Power bleaching enhances resin infiltration masking effect of dental fluorosis. A randomized clinical trial

Objectives: Patients with moderate dental fluorosis often feel esthetically compromised. Aim of this RCT was to evaluate the objectively and self-assessed masking effect of resin infiltration alone or in combination with inoffice bleaching on dental fluorosis in adults. Methods: Twenty-seven patients (9 male, 18 female, 24.81 +/- 3.7 yrs) with 410 fluorotic teeth (TF 1-4) were randomly assigned to a treatment (BLI) or control group (NBLI). Patients underwent in-office bleaching (25% H2O2) in the BLI or a placebo bleaching (ACP gel) in the NBLI group followed by resin infiltration after two weeks. Standardized digital photographs were obtained at baseline; after bleaching; before and after resin infiltration and after 1, 3, and 6 months. Color differences (AE) between sound and fluorotic areas were calculated and patient satisfaction was evaluated using a VAS (1-10). Results: Statistical analysis revealed significant differences in the mean AE values 6 months after resin infiltration between the BLI (Delta E = 1.41) and the NBLI group (Delta E = 4.33) (p = 0.024). VAS values increased after resin infiltration (p < 0.05) in both groups. After 3 months patients in the BLI group had higher VAS values than in the NBLI group (p = 0.029). Conclusions: Findings of this study suggest that resin infiltration alone can effectively mask mild to moderate dental fluorosis in young adults. In-office bleaching with 25% H2O2 before resin infiltration provides significantly better masking effects. Clinical Significance: Resin infiltration is a safe and efficient treatment option for masking fluorotic opacities. A priori in-office bleaching with 25% H2O2 enhances the masking effect.