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Nair, Radhakrishnan, and Anoop N. Das. "Esthetic Rehabilitation of Teeth with Dental Fluorosis." International Journal of Prosthodontics and Restorative Dentistry 4, no. 1 (2014): 11–13. http://dx.doi.org/10.5005/jp-journals-10019-1099.
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ABSTRACT High intake of fluoride causes developmental disturbances of tooth enamel leading to dental fluorosis. It produces mottling of enamel and its occurance depends upon the quantity of fluoride ingested and the stage of tooth development. Esthetic management of mottled teeth is planned according to the severity of discoloration and the extent of surface aberrations. A combination of different techniques makes the teeth lighter in shade with a smoother surface. This case report describes the management of fluorosed teeth which is discolored and pitted on the surface by minimally invasive procedures. How to cite this article Nair R, Das AN, Kuriakose MC, Praveena G. Esthetic Rehabilitation of Teeth with Dental Fluorosis. Int J Prosthodont Restor Dent 2014;4(1):11-13.
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Yadav, Ashish. "DENTAL FLUOROSIS AND PERIODONTAL DISEASE: AN OVERVIEW." International Journal of Advanced Research 8, no. 9 (September 30, 2020): 913–21. http://dx.doi.org/10.21474/ijar01/11741.
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Aim: The aim of this review is to discuss various effects of fluoride on hard and soft tissues of the periodontium and its importance in human life. Background : Fluoride is an essential element for life and is one of the trace elements normally present in the body. It is abundant in the environment and the main source of fluoride to humans is drinking water. Fluoride gets accumulated in hard tissues of the body and has been known to play an important role in mineralization of bone and teeth. The behaviourof fluoride ions in the human organism can be regarded as that of double-edged sword. In small amounts, it is known to have beneficial effects on dental health. On the other hand, excessive chronic intakes can result in adverse effects including the development of dental fluorosis in children and/or skeletal fluorosis in both children and adults. Although effect of fluoride on caries has been discussed in painstaking details through various studies but the effect of fluorosis on the periodontium yet remains in shadow. Review Results : Dental fluorosis is a developmental disturbance of dental enamel, caused by successive exposures to high concentrations of fluoride during tooth development, leading to enamel with lower mineral content and increased porosity. Even after continuing with the age old logic of structural changes that take place in mottled enamel it can be said with scientific plausibility that this factor of surface roughness can or must influence some of the variables in this multifactorial disease of periodontitis. This surface roughness is conducive for the bacteria to survive as well as make it difficult for scaling and root planing in fluorosed teeth. This could also jeopardize the effectiveness of the regular oral hygiene procedures. Conclusion : Dental fluorosis is not only a cosmetic problem that impairs social well-being but also affects the oral health related quality of life. Fluorosis continues to be an important problem, both for the affected individuals and for public health. More and more areas are being discovered regularly that are affected by fluorosis in different parts of the country. But ultimate solution for this fluoride menace remains to be the principal of Precaution is better than cure. Clinical Significance : Considering the role of fluorosis on hard and soft tissues and all the risk factors of periodontitis, fluorosis can be recommended strongly as an environmental risk factor for periodontitis. To be defined as one of the etiological (environmental) agent of periodontal disease requires further research studies with greater sample size from varying areas globally.
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Castilho, Lia Silva de, Efigênia Ferreira e. Ferreira, Leila Nunes Menegasse Velásquez, Lucia Maria Fantinel, and Edson Perini. "Beliefs and attitudes about endemic dental fluorosis among adolescents in rural Brazil." Revista de Saúde Pública 44, no. 2 (April 2010): 261–66. http://dx.doi.org/10.1590/s0034-89102010000200005.
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OBJECTIVE: To understand beliefs and attitudes about fluorosis among young people living in a rural area. METHODOLOGICAL PROCEDURES: Qualitative study consisting of semi-structured interviews with 23 adolescents with dental fluorosis, 14 teachers and three health authorities in the city of São Francisco, Southeastern Brazil, in 2002. Content analysis and social representation theory were applied. ANALYSIS OF RESULTS: The organoleptic characteristics of carbonates that affect groundwater (salty flavor, whitish coloration, and turbidity) associated with negative aspects of household use of this water are considered a cause of mottled enamel. Even after contact with researchers who investigated this phenomenon and helped find a solution for this condition, the local population is still unwilling to accept fluoride as the cause of the problem and does not fully agree to use water from other sources because they are afraid of the quality of water. CONCLUSIONS: Misperceptions of the causes of dental fluorosis and water treatment costs compromise the implementation of uncontaminated surface water supplies. Health education strategies are required in parallel with solutions for securing water supply in drought-ravaged areas.
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Sato, Ritsuko, Fumiko Katagiri, Kaoru Ishii, and Masataka Katagiri. "A Clinical and Histopathological Study Comparing Dental Fluorosis (Mottled Tooth) with Caries and Normal Enamel." Japanese Journal of Oral Biology 43, no. 1 (2001): 72–82. http://dx.doi.org/10.2330/joralbiosci1965.43.72.
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Horowitz, H. S. "Fluoride and Enamel Defects." Advances in Dental Research 3, no. 2 (September 1989): 143–46. http://dx.doi.org/10.1177/08959374890030021201.
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The concentration of fluoride in drinking water is the major determinant of the prevalence and severity of dental fluorosis in a community. Fluorosis is more prevalent and discernible in permanent teeth than in primary teeth; the intensity can range from barely perceptible, whitish striations in enamel to confluent pitting and dark staining. The traditional belief is that fluorosis is produced only during the secretory stages of ameloblastic activity. Some recent reports suggest that the maturation stages of enamel development are as important as or even more important than the secretory stages as the time when fluorosis can be produced. The question of timing remains unresolved. Many questions also remain about general and individual physiologic variations in relation to susceptibility to dental fluorosis. Good criteria for differential diagnosis exist to distinguish dental fluorosis from non-fluoride enamel opacities. An increasing number of reports indicates that the prevalence of fluorosis may be increasing among children in fluoridated and non-fluoridated communities. Reasons for the increases may relate to misuse of dietary fluoride supplements, ingestion of fluoride toothpastes, or increasing amounts of fluoride in foods or the atmosphere. The intensity of the increased fluorosis is in the milder categories and is not generally unsightly. It should be recognized that a small amount of fluorosis may be an alternative to a greater prevalence of dental caries, a disease that may produce cosmetic problems and sequelae worse than those produced by fluorosis.
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Houari, S., E. Picard, T. Wurtz, E. Vennat, N. Roubier, T. D. Wu, J. L. Guerquin-Kern, et al. "Disrupted Iron Storage in Dental Fluorosis." Journal of Dental Research 98, no. 9 (July 22, 2019): 994–1001. http://dx.doi.org/10.1177/0022034519855650.
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Enamel formation and quality are dependent on environmental conditions, including exposure to fluoride, which is a widespread natural element. Fluoride is routinely used to prevent caries. However, when absorbed in excess, fluoride may also lead to altered enamel structural properties associated with enamel gene expression modulations. As iron plays a determinant role in enamel quality, the aim of our study was to evaluate the iron metabolism in dental epithelial cells and forming enamel of mice exposed to fluoride, as well as its putative relation with enamel mechanical properties. Iron storage was investigated in dental epithelial cells with Perl’s blue staining and secondary ion mass spectrometry imaging. Iron was mainly stored by maturation-stage ameloblasts involved in terminal enamel mineralization. Iron storage was drastically reduced by fluoride. Among the proteins involved in iron metabolism, ferritin heavy chain (Fth), in charge of iron storage, appeared as the preferential target of fluoride according to quantitative real-time polymerase chain reaction, Western blotting, and immunohistochemistry analyses. Fluorotic enamel presented a decreased quantity of iron oxides attested by electron spin resonance technique, altered mechanical properties measured by nanoindentation, and ultrastructural defects analyzed by scanning electron microscopy and energy dispersive x-ray spectroscopy. The in vivo functional role of Fth was illustrated with Fth+/-mice, which incorporated less iron into their dental epithelium and exhibited poor enamel quality. These data demonstrate that exposure to excessive fluoride decreases ameloblast iron storage, which contributes to the defective structural and mechanical properties in rodent fluorotic enamel. They raise the question of fluoride’s effects on iron storage in other cells and organs that may contribute to its effects on population health.
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Fejerskov, O., M. J. Larsen, A. Richards, and V. Baelum. "Dental Tissue Effects of Fluoride." Advances in Dental Research 8, no. 1 (June 1994): 15–31. http://dx.doi.org/10.1177/08959374940080010601.
