Management of orthodontically induced white spot lesions: A survey of the orthodontic practitioners of Pakistan.

Objective: To assess the level of awareness among orthodontic practitioners about the diagnosis and management of orthodontically induced white spot lesions. METHODS: The cross-sectional study was conducted from August 28, 2022, to March 3, 2023, at Bakhtawar Amin Medical and Dental College, Multan, and comprised orthodontic specialists and postgraduate residents. Data was collected using a 14-item questionnaire regarding diagnosis and management of orthodontically induced white spot lesions. The questionnaire was disseminated online, and the responses were compared between the groups. Data was analysed using SPSS 24. RESULTS: Of the 278 subjects, 205(73.7%) were residents; 156(75%) females and 49(24%) males with mean professional experience of 4.24±4.08 years. There were 73(26.3%) specialists; 44(60.3%) females and 29(39.7%) males with mean professional experience 9.07±4.85 years. There were 48(66%) specialists and 131(64%) residents who thought the most commonly affected teeth with WSL were maxillary central incisors, while 30(41%) specialists and 38(33%) residents said the least commonly affected tooth was maxillary canine. Among the specialists, 29(38%) considered halting treatment and regular follow-up as the best approach for managing white spot lesions detected during orthodontic treatment, while 76(37%) residents preferred to use fluorides and casein phosphopeptide-amorphous calcium phosphate. There were significant differences between the specialists and residents for the items related to the incidence of white spot lesions, timing for additional precautions and measures for detection, management during active treatment and modalities of prevention (p<0.05). Conclusion: Despite being fairly common in orthodontic patients, the awareness regarding white spot lesions and related management protocols was found to be dubious in orthodontic practitioners, depicting lack of a standardised protocol.

Remineralizing effect of the association of nano-hydroxyapatite and fluoride in the treatment of initial lesions of the enamel: A systematic review.

OBJECTIVE: Assessed the effect of dental products containing nano-hydroxyapatite (nano-HA) + fluoride on the remineralization of white spot lesions (WSL) in vivo or in situ. METHODS: Seven databases were explored using a two-pronged approach (intervention/treatment). After screening, full-text assessment, and further exclusion, the qualitative synthesis of five studies (four clinical and one in situ) was performed. Based on the Cochrane collaboration guidelines relevant data of the studies were collected and summarized. The Cochrane risk of bias tool for randomized trials (RoB 2.0) was used to appraise the studies' methodological quality and the GRADE guidelines to assess their level of evidence. The RoB 2.0 domains were rated on their risk of bias (RoB) as low, high, or with some concerns, and an adaptation of the tool was used to the in situ study. RESULTS: The included studies assessed 151 WSL in anterior permanent teeth, on patients with varying ages. The protocol application, treatment length (7d-12 w), and control groups varied greatly between the studies making the performance of a quantitative analysis unfeasible. The general RoB of the clinical studies was classified as being of low risk (n = 2) or some concerns (n = 2). The in situ study was considered as being of low risk. The level of the evidence was moderate. Most of the studies found moderate evidence regarding the superiority of this association in clinical settings. CONCLUSION: Even with the nano-HA + fluoride promising results for the remineralization treatment of WSL, due to the restricted number of studies and types of products, its extended use cannot be recommended based on the current systematic review, especially when considering the moderate level of the evidence found. CLINICAL SIGNIFICANCE: Due to the biocompatibility and higher surface coverage of nano-HA and the remineralization capacity of fluoride formulations, the association of these elements to remineralize WSL has been positively reported. After the collection and qualitative appraise of the data, the clinical evidence of the use of these dental products is promising but limited.

An in vitro evaluation of the effects of fluoride, CPP-ACP, or resin infiltration on discoloration caused by pediatric supplements.

