REVIEW OF MODERN APPROACHES TO DENTAL FLUOROSIS MANAGEMENT

  • L.F. Kaskova Ukrainian Medical Stomatological Academy, Poltava, Ukraine
  • N.A. Morhun Ukrainian Medical Stomatological Academy, Poltava, Ukraine
  • L.I. Amosova Ukrainian Medical Stomatological Academy, Poltava, Ukraine
  • N.V. Yanko Ukrainian Medical Stomatological Academy, Poltava, Ukraine
  • A.V. Artemiev Ukrainian Medical Stomatological Academy, Poltava, Ukraine
Keywords: children, teeth, fluorosis, treatment.

Abstract

Dental fluorosis is caused by ingesting too much fluoride while the teeth are developing. Poltava region belongs to Buchach fluorine hydrogeological province which ground waters are characterized by a high content of fluorine. Such districts as Myrgorod, Lubny, Gadyach, Globino, Mashivka, Shyshaky and Novy Sanzshary have fluoride concentration in drinking water from 2,5 tо 7 mg/l. It is known that the overdose of fluoride has deleterious effect on enamel development, generating a hypomineralized porous subsuperfacial enamel. Mild fluorosis transforms into moderate fluorosis with brown pigmentation over time and increasing the severity of fluorosis is associated with increasing the patient`s dissatisfaction.

There are a few different ways that dental fluorosis can be treated. Local remineralisation therapy is the most careful way to reduce or eliminate fluorosis spots. Enamel microabrasion removes the outer porous enamel with pumice after it has been partly demineralized by the acid; topical fluoride that remineralized the enamel follows microabrasion. A teeth whitening can return teeth to their former glory in a single visit. Infiltration technique is the novel approach to fluorosis management which masks white spots. Veneers or crowns are the next option that restores teeth gleaming appearance. Unfortunately, previous reviews that have analyzed contemporary methods of fluorosis treatment didn’t determine their indications depending on the disease severity and the enamel maturation.

Purpose of the study was to systematize the methods of dental fluorosis management offered last years and to determine the indications for their use depending on the severity of the disease and the maturity of the tooth enamel. Searching strategy for identification of scientific publications published between the years 2009 - May 2019 was conducted by reviewers independently through Google. The search strategy included keywords "dental fluorosis management", «teeth whitening», «teeth microabrasion», «infiltration for fluorosis treatment» and it was complementated by checking references of the relevant review articles and the eligible studies for additional useful publications.

Over the last 10 years few articles were dealt with minerals, vitamins, adaptogens, antitoxicants prescription for fluorosis management. Such tooth pastes as «R.O.C.S» and «Novyi zhemchuh calcium» showed efficacy in local remineralisation therapy of fluorosis in children. Infiltration technique was used for mild fluorosis management and in combination with whitening for moderate fluorosis treatment in children. Different tooth whitening techniques were offered and only some of them include local remineralisation therapy that can stabilize clinical result. Carbamide and orthophosphoric acid were utilized for whitening of immature fluorosis teeth. Microabrasion in children's teeth was effective in combination with following fluoridation, for example Tooth Moose.

Direct and indirect restorations are considered the treatment of choice for moderate to severe cases of fluorosis given the optimum aesthetics, wear resistance, biocompatibility, and long-term results. Whereas veneers and crowns are indicated in mature fluorosis teeth, choice of direct composite restorations doesn’t depend on tooth maturity.

Treatment of fluorosis of various severities in children should include endogenous use of medicines that increase the enamel remineralisation. Local remineralisation therapy is indicated for mild fluorosis in immature teeth and for moderate fluorosis in combination with bleaching and microabrasion. Infiltration technique is recommended for mild fluorosis management and in combination with whitening for moderate fluorosis treatment in children. In the case of inefficiency of minimally invasive methods or severe fluorosis, direct or indirect restorations are conducted. Promising direction in fluorosis treatment is the development of new methods for fluorosis management, including general and local remineralization therapy, as well as infiltration technique.

