Enamel microabrasion - Revision history

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	~~'''Enamel microabrasion''' is a~~ procedure ~~in [[cosmetic dentistry]] used to improve the appearance of the teeth. Like [[~~tooth ~~whitening]] it is used to remove [[tooth discoloration\|discolorations of the tooth surface]] but microabrasion is a mechanical, rather than chemical, procedure.~~		{{Short description\|A dental procedure for improving tooth aesthetics}}

	~~== History ==~~		'''Enamel microabrasion''' is a minimally invasive [[dental procedure]] used to improve the aesthetic appearance of [[tooth enamel]]. This technique is primarily employed to remove superficial discolorations and defects on the enamel surface, resulting in a smoother and more uniform appearance.
	~~In the past, teeth with stains or other color changes were made to look better through the use of restorative materials, such as~~ [[dental ~~porcelain~~]]~~. These materials would create a thin [[veneer (dentistry)\|veneer]] over the outer surface of~~ the ~~tooth. Although veneers looked better, these materials did not match the structure or characteristics~~ of ~~the~~ [[tooth enamel]] ~~and replacement was frequently needed~~. ~~As far back as 1916, some researchers were advocating instead removing a thin layer of the outermost enamel~~ to ~~expose~~ the (presumably) undamaged layer underneath.<ref>{{Cite journal\|vauthors=McCloskey RJ\|date=1984\|title=A technique for removal of fluorosis stains.\|url=\|journal=J Am Dent Assoc\|volume=109:63-64.\|pages=\|via=}}</ref> The first practical application of enamel ~~microabrasion was developed by Theodore Croll and Richard Cavanaugh~~ in ~~1986, who used a combination of weak [[hydrochloric acid]] and [[pumice]] to remove~~ a few tenths of millimeters of the enamel.<ref>{{cite journal\|last1=Croll\|first1=TP\|last2=Cavanaugh\|first2=RR\|title=Enamel color modification by controlled hydrochloric acid-pumice abrasion. I. technique and examples\|journal=Quintessence Int.\|date=Feb 1986\| volume=17\|issue=2\|pages=81–7\|pmid=3457401}}</ref><ref>{{cite journal\|last1=Croll\|first1=TP\|last2=Cavanaugh\|first2=RR\|title=Enamel color modification by controlled hydrochloric acid-pumice abrasion. II. Further examples.~~\|journal=Quintessence Int\|date=Mar 1986\|volume=17\|issue=3\|pages=157–64\|pmid=3458266}}</ref>~~

	== ~~Description~~ ==		==Procedure==
	~~Contemporary enamel~~ microabrasion ~~uses a combination of~~ mechanical ~~and chemical means to remove~~ of a ~~small amount~~ of ~~tooth~~ enamel ~~(not more than~~ a ~~few tenths~~ of a millimeter) to eliminate superficial discoloration.<ref>{{cite web\|title=PRĒMA Enamel Microabrasion Compound\|url=http://www.premusa.com/product/cosmetic-whitening/prema/\|website=Premier Dental\|publisher=Premier Dental\|accessdate=15 June 2017}}</ref> These discolorations [[Tooth discoloration#Cause\|can result from]] either from extrinsic factors (such as tobacco, ~~dental plaque, certain foods, etc.)~~ or ~~intrinsic ones (most commonly [[dental fluorosis]])~~.		Enamel microabrasion involves the mechanical removal of a thin layer of enamel using a combination of abrasive agents and acidic compounds. The process typically includes the application of a specialized paste containing hydrochloric acid and abrasive particles, which is gently rubbed onto the enamel surface using a rotary instrument or manually with a rubber cup.