OBJECTIVES: White spot lesions are more susceptible to staining agents due to their porous structure. This study examines the impact of white spot lesion treatments on discoloration caused by pediatric supplements. METHOD AND MATERIALS: Three treatments (fluoride, casein phosphopeptide-amorphous calcium phosphate [CPP-ACP], resin infiltration), a control, and their respective syrup-based subgroups (iron and black elderberry syrups) were established, each with eight teeth. Artificial white spot lesions were induced, and weekly applications of fluoride varnish, daily applications of CPP-ACP paste, or a single resin infiltration procedure were performed on the white spot lesions within the treatment groups over 4 weeks. Simultaneously, samples were exposed daily to iron or black elderberry syrups. Spectrophotometer measurements were taken at baseline, after demineralization (T0), and after 1 (T1), 2 (T2), and 4 weeks (T4). ΔE00 values were calculated. Statistical analysis was conducted using a three-way mixed-design ANOVA, with the significance level set at P = .05. RESULTS: At T4, ΔE00 values from all groups exceeded the clinical acceptability limit of 1.8. At T2 and T4, the ΔE00 values obtained from the black elderberry syrup subgroups were significantly higher (P < .001). At T4, the highest ΔE00 values were seen in the CPP-ACP groups (P < .001). The lowest ΔE00 values at T2 and T4 were observed in the resin infiltration groups (P < .05). CONCLUSIONS: Supplements containing ferrous sulfate and black elderberry extract caused color changes in white spot lesions that exceeded the clinical acceptability limit. Resin infiltration of white spot lesions provides advantages over remineralization treatments, particularly in minimizing discoloration induced by pediatric supplements.

A survey of white spot lesion prevention and resolution in the US dental school curricula.

PURPOSE/OBJECTIVES: White spot lesions (WSLs) are opaque white lesions on smooth tooth surfaces as a result of demineralization. Proven methods of prevention and resolution of these lesions are available yet the incidence rate, especially in orthodontic patients, is still high. Perhaps the way dental schools are educating students on the topic is insufficient. The purpose of this study was to determine if and how predoctoral dental students are taught about the prevention and resolution of WSLs. METHODS: An electronic survey was developed and sent out to each of the 66 accredited dental schools in the United States and Puerto Rico. The survey consisted of 13 questions and inquired about whether the school includes instruction of WSLs in its predoctoral curriculum. If the school indicated instruction WSLs was in the predoctoral curriculum, further questions were asked pertaining to the content and method of the instruction. Demographic data was also gathered from each institution. RESULTS: Twenty-eight of the 66 schools responded for a 42% response rate. Eighty-two percent of schools indicated they were teaching about prevention of WSLs, while 50% indicated they were teaching about resolution, or treatment, of WSLs. The most commonly taught methods were patient education, over-the-counter fluoride mouthrinse, toothpaste, or gel, and high fluoride content toothpaste. CONCLUSION: The majority of responding dental schools are at least including some instruction of WSLs in the predoctoral curriculum. Many of the known prevention and treatment measures available, however, are not routinely taught.

Comparison of enamel demineralization and periodontal status between direct and digital indirect bonding techniques : A split-mouth clinical trial of direct vs. digital indirect bonding.

OBJECTIVES: This randomized clinical trial aimed to evaluate the effects of digital indirect bonding (DIB) compared to the direct bonding (DB) technique in terms of enamel demineralization and periodontal status. MATERIALS AND METHODS: A total of 24 patients (17 females, 7 males) with a mean age of 13.83 ± 1.55 years were bonded using DB and DIB techniques using a split-mouth study design. Bonding techniques were randomly allocated to quadrants. Demineralization measurements were performed with the DIAGNOdent pen (Kavo, Biberach, Germany) from four sides (distal, gingival, mesial, and incisal/occlusal) of all brackets immediately after bonding, 1 month (T1), and 6 months (T2) after bonding. Periodontal measurements were taken before bonding and at the same time points (T1 and T2). Data were statistically analyzed with the Mann-Whitney U test to determine possible differences between groups. RESULTS: Incisal/occlusal sides exhibited the lowest demineralization values at T2. The gingival side of upper centrals, mesial side of upper laterals, and distal sides of upper first premolar and lower laterals brackets bonded with the DIB technique exhibited significantly increased demineralization compared with the DB technique from T0 to T2 (p < 0.05). Periodontal parameters increased 1 month after bonding and decreased during the follow-up. Bonding technique showed no statistically significant difference in plaque index, gingival index, and bleeding on probing values at any time interval. CONCLUSION: There were many locations around the brackets with significantly higher demineralization after 6 months in patients who received digital indirect bonding compared to the DB group. Although periodontal health was generally adequate, complete removal of adhesive flash should be carefully carried out to decrease the risk of demineralization during indirect bonding technique with digital workflows.

Comparison between a glass ionomer cement and a compomer concerning bonded acrylic expander retention and white spot formation : A randomized clinical trial.

