Enamel Opacity Management: A Case for Tailored Resin Infiltration and Diagnostic Precision

Abstract

Aims: This case addresses an adolescent's aesthetic concerns from dental fluorosis (DF) white spots and molar incisor hypomineralization (MIH) lesions. The goal was to restore smile aesthetics via a conservative, adapted approach. Presentation of Case: A healthy 14-year-old male presented to a dental school with aesthetic dissatisfaction from mild fluorosis and HMI-TNI_2a (MIH without hypersensitivity, with defect extension less than 1/3) on anterior and posterior teeth. Lesion depth and Icon® (DMG, Hamburg, Germany) resin infiltration application were guided by transillumination. Therapy involved selective enamel reduction and 15% hydrochloric acid cycles exclusively for MIH, followed by resin infiltration (RI) for all areas. Immediate post-treatment evaluation showed significant aesthetic improvement, including reduced opacity, improved color uniformity, and masking of dyschromias. Discussion: Resin Infiltration (RI) revolutionizes the treatment of DF and HMI, delivering remarkable aesthetics while preserving tooth structure, surpassing traditional restorations. Selective enamel reduction is crucial for deeper lesions. Its success requires meticulous case selection, precise evaluation, and skilled technique, profoundly impacting contemporary dental practice and patient quality of life Conclusion: This case demonstrates the successful multimodal and personalized treatment of an adolescent's aesthetic concerns, even for MIH and DF lesions initially perceived as moderately severe. The combination of selective enamel reduction for deeper MIH lesions (revealed by transillumination) and resin infiltration for all defects promoted notable aesthetic improvement and high patient satisfaction.