	~~== Indications ==~~		The procedure is performed in a dental office and usually requires only one visit. The dentist carefully controls the amount of enamel removed to ensure that only the outermost layer is affected, preserving the underlying tooth structure. After the microabrasion, the teeth are polished to enhance their appearance and to protect the newly exposed enamel.
	* Dental fluorosis is ~~the most common indication where it ranges~~ in ~~severity from mild to severe, microabrasion should be considered the first option in treating mild~~ and ~~moderate cases of fluorosis~~.~~<ref>{{Cite journal\|vauthors=Celik EU, Yildiz G, Yazkan B\|date=2013\|title=Clinical evaluation~~ of enamel ~~microabrasion for~~ the ~~aesthetic management of mild-to-severe dental fluorosis.\|pmid=24320061\|journal=J Esthet Restor Dent\|volume=25\|issue=6\|pages=422–30\|doi=10.1111/jerd.12052}}</ref>~~
	* Removal of intrinsic enamel stains, ~~correction of surface irregularities and defects in enamel caused either after removal of orthodontic appliances or during~~ tooth ~~formation~~.~~<ref>{{Cite journal\|vauthors=Killian CM~~, ~~Croll TP\|date=1990\|title=Enamel microabrasion~~ to ~~improve~~ enamel ~~surface texture\|url=\|journal=J Esthet Dent\|volume=2:125-128~~.\|pages=\|via=}}</ref><ref>{{Cite journal\|vauthors=Croll TP\|date=1990\|title=Enamel microabrasion for removal of superficial dysmineralization and decalcification defects\|url=\|journal=J Am Dent Assoc\|volume=\|pages=\|via=}}</ref>

	== ~~Contraindications~~ ==		==Indications==
	* The patients' age is ~~not a limiting factor~~ for the ~~enamel microabrasion technique but in cases~~ of ~~not fully erupted teeth, it may be difficult to place~~ [[~~Rubber dams\|rubber dam~~]] ~~for~~ the ~~microabrasion process<ref name=Sundfeld>{{Cite journal\|vauthors=Sundfeld RH, Rahal V, de Alexandre RS, Briso AL, Sundfeld Neto D\|date=2011\|title=Smile restoration through use of~~ enamel ~~microabrasion associated with tooth bleaching\|pmid=23738859\|journal=Compend Contin Educ Dent\|volume=32\|issue=3\|pages=e53-7}}</ref>~~		Enamel microabrasion is indicated for the treatment of:
	* ~~Microabrasion is not indicated when discoloration is located in dentin such as in~~ [[~~dentigenous imperfecta~~]] or ~~[[Tetracycline antibiotics\|tetracycline discoloration~~.]]		* [[Dental fluorosis]]: A condition caused by excessive fluoride intake during tooth development, leading to white or brown stains on the enamel.
	* ~~Should be delayed or not used in patients with deficient labial seal because enamel surfaces are extremely dry which makes~~ stains ~~more obvious.so~~, ~~''Sundfeld~~, ~~et al'' in 2007, found that orthodontic lip repositioning should be done first to make removal of these stains more effective~~.<ref>{{Cite journal\|vauthors=Sundfeld RH, Croll TP, Briso AL, Alexandre RS, Sundfeld D\|date=2007\|title=Considerations about enamel microabrasion after 18 years\|pmid=17542197\|journal=Am J Dent\|volume=20\|issue=2\|pages=67–72}}</ref>		* [[Enamel hypoplasia]]: A developmental defect resulting in thin or pitted enamel.
			* Superficial stains: Discolorations caused by dietary factors, smoking, or certain medications.

	== ~~Consequences~~ ==		==Advantages==
	Patients can ~~benefit from combined microabrasion/ bleaching techniques as microabrasion causes reduction~~ in the ~~enamel surface and sometimes~~ the ~~tooth surface appear yellowish or darker due to exposure of dentin surface and thinning of enamel layer over it~~.~~In this condition, correction~~ of ~~this yellow color can be achieved by using tooth whitening technique to mask~~ the ~~color~~.~~<ref name=Sundfeld/>~~		The advantages of enamel microabrasion include:
			* Minimally invasive: The procedure preserves the majority of the tooth structure.
			* Immediate results: Patients can see an improvement in the appearance of their teeth immediately after the procedure.
			* Long-lasting effects: The results of microabrasion are permanent as long as the patient maintains good oral hygiene.