BACKGROUND: The goal of the present study was to compare a compomer and a glass ionomer cement (GIC) used for full the cementation of acrylic splint-type maxillary expanders with respect to failure rate and white spot lesions (WSLs) in vivo. METHODS: A total of 120 patients with posterior crossbite and transverse maxillary deficiency were included to the study. The patients were randomly allocated to two groups: GIC group (n = 60) and compomer group (n = 60). The hyrax screw in both groups was activated two times a day for the first week then once a day until the desired amount of expansion was achieved. The rapid maxillary expansion (RME) appliance was left in the mouth for an extra month after the active expansion phase as a retention appliance. Then cementation failures were recorded. In addition, the patients were evaluated for white spot lesions (WSLs) before cementation and after removal of the appliance. RESULTS: A total of 12 (20%) and 2 (3.3%) RME devices failed in the GIC and the compomer group, respectively. This difference between groups was statistically significant (p = 0.044). There were also statistically significant differences between the GIC and compomer groups in terms of WSLs on the central (p = 0.06) and lateral (p = 0.011) incisors, and on the first molar (0.028). However, no differences were observed for the canines (p = 0.185), first (p = 0.457) and second premolars (p = 0.116). In total, there was a statistically significant difference between the GIC and compomer groups (p = 0.048), with more WSLs in the GIC group. CONCLUSIONS: Among the products used in the study, the compomer should be preferred over the GIC for cementation of acrylic splint-type rapid maxillary expanders in terms of failure rate and WSLs.

Use of bioluminescence measurements for detection of artificial demineralization adjacent to orthodontic brackets.

PURPOSE: Enamel demineralization can occur as a side effect during orthodontic treatment with fixed appliances and should be detected as early as possible. A new approach to assess demineralization is a system consisting of a photosensitive protein that binds to free calcium ions at the enamel surface. A camera is then used to visualize the bioluminescence spots. This in vitro study aimed to evaluate the ability of the bioluminescence technology to assess artificially demineralized enamel adjacent to various orthodontic brackets. METHODS: In all, 108 human enamel samples were allocated randomly to groups with different orthodontic bracket material: stainless steel, titanium, ceramic. Initial lesions were created adjacent to the brackets. The samples were assessed by bioluminescence before and after demineralization. Images were assessed for presence of bioluminescence spots (yes/no). To quantify the bioluminescence measurements, the images' pixel values (P) were calculated within a defined area (F) adjacent to each bracket before and after demineralization. Quantitative light-induced fluorescence measurements (ΔF, ΔQ) were performed as the reference standard for demineralization. RESULTS: After demineralization, bioluminescence spots were visible (yes/no decision) in 87% of the samples. The pixel analysis of the bioluminescence spots showed significantly higher pixel values after demineralization compared to baseline (p < 0.0001). The bracket material had no influence on the bioluminescence measurements. All samples showed fluorescence loss with a median ΔF of -9.52% (±3.15) and a median ΔQ of -1.01%â€¯× mm2 (±3.34), respectively. CONCLUSION: The bioluminescence technology is a promising tool to demonstrate demineralization adjacent to different orthodontic brackets in vitro.

Effect of CPP-ACPF, resin infiltration, and colloidal silica infiltration on surface microhardness of artificial white spot lesions in primary teeth: An in vitro study.

Background: Remineralizing agents such as fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) are popular treatment choices for incipient enamel lesions. Recently introduced resin infiltration enhances the esthetics of teeth affected by these enamel lesions. Furthermore, few studies reported the utilization of colloidal silica infiltration for the white spot lesions. However, the potency of these materials for treatment in primary teeth necessitates investigation.Thus, this study evaluated and compared the effectiveness of CPP-ACP fluoride (CPP-ACPF), resin infiltration, and colloidal silica infiltration on surface microhardness in artificial white spot lesions in primary incisors using the Vickers microhardness testing machine. Materials and Methods: In this in vitro study, on the labial surface of 45 primary incisors, artificial white spot lesions were created by immersing them in a demineralizing solution. According to the evaluation method, random distribution of specimens into three groups: Group 1: CPP-ACPF, Group 2: resin infiltration, and Group 3: colloidal silica infiltration. Specimens after treatment were stored in artificial saliva, followed by microhardness evaluation using Vickers microhardness. Microhardness readings at baseline, post demineralization, and after treating them with different materials were taken. The level of significance was 0.01. Results: Enamel specimens treated with resin infiltration showed a high microhardness mean value compared to CPP-ACPF and colloidal silica infiltration. Conclusion: Resin infiltration is a promising and effective treatment option for incipient enamel lesions followed by CPP-ACPF compared to colloidal silica infiltration in primary teeth.

