Fluoride in Dentistry - A DOUBLE EDGED SWORD

1. Palani Selvi. K
Final year PG
Department of Conservative Dentistry
and Endodontics
12th July 2018
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3. FLUORIDE
In Conservative Dentistry
DENTAL
FLUOROSIS
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CARIES PREVENTION AND
FLUORIDE

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• FLOURIDE releasing Sealants are the
effective caries protective agents to the
extent they remain bond safe.
• The cariostatic properties of sealants are
attributed to the physical obstruction of
the pit and grooves.

11. FLUORIDE RELEASING DENTAL MATERIALS
GIC GIOMERS CERMETS COMPOMER COMPOSITES
AMALGAM
BOND
+
+
+
+
+
+
+
+
+
+
+
+
+ +
GC Fuji
Ketac
FX- II
ChemFil
Reva Silver
Proglass
SIlver
F 2000
Dyract Flow
Compomer
Flexi Flow
Ti- core
Alloy bond
Natural
bond DE
Beautifil II
Beautifil plus
Reactmerpaste
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F
L
O
U
R
O
S
I
S

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F
L
O
U
R
O
S
I
S

15. Dental Fluorosis - The Esthetic Perspective

16. DENTAL
FLUOROSIS
MILD –
MODERATE MICROABRASION
MACROABRASION
DIRECT
COMPOSITE
BONDING
VENEERS
CROWNS
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MODERATE –
SEVERE
BLEACHING

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SCORE TREATMENT
1 - 2 BLEACHING
3 - 4 MICROABRASION
MACROABRASION
5 – 7
and
UNSUCCESSFUL
TREATMENT TFI - 4
VENEERS
8 - 9 CROWNS
Based on
THYLSTRUP- FEJERSKOV INDEX

18. Researchgate.net October 2016
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McInnes Solution – 30 % H2O2, 36% HCl, 0.2% Ether (5:5:1)
PRE OPERATIVE POST OPERATIVE

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PRE OPERATIVE
POST OPERATIVE
Using 30% HYDROGEN PER OXIDE – (POLA OFFICE)

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PRE OPERATIVE POST OPERATIVE
Using 30% HYDROGEN PER OXIDE ( POLA OFFICE)

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PRE - OP POST - OP
Using 10% CARBAMIDE PER OXIDE

24. MICROABRASION
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PRE - OP
POST - OP
1986 – Croll & Cavanaugh:
The slurry of hydrochloric acid and silicone carbide microparticles ( PREMA)
was applied, and the surfaces were microabraded using rubber prophy cups
attached to a handpiece.

25. MACROABRASION
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PRE - OP
Recontouring and polishing using 12- fluted carbide
bur at high speed.
POST - OP
Removal Of Intrinsic Stains From Vital Teeth By A Combination Therapy
Indian Journal of Dental Sciences 2013

26. DIRECT COMPOSITE VENEER
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PRE - OP POST - OPTOOTH
PREPARATION

27. CERAMIC VENEER
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PRE - OP
UPPER TOOTH
PREPARATION
LOWER TOOTH
PREPARATION
POST - OP

28. CERAMIC VENEER
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PRE - OP POST - OPLAB PROCESSING

29. ESTHETIC CHALLENGES
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30. • Grinding of enamel removes the outer hypermineralized
50–80 µm thick enamel layer in fluorosed teeth.
• Composites and Ceramics can be reliably bonded to
fluorosed teeth,depending on the degree of fluorosis.
• Good choice of adhesive would be a good TWO-STEP
SELF-ETCH ADHESIVE
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• CERAMIC bonding – Etching with HYDROFLUORIC ACID and
AMMONIUM BIFLUORIDE followed by SILANIZATION
JOURNAL COMPILATION © 2009, WILEY PERIODICALS, INC.

31. Shade selection
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32. • The severity of the lesion alone determines
the treatment option.
• Newer treatment options which combine
these various treatment modalities are
emerging.
• The dentist must be aware of all the
treatment modalities available to us.
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33. • Sturdevant’s art and science of operative dentistry
• Moller’s textbook on Dental Fluorosis
• Fejerskov 1990- The nature and mechanism of dental
fluorosis in man. J Res Dent,
• Summit’s fundamentals of operative dentistry
• Pickard’s manual of operative dentistry
• Marc Giessberg’s Esthetic dentistry in clinical practice
• Esthetics in dentistry – Goldstein
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