Investigation of the esthetic outcomes of white spot lesion treatments

Objective: The present study compared the ability of bleaching, resin infiltration and microabrasion to restore the appearance of existing white spot lesions (WSL) on tooth surfaces as close as possible to that of the original healthy enamel. Materials and Methods: Sixty extracted human teeth with WSL were randomly assigned to three treatment groups (20/group). Prior to treatment, the colour of the surrounding healthy enamel and the WSL were measured as the baseline and pre-treatment (PreRX) colours respectively using spectrophotometer based on CIE L*A*B. The L-value was used for the statistical comparison. WSLs in each group were treated respectively by bleaching, infiltration or microabrasion following the manufacturer's instructions. Colour measurement was repeated after treatment. Both intragroup and intergroup comparisons were performed using ANOVA followed by Tukey's multiple comparison test (α=0.05). Result: In all groups the mean L-values were significantly higher in PreRX WSL (P < 0.01; Tukey) compared to baseline (sound enamel). After treatment the difference in mean L-value between baseline and WSL increased significantly (P < 0.01, Tukey) in Bleaching and Microabrasion groups by 1.4% and 1% respectively, but decreased in Infiltration group by 3.4%. Thus resin infiltration decreased the L-value of the WSL, bringing it closer to the L-value of the sound enamel while bleaching and microabrasion increased the L-value. Conclusions: Among the three treatment modalities investigated in this study, resin infiltration was the most effective in masking the WSLs.