A total of 118 maxillary and mandibular fluorosed incisors and canines in 10 patients, scored from 1 to 7 according to the Tooth Surface Index of Fluorosis, were included in this study. All of the teeth were initially treated with
enamel microabrasion (
Opalustre, Ultradent Products Inc, South Jordan, UT, USA), and after 24 hours, an in-office bleaching technique (Opalescence Boost, Ultradent) was utilized (n=118). Standardized images of the teeth were taken using a digital camera prior to treatment and 24 hours after the
enamel microabrasion and after the in-office bleaching
therapy. The study groups were assigned according to evaluation time: a) after
enamel microabrasion (Group 1) and b) after the combined approach (
enamel microabrasion and in-office bleaching) (Group 2). Two calibrated and blinded examiners scored Group 1 and Group 2 images by comparing each with baseline images for "improvement in appearance," "changes in brown stains," and "changes in white opaque areas" using the visual analogue scales (VAS) that range from 1 to 7. "Patient satisfaction," "
tooth sensitivity," and "gingival problems" were also recorded. The data were analyzed using two sample paired Wilcoxon signed-rank, Kruskal-Wallis, and Mann-Whitney U-tests (α=0.05).
RESULTS: The combined
therapy revealed significantly higher scores than the
enamel microabrasion procedure in terms of all of the evaluated criteria (p<0.001).
Enamel microabrasion provoked less
tooth sensitivity but led to lower patient satisfaction scores than the combined
therapy (p<0.001); however, in terms of gingival problems, no differences were found between both groups.
CONCLUSION: