الفهرس 
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Abstract
Summary
This study was carried out to evaluate the effect of combining minimal
invasive modalities in esthetic improvement of mild dental fluorosis and the color
stability using two different evaluation methods.
Materials and methods:
Materials used in this study were Icon®
(Resin infiltration), Pola Office
plus®
(power bleaching agent of 37.5% hydrogen peroxide), Opalustre™
(microabrasion paste of 6.6% hydrochloric acid and Silicon Carbide).
A total of fourty eight mild fluorosed teeth were included in the study.
Before the interventions, oral prophylaxis was performed for each patient. Tooth
color parameters were then recorded clinically by spectrophotometer based on CIE
Lab color system and pre-operative photographs were taken as baseline records.
The participants were then randomly allocated in four treatment modalities. Each
modality included twelve teeth (n=12). In modality one (M1) teeth were treated
with power bleaching (Pola Office plus®
). In modality two (M2) teeth were treated
with enamel microabrasion (Opalustre®
) followed by power bleaching. In modality
three (M3) teeth were treated with power bleaching followed by resin infiltration
(Icon®
). In Modality four (M4) teeth were treated with microabrasion followed by
power bleaching and resin infiltration. Post-operative photographs were taken.
each treatment modality was performed in a single visit.
All teeth were clinically evaluated at baseline (T0), immediately after
application (T1), after 3 months (T2), after 6 months (T3), and after 9 months (T4).
Color change was calculated from the formula of ΔE = [(ΔL)
2
+ (Δa)
2
+ (Δb)
2
]
1/2
,
where ∆L, ∆a and ∆b were the difference between mean values of readings at
different evaluating times from the baseline readings. Images of each follow-up
time point were compared to baseline by two blinded evaluators and were scored
for ”improvement in appearance” and ”change in white opaque areas” using VAS.
“patient satisfaction”, “tooth sensitivity” and “requirement for further treatments”
in VAS were rated by participants.
Data were collected, checked, revised and organized in tables and figures
using Microsoft Excel 2016. Data were checked for normality using Shapiro-wilk
Summary
90
normality test. ∆L, ∆a, ∆b, and ∆E were normally distributed (p>0.05) i.e.
parametric data, two-way ANOVA was applied to test the interaction between
different variables. ANOVA repeated measures were followed by Duncan multiple
range tests (DMRTs) to compare between groups. While, improvement in
appearance, change in opacity, tooth sensitivity, patient satisfaction and
requirement for further treatment were not normally distributed (p<0.05) i.e.
nonparametric data, accordingly, Freidman’s test to differentiate between
timepoints and Kruskal-Wallis to compare between treatment modalities were
applied at 0.05 level.
Results:
Regarding color change (∆E) evaluation, a significant difference was
observed in all treatment modalities at all evaluation times from baseline.
According to treatment modality, the highest ∆E mean values were recorded in
resin infiltration treatment modalities (M3 and M4). The lowest ∆E mean values
were recorded in power bleaching alone (M1). According to evaluation time the
highest ∆E mean value was recorded at T1. The lowest ∆E mean value was
recorded at T4 in M1 and M2 while in M3 and M4 the lowest ∆E mean value was
recorded at T2.
Regarding patient satisfaction evaluation, a significant difference was
observed in all treatment modalities at all evaluation times from baseline.
According to treatment modality, the highest patient satisfaction was recorded in
M3 and M4. The lowest patient satisfaction was recorded in M1. According to
evaluation time, the highest patient satisfaction was recorded at T1 and the lowest
patient satisfaction was recorded at T4..