Effect of the caries-protective self-assembling peptide P11-4 on shear bond strength of metal brackets.

PURPOSE: During orthodontic treatment with fixed appliances, demineralization around brackets often occurs. The aim of this in vitro study was to investigate the effect of the caries-protective self-assembling peptide P11­4 (SAP P11-4) on the shear bond strength of metal brackets. METHODS: In all, 45 extracted human wisdom teeth were available for the study. The teeth were randomly divided into 3 groups (each n = 15) and pretreated as follows: test group 1: application of SAP P11­4 (Curodont Repair, Windisch, Switzerland) and storage for 24 h in artificial saliva; test group 2: application of SAP P11­4; control group: no pretreatment with SAP P11­4. A conventional metal maxillary incisor bracket (Discovery, Dentaurum, Ispringen) was adhesively bonded to each buccal surface. The shear bond strength was tested according to DIN 13990. After shearing, the Adhesive Remnant Index (ARI) was determined microscopically (10 נmagnification). Analysis of variance (ANOVA) was used to check the groups for significant differences (α = 0.05). The distribution of the ARI scores was determined with the χ 2 test. RESULTS: There was no significant difference in shear forces between the groups (p = 0.121): test group 1 = 17.0 ± 4.51 MPa, test group 2 = 14.01 ± 2.51 MPa, control group 15.54 ± 4.34 MPa. The distribution of the ARI scores between the groups did not vary (p-values = 0.052-0.819). CONCLUSION: The application of the caries protective SAP P11­4 before bonding of brackets did not affect the shear bond strength. Therefore, pretreatment of the enamel surface with SAP P11­4 shortly before bracket insertion can be considered.

Low-Viscosity Resin Infiltration Efficacy on Postorthodontic White Spot Lesions: A Quantitative Light-Induced Fluorescence Evaluation.

OBJECTIVE: The aim of this in vivo study was to evaluate the efficacy of low-viscosity light-cured resin infiltration on postorthodontic white spot lesions (WSLs) on incipient and advanced lesions using quantitative light-induced fluorescence (QLF). METHODS: The study subjects were patients with clinically diagnosed postorthodontic WSLs (n=57). QLF images of the lesions were obtained using a QLF device (Inspektor-Pro, Amsterdam, The Netherlands) before any treatment. Images were processed using the built-in software (QLF patient v2.0.0.48), which produced fluorescence loss (ΔF1), lesion area (Area1), and impact (ΔF1 x Area1, ΔQ1) values. Lesions were categorized as incipient (-5<ΔF1<-12, n=14) or advanced (-12<ΔF1<-25, n=43). They were then infiltrated with low-viscosity resin (Icon-DMG, Hamburg, Germany) according to the manufacturer's instructions. QLF imaging was repeated (ΔF2, Area2, and ΔQ2) from the same aspects assured by the relative software. Kolmogorov-Smirnov, Wilcoxon, and Mann-Whitney tests were used for data evaluation. RESULTS: ΔF1 (-8.40±0.73) and Area1 (3.44±5.19) decreased to -6.58±0.88 and 0.18±0.33 for incipient lesions (p<0.001 and p=0.002, respectively). ΔF1 (-13.20±5.32) and Area1 (4.71±5.56) decreased to -7.51±2.7 and 0.29±1.86 for advanced lesions (p<0.001). When ΔF, lesion area, and ΔQ changes between the groups were compared, the decrease in ΔF was greater for advanced lesions (p<0.001), whereas the decrease in the lesion area and ΔQ was similar (p=0.690, p=0.291). CONCLUSIONS: Infiltration treatment provides improvement of WSLs in terms of fluorescence loss, lesion area, and impact for both incipient and advanced lesions, with the latter group presenting higher fluorescence loss reduction.

Effectiveness of Home Bleaching Treatment after Resin Infiltrant Application.

