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Minimally-Invasive Approaches to Treatment of Incisor Hypomineralization: Microabrasion

Setting up the case for bleaching and resin infiltration:

Often, we use transillumination to determine the nature of the hypomineralized lesion position relative to the DEJ.  If transillumination results in more transparency, the lesion is superficial and can most likely be positively affected by a microabrasion procedure.  If the entire lesion, however, is really dark, this signifies that it is more “hypomineralization” than “fluorosis, as the former is closer to the DEJ and fluorosis “staining” is more superficial.
A full rubber dam isolation setup is required (Ultradent Dermadam Synthetic was used in this case as Opalustre contains 6% HCl (aq) with silica carbide abrasive.  This case utilized 4 rounds of Opalustre in a handpiece spinning at 3,500rpm with moderate pressure over the lesion body and a light oscillating motion.  Following completion of Opalustre, the surface is etched further using UltraEtch (33% H3PO4 (aq)) and ToothMousse is applied to the area for 5 minutes before the patient is dismissed.
It will be interesting to see how the bleaching goes before we decide if further remineralization is desired before considering resin infiltration.
#Ultradent #Opalustre #UltraEtch #Dermadam #GC #ToothMousse #Microabrasion #Remineralization #MinimallyInvasiveDentistry