Micro- and Macroabrasion in the Esthetic Zone: A Narrative Review and Case Study

Abstract

Background: Micro- and macroabrasion represent a minimally invasive treatment approach for stained teeth in the esthetic zone. Diagnosing the type of stain is crucial for selecting the appropriate treatment approach. These clinical procedures involve several meticulous steps that may be confusing for less experienced clinicians. Methods: The objective of this article is to provide an updated review of the literature on the clinical procedures for micro- and macroabrasion and to present a clinical case in which a minimally invasive macroabrasion procedure was applied to treat a female patient seeking to remove stains from her anterior teeth. Preliminary reviews were conducted of existing case reports and reviews evaluating the clinical procedures and outcomes of micro- and macroabrasion. Results: A review of the literature reveals minor differences in how stains on anterior teeth are addressed. Depending on the depth of the stain, microabrasion is typically used for superficial stains, while macroabrasion is employed for deeper stains. Clinicians often combine micro- or macroabrasion with tooth whitening procedures. Literature reviews agree that micro- and macroabrasion techniques are effective minimally invasive approaches that yield high esthetic results. The case study demonstrated each clinical step of microabrasion, achieving results that fully satisfied the patient's esthetic demands. Conclusions: Micro- and macroabrasion can be effective and minimally invasive methods for treating stained anterior teeth. Superficial stains can be treated with microabrasion, while deeper stains may require macroabrasion. In some clinical scenarios, tooth whitening can also be combined with these treatments.

Keywords: esthetic zone; macroabrasion; microabrasion; resin infiltration.

Figure 1

Initial intra-oral situation and the arrows indicate the stain areas. (A) Frontal, (B) frontal with polarized lens, and (C) frontal with flash in the back to assess the stains.

Figure 2

Resin infiltration procedure. (A) Initial dental dam isolation, (B,C) hydrochloric acid application, and (D) application of the infiltrating resin.

Figure 3

Macroabrasion. (A) Initial application of phosphoric acid for central incisor, (B) right lateral, and (C) left central incisors with phosphoric acid, (D) rinsing the acid, (E) adhesive application, and (F) light-curing.

Figure 4

Restoration procedure. (A) Final microabrasion, (B) initial placement of the resin composite final application for the (C) central and (D) lateral incisors, (E) finishing, and (F) polishing of the restorations.

Figure 5

Final intra-oral situation. (A) Frontal view, (B) frontal view with polarized lens, and (C) frontal view with flashes in the back to assess the stain.

Figure 6

Final situation. (A) Patient smiling, (B) smile, and (C) teeth in occlusion.

Figure 7

Three years follow-up. (A) Face smiling, (B) smile, and (C) intra-oral situation.