title: Modification of surface pretreatment of white spot lesions to improve the safety and efficacy of resin infiltration.
abstract: OBJECTIVE
  A low-viscosity resin (infiltrant) was used to inhibit the progression of white spot lesions (WSLs) and resolve associated esthetic issues. An alternative pretreatment was explored to increase the pore volume of the surface layer of the WSLs. Also, the penetration effects of the infiltrant were evaluated for various pretreatments.
  
  
  METHODS
  Sixty two artificial lesions were fabricated on bovine teeth. As a positive control, 15% HCl gel was applied for 120 seconds. Further, 37% H3PO4 gel was applied for 30 seconds using three methods. The samples were divided as follows: H3PO4 only group, H3PO4 sponge group, and H3PO4 brush group. The acid was gently rubbed with the applicators (i.e., a sponge or brush) throughout the application time. To compare the effects of resin infiltration, twenty paired halves of specimens were treated with an infiltrant (ICON®).
  
  
  RESULTS
  Thicknesses of the removed surface layers and infiltrated areas were evaluated by confocal laser scanning microscope. The positive control and the 37% H3PO4 brush group failed to show significant differences in the removed thickness (p > 0.05); however, the mean percentage of the infiltrated area was higher in the 37% H3PO4 brush group (84.13 ± 7.58%) than the positive control (63.51 ± 7.62%, p < 0.001). Scanning electron microscope observations indicate higher pore volumes for the 37% H3PO4 brush group than for the positive control.
  
  
  CONCLUSIONS
  Application of 37% H3PO4 with a brush for 30 seconds increased the pore volume of WSL surface layers and the percentage of infiltrated areas in comparison to the use of 15% HCl for 120 seconds.
authors.affiliation: Department of Preventive Dentistry and Public Oral Health, Brain Korea 21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Korea.
authors.forename: Hyun-Kyung
authors.initials: HK
authors.lastname: Yim
authors.affiliation: Department of Preventive Dentistry and Public Oral Health, Brain Korea 21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Korea.
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Min
authors.affiliation: Department of Preventive Dentistry and Public Oral Health, Brain Korea 21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Korea.
authors.forename: Ho-Keun
authors.initials: HK
authors.lastname: Kwon
authors.affiliation: Department of Preventive Dentistry and Public Oral Health, Brain Korea 21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Korea.
authors.forename: Baek-Il
authors.initials: BI
authors.lastname: Kim
keywords: 15% Hydrochloric acid; 37% Phosphoric acid; Resin infiltration; Surface layer; White spot lesions (WSLs)