	''Fragoso, et al.'' (2011) found that applying [[Fluoride varnish\|fluoride paste]] on enamel surface after microabrasion process provides higher hardness & more enamel smoothness.<ref>{{Cite journal\|vauthors=~~Fragoso LS, Lima DA, Alexandre RS, Bertoldo CE, Aguiar FH, Lovadino JR\|date~~=~~2011\|title~~=~~Evaluation of physical properties of~~ enamel ~~after~~ microabrasion, ~~polishing~~, ~~and storage in artificial saliva~~.~~\|pmid=21487176\|journal=Biomed Mater\|volume=6\|issue=3\|pages=035001\|doi=10.1088/1748-6041/6/3/035001\|bibcode=2011BioMa...6c5001F}}</ref> in addition, ''Segura et al'' found that the treated~~ enamel ~~surface become more resistant~~ to ~~[[Demineralization (physiology)\|demineralisation]] than untreated enamel and less colonisation of bacteria occur~~.<ref>{{Cite journal\|vauthors=Segura A, Donly KJ, Wefel JS, Drake D\|date=1997\|title=Effect of enamel microabrasion on bacterial colonization\|pmid=9590914\|journal=Am J Dent\|volume=10\|issue=6\|pages=272–4}}</ref>		==Limitations==
			While enamel microabrasion is effective for superficial defects, it is not suitable for:
			* Deep intrinsic stains: Discolorations that originate from within the tooth structure, such as those caused by tetracycline antibiotics.
			* Extensive enamel loss: Cases where significant enamel has been lost due to erosion or wear.

	== ~~References~~ ==		==Aftercare==
	~~{{reflist}}~~		Following enamel microabrasion, patients are advised to:
			* Maintain good oral hygiene practices, including regular brushing and flossing.
			* Avoid foods and beverages that can stain the teeth, such as coffee, tea, and red wine.
			* Use a fluoride toothpaste to help strengthen the enamel.

			==Related pages==
			* [[Tooth whitening]]
			* [[Dental fluorosis]]
			* [[Enamel hypoplasia]]
			* [[Cosmetic dentistry]]

	[[Category:Dentistry]]		[[Category:Dentistry]]
	~~{{dictionary-stub1}}~~		[[Category:Cosmetic dentistry]]
	~~{{No image}}~~

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'''Enamel microabrasion''' is a procedure in [[cosmetic dentistry]] used to improve the appearance of the teeth. Like [[tooth whitening]] it is used to remove [[tooth discoloration|discolorations of the tooth surface]] but microabrasion is a mechanical, rather than chemical, procedure.

== History ==
In the past, teeth with stains or other color changes were made to look better through the use of restorative materials, such as [[dental porcelain]]. These materials would create a thin [[veneer (dentistry)|veneer]] over the outer surface of the tooth. Although veneers looked better, these materials did not match the structure or characteristics of the [[tooth enamel]] and replacement was frequently needed. As far back as 1916, some researchers were advocating instead removing a thin layer of the outermost enamel to expose the (presumably) undamaged layer underneath.<ref>{{Cite journal|vauthors=McCloskey RJ|date=1984|title=A technique for removal of fluorosis stains.|url=|journal=J Am Dent Assoc|volume=109:63-64.|pages=|via=}}</ref> The first practical application of enamel microabrasion was developed by Theodore Croll and Richard Cavanaugh in 1986, who used a combination of weak [[hydrochloric acid]] and [[pumice]] to remove a few tenths of millimeters of the enamel.<ref>{{cite journal|last1=Croll|first1=TP|last2=Cavanaugh|first2=RR|title=Enamel color modification by controlled hydrochloric acid-pumice abrasion. I. technique and examples|journal=Quintessence Int.|date=Feb 1986| volume=17|issue=2|pages=81–7|pmid=3457401}}</ref><ref>{{cite journal|last1=Croll|first1=TP|last2=Cavanaugh|first2=RR|title=Enamel color modification by controlled hydrochloric acid-pumice abrasion. II. Further examples.|journal=Quintessence Int|date=Mar 1986|volume=17|issue=3|pages=157–64|pmid=3458266}}</ref>

== Description ==
Contemporary enamel microabrasion uses a combination of mechanical and chemical means to remove of a small amount of tooth enamel (not more than a few tenths of a millimeter) to eliminate superficial discoloration.<ref>{{cite web|title=PRĒMA Enamel Microabrasion Compound|url=http://www.premusa.com/product/cosmetic-whitening/prema/|website=Premier Dental|publisher=Premier Dental|accessdate=15 June 2017}}</ref> These discolorations [[Tooth discoloration#Cause|can result from]] either from extrinsic factors (such as tobacco, dental plaque, certain foods, etc.) or intrinsic ones (most commonly [[dental fluorosis]]).