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It is now well-established that a linear relationship exists between fluoride dose and enamel fluorosis in human populations. With increasing severity, the subsurface enamel all along the tooth becomes increasingly porous (hypomineralized), and the lesion extends toward the inner enamel. In dentin, hypomineralization results in an enhancement of the incremental lines. After eruption, the more severe forms are subject to extensive mechanical breakdown of the surface. The continuum of fluoride-induced changes can best be classified by the TF index, which reflects, on an ordinal scale, the histopathological features and increases in enamel fluoride concentrations. Human and animal studies have shown that it is possible to develop dental fluorosis by exposure during enamel maturation alone. It is less apparent whether an effect of fluoride on the stage of enamel matrix secretion, alone, is able to produce changes in enamel similar to those described as dental fluorosis in man. The clinical concept of post-eruptive maturation of erupting sound human enamel, resulting in fluoride uptake, most likely reflects subclinical caries. Incorporation of fluoride into enamel is principally possible only as a result of concomitant enamel dissolution (caries lesion development). At higher fluoride concentrations, calcium-fluoride-like material may form, although the formation, identification, and dissolution of this compound are far from resolved. It is concluded that dental fluorosis is a sensitive way of recording past fluoride exposure because, so far, no other agent or condition in man is known to create changes within the dentition similar to those induced by fluoride. Since the predominant cariostatic effect of fluoride is not due to its uptake by the enamel during tooth development, it is possible to obtain extensive caries reductions without a concomitant risk of dental fluorosis.
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Kaskova, L. F., N. A. Morhun, L. I. Amosova, N. V. Yanko, and A. V. Artemiev. "REVIEW OF MODERN APPROACHES TO DENTAL FLUOROSIS MANAGEMENT." Ukrainian Dental Almanac, no. 3 (September 6, 2019): 71–76. http://dx.doi.org/10.31718/2409-0255.3.2019.11.
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Dental fluorosis is caused by ingesting too much fluoride while the teeth are developing. Poltava region belongs to Buchach fluorine hydrogeological province which ground waters are characterized by a high content of fluorine. Such districts as Myrgorod, Lubny, Gadyach, Globino, Mashivka, Shyshaky and Novy Sanzshary have fluoride concentration in drinking water from 2,5 tо 7 mg/l. It is known that the overdose of fluoride has deleterious effect on enamel development, generating a hypomineralized porous subsuperfacial enamel. Mild fluorosis transforms into moderate fluorosis with brown pigmentation over time and increasing the severity of fluorosis is associated with increasing the patient`s dissatisfaction.
There are a few different ways that dental fluorosis can be treated. Local remineralisation therapy is the most careful way to reduce or eliminate fluorosis spots. Enamel microabrasion removes the outer porous enamel with pumice after it has been partly demineralized by the acid; topical fluoride that remineralized the enamel follows microabrasion. A teeth whitening can return teeth to their former glory in a single visit. Infiltration technique is the novel approach to fluorosis management which masks white spots. Veneers or crowns are the next option that restores teeth gleaming appearance. Unfortunately, previous reviews that have analyzed contemporary methods of fluorosis treatment didn’t determine their indications depending on the disease severity and the enamel maturation.
Purpose of the study was to systematize the methods of dental fluorosis management offered last years and to determine the indications for their use depending on the severity of the disease and the maturity of the tooth enamel. Searching strategy for identification of scientific publications published between the years 2009 - May 2019 was conducted by reviewers independently through Google. The search strategy included keywords "dental fluorosis management", «teeth whitening», «teeth microabrasion», «infiltration for fluorosis treatment» and it was complementated by checking references of the relevant review articles and the eligible studies for additional useful publications.
Over the last 10 years few articles were dealt with minerals, vitamins, adaptogens, antitoxicants prescription for fluorosis management. Such tooth pastes as «R.O.C.S» and «Novyi zhemchuh calcium» showed efficacy in local remineralisation therapy of fluorosis in children. Infiltration technique was used for mild fluorosis management and in combination with whitening for moderate fluorosis treatment in children. Different tooth whitening techniques were offered and only some of them include local remineralisation therapy that can stabilize clinical result. Carbamide and orthophosphoric acid were utilized for whitening of immature fluorosis teeth. Microabrasion in children's teeth was effective in combination with following fluoridation, for example Tooth Moose.
Direct and indirect restorations are considered the treatment of choice for moderate to severe cases of fluorosis given the optimum aesthetics, wear resistance, biocompatibility, and long-term results. Whereas veneers and crowns are indicated in mature fluorosis teeth, choice of direct composite restorations doesn’t depend on tooth maturity.
Treatment of fluorosis of various severities in children should include endogenous use of medicines that increase the enamel remineralisation. Local remineralisation therapy is indicated for mild fluorosis in immature teeth and for moderate fluorosis in combination with bleaching and microabrasion. Infiltration technique is recommended for mild fluorosis management and in combination with whitening for moderate fluorosis treatment in children. In the case of inefficiency of minimally invasive methods or severe fluorosis, direct or indirect restorations are conducted. Promising direction in fluorosis treatment is the development of new methods for fluorosis management, including general and local remineralization therapy, as well as infiltration technique.
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Rigo, Lilian, Leodinei Lodi, and Raíssa Rigo Garbin. "Differential diagnosis of dental fluorosis made by undergraduate dental students." Einstein (São Paulo) 13, no. 4 (December 2015): 547–54. http://dx.doi.org/10.1590/s1679-45082015ao3472.
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ABSTRACT Objective To check knowledge of undergraduate dental students to make diagnosis of dental fluorosis with varying degrees of severity and choose its appropriate treatment. Methods Data were collected using a semi-structured questionnaire addressing knowledge of undergraduates based on ten images of mouths presenting enamel changes. Results Only three images were correctly diagnosed by most undergraduates; the major difficulty was in establishing dental fluorosis severity degree. Conclusion Despite much information about fluorosis conveyed during the Dentistry training, as defined in the course syllabus, a significant part of the students was not able to differentiate it from other lesions; they did not demonstrate expertise as to defining severity of fluorosis and indications for treatment, and could not make the correct diagnosis of enamel surface changes.
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Evans, R. W. "Changes in Dental Fluorosis Following an Adjustment to the Fluoride Concentration of Hong Kong's Water Supplies." Advances in Dental Research 3, no. 2 (September 1989): 154–60. http://dx.doi.org/10.1177/08959374890030021401.
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In June, 1978, the fluoride concentration in Hong Kong water supplies was reduced from 1.0 to 0.7 mg/ L. The objectives of this study were (1) to determine whether, as a result of this minor adjustment, a consequent reduction in the prevalence and severity of dental fluorosis came about, and (2) to determine whether dental fluorosis develops during enamel secretion and primary mineralization or during the maturation stage of enamel development. Dental fluorosis was assessed by Dean's community fluorosis index (CFI) on upper central incisors in 2382 children aged from 7 (exposed to 0.7 mg/L only) to 13 years. The children were selected from four districts served with drinking water by four different water treatment stations. Differences in the distributions of dental fluorosis scores across ages were significant in all districts. The susceptibility to fluoride was assessed statistically through a series of analyses whereby the fluoride concentration in the drinking water (both coincident with enamel secretion and periods of enamel maturation) was correlated with CFI. It was concluded (1) that CFI values were reduced following a minor adjustment to the fluoride concentration in drinking water, (2) that dental fluorosis develops during the maturation stage of enamel development, (3) that the development of dental fluorosis may occur over a period of 16 to 24 months, commencing from 12 to 32 months following enamel secretion, and (4) that Dean's index is a suitable instrument for monitoring the effects on dental fluorosis of minor adjustments to the fluoride concentration in drinking water.
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Ibarra-Santana, Claudia, Ma del Socorro Ruiz-Rodríguez, Ma del Pilar Fonseca-Leal, Francisco Javier Gutiérrez-Cantú, and Amaury de Pozos-Guillén. "Enamel Hypoplasia in Children with Renal Disease in a Fluoridated Area." Journal of Clinical Pediatric Dentistry 31, no. 4 (July 1, 2007): 274–77. http://dx.doi.org/10.17796/jcpd.31.4.m97777625k278261.
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The aim of this study was to compare the frequency of enamel hypoplasia in children with renal disease and healthy children, all of whom live in a fluoridated area. A cross-sectional study was made in 42 children divided into 2 groups. To describe enamel changes, 3 diagnostic criteria were applied: TSIF Index to describe dental fluorosis, Jackson-Al-Alousi Index to describe enamel hypoplasia, and Russell criteria to differentiate mild forms of dental fluorosis and enamel hypoplasia. The frequency of enamel hypoplasia in patients with renal disease was 38.09%. This frequency is smaller than that seen in other studies. There was no difference in the frequency of dental fluorosis between patients with renal disease and patients without renal disease. However, the patients with renal disease presented more severe dental fluorosis than children without renal disease.
