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Advisory Committee Chair

Chung How Kau

Advisory Committee Members

Andre Ferreira

Amjad Javed

Christos Vlachos

Document Type

Thesis

Date of Award

2012

Degree Name by School

Master of Science in Dentistry (MScD) School of Dentistry

Abstract

Introduction: Despite an increased awareness by clinicians and their attempt to aid patients in the prevention of white spot lesions, enamel demineralization continues to be a problem associated with orthodontic treatment. Current treatment options for these unaesthetic scars on the teeth range from conservative options for remineralization such as the use of fluoride and CPP-ACP to more aggressive treatment involving loss of tooth structure with microabrasion or restorations. An innovative option for treatment has recently been introduced in the form of the infiltrant resin, Icon. Icon infiltration is a minimally invasive procedure performed by a dentist that is claimed to penetrate and fill the porosities of lesions with a light-cured resin material. This treatment has the potential to mask white spot lesions by occluding porosities and restoring natural optical properties of the enamel. The aim of this study was to evaluate the immediate and short term effect of Icon in masking post-orthodontic white spot lesions. Material and Methods: Eleven patients with post-orthodontic white spot lesions were recruited for this randomized controlled clinical trial utilizing a split-mouth design. Premolar and anterior teeth on the treatment side of the mouth were treated with Icon according to the manufacturer's instructions. Teeth on the opposite side of the mouth were used as controls. Intraoral photographs were taken of control and treated teeth before treatment (T1), after treatment (T2), and four to six weeks after treatment (T3). A modified Enamel Decalcification Index was used to score lesions at all timepoints. Results: From T1 to T2, 36.46% of treated lesions decreased by one or more lesion grade compared to only 7.29% of the non-treated lesions (p<0.0001). Over the course of the study period (i.e. T1-T3), 45.57% of treated lesions decreased in grade compared to 6.25% of non-treated lesions. Furthermore, Icon treatment resulted in a total masking effect of 24% of lesions. This difference was statistically significant (p<0.0001). Conclusions: Icon treatment decreased the size of many post-orthodontic white spot lesions compared to untreated controls. Icon infiltration provides a unique treatment option for patients that allows them to achieve immediate masking of lesions with no long-term compliance necessary.

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