This case report describes a combination treatment composed of tooth whitening, microabrasion, resin infiltration, and resin-based composite restoration to manage multifactorial stained enamel lesions on anterior teeth.

Clinical Considerations

The patient’s primary concern was to improve the esthetics of their smile after about a decade of extensive orthodontic and orthognathic procedures. After clinical evaluation and history taking, the authors determined that the enamel defects were the result of carious and developmental factors. In-office tooth whitening took place in one visit, followed by micro abrasion and resin infiltration in another visit. Thirteen months later, a follow-up visit showed that the results were stable and that the patient was satisfied with the overall outcome. A small resin composite restoration was added at the follow up visit to repair a previous restoration and to reestablish the facial contours of the central incisor.


A combination treatment protocol composed of tooth whitening, microabrasion, and resin infiltration can improve patient satisfaction and avoid unnecessary invasive treatment.

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