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Den Besten, P. K. "Dental Fluorosis: Its Use as a Biomarker." Advances in Dental Research 8, no. 1 (June 1994): 105–10. http://dx.doi.org/10.1177/08959374940080010201.
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Several epidemiological studies, beginning with those of Dean and co-workers in the 1940's, clearly demonstrate the relationship between dental fluorosis in humans and the level of fluoride in water supplies. These studies and others have shown that, in a population, there is a direct relationship among the degree of enamel fluorosis, plasma and bone fluoride levels, and the concentration of fluoride in drinking water. However, dental fluorosis is a reflection of fluoride exposure only during the time of enamel formation, somewhat limiting its use as a biomarker. In addition, the degree of fluorosis is dependent not only on the total fluoride dose, but also on the timing and duration of fluoride exposure. At the level of an individual response to fluoride exposure, factors such as body weight, activity level, nutritional factors, and the rate of skeletal growth and remodeling are also important. These variables, along with an individual variability in response to similar doses of fluoride, indicate that enamel fluorosis cannot be used as a biological marker of the level of fluoride exposure for an individual.
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Richards, A., J. Kragstrup, K. Josephsen, and O. Fejerskov. "Dental Fluorosis Developed in Post-secretory Enamel." Journal of Dental Research 65, no. 12 (December 1986): 1406–9. http://dx.doi.org/10.1177/00220345860650120501.
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The aim of this study was to test whether dental fluorosis can be produced by administration of chronic doses of fluoride during only the post-secretory stage of enamel mineralization. Eight control and eight experimental pigs matched by weight and litter were fed a low-fluoride diet (<0.05 mg F-/kg b.w. daily) from weaning to slaughter at 14 months. The test group received an oral dose of 2 mg F -/kg b.w. per day from 8 months of age. Lower fourth pre-molars were at the post-secretory stage at the start of fluoride administration (confirmed by tetracycline marker) and were just erupting at slaughter. All of the fourth pre-molar teeth from the test group developed diffuse enamel hypomineralization indistinguishable from human fluorosis. No such lesions were seen in any of the teeth from the control animals. It was concluded that enamel fluorosis may be caused by fluoride exposure in the maturation phase only. The pathogenic mechanism may be an effect either on the selective loss of protein or on the influx of mineral, both of which occur during the post-secretory or maturation stage of enamel formation.
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Achmad, Muh Harun. "Penanganan fluorosis pada gigi sulung dengan menggunakan teknik mikroabrasi." Journal of Dentomaxillofacial Science 6, no. 1 (April 30, 2007): 42. http://dx.doi.org/10.15562/jdmfs.v6i1.136.
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Fluorosis is a pathological endemic effect of ion intake of flour which is more than 1ppm. Enamel fluorosis is tooth enamel demineralization due to excessive flour intakeduring tooth calcification period. Fluorosis is disparity of tooth which is initially markedwith a white line across the enamel surface, and at severe level can change tooth form.Dental fluorosis is hypoplasia or hypomaturation of tooth enamel or dentine because ofchronic usage of excessive fluor at period and development of dentition. Dental fluorosisis qualitative defect of enamel, resulted from the increase of fluor concentration at cellmicroenvironment of ameloblast during development and tooth formation. Quantitativedefect of enamel can occur on severe type of dental fluorosis. Microabrasion, consist ofair abrasion and enamel microabrasion, is a method of reducing tooth structure which isthe best alternative rather than drilling method. The mechanism of air abrasion techniqueis blast pressure of abrasive particles to remove tooth caries. The principle of kineticenergy is the abrasive particles with high pressure and speed, hit the tooth, remove toothcaries, and reduce tooth structure.
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Sabokseir, Aira, Ali Golkari, and Aubrey Sheiham. "Distinguishing between enamel fluorosis and other enamel defects in permanent teeth of children." PeerJ 4 (February 25, 2016): e1745. http://dx.doi.org/10.7717/peerj.1745.
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Background.The inconsistent prevalence of fluorosis for a given level of fluoride in drinking water suggests developmental defects of enamel (DDEs) other than fluorosis were being misdiagnosed as fluorosis. The imprecise definition and subjective perception of fluorosis indices could result in misdiagnosis of dental fluorosis. This study was conducted to distinguish genuine fluorosis from fluorosis-resembling defects that could have adverse health-related events as a cause using Early Childhood Events Life-grid method (ECEL).Methods.A study was conducted on 400 9-year-old children from areas with high, optimal and low levels of fluoride in the drinking water of Fars province, Iran. Fluorosis cases were diagnosed on the standardized one view photographs of the anterior teeth using Dean’s and TF (Thylstrup and Fejerskov) Indices by calibrated dentists. Agreements between examiners were tested. Early childhood health-related data collected retrospectively by ECEL method were matched with the position of enamel defects.Results.Using both Dean and TF indices three out of four dentists diagnosed that 31.3% (115) children had fluorosis, 58.0%, 29.1%, and 10.0% in high (2.12–2.85 ppm), optimal (0.62–1.22 ppm), and low (0.24–0.29 ppm) fluoride areas respectively (p< 0.001). After matching health-related events in the 115 (31.3%) of children diagnosed with fluorosis, 31 (8.4%) of children had fluorosis which could be matched with their adverse health-related events. This suggests that what was diagnosed as fluorosis were non-fluoride related DDEs that resemble fluorosis.Discussion.The frequently used measures of fluorosis appear to overscore fluorosis. Use of ECEL method to consider health related events relevant to DDEs could help to differentiate between genuine fluorosis and fluorosis-resembling defects.
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Patidar, Deepika, Suma Sogi, Dinesh Chand Patidar, Atul Sharma, Mansi Jain, and Priyanka Prasad. "Enlightening Diagnosis and Differential Diagnosis of Dental Fluorosis—A Hidden Entity in a Crowd." Dental Journal of Advance Studies 9, no. 01 (March 18, 2021): 14–21. http://dx.doi.org/10.1055/s-0041-1725218.
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Abstract Aim To provide diagnosis as well as differential diagnosis of dental fluorosis. Background Dental fluorosis is a developmental defect of enamel, due to consecutive exposures of tooth during the formative stage of development to the higher concentration of fluoride, resulting in enamel with lesser mineral content and enhanced porosity. Several epidemiological indices have been utilized for diagnosis and assessment of dental fluorosis on the basis of clinical appearance. Fluorosis of the deciduous teeth occurs less commonly and is milder than that of permanent teeth. Highlights The diagnostic difficulties are usually associated between fluorotic and nonfluoride opacities. A complete history of the clinical condition, teeth affected with specific areas, pattern of lesion, color and its method of detection are the few important diagnostic criteria for differentiating dental fluorosis from nonfluoride discolorations of the teeth. Conclusion This review article has enlightened the diagnosis and differential diagnosis of dental fluorosis among various nonfluoride tooth discolorations. A correct diagnosis results in an appropriate and early management of dental fluorosis and plays an important role in oral epidemiology and public health.
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Bertassoni, Luiz, Juliana Martin, Vladja Torno, Sérgio Vieira, Rodrigo Nunes Rached, and Rui Mazur. "In-Office Dental Bleaching and Enamel Microabrasion for Fluorosis Treatment." Journal of Clinical Pediatric Dentistry 32, no. 3 (April 1, 2008): 185–88. http://dx.doi.org/10.17796/jcpd.32.3.20757r27312334u8.
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Recently, mostly as a result of drinking water fluoridation, the number of young patients affected by fluorosis increased considerably. This study describes a minimally invasive technique, using in-office dental bleaching (35% hydrogen peroxide) and enamel microabrasion (silicon carbide and 12% hydrochloric acid)to eliminate fluorosis like stains. The association of techniques was efficient and can be recommended as a good conservative alternative for the treatment of fluorosis affected teeth.
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Aulestia, Francisco J., Johnny Groeling, Guilherme H. S. Bomfim, Veronica Costiniti, Vinu Manikandan, Ariya Chaloemtoem, Axel R. Concepcion, et al. "Fluoride exposure alters Ca2+ signaling and mitochondrial function in enamel cells." Science Signaling 13, no. 619 (February 18, 2020): eaay0086. http://dx.doi.org/10.1126/scisignal.aay0086.
