Minimally Invasive Technique to Mask White Spot Lesion with Resin Infiltration (Icon®, DMG): Case Report

Case Report

J Dent & Oral Disord. 2016; 2(8): 1043.

Minimally Invasive Technique to Mask White Spot Lesion with Resin Infiltration (Icon®, DMG): Case Report

Fonseca NMAH¹, Públio JC¹, Hernandes DKL¹, Barros TEP¹, Borelli Neto L¹ and Alves N2,3*

¹Guarulhos Faculty of Sciences, Guarulhos, Brazil

²CIMA Research Group, Temuco, Chile

³Department of Dentistry, Universidad de La Frontera, Chile

*Corresponding author: Nilton Alves, Department of Dentistry, Universidad de La Frontera, Temuco, Chile

Received: October 11, 2016; Accepted: November 14, 2016; Published: November 15, 2016


The case report describes a minimally invasive technique to mask white spots lesion with resin infiltration Icon, DMG. The etching procedure on the white spot lesion exposes the microporosities, permitting the penetration of lowviscosity light-curing resins by capillary force. When the lesions are infiltrated, the microporosities are occluded and the whitish appearance disappears. The use of this technique is an alternative to restorative treatment and the micro abrasion.

Keywords: White spot lesions; Caries infiltration; Aesthetics


White Spot Lesions (WSP) are detected frequently and can be problematic for the patients with important esthetic concerns [1]. WSP are the earliest clinically evident manifestation of the caries process, exhibiting subsurface porosity caused by an imbalance between the biological dynamic processes of demineralisation and remineralisation [2,3].

These lesions develop as a result of prolonged plaque due to inadequate oral hygiene. The insertion of fixed orthodontic appliances creates stagnation areas for plaque and makes tooth cleaning more difficult; therefore, for success the patient must be more careful with oral hygiene and use preventive strategies involving oral health promotion.

White spot prevalence of 50% [4], 60% [5] or even 97% [6] after bonded or banded orthodontic treatments has been reported and can appear on any tooth surface, however, most frequently occurs on the vestibular surfaces of anterior teeth causing esthetic problems [7-9].

Several techniques have been proposed to mask the appearance of white spot lesions and some authors demonstrated that infiltration treatment was capable to cosmetically camouflage enamel caries lesions [10,11].Treatment for white spot lesions comprises restorative procedures, improvement of remineralization using a complex of casein phosphopeptides and amorphous calcium phosphate (CCPACP) or flouride-containing products, microabrasion, argon-laser irradiation [12].

The aim of this study was to report a case of treatment using the technique to mask white spots lesion with resin infiltration Icon® (DMG), after orthodontic treatment.

Case Presentation

An 18-year-old female patient came to Guarulhos Faculty of Sciences- Brazil, to correct the white lesions on her upper and lower teeth. Patient’s history included orthodontic treatment for 2 years, but the orthodontic professional decided to stop orthodontic treatment due to that the patient presents inadequate oral hygiene. The oral examination, that was performed after dental prophylaxis, revealed cavities on the cervical third of 31 and 32 and carious white spot lesion on the upper and lower anterior teeth (Figure 1a). Following the manufacturer’s instructions, Icon® (DMG, Hamburg, Germany) was applied. Initially, a rubber dam was applied to protect soft tissue (Figure 1b), followed by an application of Icon Etch (15% hydrochloric acid gel) for 2 min on the white spot lesion (Figure 1c). The etching gel was washed for 30s using a water spray. The lesion is dried by applying ethanol (Icon-Dry) for 30s followed by air drying (Figure 1d). Infiltrant was applied for 3 min (Figure 1e). The Icon® (DMG, Hamburg, Germany) application was repeated for 1 minute to minimize enamel porosity. Both applications were light cured for 40s (Figure 1f). Figure 1g shows the results obtained immediately after the Icon application. The procedure was repeated in the other incisor. Figures 1h and 1i show the aspect before Icon application and the immediate post-operative, respectively. We observed that, despite the appearance of the enamel was not 100% reestablished, aesthetic appearance improved significantly.

Citation:Fonseca NMAH, Públio JC, Hernandes DKL, Barros TEP, Borelli Neto L and Alves N. Minimally Invasive Technique to Mask White Spot Lesion with Resin Infiltration (Icon®, DMG): Case Report. J Dent & Oral Disord. 2016; 2(8): 1043. ISSN:2572-7710