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Table of Contents
CASE REPORT
Year : 2021  |  Volume : 9  |  Issue : 1  |  Page : 36-38

Resin infiltration technique: A case report and literature review


Department of Pediatric and Preventive Dentistry, K M Shah Dental College and Hospital, Sumadeep Vidyapeeth, Vadodara, Gujarat, India

Date of Submission08-Apr-2021
Date of Decision03-Jun-2021
Date of Acceptance14-Jun-2021
Date of Web Publication17-Aug-2021

Correspondence Address:
Dr. Deepika N Chari
Department of Pediatric and Preventive Dentistry, K M Shah Dental College and Hospital, Sumadeep Vidyapeeth, Vadodara - 391 760, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jihs.jihs_9_21

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  Abstract 


An incomplete/defective formation of organic enamel matrix of teeth leads to enamel hypoplasia. Such spots are prone to caries and provoke plaque accumulation. This can involve color alternation which can be of major esthetic concern. Although complete color making might not be achieved, resin Infiltration CONcept (ICON) has few benefits over other methods of being noninvasive, does not require anesthesia, and the procedure can be performed in a single sitting. This paper along with a case has a brief literature review of ICON (resin infiltration technique).

Keywords: Color masking, enamel hypoplasia, hydrochloric acid etching, infiltration concept, resin infiltration, Turner's hypoplasia


How to cite this article:
Chari DN, Dave BH, Shah PS. Resin infiltration technique: A case report and literature review. J Integr Health Sci 2021;9:36-8

How to cite this URL:
Chari DN, Dave BH, Shah PS. Resin infiltration technique: A case report and literature review. J Integr Health Sci [serial online] 2021 [cited 2021 Dec 7];9:36-8. Available from: https://www.jihs.in/text.asp?2021/9/1/36/323958




  Introduction Top


Intrusion being most common trauma to primary tooth[1] can cause various effects on succedaneous tooth. The extent of trauma depends on three factors: age, degree of trauma, and direction of trauma.[2] The natural remineralization is a slow process[3] as the minerals in saliva are available only on the surface and also because of the low ion concentration gradient from saliva into the lesion.[4] Various treatment modalities include the use of fluorinated toothpaste, mouthwash, application of fluorinated varnish, microabrasion using casein phosphopeptide amorphous calcium phosphate, bleaching and lasers. The remineralizing agents reach only upto a depth of 30 μm hence not useful for esthetics/improve structural properties.[5] Around 2000 AD Robertson et al.[6] stated that caries can be arrested at initial phase by infiltration of pores with resorcinol-formaldehyde later on which was replaced by ICON (©DMG, Germany).


  Case Report Top


This paper describes the management of single tooth enamel hypoplasia by resin infiltration technique and a literature review on ICON. A 10-year-old girl child reported to the Department of Pediatric and Preventive Dentistry with the chief complaint of white discoloration/patch on the upper front tooth. Parent reported a history of trauma due to fall while playing to upper front teeth, when the child was 4 years old. Discoloration/patch had been reported as esthetic concern by the parent. The child and the parent were explained about the procedure, and written informed consent was obtained. Child was shown videos of the treatment before the procedure was initiated in order to effectively treat the lesion and instill a positive dental attitude. The step by step procedure done in this case has been depicted in [Figure 1], [Figure 2], [Figure 3], [Figure 4] and the importance of each step explained in [Table 1].
Figure 1: (a) Preoperative front view. (b) Rubber dam isolation

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Figure 2: ICON kit

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Figure 3: (a) Application of Icon-Etch. (b) Rinse and dry. (c) Application of Icon- Dry. (d) Application of ICON

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Figure 4: (a) Postoperative and (b) Postoperative front view

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Table 1: Steps in infiltration concept application

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  Discussion Top


The 10-year-old female patient presented with a small opaque patch in the right permanent maxillary incisor tooth along with a history of trauma to primary tooth when the patient was 4 years old.

Intrusion of deciduous tooth is the most common cause for the developmental disturbance for the succeedenous tooth.[1],[2] Age at which trauma had occurred along with the degree and direction of the trauma are the major factors that determine the sequel of trauma to succeedenous permanent teeth. Mildest and the most common sequel to trauma to primary tooth is the discoloration/hypoplasia of enamel. White patch seen along with a history of trauma is indicative of turners hypoplasia.[9] The opacity is due to physicochemical penetration of demineralized aspect of hydroxyapatite crystal. The reduction in enamel mineral phase results in altering the chemical composition along with alteration in optical appearance.[10]

ICON resin infiltration procedure being noninvasive is a single-visit procedure that provides mechanical stabilization of demineralized enamel and has deeper penetration of resin. It helps arrests/retard lesion progression and also minimizes the risk of secondary caries. There has been no reported risk of postoperative sensitivity or pulpal irritation neither risk of gingivitis/periodontitis. It has improved masking property with excellent patient acceptance[9] which was also observed to have better esthetic effect when followed up for 12 months compared to microabrasion.[11] In a systematic review, Shahroom et al.[12] have concluded that ICON is the best management option with increased infiltration time in comparison to other methods.