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Fluoride ions are highly reactive, and their incorporation in forming dental enamel at low concentrations promotes mineralization. In contrast, excessive fluoride intake causes dental fluorosis, visually recognizable enamel defects that can increase the risk of caries. To investigate the molecular bases of dental fluorosis, we analyzed the effects of fluoride exposure in enamel cells to assess its impact on Ca2+ signaling. Primary enamel cells and an enamel cell line (LS8) exposed to fluoride showed decreased internal Ca2+ stores and store-operated Ca2+ entry (SOCE). RNA-sequencing analysis revealed changes in gene expression suggestive of endoplasmic reticulum (ER) stress in fluoride-treated LS8 cells. Fluoride exposure did not alter Ca2+ homeostasis or increase the expression of ER stress–associated genes in HEK-293 cells. In enamel cells, fluoride exposure affected the functioning of the ER-localized Ca2+ channel IP3R and the activity of the sarco-endoplasmic reticulum Ca2+-ATPase (SERCA) pump during Ca2+ refilling of the ER. Fluoride negatively affected mitochondrial respiration, elicited mitochondrial membrane depolarization, and disrupted mitochondrial morphology. Together, these data provide a potential mechanism underlying dental fluorosis.
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Rojas-Sánchez, F., M. Alaminos, A. Campos, H. Rivera, and M. C. Sánchez-Quevedo. "Dentin in Severe Fluorosis: a Quantitative Histochemical Study." Journal of Dental Research 86, no. 9 (September 2007): 857–61. http://dx.doi.org/10.1177/154405910708600910.
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Dentin responds to different alterations in the enamel with hypermineralization, and is a biomarker of fluoride exposure. We hypothesized that severe fluorosis would lead to hypermineralization of the dentin when the enamel was severely affected. We used scanning electron microscopy and quantitative electron-probe microanalysis to compare dentin and enamel from healthy and fluorotic teeth. The dentin in fluorotic teeth was characterized by a highly mineralized sclerotic pattern, in comparison with control teeth (p < 0.001) and fluorotic enamel lesions (p < 0.001). Enamel near the lesions showed hypercalcification in comparison with dentin (p < 0.001). In response to the effects of severe fluorosis in the enamel, the dentin showed hypermineralization, as found in other enamel disorders. The hypermineralization response of the dentin in our samples suggests that the mechanism of the response should be taken into account in dental caries and other dental disorders associated with severe fluorosis.
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Pandey, P., A. A. Ansari, P. Moda, and M. Yadav. "Enamel microabrasion for aesthetic management of dental fluorosis." Case Reports 2013, oct11 1 (October 11, 2013): bcr2013010517. http://dx.doi.org/10.1136/bcr-2013-010517.
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Richards, A., O. Fejerskov, and V. Baelum. "Enamel Fluoride in Relation To Severity of Human Dental Fluorosis." Advances in Dental Research 3, no. 2 (September 1989): 147–53. http://dx.doi.org/10.1177/08959374890030021301.
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The aim of this study was to test whether the concentrations of fluoride in fluorotic human enamel are related to the degree of severity of dental fluorosis classified according to the index described by Thylstrup and Fejerskov. Teeth representing the entire spectrum of human dental fluorosis were analyzed. Fluoride concentrations were determined by serial acid-etching from surface to interior of blocks of enamel cut from each tooth. Fluoride was measured by ion electrode and calcium by atomic absorption spectrophotometry. The results showed that the pattern of distribution of fluoride in fluorotic enamel is similar to that described for normal enamel. Increasing severity of fluorotic lesions was associated with increasing concentrations of fluoride throughout the enamel. It is concluded that although further studies are required to establish the relative contribution of fluoride which may be taken up posteruptively by fluorotic enamel, the findings support the hypothesis that the TF index reflects increasing exposure to fluoride during tooth development.
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Woltgens, J. H. M., E. J. Etty, W. M. D. Nieuwland, and D. M. Lyaruu. "Use of Fluoride by Young Children and Prevalence of Mottled Enamel." Advances in Dental Research 3, no. 2 (September 1989): 177–82. http://dx.doi.org/10.1177/08959374890030021701.
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The prevalence of mottled enamel in the permanent dentition of children participating in a fluoride (F-) program at the dental school of the Vrije Universiteit (Amsterdam) was investigated in a study utilizing the Thylstrup-Fejerskov (TF) index. The randomly chosen children received a F- regime considered optimal by the Dutch Advisory Committee for Prevention of Oral and Dental Diseases. From the children examined (n = 83; 49 boys and 34 girls; mean age, 13 years and 5 months), 74% exhibited mottled enamel in a slight to moderate degree. More teeth were affected and the degree of mottling was higher when children started to use F- at an earlier age. Unintentional ingestion of toothpaste containing 0.15% F- during frequent toothbrushing in combination with the daily intake of F- tablets before the age of four may explain the high prevalence of mottled enamel. After these treatments, F- concentrations in plasma of young children can reach values which can directly affect the developing tooth germ.
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Wang, Y., Y. Sa, S. Liang, and T. Jiang. "Minimally Invasive Treatment for Esthetic Management of Severe Dental Fluorosis: A Case Report." Operative Dentistry 38, no. 4 (June 1, 2013): 358–62. http://dx.doi.org/10.2341/12-238-s.
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SUMMARY Dental fluorosis is a developmental disturbance of enamel caused by excessive fluoride on ameloblasts during enamel formation. Patients often present to the dentist with a main goal of improving their esthetic appearance. This case report describes a minimally invasive technique for treating a severe case of enamel fluorosis with brown surface aspect and small defects. A selective mega-abrasion and microabrasion were used to recreate macro- and micro- surface morphology, followed by power bleaching, home bleaching, and resin infiltration to improve the esthetic appearance.
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R, Suma, KK Shashibhushan, ND Shashikiran, and VV Subba Reddy. "Progression of Artificial Caries in Fluorotic and Nonfluorotic Enamel. An in vitro Study." Journal of Clinical Pediatric Dentistry 33, no. 2 (December 1, 2008): 127–30. http://dx.doi.org/10.17796/jcpd.33.2.y5837p7227x62813.
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Background and objectives: Fluorosis is an important clinical and public health problem in several parts of the world. Although the relationship of fluoride level in drinking water to dental caries and dental fluorosis is known, relationship of fluorosis with the caries is not clear. This study was conducted to evaluate and compare the thickness of enamel and depth of lesion after inducing artificial caries in fluorotic and nonfluorotic teeth. Methods: Study group included 15 fluorosis affected and 15 normal teeth. Artificial caries was induced and teeth were sectioned to 150 microns and observed under polarized light microscope to measure the enamel thickness and depth of lesion in microns. Results: Statistical analyses of the measurements were made using student's unpaired t-test. Thickness of the enamel of nonfluorotic teeth was found to be significantly more when compared with the fluorotic teeth(p-value 0.0404) and depth of lesion was significantly more in fluorotic teeth when compared with the nonfluorotic teeth(p-value 0.0218). Conclusion:Although fluoride is acknowledged as an essential factor in the prevention of dental caries there has to be careful balance in the amount consumed to ensure that fluorosis does not occur.
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Lima Leite, Aline, Mileni Silva Fernandes, Senda Charone, Gary Milton Whitford, Eric T. Everett, and Marília Afonso Rabelo Buzalaf. "Proteomic Mapping of Dental Enamel Matrix from Inbred Mouse Strains: Unraveling Potential New Players in Enamel." Caries Research 52, no. 1-2 (December 16, 2017): 78–87. http://dx.doi.org/10.1159/000479039.
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Enamel formation is a complex 2-step process by which proteins are secreted to form an extracellular matrix, followed by massive protein degradation and subsequent mineralization. Excessive systemic exposure to fluoride can disrupt this process and lead to a condition known as dental fluorosis. The genetic background influences the responses of mineralized tissues to fluoride, such as dental fluorosis, observed in A/J and 129P3/J mice. The aim of the present study was to map the protein profile of enamel matrix from A/J and 129P3/J strains. Enamel matrix samples were obtained from A/J and 129P3/J mice and analyzed by 2-dimensional electrophoresis and liquid chromatography coupled with mass spectrometry. A total of 120 proteins were identified, and 7 of them were classified as putative uncharacterized proteins and analyzed in silico for structural and functional characterization. An interesting finding was the possibility of the uncharacterized sequence Q8BIS2 being an enzyme involved in the degradation of matrix proteins. Thus, the results provide a comprehensive view of the structure and function for putative uncharacterized proteins found in the enamel matrix that could help to elucidate the mechanisms involved in enamel biomineralization and genetic susceptibility to dental fluorosis.
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Madhushankari, G. S., and M. Selvamani. "Prevalence and distribution of dental anomalies and fluorosis in a small cohort of Indian school children and teenager." CODS Journal of Dentistry 6, no. 1 (2014): 9–12. http://dx.doi.org/10.5005/cods-6-1-9.
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Abstract Objective The purpose of this study was to determine the prevalence of developmental dental anomalies and fluorosis in small cohort of Indian school children & teenagers. Method A total of 473 school children and teenagers (250 female & 223 male) of 6 - 17 years were examined clinically for developmental anomalies of teeth such as peg lateral, supernumerary teeth (mesiodens), and talon's cusp. Children were also examined for dental fluorosis. Result On examination 1.47% of the sample population, had at least one developmental dental anomaly. Prevalence of Peg lateral, Mesiodens, and Talon's cusp was 0.63%, 0.63% and 0.21% respectively while 87.9% showed fluorosis induced enamel hypoplasia. Conclusions the most common dental anomalies was Peg lateral and Mesiodens. The present study also emphasizes the need for de-fluoridation of water in the region, because of high incidence of enamel hypoplasia induced by fluorosis in the study group. Other developmental dental anomalies also differed in prevalence from previous reports, pointing to a possible ethnic variation. How to cite this article Selvamani M, Praveen SB, Madhushankari GS. Prevalence and distribution of dental anomalies and fluorosis in a small cohort of Indian school children and teenagers CODS J Dent 2014;6;9-12
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Do Amaral, Juliana Cardoso Neves, Erika Calvano Küchler, Lívia Azeredo Alves Antunes, Leonardo Dos Santos Antunes, and Marcelo De Castro Costa. "AESTHETIC SOLUTION TO FLUOROSIS IN A CHILD." Revista de Odontologia da Universidade Cidade de São Paulo 26, no. 1 (November 28, 2017): 96. http://dx.doi.org/10.26843/ro_unicid.v26i1.290.
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Dental fluorosis is a defect of enamel formation caused by chronic ingestion of fluoride from different sources during tooth development, which results in interference in proper mineralization. Clinically the tooth enamel may present as white striae along the lines of enamel, opaque white spot and in more severe cases as brown spots. Diagnosis is based on clinical characteristics associated with a history of exposure to fluoride. The aim of this report is to present a treatment in a child with severe aesthetic compromising in anterior maxillary permanent teeth caused by fluorosis. The treatment was based on a combination of three techniques in order to be minimally invasive, enhance aesthetics and preserving the dental structure.
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Da Cunha, Leonardo Fernandes, Juliana Feltrin De Souza, Marina Samara Baechtold, Gisele Maria Correr, Bruna Luiza Nescimento, and Carla Castiglia Gonzaga. "Conservative treatment of enamel hypomineralization: microabrasion and bleaching for re-estabilishing esthetics." Revista Odonto Ciência 31, no. 1 (November 17, 2016): 36. http://dx.doi.org/10.15448/http://dx.doi.org/10.15448/1980-6523.2016.1.17269.
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Objective: Dental hypomineralization such as dental fluorosis has increased in recent times, which leads to unaesthetic appearance of teeth visible at close quarters. There are different treatment possibilities to improve the aesthetic appearance of hypomineralized enamel described in dental literature. The enamel microabrasion has been a feasible alternative, since it is a fast, safe, conservative, and easy to perform, which promotes good esthetic results. oreover, this technique is a conservative method that improves the appearance of the teeth without causing significant structural loss. The association of different techniques, such as dental bleaching, can provide good esthetic outcomes, but the etiology, intensity and depth of stain should be considered. Thus, the aim of this article is to describe an easy technique for managing mild to moderate dental fluorosis using microabrasion in association with dental bleaching.Case Report: First, application of the microabrasion material on the enamel surface was performed with 6% hydrochloric acid and silicon carbide and then with 37% phosphoric acid and pumice paste. Subsequently, dental bleaching employing 10% carbamide peroxide gel was indicated.Conclusion: This conservative approach may be considered an interesting alternative treatment to remove fluorosis staining and to improve aesthetic appearance.
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AlDaiji, Reem, Malak Alotaibi, Dania Alnowaiser, Rawan Albahely, Rama Bachat, Alaa Alshayea, and Fatima Alotaibi. "Awareness of dental fluorosis among undergraduate dental students in Riyadh region: a survey based study." International Journal of Research in Medical Sciences 6, no. 12 (November 26, 2018): 3852. http://dx.doi.org/10.18203/2320-6012.ijrms20184739.
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Background: Fluoride protects the teeth from dental caries using the needed amount of fluoride products.Methods: A Modified structured questionnaire has been validated through a pilot trial (20 responses) prior to administration that contains16 questions was distributed. Other than the demographics, the data were collected from 500 participants including undergraduate male and female dental students.Results: The majority described the mild fluorosis appearance in the teeth according to Dean’s index appropriately as white opacity of the enamel (64%, n=320). On the other hand, only 31.1% (n=155) and 46% (n=229) described the moderate and severe fluorosis appearance in the teeth according to Dean’s index appropriately.Conclusions: The dissemination and education about dental fluorosis is urgently needed and should be tailored to reach this population. The knowledge about causes of fluoride and the effect on dental fluorosis should be presented in the education.
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Yanagisawa, T., S. Takuma, and O. Fejerskov. "Ultrastructure and Composition of Enamel in Human Dental Fluorosis." Advances in Dental Research 3, no. 2 (September 1989): 203–10. http://dx.doi.org/10.1177/08959374890030022101.
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Materials used in this work were 13 permanent molars exhibiting dental fluorosis (between 5 and 9 on the Thylstrup-Fejerskov scale, 1978) obtained from adults (aged 20-40 years) living in regions with 3.5 ppm fluoride in the water supplies. Small but deep occlusal caries lesions necessitated extraction. Light and polarized microscopic, microradiographic, electron microscopic, and electron-probe- and ion-micro-analytical studies were made. Enamel surfaces were generally cloudy to opaque, with several pits or defects of various sizes and degrees of brown-staining. An extensively hypomineralized area extended from the inner enamel to the surface layer, which was mineralized to a high degree. The hypomineralized area contained sparsely arranged, flattened, hexagonal crystals with either perforated centers or defects extending from the perimeter and indicating either no or low fluoride content. The highly mineralized surface layer, however, was composed of many large, flattened, hexagonal crystals and extremely small, irregularly shaped crystals. Both types were free of central perforations and defects. A high fluoride concentration was determined in the highly mineralized surface layer. These findings suggest that the hypomineralized area undergoes caries-like changes in terms of crystal dissolution and that the highly mineralized surface layer contains hydroxyapatite and fluoridated-hydroxyapatite, or fluorapatite, or both.
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Wang, Qingqing, Qingfei Meng, and Jian Meng. "Minimally invasive esthetic management of dental fluorosis: a case report." Journal of International Medical Research 48, no. 10 (October 2020): 030006052096753. http://dx.doi.org/10.1177/0300060520967538.
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Dental fluorosis is a dental condition caused by excessive intake of fluoride during enamel formation, which can lead to color abnormalities or defects on the tooth surface. The resultant abnormal appearance ranges in severity from mildly white and opaque to dark brown, which substantially affects patients’ esthetic characteristics and self-confidence. Treatment methods include tooth whitening or restoration. This clinical report describes the use of a minimally invasive esthetic technique in a 22-year-old woman with moderate dental fluorosis. The treatment plan included enamel microabrasion, at-home bleaching for 2 weeks, and subsequent resin infiltration for each tooth under a rubber dam. After 2 years of follow-up, evaluation of the patient’s esthetic appearance revealed that teeth affected by dental fluorosis could be successfully treated with a minimally invasive technique involving microabrasion, at-home bleaching, and resin infiltration.
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Goel, Aditi, Ashtha Arya, Anshul Arora, Mandeep S. Grewal, and Simran Verma. "Microabrasion - A Conservative Approach for Mild to Moderate Fluorosis – A Case Report." Journal of Evolution of Medical and Dental Sciences 10, no. 30 (July 26, 2021): 2334–37. http://dx.doi.org/10.14260/jemds/2021/477.