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References

1. Nikolishin A.K. Fljuoroz zubov. – Poltava,1999. –135c.
2. Toronchenko O.M. Ekologichne doslidzhennya koncentraciyi ftoru u py`tnij vodi Poltavs`koyi oblasti ta analiz vply`vu na zdorov'ya naselennya / O.M. Toronchenko // World of medicine and biology. – 2013. – 4, 52-57.
3. Aoba T. Dental fluorosis: Chemistry and biology / T. Aoba, O. Fejerskov // Rev. Oral. Biol. Med. – 2002. – №13 – Р. 155-177.
4. Obgruntuvannja diferencіjnogo pіdhodu do vtorinnoї profіlaktiki fljuorozu postіjnih zubіv u dіtej / L.F.Kas'kova, І.O.Padalka, L.І.Amosova [ tа іn.] // Profіlaktichna ta ditjacha stomatologіja. – 2011. – №1 (4). – S. 37-40.
5. Kas'kova L.F. Metodi lіkuvannja fljuorozu v dіtej / L.F.Kas'kova, N.V.Janko // Sovremennaja stomatologija. – 2014. – №5 (74). – S. 42-45.
6. Akpata E.S.Therapeutic management of dental fluorosis: A critical review of literature / Akpata, E.S. // Saudi J. Oral Sci. – 2014. –№1. – Р. 3–13. doi: https://doi.org/10.4103/WKMP-0056.124179.
7. Makeeva I.M. Jendemicheskij fljuoroz zubov — prichiny, profilaktika i lechenie / I.M.Makeeva, A.G.Volkov, A.A.Musiev // Rossijskij stomatologicheskij zhurnal. – 2017. – T.21, №6. – S. 340-344.
8. Vpliv lіkuval'no-profіlaktichnih kompleksіv na rozmіr «chistih» dіljanok zubіv, urazhenih fljuorozom / L.F.Kas'kova, N.A.Morgun, O.Ju.Andrіjanova [ tа іn.] // Ukraїns'kij stomatologіchnij al'manah. – 2011. – №1. – S. 38-40.
9. Kazarina L.N. Vlijanie remineralizujushhej terapii na nekotorye pokazateli svobodno-radikal'nogo okisenija i imunnoj zashhity v sljune detej s fljuorozom zubov / L.N.Kazarina, A.N.Samarkina, O.O.Gushhina // Stomatologija detskogo vozrasta i profіlaktika. – 2015. – № 2. – S. 26-29.
10. Kazarina L.N. Vlijanie kompleksnoj terapii na rezistentnost' jemali zubov i gigienicheskoe sostojanie polosti rta u detej s fljuorozom / L.N.Kazarina, A.N.Samarkina, O.O.Gushhina // Sovremennye problemy nauki i obrazovanija – 2015. –№ 2. –S. 32-35.
11. Gadaeva M.V. Kliniko-jeksperimental'noe obosnovanie ispol'zovanija medikamentoznyh shem lechenija fljuoroza zubov: dis. …kand. med. nauk: 14.01.14 / Gadaeva Marina Vladimirovna; Nizhegorodskaja gosudarstvennaja medicinskaja akademija. – N. Novgorod, 2015. – 190 s.
12. Auschill M. Resin infiltration for aesthetic improvement of mild to moderate fluorosis: a six-month follow-up case report / M.Auschill, K.E.Schmidt, N.B. Arweiler // Oral Health Prev. Dent. – 2015. – №13. – Р. 317-322. doi: https://doi.org/10.3290/j.ohpd.a32785.
13. Gorohіvs'kij V. N. Profіlaktika ta lіkuvannja urazhen' tverdih tkanin zubіv u regіonah z pіdvishhenim vmіstom ftoru v pitnіj vodі / V.N. Gorohіvs'kij, O. V. Den'ga // Profіlaktichna ta ditjacha stomatologіja. – 2016. – № 2. – S. 16-20.
