Treatment of fluorosed and white-spot human enamel with calcium sucrose phosphate in vitro.

A number of treatments have been devised to improve the appearance of fluorosed enamel. However, many of these have been empirically based, and the success of the various treatment regimens have not been quantitated. In this study, the relative whiteness of normal, mildly fluorosed, moderately fluorosed, and carious white-spot lesions on extracted teeth was quantitated by light reflectance using a Minolta Chroma Meter. The color was again determined following a number of treatment regimens to assess the potential use of various agents in treating the enamel lesions. Treatment of the enamel with a 35% hydrogen peroxide gel resulted in a significantly increased whitening, which was not reduced by subsequent treatment (P < 0.05). Removal of the enamel surface with a dental bur, followed by treatment with 5.25% sodium hypochlorite and placement in an artificial saliva was successful for returning white-spot lesions to a normal enamel color. Treatment of enamel with 5.25% sodium hypochlorite followed by calcium sucrose phosphate paste and placement in artificial saliva was most successful in returning both white-spot and fluorosed lesions to a normal color. SEM imaging of the calcium sucrose phosphate treated enamel suggests that this treatment filled the porous enamel, resulting in a normal light reflectance from the enamel.

Characterization of fluorosed human enamel by color reflectance, ultrastructure, and elemental composition.

Mature fluorosed human enamel has been described as a subsurface enamel hypomineralization, with porosity increasing relative to the degree of fluorosis. The purpose of the current study was to quantitatively measure the color of the fluorosed enamel by light reflectance, and to further characterize the enamel by scanning electron microscopy. Teeth with varying degrees of fluorosis were obtained and divided in groups of mild, moderate and severe fluorosis using Dean's index for fluorosis. The color of the labial enamel surface was measured using a Minolta Chroma Meter CR241 (Minolta, Ramsey, N.J., USA). The teeth were further characterized for elemental composition using an energy-dispersive spectrometer, and imaged in both secondary and backscattered electron modes. The results of this study showed that the moderately and severely fluorosed enamel contained an uneven distribution of areas which were more electron-absorbent with a relatively increased carbon content. The changes in the physical characteristics of the teeth could be quantitated by measurements of light reflectance. The color of the teeth was significantly different between groups, with all groups significantly different than normal.