*CorrespondingAuthorAddress:Dr.DerekMahony,49BotanyStreet,RandwickNSW2031,Sydney,AustraliaEmail: mpinot@fullfaceorthodontics.com.au International Journal of Dental and Health Sciences Volume 01,Issue 03

Short Communication TREATMENTOFWHITESPOTLESIONS AFTERREMOVALOFFIXEDORTHODONTIC APPLIANCES DEREK MAHONY ORTHODONTIST,BDS(Syd) MScOrth(Lon) DOrth RCS(Edin) MDOrth RCSP(Glas) MOrth RCS(Eng) MOrth RCS(Edin)/FCDS(HK) FRCD(Can) IBO FICD FICCDE. Demineralisedwhitespotlesionsoccur frequently,afterorthodontictreatment.Someteetharemoreproneto demineralization(typicallythemaxillary lateralincisorsandthemandibularcanine teeth).Thedisto-gingivalareaofthe labial enamel surface is the area most commonly affected.(Fig. 1)In the first few weeks after removal of the fixedappliances,thereisareductionin whitespotlesionsize,andappearance, possiblyduetotheactionofsaliva.(Fig. 2)

Figure1WhiteSpots-typical:C-shaped or irregular. Figure 2 Smooth surface caries lesion. Varioustreatmentshavebeenproposedto assistremineralization.Itisimportantto notethatfluorideshouldnotbeused,in highconcentration,asittendstoprevent remineralizationandcanleadtofurther unsightlystaining.Lowconcentrationsof fluoridemayassistremineralisation,such asthoseamountsfoundincaseincalcium phosphatematerials.Stimulationof salivary flow, by chewing sugar- free gum, isalsohelpful. Mahony D., Int J Dent Health Sci 2014; 1(3): 367-369 368 Figure 3 Clinical image of an incipient caries lesion. Thisarticlewilldescribearevolutionary new approach to the cosmetic treatment of whitespotlesions(Fig.3).Iconresin representsarapidapproachtothe treatmentofthesecariouslesions.The breakthrough,microinvasivetechnology, fillsandreinforcesdemineralisedenamel, without drilling or anesthesia. (Fig. 4 & 5) Figure4Clinicalimageofanincipient caries lesion. Figure5Poresystemofanincipientcaries lesion. Thereasonpreviousapproacheshave fallenshort,isbecausefluoridetherapyis not always effective in the advanced stages of decay, and the use of restorative fillings almostalwayssacrificessignificant amounts of healthy tooth structure. Insteadofadoptingawaitandsee approach,Iconresincanarrestthe progress of early enamel lesions, up to the firstthirdofdentine(Fig.6).Thisisdone inonesimpleprocedure,withoutthe unnecessary loss of healthy tooth structure. Figure 6 The first treatment to bridge the gap between prevention and restoration. Mahony D., Int J Dent Health Sci 2014; 1(3): 367-369 369 Theprocedure,whenusingIcon,isas follows:the surface area of the white spot lesion is eroded with a 15% HCl gel.This openstheporesystemofthelesion.The poresystemisthendriedwithethanol.Iconresinisthenappliedtothelesion, withtheapplicationaid.Theextremely highpenetrationcoefficientoftheIcon resinenablesittopenetrateintothepores ofthecariouslesion.Excessmaterialis thenremoved,andthematerialislight cured.The total treatment time is about 15 minutes. (Fig.7) Figure 7 Smooth surface procedure. Thecosmetictreatmentofcariogenic whitespots,inonepatientvisit,isvery appealingtopatients,andtheirparents (Fig.8a,b).Thereisnodrillingor anesthesiaisrequired,sothereisgreater patient comfort.Furthermore, patients that havealreadydemonstratedpoor compliancewiththeirbrushing,canbe treatedearlier.Thisisnotjustminimally invasiveDentistry;itismicro-invasive Dentistry. Figure 8a Lesions before Icon treatment. Figure 8b After icon treatment. Iwouldrecommendthatallclinicianstry theIconproductwhenattemptingto remineralizewhitespotlesions,post orthodontic treatment.