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The undesirable discoloration or pitting of teeth due to fluorosis or developmental defects like amelogenesis imperfecta or enamel hypoplasia pose a challenge to the clinician to cater to the aesthetic requirements of patients. Fluorosis had been reported way back in 1901. There are treatment options depending upon individual cases as follows: microabrasion / macroabrasion, bleaching, composite restoration, veneers or full crowns. For the aesthetic enhancement of stains associated with mild to moderate fluorosis enamel microabrasion is the preferred treatment. This technique involves removal of entrapped stains by rubbing of slurry containing HCl acid and an abrasive agent on the stained enamel surface. But if the depth of the defect is more then microabrasion can be done in conjunction with bleaching or bonded restorations can be done to achieve optimal aesthetics. Casein phospopeptide - Amorphous calcium phosphate (CPP – ACP) can be topically applied after microabrasion which enhances remineralisation and prevents post-operative sensitivity. The present paper illustrates the management of mild to moderate dental fluorosis by microabrasion to remove stains on the enamel surface followed by remineralisation using CPP - ACP paste. An unaesthetic smile has psychological impact especially on young patients and lowers their confidence.1 Discoloration of the young permanent anterior teeth is mostly seen due to varying developmental defects. This could be due to extrinsic aetiology such as those caused by coffee, tea, red wine and tobacco or due to intrinsic aetiology. The intrinsic stains may be due to pre-eruptive or post-eruptive causes.2 Pre-eruptive causes of intrinsic stains include dentinogenesis imperfecta and fluorosis, whereas post-eruptive causes of intrinsic stains include tetracycline dentine staining or due to injuries.3 The excessive and chronic ingestion of fluoride during amelogenesis leads to fluorosis which can be skeletal or dental depending upon the intake.4,5 Dental fluorosis is characterized by white opaque flecks on teeth or yellow to brown discolorations with pitting on the enamel surface.6,7 The enamel microabrasion is an effective and non-invasive procedure for removing the stains limited to outer enamel layer.7,8 It uses a rubber cup along with abrasive materials and chemical solutions.9,10 Currently, many products are commercially available for enamel microabrasion such as Prema Compound (Premier Dental Products, Norristown, PA, USA) containing 15 % HCl and Opalustre (Ultradent, South Jordan, UT, USA) containing 6.6 % HCl and silicon carbide.7 (Table 1) Since these products are expensive, the prototype paste containing 18 % HCl and pumice, as described by Croll in 1986 is most commonly used in clinical practice.8
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Suvorova, Marina, Galina Emelina, Anna Teplova, and Anna Belousova. "THE PREVALENCE OF NON-CARIOUS TOOTH DEFECTS ASSOCIATED WITH INDUSTRIAL EXPOSURE IN RESIDENTS OF PENZA REGION (RUSSIA)." Archiv Euromedica 11, no. 2 (June 27, 2021): 101–3. http://dx.doi.org/10.35630/2199-885x/2021/11/2/26.
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— Aim of the study: to assess the level of dental pathology in Penza Region (Russia) and estimate the impact of the industrial environment. Materials and methods: A clinical examination and analysis of the frequency of enamel erosion, fluorosis and hypoplasia, wedge-shaped defect and multiple enamel cracks were carried out among the main professional groups of the region's population — workers of the machine-building and timber processing industries in the Penza region. Results and Discussion. Among the residents of Penza region, the frequency of enamel erosion was 4.0%, pathological tooth wear — 7.1%, wedge-shaped defect — 6.1%, multiple enamel fractures — 11.1%. There is a high frequency of noncarious tooth defects that occur before teething. In patients working in the machine-building industry, a high frequency of pathological tooth wear was noted (24,5%); in workers of the timber processing industry, it was 2 times lower (12,6%), as well as a high frequency of wedge- shaped defects, enamel erosion and multiple enamel cracks — all this was 2–2.5 times higher compared to similar indicators in patients from agricultural populations. However, the prevalence of dental fluorosis and hypoplasia was almost the same as in the agricultural population. Conclusion: Penza region has a high prevalence of dental fluorosis and hypoplasia. At the same time, the influence of industrial environment on the incidence of various types of non-carious dental pathology in workers of machine-building and timber processing industries in Penza region was established.
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Souza, Danielle Ferreira Sobral de, Josué Junior Araújo Pierote, Flávio Henrique Baggio Aguiar, Luís Alexandre Maffei Sartini Paulillo, and Débora Alves Nunes Leite Lima. "Resolution of a fluorosis case through the association of minimally invasive techniques." Brazilian Journal of Oral Sciences 18 (November 18, 2019): e191663. http://dx.doi.org/10.20396/bjos.v18i0.8657330.
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Color changes may interfere with smile balance and they represent a clinical challenge to dentists. Dental fluorosis originates from intrinsic factors and it is a disorder of enamel formation during the phase of teeth development, resulting in the change of enamel color. This clinical case report aimed to present the resolution of a case of dental fluorosis through the association of minimally invasive techniques, namely microabrasion and tooth bleaching. A 27-year-old male patient sought the dental clinic of the School of Dentistry of Piracicaba (FOP - UNICAMP, Brazil) presenting striped and symmetrical white stains and generalized chromogenic biofilm. After anamnesis and clinical examination, the patient was diagnosed with fluorosis stains. Initially, adequacy of the oral environment was performed with prophylaxis and supragingival scraping. Then, the enamel microabrasion technique was performed with 6% hydrochloric acid associated with silicon carbide (Whiteness RM - FGM) and supervised at-home bleaching was performed with 16% carbamide peroxide (Whiteness Simple 16% - FGM). In conclusion, the treatment performed reestablished the aesthetics and harmony of smile color with minimally invasive procedures without causing tooth sensitivity.
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Sundfeld, D., CC Pavani, NIP Pini, LS Machado, TC Schott, and RH Sundfeld. "Enamel Microabrasion and Dental Bleaching on Teeth Presenting Severe-pitted Enamel Fluorosis: A Case Report." Operative Dentistry 44, no. 6 (November 1, 2019): 566–73. http://dx.doi.org/10.2341/18-116-t.
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SUMMARY The present clinical case report describes the clinical steps of enamel microabrasion associated with dental bleaching to restore severely-pitted fluorosed teeth. The process of removing the fluorotic superficial stains started by using macroabrasion with a water-cooled fine tapered 3195 FF diamond bur. Rubber dam isolation of the operative field was used to remove the remaining enamel stains and superficial irregularities with the Opalustre microabrasive compound (6.6% hydrochloric acid associated with silicon carbide particles) followed by polishing using fluoridated paste and subsequent 2% neutral fluoride gel topical application. After one month, dental bleaching was performed using 10% carbamide peroxide in custom-formed acetate trays for two hours/day for 42 days. The association of enamel microabrasion with dental bleaching was effective for reestablishing the dental esthetics of a patient with severe dental fluorosis.
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de Lemos Costa, Karini. "MICROABRASÃO DO ESMALTE." Revista Científica Semana Acadêmica 9, no. 211 (September 20, 2021): 1–15. http://dx.doi.org/10.35265/2236-6717-211-9257.
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Enamel defects are described as changes in its structure characterized by local decrease or loss of its translucency from fluorosis, hypocalcifications, hypoplasias and inactive carious lesions with superficial and medium depth. The microabrasion of enamel selectively promotes the removal of its surface layer that presents color or structure modification through a mixture of abrasive and erosive agents mechanically. The association of these agents exposes a sub-layer of enamel with normal characteristics. This procedure can be used alone or associated with one or more aesthetic treatments, such as tooth whitening and composite resin restorations. Objective: to approach the microabrasion technique applied in dental enamel with changes in color and structure. Methodology: a non-systematic review of the scientific literature, published from 2009 to 2019, was carried out in the Virtual Health Library and in the academic Google. The inclusion criteria were articles in Portuguese and English, published in the last 10 years, that addressed the proposed theme. Conclusion: Dental microabrasion is a good alternative for aesthetic treatment for changes in the superficial structure of dental enamel, fluorosis and hypoplasia, because it wears little dental structure, restores aesthetics, does not cause damage to the pulp or periodontal tissues, requires little treatment time, does not require cavitary preparation, nor restorative material and is low cost. Aesthetic dissatisfaction is a concern of patients of all ages and the diagnosis of dental fluorosis should be the result of careful anamnesis and it should be taken into account that the etiology may be of various origins.
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Khairuddin, Muhammad Nur Izham, Pengiran Muhammad Badi’uzzaman Awang Iskanderdzulkarnein, and Mohd Haikal Mohd Halil. "Resin Infiltration Technique as Minimal Invasive Approach Towards Mild to Moderate Dental Fluorosis in an Adolescent: a Case Report." IIUM Journal of Orofacial and Health Sciences 2, no. 2 (July 31, 2021): 63–72. http://dx.doi.org/10.31436/ijohs.v2i2.98.
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Dental fluorosis can be defined as a developmental condition that affects dental hard tissue, mainly enamel characterised with white or yellowish lesions due to excessive fluoride exposure. Fluorosis can have a major impact on the appearance, structure and shape of the tooth which posed a significant aesthetic concern to individuals having this condition. There are several treatments recommended in treating dental fluorosis depending on the severity of the disease itself ranging from tooth bleaching to prosthetic crowns in severe cases. This case report describes the use of resin infiltration technique on a patient with mild to moderate severity of dental fluorosis of the upper anterior teeth which produce an acceptable improvement of the appearance of the affected tooth. Resin infiltration technique in this case provided a conservative and inexpensive approach in treating mild to moderate dental fluorosis for the patient, improving the aesthetic without significant loss of tooth structure.
