-during-fixed-brace-treatment. Accessed 2021
  • 10 Aimutis WR. Bioactive properties of milk proteins with particular focus on anticariogenesis. J Nutr 2004; 134 (04) 989S-995S
    CrossrefPubMedGoogle Scholar
  • 11 Tung MS, Eichmiller FC. Dental applications of amorphous calcium phosphates. J Clin Dent 1999; 10 (1 Spec No) 1-6
    PubMedGoogle Scholar
  • 12 Bailey DL, Adams GG, Tsao CE. et al Regression of post-orthodontic lesions by a remineralizing cream. J Dent Res 2009; 88 (12) 1148-1153
    CrossrefPubMedGoogle Scholar
  • 13 González-Cabezas C. The chemistry of caries: remineralization and demineralization events with direct clinical relevance. Dent Clin North Am 2010; 54 (03) 469-478
    CrossrefPubMedGoogle Scholar
  • 14 Paris S, Meyer-Lueckel H. Infiltrants inhibit progression of natural caries lesions in vitro. J Dent Res 2010; 89 (11) 1276-1280
    CrossrefPubMedGoogle Scholar
  • 15 Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6 (07) e1000097
    CrossrefPubMedGoogle Scholar
  • 16 Faggion Jr CM. Guidelines for reporting pre-clinical in vitro studies on dental materials. J Evid Based Dent Pract 2012; 12 (04) 182-189
    CrossrefPubMedGoogle Scholar
  • 17 Higgins JP, Altman DG, Gotzsche PC. et al The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials BMJ (Clin. Res. ed.) 2011; 343-d5928
    PubMed
  • 18 Behrouzi P, Heshmat H, Hoorizad M Ganjkar, Tabatabaei SF, Kharazifard MJ. Effect of two methods of remineralization and resin infiltration on surface hardness of artificially induced enamel lesions. J Dent (Shiraz) 2020; 21 (01) 12-17
    Google Scholar
  • 19 Torres CRG, Zanatta RF, Fonseca BM, Borges AB. Fluorescence properties of demineralized enamel after resin infiltration and dental bleaching. Am J Dent 2019; 32 (01) 43-46
    PubMedGoogle Scholar
  • 20 Yadav P, Desai H, Patel K, Patel N, Iyengar S. A comparative quantitative & qualitative assessment in orthodontic treatment of white spot lesion treated with 3 different commercially available materials - In vitro study. J Clin Exp Dent 2019; 11 (09) e776-e782
    PubMedGoogle Scholar
  • 21 Arora TC, Arora D, Tripathi AM, Yadav G, Saha S, Dhinsa K. An In-Vitro evaluation of resin infiltration system and conventional pit and fissure sealant on enamel properties in white spot lesions. J Indian Soc Pedod Prev Dent 2019; 37 (02) 133-139
    CrossrefPubMedGoogle Scholar
  • 22 Silva LO, Signori C, Peixoto AC, Cenci MS, Faria-E-Silva AL. Color restoration and stability in two treatments for white spot lesions. Int J Esthet Dent 2018; 13 (03) 394-403
    PubMedGoogle Scholar
  • 23 Prasada KL, Penta PK, Ramya KM. Spectrophotometric evaluation of white spot lesion treatment using novel resin infiltration material (ICON®). J Conserv Dent 2018; 21 (05) 531-535
    CrossrefPubMedGoogle Scholar
  • 24 Wierichs RJ, Kogel J, Lausch J, Esteves-Oliveira M, Meyer-Lueckel H. Effects of self-assembling peptide P11-4, fluorides, and caries infiltration on artificial enamel caries lesions in vitro. Caries Res 2017; 51 (05) 451-459
    CrossrefPubMedGoogle Scholar
  • 25 Yuan H, Li J, Chen L, Cheng L, Cannon RD, Mei L. Esthetic comparison of white-spot lesion treatment modalities using spectrometry and fluorescence. Angle Orthod 2014; 84 (02) 343-349
    CrossrefPubMedGoogle Scholar
  • 26 Yetkiner E, Wegehaupt F, Wiegand A, Attin R, Attin T. Colour improvement and stability of white spot lesions following infiltration, micro-abrasion, or fluoride treatments in vitro. Eur J Orthod 2014; 36 (05) 595-602
    CrossrefPubMedGoogle Scholar
  • 27 Kannan A, Padmanabhan S. Comparative evaluation of Icon® resin infiltration and Clinpro™ XT varnish on colour and fluorescence changes of white spot lesions: a randomized controlled trial. Prog Orthod 2019; 20 (01) 23
    CrossrefPubMedGoogle Scholar
