Enamel pretreatment with sodium hypochlorite to enhance bonding in hypocalcified amelogenesis imperfecta: case report and SEM analysis. Paediatr Dent

Department of Pediatric Dentistry, University of North Carolina at Chapel Hill.
Pediatric dentistry (Impact Factor: 0.56). 11/1993; 16(6):433-6.
Source: PubMed


Bonding composite resin to enamel of teeth affected by amelogenesis imperfecta (AI) is often problematic, especially in cases with poorly mineralized, friable enamel. Difficulty in bonding hypomineralized enamel can significantly limit the restorative and orthodontic treatment options for AI patients. In this report, we document a novel approach to bonding AI enamel by pretreating the tooth surface with 5% sodium hypochlorite (NaOCl), resulting in improved bonding of an orthodontic bracket to a previously impacted maxillary canine.

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    • "A few studies evaluated the adhesion of adhesive resins to hypomineralised enamel and suggested some methods to improve the bonding interface. Pretreatment of hypomineralised enamel with 5% sodium hypochlorite (NaOCl) has been recommended to remove excess enamel proteins (deproteinisation), thus improving the bond strength [9-12]. Some authors [13] believe that self-etching adhesives bond better to hypomineralised enamel than total-etch systems. "
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    ABSTRACT: The aim of this investigation was to assess the effects of different treatments of demineralised enamel on microleakage under orthodontic brackets. Seventy-five intact premolars were randomly assigned to five groups. The teeth in groups 2 through 5 were immersed in a demineralising solution for 16 weeks. In groups 1 (control) and 2 (demineralised/control), conventional acid etching was used. In group 3, sodium hypochlorite (NaOCl) was applied on the enamel surface for 1 min after acid etching, and in group 4, Transbond Plus (3M Unitek, Monrovia, CA, USA) self-etching primer (SEP) was used. The teeth in group 5 were treated with 2% sodium fluoride (NaF) for 4 min before etching. After bracket bonding, the specimens were thermocycled, sealed with nail varnish, immersed in 0.5% basic fuchsine solution for 24 h and sectioned. Microleakage was measured under a stereomicroscope for the enamel-adhesive and adhesive-bracket interfaces of both occlusal and gingival sides. Demineralised teeth showed more microleakage at the enamel-adhesive interface on both occlusal and gingival sides compared to sound teeth, but the difference was not significant (P > 0.005). Treating the demineralised enamel with 5% NaOCl or Transbond Plus SEP was not effective in reducing microleakage. NaF treatment followed by acid etching of demineralised enamel resulted in significantly lower microleakage in most comparisons (P < 0.005). The use of 2% NaF on hypomineralised enamel before the bracket bonding procedure is an effective way to decrease microleakage.
    Full-text · Article · May 2013
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    • "We experienced bonding failure several times in eruption of impacted teeth and during the fixed orthodontic therapy. Although in teeth affected with hypocalcified-AI, enamel shear bond strength may be enhanced with pretreating the tooth surface with 5% sodium hypoclorite,37–39 there is no method to enhance bond strength for the hypomature and hypoplastic types of AI. In addition to this, the unfavorable morphology of the affected and sensitive teeth also makes them inappropriate for removable orthodontic appliances.31 "
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    ABSTRACT: Amelogenesis imperfecta (AI) encompasses a complicated group of hereditary conditions that cause developmental alterations in the structure of the enamel in the absence of a systemic disorder. AI primarily affects the quality and/or quantity of dental enamel, and it may affect all or only some of the teeth in the primary and/or permanent dentition. This clinical report describes the oral rehabilitation of a 21-year-old man diagnosed with hypomaturation-type AI. He presented with discolored and mutilated teeth. Cephalometrically, the patient has skeletal class II malocclusion due to mandibular deficiency considered as a result of maxillary constriction. The interdisciplinary approach was followed because of the complex needs of the patient. The aim of treatment was to restore aesthetics, improve malocclusion and masticatory function. Aesthetic and functional expectations were met with metal ceramic restorations. In this report, the interdisciplinary approach for a patient with AI and a malocclusion is described.
    Preview · Article · Apr 2011
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    • "15 Abdulkadir Sengun1 managed a 14-year-old boy with X linked recessive hypomaturation type of amelogenesis imperfecta with the placement of nickel chrome onlays in the molar region and direct resin composite restoration on the incisors, canines and premolars. However, the etching pattern of amelogenesis imperfecta is atypical due to abnormal prism structures16 so pretreatment of the affected enamel by sodium hypochlorite solution to enhance bonding has been suggested.17 Full coverage adhesive composite crowns or polycarbonate crowns have also been advocated but strict oral hygiene measures need to be implemented because of the plaque retentive nature of the restorative materials and passive eruption, which will inevitably expose more defective enamel.6 "
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    ABSTRACT: Amelogenesis Imperfecta is a hereditary anomaly that affects the enamel of human teeth and is not associated with any systemic disorder of affected patients. The affected teeth are disturbed in coloration, thickness and resistance. The rehabilitation of amelogenesis imperfecta in a child must take into account the development of the child's teeth, the health of the periodontal tissues and the maxillary and mandibular growth. This article reports the endodontic and occlusal rehabilitation of a 14-year-old girl affected with autosomal recessive hypocalcified type of amelogenesis imperfecta with multiple periapical cysts.
    Full-text · Article · Sep 2008
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