Dr Maryem Muneer Awan, Dr Shaista Zahid, Dr Naila Aman
The long-term clinical performance of combined therapy including enamel micro-abrasion and vital bleaching is debatable due to the abrasion of outer enamel surface. The aim of this longitudinal cohort study was to evaluate the 3-year clinical performance of enamel micro-abrasion in combination with vital tooth bleaching for the esthetic management of fluorosed teeth. Fifteen patients with 176 flourished incisors and canines were included in this study. All the teeth were treated with enamel micro-abrasion (Opalustre, Ultradent), and at-home bleaching technique (10% Opalescence PF, Ultradent). Fluorosed teeth were evaluated at baseline, after micro-abrasion, after combined therapy, and at 3-year follow-up in terms of esthetical criteria (esthetical appearance, brown stains, and opaque white areas), side effects, and patient satisfaction using visual analogue scales. The data were statistically analysed (α = 0.05). Results: Flourished teeth revealed significantly better esthetical appearance after micro-abrasion and combined therapy and at 3-year follow-up compared to those at baseline (P < 0.05). There was a significant relapse in the esthetical appearance and brown stains at 3 year follow-up (P < 0.05). The combined therapy was effective in the esthetical management of flourished teeth. However, a significant relapse was observed in the esthetical appearance and brown stains of these patients after 3 years, which also reduced patient satisfaction. Keywords: Clinical trial, dental fluorosis, enamel micro-abrasion, relapses in bleaching, vital bleaching.