  • 28 Gu X, Yang L, Yang D. et al Esthetic improvements of postorthodontic white-spot lesions treated with resin infiltration and microabrasion: A split-mouth, randomized clinical trial. Angle Orthod 2019; 89 (03) 372-377
    CrossrefPubMedGoogle Scholar
  • 29 Gözetici B, Öztürk-Bozkurt F, Toz-Akalın T. Comparative evaluation of resin infiltration and remineralization of noncavitated smooth surface caries lesions: 6-month results. Oral Health Prev Dent 2019; 17 (02) 99-106
    PubMedGoogle Scholar
  • 30 Giray FE, Durhan MA, Haznedaroglu E, Durmus B, Kalyoncu IO, Tanboga I. Resin infiltration technique and fluoride varnish on white spot lesions in children: preliminary findings of a randomized clinical trial. Niger J Clin Pract 2018; 21 (12) 1564-1569
    CrossrefPubMedGoogle Scholar
  • 31 Ciftci ZZ, Hanimeli S, Karayilmaz H, Gungor OE. The efficacy of resin infiltrate on the treatment of white spot lesions and developmental opacities. Niger J Clin Pract 2018; 21 (11) 1444-1449
    CrossrefPubMedGoogle Scholar
  • 32 Turska-Szybka A, Gozdowski D, Mierzwińska-Nastalska E, Olczak-Kowalczyk D. Randomised clinical trial on resin infiltration and fluoride varnish vs fluoride varnish treatment only of smooth-surface early caries lesions in deciduous teeth. Oral Health Prev Dent 2016; 14 (06) 485-491
    PubMedGoogle Scholar
  • 33 Attia ML, Aguiar FH, Mathias P, Ambrosano GM, Fontes CM, Liporoni PC. The effect of coffee solution on tooth color during home bleaching applications. Am J Dent 2009; 22 (03) 175-179
    PubMedGoogle Scholar
  • 34 Knösel M, Eckstein A, Helms HJ. 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; 144 (01) 86-96
    CrossrefPubMedGoogle Scholar
  • 35 Neuhaus KW, Graf M, Lussi A, Katsaros C. Late infiltration of post-orthodontic white spot lesions. J Orofac Orthop 2010; 71 (06) 442-447
    CrossrefPubMedGoogle Scholar
  • 36 Sava Rosianu R, Codruta Podariu A, Negrutiu ML, Szuhanek C, Sinescu C. Low viscosity resin penetration degree in incipient caries lesions. Rev Chim. 2017; 68: 2588-2592
    CrossrefGoogle Scholar
  • 37 Attin R, Stawarczyk B, Keçik D, Knösel M, Wiechmann D, Attin T. Shear bond strength of brackets to demineralize enamel after different pretreatment methods. Angle Orthod 2012; 82 (01) 56-61
    CrossrefPubMedGoogle Scholar
  • 38 El-Zankalouny SM, El Fattah WM. Penetration depth and enamel microhardness of resin infiltrant and traditional techniques for treatment of artificial enamel lesions. Alex Dent J 2016; 41: 20-25
    CrossrefGoogle Scholar
  • 39 Kane B, Karren J, Garcia-Godoy C, Garcia-Godoy F. Sealant adaptation and penetration into occlusal fissures. Am J Dent 2009; 22 (02) 89-91
    PubMedGoogle Scholar
  • 40 Mandava J, Reddy YS, Kantheti S, Chalasani U, Ravi RC, Borugadda R. Microhardness and penetration of artificial white spot lesions treated with resin or colloidal silica infiltration. J Clin Diagn Res 2017; 11: 142-146
    Google Scholar
  • 41 Arnold WH, Meyer AK, Naumova EA. Surface roughness of initial enamel caries lesions in human teeth after resin infiltration. Open Dent J 2016; 10: 505-515
    CrossrefPubMedGoogle Scholar
  • 42 Sideridou I, Tserki V, Papanastasiou G. Study of water sorption, solubility and modulus of elasticity of light-cured dimethacrylate-based dental resins. Biomaterials 2003; 24 (04) 655-665
    CrossrefPubMedGoogle Scholar
  • 43 Lo Giudice R, Puleio F, Verrusio C, Matarese M, Alibrandi A, Lizio A. Bulk vs wedge shape layering techniques in V class cavities: Marginal infiltration evaluation. G Ital Endod 2017; 31: 73-77
    CrossrefGoogle Scholar
  • 44 Dietschi D, Campanile G, Holz J, Meyer JM. Comparison of the color stability of ten new-generation composites: an in vitro study. Dent Mater 1994; 10 (06) 353-362
    CrossrefPubMedGoogle Scholar
  • 45 Rey N, Benbachir N, Bortolotto T, Krejci I. Evaluation of the staining potential of a caries infiltrant in comparison to other products. Dent Mater J 2014; 33 (01) 86-91
