Had the opportunity to try a cool, novel technique for enamel hypoplasia. This 57 year old patient with congenitally-missing upper lateral incisors presented with unsightly hypoplastic spots generalised to the upper arch. Following needed restorative treatment on other teeth, the patient was bleached to the maximum extent possible, further accentuating the lesions but lightening the body value shade of the teeth. The teeth were isolated using rubber dam (non-latex) (Roeko, Coltene) and the spots subjected to 4 rounds of a 10% HCl (aq) dwell for 2 minutes before rinsing (30 seconds) and drying fully with compressed air. Icon-Dry was used (EtOH) to dessicate the enamel further. This process was repeated 4 times in total, allowing for maximum surface porosity before infiltration using Icon with a 3 minute wet dwell time before air thinning and curing. The infiltration step was completed once more and the teeth finished and polished. Besides a slight change in surface texture, the color shift is permanent and dramatic, visually breaking up the “blocks” that caused her social anxiety.
The teeth should look much better on reassessment when fully rehydrated. Cross-polarization (Polar-Eyes) shots show the dramatic, ultraconservative correction of hypoplastic lesions.