Enamel microabrasion for removal of superficial coloration and surface texture defects

Enamel microabrasion is a method of removing superfi cial enamel coloration defects. Brown, white, and multicolored spots and streaks in tooth surfaces have been called “dysmineralization,” and in some cases, such as fl uorosis, their cause is known. In other cases in which etiology of the defect is unknown, the proper diagnosis is “idiopathic enamel dysmineralization.” Decalcifi cation defects, which are white, result from acid dissolution of the outer layer of enamel and are the fi rst stage in the dental caries process. Analogous to dermabrasion on skin surfaces, enamel microabrasion permanently removes coloration defects with a compound made of dilute hydrochloric acid and a fi ne abrasive powder, in a water-soluble silica gel. The enamel surface is reduced microscopically by simultaneous abrasion and erosion, and enamel loss is insignifi cant and unrecognizable. This chapter reviews the procedure of microbrasion of enamel surfaces and gives examples of treatment for decalcifi cation, dysmineralization, and surface texture improvement. A fourth case shows 27-year postoperative results.