    CrossrefPubMedGoogle Scholar
  • 46 Borges A, Caneppele T, Luz M, Pucci C, Torres C. Color stability of resin used for caries infiltration after exposure to different staining solutions. Oper Dent 2014; 39 (04) 433-440
    CrossrefPubMedGoogle Scholar
  • 47 Araújo GS, Naufel FS, Alonso RC, Lima DA, Puppin-Rontani RM. Influence of staining solution and bleaching on color stability of resin used for caries infiltration. Oper Dent 2015; 40 (06) E250-E256
    CrossrefPubMedGoogle Scholar
  • 48 Lo Giudice R, Lipari F, Puleio F. et al Spectrophotometric evaluation of enamel color variation using infiltration resin treatment of white spot lesions at one year follow-up. Dent J (Basel) 2020; 8(2): 35
    CrossrefPubMedGoogle Scholar
  • 49 Lo Giudice G, Lo Giudice R, Matarese G. et al Evaluation of magnification systems in restorative dentistry. An in-vitro study. Dent Cadmos 2015; 83 (05) 296-305
    Google Scholar
  • 50 Lo Giudice G, Cicciù M, Cervino G, Lizio A, Visco AM. Flowable resin and marginal gap on tooth third medial cavity involving enamel and radicular cementum: a SEM evaluation of two restoration techniques. Indian J Dent Res 2012; 23 (06) 763-769
    CrossrefPubMedGoogle Scholar
  • 51 Eckstein A, Helms HJ, Knösel M. Camouflage effects following resin infiltration of postorthodontic white-spot lesions in vivo: One-year follow-up. Angle Orthod 2015; 85 (03) 374-380
    CrossrefPubMedGoogle Scholar
  • 52 Fiorillo L. Oral Health: The First Step to Well-Being. Medicina (Kaunas) 2019; 55 (10) 676
    CrossrefPubMedGoogle Scholar
  • 53 Nastro E, Musolino C, Allegra A. et al Bisphosphonate-associated osteonecrosis of the jaw in patients with multiple myeloma and breast cancer. Acta Haematol 2007; 117 (03) 181-187
    CrossrefPubMedGoogle Scholar
  • 54 Stacchi C, Lombardi T, Cusimano P. et al Bone Scrapers Versus Piezoelectric Surgery in the Lateral Antrostomy for Sinus Floor Elevation. J Craniofac Surg 2017; 28 (05) 1191-1196
    CrossrefPubMedGoogle Scholar
  • 55 Herford AS, Lu M, Akin L, Cicciù M. Evaluation of a porcine matrix with and without platelet-derived growth factor for bone graft coverage in pigs. Int J Oral Maxillofac Implants 2012; 27 (06) 1351-1358
    Google Scholar
  • 56 Onwubu SC, Mdluli PS, Singh S, Bharuth V. Remineralization potential of a modified eggshell-titanium composite-scanning electron microscope study. Eur J Dent 2019; 13 (02) 187-192
    Article in Thieme ConnectPubMedGoogle Scholar
  • 57 Ishak H, Field J, German M. Baseline Specimens of Erosion and Abrasion Studies. Eur J Dent 2021; 15 (02) 369-378
    Article in Thieme ConnectPubMedGoogle Scholar
  • 58 Hashemikamangar SS, Hoseinpour F, Kiomarsi N, Dehaki MG, Kharazifard MJ. Effect of an optical whitening toothpaste on color stability of tooth-colored restorative materials. Eur J Dent 2020; 14 (01) 85-91
    Article in Thieme ConnectPubMedGoogle Scholar
  • 59 Ebaya MM, Ali AI, Mahmoud SH. Evaluation of marginal adaptation and microleakage of three glass ionomer-based class V restorations: in vitro study. Eur J Dent 2019; 13 (04) 599-606
    Article in Thieme ConnectPubMedGoogle Scholar
  • 60 Marra PM, Iorio B, Itro A, Santoro R, Itro A. Association of tooth agenesis with dental anomalies in young subjects. Oral Maxillofac Surg 2021; 25 (01) 35-39
    CrossrefPubMedGoogle Scholar
  • 61 Marra PM, Lupo G, Itro A. Surgical management of compound odontomas: piezoelectric surgery or rotary instruments? A clinical study. Minerva Stomatol 2020; 69 (04) 203-206
    CrossrefPubMedGoogle Scholar
  • 62 Meto A, Colombari B, Sala A. et al Antimicrobial and antibiofilm efficacy of a copper/calcium hydroxide-based endodontic paste against Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans. Dent Mater J 2019; 38 (04) 591-603
    CrossrefPubMedGoogle Scholar