Associação de terapias minimamente invasivas no tratamento da fluorose dentária: revisão da literatura

Abstract

Fluoride is considered to be the main anti-caries agent in dentistry and is an important strategic element in disease prevention systems because it interferes with the dynamics of dental caries and reduces its prevalence. However, as caries declines in the population, the prevalence of fluorosis increases. It manifests itself clinically as porosity in the enamel, with the presence of bilateral, diffuse, thin, horizontal white streaks and discolorations ranging from yellow to dark brown. In this sense, patients with dental fluorosis often feel aesthetically dissatisfied and seek minimally invasive treatments. Therefore, the aim of this study is to conduct a literature review on the effectiveness of the association of minimal-intervention treatments to improve the aesthetics of white spot lesions of fluorosis in anterior teeth. A literature search was conducted in Pubmed, Lilacs and SciSearch databases in search of randomized clinical trials, systematic reviews or prospective studies in English that combined the therapies of microabrasion, dental bleaching and resin infiltration in different degrees of fluorosis in a period from 2012 to 2022. The results, exported to the Rayyan tool, were selected based on reading the title, abstract and subsequently full text remaining 10 articles. The findings of this study suggest that the choice of therapies is based on the correct clinical classification of the degree of fluorosis, with the combination of bleaching and microabrasion being the most indicated for mild fluorosis. For mild to moderate fluorosis the combination of bleaching and resin infiltration is also presented and preferred by some authors. Regarding microabrasion followed by bleaching and resin infiltration, only one study has demonstrated its effectiveness, being an excellent alternative for treatment of moderate fluorosis cases. Therefore, the association protocols that included microabrasion, bleaching and resin infiltration are effective for the treatment of fluorotic enamel defects, such as white spots, brown spots and porosities.