Resin Infiltration Technique for White Spot Lesions – A Minimally Invasive Approach with Aesthetic and Functional Outcomes

Abstract

<p><br>Introduction / Background<br>The resin infiltration technique (ICON, DMG) represents a paradigm shift in managing early enamel lesions, combining minimally invasive principles with aesthetic enhancement. Initially developed to arrest non-cavitated carious lesions by occluding enamel porosity, its applications now extend to treating fluorosis, post-orthodontic demineralization, and developmental defects like amelogenesis imperfecta. This technique, which employs a low-viscosity triethylene glycol dimethacrylate (TEGDMA)-based resin, penetrates enamel pores via capillary action, replacing air/water (refractive index [RI] = 1.0–1.33) with resin (RI = 1.52), thereby reducing light scattering and masking discoloration. While its immediate aesthetic results are well-documented, concerns persist regarding long-term color stability and susceptibility to extrinsic staining.</p><p>Objective / Method<br>This review evaluates the clinical efficacy, color stability, and limitations of resin infiltration for white spot lesions (WSLs), synthesizing evidence from in vitro and in vivo studies to guide clinical decision-making.</p><p>Key Findings / Result</p><p>Mechanism and Immediate Efficacy:</p><p>Resin infiltration fills 70–90% of enamel porosity, increasing surface microhardness by 30–50% and reducing lesion progression by 85–95% (Paris et al., 2010; Senestraro et al., 2013).<br>Aesthetic improvement is immediate, with ΔE (color difference) values <3.7 (clinically imperceptible) in 90% of cases, effectively masking WSLs (Kim et al., 2011).<br>Long-Term Color Stability:</p><p>In vivo studies report ΔE >5.0 (clinically noticeable) in 20–30% of cases at 12–24 months, linked to extrinsic staining from coffee, tea, or smoking (Knösel et al., 2017).<br>In vitro models underestimate staining due to the absence of biofilm and dietary variables, showing ΔE <2.0 after 6 months (Sundfeld et al., 2019).<br>Comparative Outcomes:</p><p>Superior to fluoride varnishes in lesion arrest (OR = 3.2; 95% CI: 1.8–5.6) and less invasive than microabrasion or composite restorations (Soviero et al., 2021).<br>Contraindicated for lesions extending beyond the outer enamel third, with retention rates >85% at 2 years (Cochrane et al., 2012).<br>Clinical Implications / Result</p><p>Advantages: Single-visit, painless, and preserves tooth structure. Ideal for anxious patients and active lesions.<br>Limitations: Variable long-term aesthetics; requires patient compliance to avoid chromogenic agents.<br>Conclusion<br>Resin infiltration is a gold-standard minimally invasive treatment for WSLs, offering immediate aesthetic and functional benefits. However, clinicians must address its susceptibility to extrinsic staining through patient education and periodic follow-ups. Future research should focus on resin modifications (e.g., nano-filled infiltrants) to enhance durability and color stability.</p>