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Catani, Danilo Bonadia, Livia Maria Andaló Tenuta, Fernanda Alcântara Andaló, and Jaime Aparecido Cury. "Fluorosis in rats exposed to oscillating chronic fluoride doses." Brazilian Dental Journal 21, no. 1 (January 2010): 32–37. http://dx.doi.org/10.1590/s0103-64402010000100005.
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Considering that blood fluoride concentration varies according to fluoride exposure and that dental fluorosis is related to the amount of enamel formed under a given fluoride dose, the present study investigated whether the fluorosis produced by an oscillating chronic fluoride dose would be similar to that caused by exposure to a constant dose, representing the mean of the oscillation during a given time. Rats received during 78 days water with fluoride concentrations of 0, 12.5, 25 or 37.5 µg F/mL, or oscillating concentrations of 12.5 and 37.5 µg F/mL every 72 h (mean exposure=25 µg F/mL). The concentrations of fluoride in the plasma, femur and incisors of the rats were determined at the end of the experimental period. Also, the enamel dental fluorosis index was determined in the incisors using a quantitative method developed by our research group named Dental Fluorosis by Image Analysis (DFIA). Fluoride concentrations in plasma, femur and teeth, and DFIA increased linearly for constant fluoride concentrations in water (p<0.0001, r values=0.87-0.98). The results of the oscillating group and the groups receiving 25 µg F/mL did not differ significantly (p>0.05). The findings of this study suggest that in animals chronically exposed to symmetrically oscillating fluoride doses, the resulting dental fluorosis reflects the metabolic effect of the mean of the oscillating doses.
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Ahmad, Fareed, Ali Anwaar, Bilal Abdul Qayum Mirza, Mustafa Qadeer, Muhammad Afzal, and Anwaar Alam. "Is Dental Fluorosis More Prone/Susceptible to Tooth Erosion?" Pakistan Journal of Medical and Health Sciences 15, no. 8 (August 26, 2021): 2067–69. http://dx.doi.org/10.53350/pjmhs211582067.
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Background: The fluoride drug is mentioned as a double-edged weapon due to its positive and negative outcomes. Reducing dental caries in large population, cost effective and excess fluoride in teeth or body may lead to systemic diseases and even death. Dental erosion affects the hard tissues of the teeth rendering them vulnerable to decay. Methods & Materials: A school based descriptive cross-sectional survey. Purposive sampling was performed. All examiners were calibrated and trained for the criteria to identify dental fluorosis and dental erosion. The World Health Organisation Oral Health Assessment form 2013 was used to fill and measure dental fluorosis and erosive tooth wear. For Univariate analysis, mean, frequencies of both genders (dental erosion and Fluorosis) while Chi square was calculated and for bivariate analysis. Results: 22.7 % students were found to have fluorosis (ranging from questionable level to severe). Male students (primarily teenagers) had more enamel erosion as compared to the female’s ones. Conclusion: The higher levels of fluoride in water may make children and adults more susceptible to erosive tooth wear. Consuming excess fluoridated water may turn the mild fluorosis cases into moderate or severe ones. Keywords: Fluorosis, Erosive Tooth Wear, Gender, Fluoride
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Lee, Jason D., Natalie Inoue, Christine Lee, Sohyun Park, and Sang J. Lee. "Comprehensive Management of Severe Dental Fluorosis with Adhesively Bonded All-Ceramic Restorations." Prosthesis 3, no. 3 (July 26, 2021): 194–208. http://dx.doi.org/10.3390/prosthesis3030020.
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Dental fluorosis is a common disorder caused by excessive fluoride intake during tooth development. The esthetic consequences of dental fluorosis can negatively affect oral health-related quality of life and have lasting psychosocial effects. In severe cases, where the fluorosed enamel is prone to chipping, flaking, and developing caries, minimally invasive procedures are ineffectual and a more substantial restorative approach is required to restore optimal function and esthetics. However, no definitive guidelines exist for the management and treatment of severe dental fluorosis due to the limited evidence available in the literature. This case report describes the full-mouth rehabilitation of a patient with severe dental fluorosis utilizing adhesively bonded all-ceramic crowns, veneers, and overlays. The successful follow-up on this case indicates that adhesively bonded restorations may provide a viable option in the functional and esthetic management of severely fluorosed dentition.
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Angmar-Månsson, B., E. De Josselin de Jong, F. Sundström, and J. J. Ten Bosch. "Strategies for Improving the Assessment of Dental Fluorosis: Focus on Optical Techniques." Advances in Dental Research 8, no. 1 (June 1994): 75–79. http://dx.doi.org/10.1177/08959374940080011301.
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In its milder forms, enamel fluorosis is characterized clinically by diffuse opacities. The appearance is due to optical properties of a subsurface or surface porous layer with lower mineral content. These areas usually have texture and color similar to those of initial caries lesions but generally another shape and location. Therefore, several optical methods, previously used to diagnose initial caries lesions, were applied to fluoride-induced opacities on extracted premolars and on incisors of four subjects in vivo. These methods included light-scattering measurements, white light illumination, violet light illumination, ultraviolet illumination, and laser fluorescence. Video images were captured with a charge-coupled-device (CCD) camera, digitized, and computer-processed. It is concluded that the light-scattering monitor can be used for the determination of the local porosity of fluorotic enamel and that the laser fluorescence method might be developed into a method applicable for the assessment of the severity of enamel fluorosis.
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Vieira, A. P. G. F., R. Hancock, H. Limeback, R. Maia, and M. D. Grynpas. "Is Fluoride Concentration in Dentin and Enamel a Good Indicator of Dental Fluorosis?" Journal of Dental Research 83, no. 1 (January 2004): 76–80. http://dx.doi.org/10.1177/154405910408300115.
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Despite some studies correlating dental fluorosis (DF) and fluoride (F) concentration in dental enamel, no information is available about DF and dentin F concentration. Our objective was to determine the correlation between teeth F concentration and DF severity in unerupted human 3rd molars, and the correlation between dentin and enamel F concentrations in the same tooth. Ninety-nine 3rd molars were studied—53 from Fortaleza, Brazil (F water, 0.7 ppm), 22 from Toronto (1.0 ppm), and 24 from Montreal (0.2 ppm). DF severity was evaluated according to the Thylstrup-Fejerskov Index, while F concentration was analyzed by Instrumental Neutron Activation Analysis. DF severity varied between TF0 and TF4, while F concentration ranged between 39 and 550 ppm in enamel and 101 and 860 ppm in dentin. Our results showed correlation between dentin F concentration and DF (rS = 0.316, p = 0.001), but no correlation between enamel F concentration and DF (rS = 0.154, p = 0.133). No correlation was observed between dentin and enamel F concentrations in the same tooth (rS = 0.064, p = 0.536).
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James, Patrice, Mairead Harding, Tara Beecher, Carmel Parnell, Deirdre Browne, Marie Tuohy, Dympna Kavanagh, et al. "Fluoride And Caring for Children’s Teeth (FACCT): Clinical Fieldwork Protocol." HRB Open Research 1 (February 28, 2018): 4. http://dx.doi.org/10.12688/hrbopenres.12799.1.
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Background: The reduction in dental caries seen between Irish national surveys of children’s oral health in 1984 and 2002 was accompanied by an increase in the prevalence of enamel fluorosis. To minimise the risk of enamel fluorosis in Irish children, in 2007, the level of fluoride in drinking water was reduced from 0.8-1.0 ppm to 0.6-0.8 ppm fluoride. Recommendations on the use of fluoride toothpastes in young children were issued in 2002. Fluoride and Caring for Children’s Teeth (FACCT) is a collaborative project between the Oral Health Services Research Centre, University College Cork and the Health Service Executive dental service, with funding from the Health Research Board. Aim: FACCT aims to evaluate the impact and the outcome of the change in community water fluoridation (CWF) policy (2007) on dental caries and enamel fluorosis in Irish schoolchildren, while also considering the change in policy on the use of fluoride toothpastes (2002). Methods/Design: A cross-sectional study with nested longitudinal study will be conducted in school year (SY) 2013-2014 by trained and calibrated dental examiners in primary schools in counties Dublin, Cork and Kerry for a representative sample of children born either prior to or post policy changes; age 12 (born 2001) and age 5, (born 2008). Five-year-olds will be followed-up when they are 8-year-olds (SY 2016-2017). The main explanatory variable will be fluoridation status of the children (lifetime exposure to CWF yes/no). Information about other explanatory variables will be collected via parent (of 5-, 8- and 12-year-olds) and child completed (8- and 12-year-olds only) questionnaires. The main outcomes will be dental caries (dmf/DMF Index), enamel fluorosis (Dean’s Index) and oral health-related quality of life (OHRQoL). Multivariate regression analyses will be used to determine the impact and outcome of the change in CWF policy on oral health outcomes controlling for other explanatory variables.