PURPOSE: Resin infiltration may be a barrier for bleaching gels. The aim of this study was to compare dental bleaching effectiveness using low-concentration gels on heavily or mildly stained teeth that were or were not treated with resin infiltration agents. MATERIALS AND METHODS: Forty bovine enamel surfaces were submitted to demineralisation, after which two staining protocols were performed. Twenty specimens were immersed in a staining broth for 24 h (Lab 1) or 7 days (Lab 2). Ten specimens of each group received resin infiltrant application following the manufacturer's recommendation. All specimens were bleached using 15% carbamide peroxide gel for 14 days (8 h daily). Colour measurement was performed using a reflectance spectrophotometer at three time points: baseline, after staining, and after bleaching. Data (CIEDE00) were analysed using Student's t-test (p < 0.05). RESULTS: No statistically significant differences were observed in Lab 1 (p = 0.560). For Lab 2, statistically significant differences were detected (p = 0.031). Once bleaching was achieved to some degree (Lab 2), the resin infiltrant may have behaved as a semipermeable barrier to the carbamide peroxide gels. CONCLUSION: Bleaching treatment was effective on mildly pigmented tooth surfaces. On the other hand, in comparison to the control group, the heavily pigmented surfaces bleached less in the presence of the resin infiltrant, possibly due to the lack of free radicals penetrating into the substrate.

Optical coherence tomography and polarized light microscopy for the evaluation of artificial caries: a preliminary study.

This study was designed to investigate whether there is a correlation between the findings of optical coherence tomography (OCT) and polarized light microscopy (PLM) when these techniques are used to evaluate standard enamel white-spot lesions developed by distinct cariogenic challenges. Bovine enamel fragments (N = 168) were randomly allocated into 6 experimental groups according to the microbiologic model (Streptococcus mutans UA159, Streptococcus sobrinus ATCC 33478, or mixed S mutans and S sobrinus) and carbohydrate sources (1% sucrose or combined 1% sucrose and 1% starch). Specimens were examined by OCT and PLM every day within a period of 7 days. Five measurements of demineralization depth were recorded for each specimen, and means were calculated. Data were analyzed with analysis of variance and Tukey tests (α = 0.05), and a correlation test was performed. All cariogenic challenges created sub-superficial lesions. In both the OCT and PLM analyses, the demineralization depth reached its peak between days 6 and 7 of the cariogenic challenge, except for the group challenged with S sobrinus supplemented with combined sucrose and starch; for that group, demineralization peaked on day 5 in the OCT analysis. There was a significant correlation between OCT and PLM (P = 0.00; r = 0.842). This preliminary study suggests that OCT is a reliable, nondestructive method to measure the demineralization depth of enamel white-spot lesions, which can be useful for the laboratory and has potential for clinical studies. Using the 1% sucrose and S mutans model for 6 days is a simple and effective method to induce enamel caries-like lesions without compromising the depth and morphologic features of the obtained lesions.

The in vitro remineralizing effect of CPP-ACP and CPP-ACPF after 6 and 12 weeks on initial caries lesion

Abstract Objective: The aim of this in vitro study was to determine the effects of remineralization promoting agents containing casein phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP), or CPP-ACP in combination with fluoride (CPP-ACPF) on artificial white spot lesions (WSLs) after 6 and 12 weeks. Methodology: White spot lesions were created on 123 sectioned premolars (246 specimens) with a demineralization solution during a 96 hours pH-cycling regime. Two experimental groups were created: a CPP-ACP group (Tooth Mousse™), and a CPP-ACPF group (Mi Paste Plus™). Additionally, two control groups were created, one using only a conventional toothpaste (1450 ppm fluoride) and another one without any working agents. All teeth were also daily brushed with the conventional toothpaste except the second control group. Tooth Mousse™ and Mi Paste Plus™ were applied for 180 seconds every day. The volume of demineralization was measured with transverse microradiography. Six lesion characteristics regarding the lesion depth and mineral content of WSLs were also determined. Results: The application of CPP-ACP and CPP-ACPF had a significant regenerative effect on the WSLs. Compared to Control group 1 and 2 the volume of demineralization after 6 weeks decreased significantly for CPP-ACP (respectively p<0.001 and p<0.001) and CPP-ACPF (respectively p=0.001 and p=0.003). The same trend was observed after 12 weeks. For the CPP-ACPF group, WSL dimensions decreased significantly between 6 and 12 weeks follow-up (p=0.012). The lesion depth reduced significantly after application of CPP-ACP and CPP-ACPF but increased significantly in the Control groups. Mineral content increased for CPP-ACP and CPP-ACPF after an application period of 12 weeks, but this was only significant for CPP-ACP. Conclusions: Long-term use of CPP-ACP and CPP-ACPF in combination with a conventional tooth paste shows beneficial effects in the recovery of in vitro subsurface caries lesions.

