Clinical Relevance

Enamel microabrasion is an effective first-line esthetic treatment for the removal of tooth stains due to fluorosis, with an improvement in the appearance of teeth that is associated with a high level of patient acceptance.


To assess the immediate postoperative clinical efficacy of an enamel microabrasion procedure for the management of stained dental fluorosis.

Methods and Materials:

A total of 103 maxillary and mandibular teeth exhibiting fluorosis from 21 patients assessed according to the Thylstrup-Fejerskov (TF) index were treated using enamel microabrasion. All teeth were subjected to enamel microabrasion using Opalustre (Ultradent Products Inc, South Jordan, UT, USA). Pretreatment and 24-hour posttreatment photographs were taken using a digital single-lens reflex camera. A visual analog scale (VAS) with scores ranging from 1 to 7 was used to assess improvement in appearance and change in brown stains followed by photographic ΔE assessment using the CIEDE2000 formula. Patient satisfaction and tooth sensitivity were recorded on a VAS ranging from 1 to 5. Data were analyzed using parametric and nonparametric tests (α=0.05).


There was a significant difference (p<0.001) between the pretreatment appearance/brown stain scores and the posttreatment appearance/change in staining scores. A significant difference (p<0.05) was noted in the posttreatment L* and ΔE values, and 80% of patients were satisfied with the treatment. No patients reported sensitivity.


The results of the present study show the efficacy of microabrasion for the esthetic management of stained dental fluorosis with a high level of patient acceptance and absence of tooth sensitivity. The drawback of microabrasion in the posttreatment result is influenced by the preoperative severity of the initial fluorosis.

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