Clinical management of non-carious enamel defects

Abstract

Enamel defects not caused by decay may occur singly or may be generalized over the entire tooth surface. In the past, treatment of these aesthetic problems required large cavity preparations or full crown coverage of the affected teeth. Now, with the advent of various resin restorative materials capable of bonding to enamel, new techniques are being developed which are less radical. By etching the surface of the enamel with varying concentrations of dilute phosphoric acid, sufficient porosity is produced to allow the resin to adhere to it. Thus, by removing a minimal amount of tooth structure, the affected area can be masked with a thin layer of resin material after the surface has been properly prepared. If the fault in the enamel is generalized, the whole surface of the tooth may be restored using this technique, effectively covering the tooth with an aesthetic veneer. The new resin filling materials offer good colour stability as well as resistance to abrasive wear. Tests have revealed that this mode of treatment has a successful retention rate of over 92 per cent after 5 years. Lightly discoloured or stained defects of the enamel may be treated by bleaching the affected area with no adverse effect on the pulp tissue. Those teeth not improved by bleaching can be conservatively managed by veneering their surfaces with smooth finishing plastic materials.