14. Janko N.V. Lіkuvannja duzhe legkogo stupenja fljuorozu z dopomogoju іnfіl'tracіjnoї tehnіki / N.V. Janko, L.F. Kas'kova, S.A. Jakobenchuk // Sjajvo posmіshki: zbіrnik nauk. prac' nauk.-prakt. stomatologіchnoї konf. u ramkah konkursu, 20 listopala 2015 r. – Harkіv, 2015. – S. 122-123.
15. Sundfeld R.H., Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups / R.H.Sundfeld, D. Sundfeld-Neto, L.S.Machado [еt аl.] // J. Appl. Oral Sci. – 2014. – № 22. – Р. 347-354. doi: https://doi.org/10.1590/1678-775720130672.
16. Fljuoroz zubov / A.Ch.Pashaev // Stomatologija dlja vseh. – 2009. –№1. – S.10– 13.
17. Conservative Minimal Invasive Treatment of Dental Fluorosis in Pediatric Patients: Report of Two Cases /[ Singh R., Singh, T., Singh G. P., & Kaur M. ] // Asian J. Oral Health Allied Sci. –2011. – № 3. – Р. 209-221.
18. Gazhva S.I. Ocenka jeffektivnosti ispol'zovanija diodnogo lazera v algoritme ustranenija izmenenij cveta zubov / S.I. Gazhva, T.V. Volkomorova, D.A. Progressova // Sovremennye problemy nauki i obrazovanija. – 2014. – № 6 [Jelektronnyj resurs]. – Rezhim dostupu: http://www.science-education.ru/ru/article/view?id=15759 (data dostupu: 24.05.2019).
19. Fljuoroz zubіv peremozhenij / A. K. Nіkolіshin [ta іn.]; za red. A. K. Nіkolіshina. – Poltava: Ukrpromtorgservіs, 2018. – 133 s.
20. Fedotova M.V. Lechenie jerozivno-krapchatoj formy fljuoroza preparatami R.O.C.S / M.V. Fedotova, S.Ju. Byval'ceva // Bjuleten' VSNC RO NAMN. –2014. – № 2 (96). – S. 134-136.
21. Kriheli N.I. Opyt primenenija metoda mikroabrazii dlja lechenija fljuoroza zubov / N.I. Kriheli, B.V. Juhananova // Rossijskaja stomatologija. – 2016. – T.9, №3. – S. 14-16.
22. Doneria D. A combination technique of microabrasion and remineralizing agent for treatment of dental fluorosis stains SRM / D.Doneria, K.Keshav & S.S.P. Chauhan // J. Res. Dent Sci. 2018.– № 9. –Р. 145-147.
23. Deshpande A.N. Microabrasion-remineralization (MAb-Re): An innovative approach for dental fluorosis / A.N. Deshpande, N.R.Pradhan, R.Y. Raol //J. Indian Soc. Pedod. Prev. Dent. – 2017. –№35. – Р.384-387.
24. Shafiei F. Direct esthetic rehabilitation of teeth with severe fluorosis: a case report / F. Shafiei, M.Tavangar, A. Alavi // J. Dent (Shiraz). – 2014. – №1 (15). – Р. 44–47.
25. El Mourad A.M. Aesthetic rehabilitation of a severe dental fluorosis case with ceramic veneers: a step-by-step guide. Case Reports in Dentistry. – 2018. – article ID 4063165. – 4 pages. doi: https://doi.org/10.1155/2018/4063165.
Published
2019-09-06
How to Cite
Kaskova, L., Morhun, N., Amosova, L., Yanko, N., & Artemiev, A. (2019). REVIEW OF MODERN APPROACHES TO DENTAL FLUOROSIS MANAGEMENT. Ukrainian Dental Almanac, (3), 71-76. https://doi.org/10.31718/2409-0255.3.2019.11
Section
CHILDHOOD STOMATOLOGY

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