Effectiveness of microabrasion technique for improvement of dental aesthetics

To investigate which types of enamel opacity are effectively treated by the microabrasion technique and whether this technique could be used as a diagnostic aid to determine the aetiology of these defects.

Thirty two patients who had enamel opacities affecting both upper central incisors were selected and the disfigurements were classified into four types: single line, multi-line, patched and diffused. The patient's previous medical history, possible history of fluoride ingestion, presence of taurodontism and family history of similar enamel defects were recorded. Both incisors were treated with Prèma abrasive paste mixed with 18% hydrochloric acid. The aesthetic improvements were assessed by the patients and their parents and their satisfaction level after the treatment was recorded.

Approximately two-thirds (65.6%) of the patients were satisfied with their appearance after microabrasion. Apart from four patients, the improved appearance was stable and acceptable to the remaining patients at the six month recall. Statistical analysis showed that acceptable improvement was found in patients with single line/patched types of defects but not in multi-line/diffused types (P = 0.03). However, the aesthetic improvement was not related to the patient's fluoride history, presence of taurodontism or the family history of enamel defects.

Microabrasion using Prèma abrasives with 1 8% HCI is effective in improving the appearance of enamel with single-line or patched opacities, indicating that these defects are a surface phenomenon. For the multi-line and diffused types, the defects appear to extend deeper into the enamel. The technique failed to assist in determining the aetiology of these defects.