Certain limitations that can be foreseen include the precaution to be taken to keep the area of application dry, the proper depth of penetration is not known and in cases of trauma where the defects are circular – there is an acute angle formation with enamel surface which might hamper the infiltration giving it an edge effect.[9]

ICON has a masking effect, and favorable results have been found when used in mild-to-moderate fluorosis and traumatic hypoplasia.[10] ICON helps stop caries progression and also provides a camouflage effect.[13] This camouflage effect depends on the depth of the lesion also. Studies are yet to be done to check for the long-term effect and the durability due to staining and aging of the ICON.


  Conclusion Top


Resin infiltration with its clinical advantages has found to be suitable for both the clinicians and the patients. Treating the lesion at the initial stage is very important to prevent the progression of the lesion. In addition to masking the opacity, it penetrates deep down in the lesion to improve the optical appearance.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Cardoso M, de Carvalho Rocha MJ. Traumatized primary teeth in children assisted at the Federal University of Santa Catarina, Brazil. Dent Traumatol 2002;18:129-33.  Back to cited text no. 1
    
2.
Diab M, elBadrawy HE. Intrusion injuries of primary incisors. Part II: Sequelae affecting the intruded primary incisors. Quintessence Int 2000;31:335-41.  Back to cited text no. 2
    
3.
Dowd FJ. Saliva and dental caries. Dent Clin North Am 1999;43:579-97.  Back to cited text no. 3
    
4.
Silverstone LM. Remineralization of human enamel in vitro. Proc R Soc Med 1972;65:906-8.  Back to cited text no. 4
    
5.
Schmidlin P, Zobrist K, Attin T, Wegehaupt F. In vitro re-hardening of artificial enamel caries lesions using enamel matrix proteins or self-assembling peptides. J Appl Oral Sci 2016;24:31-6.  Back to cited text no. 5
    
6.
Robertson MA, Kau CH, English JD, Lee RP, Powers J, Nguyen JT: MI paste plus to prevent demineralization in orthodontic patients: A prospective randomized controlled trial. Am J Orthod Dentofacial Orthop 2011;140:660-8.  Back to cited text no. 6
    
7.
Meyer-Lueckel H, Paris S, Kielbassa AM. Surface layer erosion of natural caries lesions with phosphoric and hydrochloric acid gels in preparation for resin infiltration. Caries Res 2007;41:223-30.  Back to cited text no. 7
    
8.
Robinson C, Brookes SJ, Kirkham J, Wood SR, Shore RC. In vitro studies of the penetration of adhesive resins into artificial caries-like lesions. Caries Res 2001;35:136-41.  Back to cited text no. 8
    
9.
Manoharan V, Arun Kumar S, Arumugam SB, Anand V, Krishnamoorthy S, Methippara JJ. Is resin infiltration a micro invasive approach to white lesions of calcified tooth structures? A systemic review. Int J Clin Pediatr Dent 2019;12:53-8.  Back to cited text no. 9
    
10.
Silverstone LM, Hicks MJ, Featherstone MJ. Dynamic factors affecting lesion initiation and progression in human dental enamel. II. Surface morphology of sound enamel and carieslike lesions of enamel. Quintessence Int 1988;19:773-85.  Back to cited text no. 10
    
11.
Gu X, Yang L, Yang D, Gao Y, Duan X, Zhu X, et al. Esthetic improvements of postorthodontic white-spot lesions treated with resin infiltration and microabrasion: A split-mouth, randomized clinical trial. Angle Orthod 2019;89:372-7.  Back to cited text no. 11
    
12.
Shahroom NS, Mani G, Ramakrishnan M. Interventions in management of dental fluorosis, an endemic disease: A systematic review. J Family Med Prim Care 2019;8:3108-13.  Back to cited text no. 12
[PUBMED]  [Full text]  
13.
Muñoz MA, Arana-Gordillo LA, Gomes GM, Gomes OM, Bombarda NH, Reis A, et al. Alternative esthetic management of fluorosis and hypoplasia stains: Blending effect obtained with resin infiltration techniques. J Esthet Restor Dent 2013;25:32-9.  Back to cited text no. 13
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1]



 

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Introduction
Case Report
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