Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2020; 8(4): 743-756
Published online Feb 26, 2020. doi: 10.12998/wjcc.v8.i4.743
Effectiveness of a microabrasion technique using 16% HCL with manual application on fluorotic teeth: A series of studies
Martina Nevárez-Rascón, Nelly Molina-Frechero, Edith Adame, Ethel Almeida, Uriel Soto-Barreras, Enrique Gaona, Alfredo Nevárez-Rascón
Martina Nevárez-Rascón, Edith Adame, Ethel Almeida, Uriel Soto-Barreras, Alfredo Nevárez-Rascón, Facultad de Odontología, Maestría en Estomatología, Universidad Autónoma de Chihuahua, Chihuahua 31000, México
Nelly Molina-Frechero, Enrique Gaona, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Xochimilco 04960, México
Author contributions: These authors determined the methodological design of the study and performed all the data collection and analysis: Nevárez-Rascón M, Molina-Frechero N, Nevárez-Rascón A, Almeida E and Adame E; These authors conducted the statistical tests and analyzed all the results: Nevárez-Rascón M, Molina-Frechero N, Soto-Barreras U and Gaona E. All authors participated in drafting and reviewing the article.
Institutional review board statement: The study was reviewed and approved at the Universidad Autónoma de Chihuahua.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Martina Nevárez-Rascón, DDS, PhD, Full Professor, Facultad de Odontología, Maestría en Estomatología, Universidad Autónoma de Chihuahua, Calle Escorza No. 900, Colonia Centro, Chihuahua 31000, México. martina.nevarez@gmail.com
Received: November 19, 2019
Peer-review started: November 19, 2019
First decision: December 4, 2019
Revised: January 10, 2020
Accepted: January 11, 2020
Article in press: January 11, 2020
Published online: February 26, 2020
Processing time: 99 Days and 9.4 Hours
Abstract
BACKGROUND

Dental fluorosis is caused by excessive fluoride ingestion during tooth formation. As a consequence, there is a higher porosity on the enamel surface, which causes an opaque look.

AIM

The aim of this study was to identify a dental intervention to improve the smile in patients with tooth fluorosis. Additional aims were to relate the stain size on fluorotic teeth with the effectiveness of stain removal, enamel loss and procedure time using a manual microabrasion technique with 16% hydrochloric acid (HCL).

METHODS

An experimental study was carried out on 84 fluorotic teeth in 57 adolescent patients, 33 females and 24 males, with moderate to severe fluorosis. The means, standard deviations and percentages were analyzed using nonparametric statistics and ArchiCAD 15 software was used for the variables including stain size and effectiveness of stain removal.

RESULTS

The average enamel loss was 234 µm and was significantly related to the procedure time categorized as 1-4 min and 4.01-6 min, resulting in a P > 0.000. The microabrasion technique using 16% HCL was effective in 90.6% of patients and was applied manually on superficial stains in moderate and severe fluorosis. Procedure time was less than 6 min and enamel loss was within the acceptable range.

CONCLUSION

Microabrasion is a first-line treatment; however, the clinician should measure the average enamel loss to ensure that it is within the approximate range of 250 µm in order to avoid restorative treatment.

Keywords: Microabrasion of the enamel; Dental fluorosis; Enamel stains; Fluorotic teeth; Hydrochloric acid 16%; Stain removal

Core tip: This aim of this study was to promote awareness among clinicians and researchers of the use of the proposed minimally invasive technique to treat teeth with enamel fluorosis, to allow recovery of the appearance of natural teeth with 90% efficiency, and an acceptable level of tooth enamel removal. Our results showed that this manual procedure using 16% HCL resulted in a procedure time of less than 6 min, an acceptable loss of enamel (234 µm), and did not require repeated microabrasion.