== Indications ==
* Dental fluorosis is the most common indication where it ranges in severity from mild to severe, microabrasion should be considered the first option in treating mild and moderate cases of fluorosis.<ref>{{Cite journal|vauthors=Celik EU, Yildiz G, Yazkan B|date=2013|title=Clinical evaluation of enamel microabrasion for the aesthetic management of mild-to-severe dental fluorosis.|pmid=24320061|journal=J Esthet Restor Dent|volume=25|issue=6|pages=422–30|doi=10.1111/jerd.12052}}</ref>
* Removal of intrinsic enamel stains, correction of surface irregularities and defects in enamel caused either after removal of orthodontic appliances or during tooth formation.<ref>{{Cite journal|vauthors=Killian CM, Croll TP|date=1990|title=Enamel microabrasion to improve enamel surface texture|url=|journal=J Esthet Dent|volume=2:125-128.|pages=|via=}}</ref><ref>{{Cite journal|vauthors=Croll TP|date=1990|title=Enamel microabrasion for removal of superficial dysmineralization and decalcification defects|url=|journal=J Am Dent Assoc|volume=|pages=|via=}}</ref>

== Contraindications ==
* The patients' age is not a limiting factor for the enamel microabrasion technique but in cases of not fully erupted teeth, it may be difficult to place [[Rubber dams|rubber dam]] for the microabrasion process<ref name=Sundfeld>{{Cite journal|vauthors=Sundfeld RH, Rahal V, de Alexandre RS, Briso AL, Sundfeld Neto D|date=2011|title=Smile restoration through use of enamel microabrasion associated with tooth bleaching|pmid=23738859|journal=Compend Contin Educ Dent|volume=32|issue=3|pages=e53-7}}</ref>
* Microabrasion is not indicated when discoloration is located in dentin such as in [[dentigenous imperfecta]] or [[Tetracycline antibiotics|tetracycline discoloration.]]
* Should be delayed or not used in patients with deficient labial seal because enamel surfaces are extremely dry which makes stains more obvious.so, ''Sundfeld, et al'' in 2007, found that orthodontic lip repositioning should be done first to make removal of these stains more effective.<ref>{{Cite journal|vauthors=Sundfeld RH, Croll TP, Briso AL, Alexandre RS, Sundfeld D|date=2007|title=Considerations about enamel microabrasion after 18 years|pmid=17542197|journal=Am J Dent|volume=20|issue=2|pages=67–72}}</ref>

== Consequences ==
Patients can benefit from combined microabrasion/ bleaching techniques as microabrasion causes reduction in the enamel surface and sometimes the tooth surface appear yellowish or darker due to exposure of dentin surface and thinning of enamel layer over it.In this condition, correction of this yellow color can be achieved by using tooth whitening technique to mask the color.<ref name=Sundfeld/>

''Fragoso, et al.'' (2011) found that applying [[Fluoride varnish|fluoride paste]] on enamel surface after microabrasion process provides higher hardness & more enamel smoothness.<ref>{{Cite journal|vauthors=Fragoso LS, Lima DA, Alexandre RS, Bertoldo CE, Aguiar FH, Lovadino JR|date=2011|title=Evaluation of physical properties of enamel after microabrasion, polishing, and storage in artificial saliva.|pmid=21487176|journal=Biomed Mater|volume=6|issue=3|pages=035001|doi=10.1088/1748-6041/6/3/035001|bibcode=2011BioMa...6c5001F}}</ref> in addition, ''Segura et al'' found that the treated enamel surface become more resistant to [[Demineralization (physiology)|demineralisation]] than untreated enamel and less colonisation of bacteria occur.<ref>{{Cite journal|vauthors=Segura A, Donly KJ, Wefel JS, Drake D|date=1997|title=Effect of enamel microabrasion on bacterial colonization|pmid=9590914|journal=Am J Dent|volume=10|issue=6|pages=272–4}}</ref>

== References ==
{{reflist}}

[[Category:Dentistry]]
{{dictionary-stub1}}