Reminova and EAER: Keeping Enamel Whole through Caries Remineralization.

This article aims to outline the early development of a King's College London dental spinout company, Reminova, formed to commercialize a novel clinical method of caries remineralization: electrically accelerated and enhanced remineralization (EAER). This method is being developed to address the unmet clinical need identified by modern caries management strategies to keep enamel "whole" through remineralization of clinical caries as a form of nonoperative caries treatment for initial-stage and moderate lesions. A progressive movement within dentistry is shifting away from the restorative-only model, which, it is suggested, has failed. The high prevalence of initial-stage caries across populations provides a significant opportunity to prevent restorations and reduce repeat restorations over a patient's lifetime. Reminova has set out to provide a method to repair lesions without drilling, filling, pain, or injections. The article outlines the rationale for and the chronological stages of the technology and company development. It then outlines corroborative evidence to show that EAER treatment can, in this preliminary in vitro investigation, remineralize clinically significant caries throughout the depth of the lesion as measured by Knoop microhardness and corroborated by scanning electron microscopy. Furthermore, the presented data show that EAER-treated enamel is harder than the healthy enamel measured nearby in each sample and is very similar in appearance to healthy enamel from the subjective interpretation made possible by scanning electron microscopy imagery. The data presented also show that this more "complete" remineralization to a high hardness level has been achieved with 2 remineralizing agents via in vitro human tooth samples. The broad clinical potential of this new treatment methodology seems to be very encouraging from these results. Reminova will strive to continue its mission, to ensure that, in the future, dental teams will not need to drill holes for the treatment of initial-stage and moderate caries lesions.

Effects of different orthodontic primers on enamel demineralization around orthodontic brackets.

AIM: The purpose of this work is to evaluate the effectiveness of one self-etching and two filled orthodontic primers on enamel demineralization around orthodontic brackets. METHODS: Brackets were bonded to 84 bovine teeth and the vestibular enamel surfaces covered with acid-resistant nail varnish exposing 1 mm of space on each side of the bracket base. The teeth were allocated to four groups, using either Transbond XT conventional primer on etched enamel (group 1), Transbond Plus Self-Etching Primer on untreated enamel (group 2), Pro Seal filled resin primer on etched enamel (group 3), or Opal Seal filled resin primer on etched enamel (group 4). Each tooth was subjected to 15,000 strokes of brushing followed by exposure to an acid challenge. Calcium-ion release from each sample was calculated using atomic absorption spectrophotometry. Data were analyzed using one-way ANOVA and a post hoc Tukey test. Differences were considered statistically significant at p ≤ 0.05. RESULTS: Statistically significant differences were observed between the four groups (p < 0.001). No significant difference was found between the controls (group 1) and the Opal Seal group. Higher calcium release was observed in the Pro Seal group and the self-etching primer group compared to the controls. The highest calcium release was recorded in the self-etching primer group. CONCLUSION: Filled sealants may not have a protective effect against enamel demineralization. Transbond Plus Self-Etching Primer should be used cautiously, considering the risk of demineralization involved in its application.

Evaluation of penetration depth of a commercially available resin infiltrate into artificially created enamel lesions: An in vitro study.

BACKGROUND: Early enamel lesions have a potential to re-mineralize and prevent caries progress. AIM: The aim of the following study is to determine the depth of penetration of low viscosity resin into artificially created enamel lesions. MATERIALS AND METHODS: A sample of 20 sound premolars, indicated for orthodontic extraction, formed the study group. The teeth were coated with a nail varnish, leaving a window of 4 mm × 4 mm, on buccal surfaces of sound, intact enamel. Each tooth was subsequently immersed in demineralizing solution for 4 days to produce artificial enamel lesions. The demineralized area was then infiltrated with low viscosity resin (Icon Infiltrant, DMG, Hamburg, Germany) as per the manufacturer's instructions. All the restored teeth were then immersed in methylene blue dye for 24 h at 37°C. Teeth were then sectioned longitudinally through the lesion into two halves. The sections were observed under stereomicroscope at ×80 magnification and depth of penetration of the material was measured quantitatively using Motic software. RESULTS: The maximum depth of penetration of the resin material was 6.06 ± 3.31 µm. CONCLUSIONS: Resin infiltration technique appears to be effective in sealing enamel lesions and has great potential for arresting white spot lesions.