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Li, Qianrui, Jiaqi Shen, Tao Qin, Ge Zhou, Yifeng Li, Zhu Chen, and Mingyun Li. "A Qualitative and Comprehensive Analysis of Caries Susceptibility for Dental Fluorosis Patients." Antibiotics 10, no. 9 (August 27, 2021): 1047. http://dx.doi.org/10.3390/antibiotics10091047.
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Dental fluorosis (DF) is an endemic disease caused by excessive fluoride exposure during childhood. Previous studies mainly focused on the acid resistance of fluorotic enamel and failed to reach a consensus on the topic of the caries susceptibility of DF patients. In this review, we discuss the role of DF classification in assessing this susceptibility and follow the “four factors theory” in weighing the pros and cons of DF classification in terms of host factor (dental enamel and saliva), food factor, bacteria factor, and DF treatment factor. From our analysis, we find that susceptibility is possibly determined by various factors such as the extent of structural and chemical changes in fluorotic enamel, eating habits, fluoride levels in diets and in the oral cavity, changes in quantity and quality of saliva, and/or oral hygiene. Thus, a universal conclusion regarding caries susceptibility might not exist, instead depending on each individual’s situation.
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Clarkson, J. "Review of Terminology, Classifications, and Indices of Developmental Defects of Enamel." Advances in Dental Research 3, no. 2 (September 1989): 104–9. http://dx.doi.org/10.1177/08959374890030020601.
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A wide variety of terms and definitions are used to describe various developmental defects of enamel. Some are simple descriptive clinical terms, and others are linked with the causative agent or the histopathology of the defect. Some confusion exists as to the most appropriate type of index to use to measure defects of enamel due to fluoride ingestion (dental fluorosis). This is primarily due to difficulties some researchers have in distinguishing between defects of fluoride and non-fluoride origin. This problem has resulted in the development of specific fluorosis indices and purely descriptive indices. The main fluorosis indices are those of Dean, Thylstrup and Fejerskov, and the TSIF Index. Dean's Index does not provide adequate information on the distribution of fluorosis within the dentition and is not sensitive at high fluorosis levels. The Thylstrup and Fejerskov Index is related to the histology of fluorosis; however, the initial minute changes observed on dry enamel surfaces are of little esthetic importance. The TSIF Index does overcome some of the limitations of Dean's Index. The DDE Index has replaced the Al-Alousi Index as the main descriptive index. The DDE Index is time-consuming, and the analyses of data are complicated. Modifications have now been proposed to make it simpler to use and the data more meaningful. Further research needs to be carried out into both the validity of the fluorosis indices and making the DDE Index more universally acceptable.
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Onoriobe, U., R. G. Rozier, J. Cantrell, and R. S. King. "Effects of Enamel Fluorosis and Dental Caries on Quality of Life." Journal of Dental Research 93, no. 10 (August 25, 2014): 972–79. http://dx.doi.org/10.1177/0022034514548705.
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Küchler, Erika Calvano, Carolina Dea Bruzamolin, Marjorie Ayumi Omori, Marcelo C. Costa, Leonardo Santos Antunes, Giovana Daniela Pecharki, Paula Cristina Trevilatto, Alexandre Rezende Vieira, and João Armando Brancher. "Polymorphisms in Nonamelogenin Enamel Matrix Genes Are Associated with Dental Fluorosis." Caries Research 52, no. 1-2 (December 6, 2017): 1–6. http://dx.doi.org/10.1159/000479826.
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The aim of this study was to evaluate whether genetic polymorphisms in AMELX, AMBN, ENAM, TFIP11, and TUFT1 genes are associated with dental fluorosis (DF). A total of 1,017 children from 2 Brazilian cohorts were evaluated. These populations lived in cities with fluoridation of public water supplies. DF was assessed in erupted permanent teeth using the modified Dean index. The polymorphisms rs946252, rs12640848, rs4694075, rs5997096, and rs4970957 were analyzed by real-time PCR from genomic DNA. Associations between DF, genotype, and allele distribution were evaluated using the χ2 test, with an alpha of 5%. The polymorphisms rs4694075, rs5997096, and rs4970957 in AMBN, TFIP11, and TUFT1 were associated with DF (p < 0.05). In conclusion, enamel matrix genes are associated with DF.
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Iida, Hiroko, and Jayanth V. Kumar. "The Association Between Enamel Fluorosis and Dental Caries in U.S. Schoolchildren." Journal of the American Dental Association 140, no. 7 (July 2009): 855–62. http://dx.doi.org/10.14219/jada.archive.2009.0279.
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LIMA, Laynna Marina Santos, Neusa Barros DANTAS-NETA, Werttey da Silva MOURA, Marcoeli Silva de MOURA, Andrea MANTESSO, Lúcia de Fátima Almeida de Deus MOURA, and Marina Deus Moura LIMA. "Impact of dental fluorosis on the quality of life of children and adolescents." Revista de Odontologia da UNESP 43, no. 5 (October 2014): 326–32. http://dx.doi.org/10.1590/rou.2014.052.
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INTRODUCTION: Dental fluorosis is a disturbance of high prevalence caused by the ingestion of fluoride ions present mainly in toothpaste. Preventive measures to avoid it are still controversial. Thus, knowing the impact that fluorosis can cause on the population's quality of life it is important for planning public health policies.OBJECTIVE: To evaluate the impact of dental fluorosis on the quality of life of children and adolescents.MATERIAL AND METHOD: We studied 300 subjects aged 8 to 12 years divided into 4 groups: children (8-10 years) and adolescents (10 to 12 years) with and without fluorosis. The diagnosis of fluorosis was performed according to the index Thylstrup and Fejerskov and quality of life was evaluated using Child Perceptions Questionnaire 8-10 and 11-14. The socio-demographic characteristics of the patients were also evaluated. For inclusion in the sample, selected patients should present eight permanent incisors with crowns fully erupted. Patients who had extensive restorations, fractured teeth, other dental enamel defects and who wore braces were excluded.RESULT: Fluorosis was present in 64.7% of the patients analyzed and in most cases (80.3%) was mild or very mild. In children, the average overall score of the questionnaire was 15.9 for the group without fluorosis and 18.3 for the group with fluorosis (p = 0.255). The teenagers' score in the group without fluorosis was 26.1, while the group with fluorosis was 22.7 (p = 0.104).CONCLUSION: Dental fluorosis caused impact on the quality of life of the population analyzed only in the functional domain.
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Flores, Aurora Cárdenas, Héctor Flores Reyes, Antonio Gordillo Moscoso, Juan Pablo Castanedo Cázares, and Amaury de Pozos Guillén. "Clinical Efficacy of 5% Sodium Hypochlorite for Removal of Stains Caused by Dental Fluorosis." Journal of Clinical Pediatric Dentistry 33, no. 3 (April 1, 2009): 187–92. http://dx.doi.org/10.17796/jcpd.33.3.c6282t1054584157.
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The objective of this study was to evaluate the clinical efficacy of 5% sodium hypochlorite solution for removal of stains caused by dental fluorosis in young patients. A clinical trial involved 33 patients with diffuse opacities on the enamel surfaces of maxillary incisors due to effects of dental fluorosis. The protocol of treatment 3 steps:(1) cleaning and enamel etching with 37% phosphoric acid in order to eliminate the layer that covers the fluorotic enamel surface and allow better penetration of the bleaching agent,(2) application of 5% sodium hypochlorite to remove stains caused by organic material, and (3) filling the opened microcavities with a light-cured, composite surface sealant to prevent restaining. The whiteness of the enamel lesions before and after treatment were expressed in L*, a*, and b* color space measurements using a Minolta Chroma Meter CR300. Analysis of parameters of ¢E (L*, a*, b*) showed that changes were observed in the L* (brightness) and a* (redness), which paralleled the ¢E differences. There was no significant difference in the b* (yellow) parameter. The technique described in this study appears to have advantages over other methods for improving the appearance of fluorotic lesions. It is simple, low cost, non invasive so the enamel keeps its structure, relatively rapid, and safe; it requires no special materials, and it can be used with safety on young permanent teeth.