Acceptability, efficacy and safety of two treatment protocols for dental fluorosis: a randomized clinical trial.
OBJECTIVE
This parallel randomized clinical trial evaluated the efficacy of two treatments for removing fluorosis stains.


METHODS
Seventy individuals living in an area endemic for fluorosis, with at least four maxillary anterior teeth presenting fluorosis with a Thylstrup and Fejerskov index from 1 to 7, were randomized into two treatment groups (n=35): GI - enamel microabrasion or GII - microabrasion associated with at-home bleaching. Microabrasion was performed using 37% phosphoric acid and pumice and, at-home tooth bleaching was performed with 10% carbamide peroxide. Areas of enamel opacities were recorded by digital camera at baseline and 1-month (1M) after treatment. Two blinded examiners evaluated the reduction in the area (mm(2)) of opacity using software. Two visual analogue scales were used: one for recording tooth sensitivity and/or gingival irritation ranging from 1 (none) to 5 (severe) and the other to evaluate participant satisfaction with the treatment used ranging from 1 (no improvement) to 7 (exceptional improvement).


RESULTS
1M after treatment, both groups showed a significant reduction in the area of enamel opacity (p=0.0001) and there was no difference between groups (p=0.1). Most of the participants from both treatment groups reported no or mild tooth sensitivity and gingival irritation (p>0.05). Participants reported that they were happy with the improvement in dental appearance, however, individuals from GII reported that they were happier than those from GI (p=0.004).


CONCLUSIONS
Both treatment protocols were effective in reducing fluoride stains, however, when home bleaching was associated to enamel microabrasion, patients reported a major satisfaction with dental appearance.
Federal University of Paraiba, João Pessoa, PB, Brazil.
Kaline Silva
KS
Castro
Federal University of Pelotas, Pelotas, RS, Brazil.
Ana Cláudia de Araújo
AC
Ferreira
Department of Operative Dentistry, Federal University of Paraiba, João Pessoa, PB, Brazil.
Rosângela Marques
RM
Duarte
Department of Operative Dentistry, Federal University of Paraiba, João Pessoa, PB, Brazil.
Fábio Correia
FC
Sampaio
Department of Operative Dentistry, Federal University of Paraiba, João Pessoa, PB, Brazil. Electronic address: soniasaeger@hotmail.com.
Sônia Saeger
SS
Meireles
D000293:Adolescent; D000328:Adult; D000077463:Carbamide Peroxide; D002985:Clinical Protocols; D003743:Dental Enamel / Q000187:drug effects / Q000473:pathology; D003807:Dentin Sensitivity / Q000209:etiology; D019243:Enamel Microabrasion / Q000379:methods*; D005260:Female; D009050:Fluorosis, Dental / Q000628:therapy*; D005500:Follow-Up Studies; D005891:Gingivitis / Q000209:etiology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D017060:Patient Satisfaction; D010545:Peroxides / Q000627:therapeutic use; D010756:Phosphoric Acids / Q000627:therapeutic use; D023861:Photography, Dental / Q000379:methods; D012449:Safety; D017640:Silicates / Q000627:therapeutic use; D014073:Tooth Bleaching / Q000379:methods*; D058205:Tooth Bleaching Agents / Q000627:therapeutic use; D014075:Tooth Discoloration / Q000628:therapy; D016896:Treatment Outcome; D014508:Urea / Q000031:analogs & derivatives / Q000627:therapeutic use; D064232:Visual Analog Scale; D055815:Young Adult
D010545:Peroxides; D010756:Phosphoric Acids; D017640:Silicates; D058205:Tooth Bleaching Agents; D000077463:Carbamide Peroxide; D014508:Urea; C030242:phosphoric acid; C005144:pumice
Clinical trial; Dental fluorosis; Enamel microabrasion; Tooth bleaching