Enamel microabrasion is a procedure in

cosmetic dentistry Cosmetic dentistry is generally used to refer to any dental work that improves the appearance (though not necessarily the functionality) of teeth, gums and/or bite. It primarily focuses on improvement in dental aesthetics in color, position, shape, ...

used to improve the appearance of the teeth. Like

tooth whitening Tooth whitening or tooth bleaching is the process of lightening the color of human teeth. Whitening is often desirable when teeth become yellowed over time for a number of reasons, and can be achieved by changing the intrinsic or extrinsic color o ...

it is used to remove discolorations of the tooth surface but microabrasion is both a mechanical and chemical procedure.

History

In the past, teeth with stains or other color changes were made to look better through the use of restorative materials, such as

dental porcelain Dental porcelain (also known as dental ceramic) is a dental material used by dental technicians to create biocompatible lifelike dental restorations, such as crowns, bridges, and veneers. Evidence suggests they are an effective material as they a ...

. These materials would create a thin

veneer Veneer may refer to: Materials * Veneer (dentistry), a cosmetic treatment for teeth * Masonry veneer, a thin facing layer of brick * Stone veneer, a thin facing layer of stone * Wood veneer, a thin facing layer of wood Arts and entertainment * ' ...

over the outer surface of the tooth. Although veneers looked better, these materials did not match the structure or characteristics of the

tooth enamel Tooth enamel is one of the four major Tissue (biology), tissues that make up the tooth in humans and many other animals, including some species of fish. It makes up the normally visible part of the tooth, covering the Crown (tooth), crown. The ...

and replacement was frequently needed. As far back as 1916, some researchers were advocating instead removing a thin layer of the outermost enamel to expose the (presumably) undamaged layer underneath. The first practical application of enamel microabrasion was developed by Theodore Croll and Richard Cavanaugh in 1986, who used a combination of weak

hydrochloric acid Hydrochloric acid, also known as muriatic acid, is an aqueous solution of hydrogen chloride. It is a colorless solution with a distinctive pungent smell. It is classified as a strong acid Acid strength is the tendency of an acid, symbol ...

and

pumice Pumice (), called pumicite in its powdered or dust form, is a volcanic rock that consists of highly vesicular rough-textured volcanic glass, which may or may not contain crystals. It is typically light-colored. Scoria is another vesicular vol ...

to remove a few tenths of millimeters of the enamel.

Description

Contemporary enamel microabrasion uses a combination of mechanical and chemical means to remove of a small amount of tooth enamel (not more than a few tenths of a millimeter) to eliminate superficial discoloration. These discolorations can result from either from extrinsic factors (such as tobacco, dental plaque, certain foods, etc.) or intrinsic ones (most commonly

dental fluorosis Dental fluorosis is a common disorder, characterized by hypomineralization of tooth enamel caused by ingestion of excessive fluoride during enamel formation. It appears as a range of visual changes in enamel causing degrees of intrinsic tooth d ...

Indications

* Dental fluorosis is the most common indication where it ranges in severity from mild to severe, microabrasion should be considered the first option in treating mild and moderate cases of fluorosis. * Removal of intrinsic enamel stains, correction of surface irregularities and defects in enamel caused either after removal of orthodontic appliances or during tooth formation.

Contraindications

* The patients' age is not a limiting factor for the enamel microabrasion technique but in cases of not fully erupted teeth, it may be difficult to place rubber dam for the microabrasion process * Microabrasion is not indicated when discoloration is located in dentin such as in dentigenous imperfecta or tetracycline discoloration. * Should be delayed or not used in patients with deficient labial seal because enamel surfaces are extremely dry which makes stains more obvious.so, ''Sundfeld, et al'' in 2007, found that orthodontic lip repositioning should be done first to make removal of these stains more effective.

Consequences

Patients can benefit from combined microabrasion/ bleaching techniques as microabrasion causes reduction in the enamel surface and sometimes the tooth surface appear yellowish or darker due to exposure of dentin surface and thinning of enamel layer over it. In this condition, correction of this yellow color can be achieved by using tooth whitening technique to mask the color. ''Fragoso, et al.'' (2011) found that applying fluoride paste on enamel surface after microabrasion process provides higher hardness & more enamel smoothness. in addition, ''Segura et al'' found that the treated enamel surface become more resistant to demineralisation than untreated enamel and less colonisation of bacteria occur.

References

{{reflist Dentistry