Clinical Case of At-Home Bleaching and Resin Infiltration

Minimally invasive concepts in Restorative Dentistry involve noninvasive and microinvasive strategies. Noninvasive procedures aim at arresting or reverting noncavitated enamel caries lesions, while microinvasive procedures involve barriers that prevent further dissolution of enamel by the acidic challenge of cariogenic bacteria. Enamel white spot lesions (EWSL) correspond to the pre-cavitation phase of the caries process, in which enamel hydroxyapatite has been lost from the enamel subsurface leaving an apparently intact or pseudo-intact surface layer covering the mineral-deprived area. EWSL have become an esthetic challenge when they occur in anterior teeth. The microinvasive treatment of choice for EWSL is resin infiltration. The infiltration of the demineralized enamel using a low-viscosity light-cured resin with a refractive index similar to that of hydroxyapatite has been shown to reverse the opacity of the EWSL resulting in a very esthetic outcome. At-home bleaching can be prescribed for darker teeth prior to the resin infiltration.