Amber Auger RDH, MPH

Orthodontic treatment with fixed appliances increases the concentration of acidogenic bacteria in the plaque and raise the levels of Streptococcus mutans and Lactobacilli.1 This increase of acid attack increases White spot lesions (WSLs) are very common post orthodontic treatment.1 Clinical studies demonstrate that WSLs can appear within the first four weeks of traditional orthodontic treatment. These factors provide an environment where the bacteria can rapidly progress the rate of tooth decay. Studies demonstrate that males are more likely to be affected by WSLs as they tend to lack meticulous homecare.1 Empowering the patient to select therapeutic products to reduce their risks and improved homecare will reduce the progression of demineralization. Providing a white spot lesion treatment chairside can provide the patient with a confident smile.

Icon® Infiltration Concept – Smooth Surface Mini Kit, 2/Pkg - DMG-America Icon® is used for the microinvasive treatment of dental lesions in the proximal region and on smooth surfaces. In one patient visit, and with no drilling, Icon® can arrest the progression of early enamel lesions (caries) and white spot caries-like lesions.
Written by Dr. Chad Duplantis Icon has been a great addition to our practice and an effective service for our patients following orthodontic treatment. Prior to Icon, we experienced mixed results when treating “white spot lesions” with fluoride protocols. This minimally invasive treatment option has provided fantastic results.

Resin Infiltration
A resin infiltration, known as DMGs Icon® treatment is a minimally invasive restorative treatment for WSLs and hypocalcified enamel lesions often found congenitally. Clinical studies demonstrate that a “resin infiltration is a micro-invasive technique, as in the process a superficial layer of less than 30 μm of demineralized and sound enamel is removed.”2 The goal of the infiltration treatment is to reduce the risk of multiple restorations on an area. This resin infiltration procedure can be completed on radiographically confirmed lesions that effect half of the enamel or in the outer third of the dentin.2

The Icon treatment seals micro permeability of the incipient caries and prevents the bacteria from invading further into the enamel. The low-viscosity hydrophilic light-curing material is able to penetrate the subsurface lesion to prevent the progression of the demineralization. This application is completed by cleaning and drying the tooth surface; applying a rubber dam; using a wedge to separate the teeth from one another; etching for two minutes with HCL 15%; water-air spray in order to remove any additional etch; application of 99% ethanol for 30 seconds to assist dryness and application of resin infiltrate.

Patient Selection
Resin infiltration is a minimally invasive treatment that any patient with a WSL can benefit from. This is especially important in the prevention of the progression of decay through blocking the bacteria from entering into an area that is already compromised from demineralization. When selecting your patients, the Icon product can serve a wide range of patients such as those who have limited resources, developmental challenges, pediatric and geriatric patients. There are no limitations who can benefit from the Icon treatment.

Placement by Registered Dental Hygienists
State regulations dictate if the dental hygienist can place the Icon technology. The dental professional will need to determine if an additional certificate is needed to comply with state laws. The states that allow RDHS to place the Icon technology are Arkansas, California for those with RDAEF, Idaho, Kentucky, Maine, New Mexico, New York, North Dakota, Oregon, Pennsylvania, Washington and Wyoming with additional certificate.3

Placement by Registered Dental Assistants
The benefits of the Icon treatment are impressive. Icon provides an esthetic result on smooth surfaces and allows the caries to be arrested at its earliest stages. Empowering patients to choose products that will decrease their risk of tooth decay and improve oral hygiene habits is essential to inhibit further and future decay. Icon is a minimally invasive therapy that can be completed in the dental hygiene department. To determine what services can be provided by a dental assistant visit the Dental Assisting National Board Inc at DANB.ORG.4

Jul 28, 2017 To date, it’s been the most effective treatment modality I’ve had for dealing with fluorosis stains, white spot lesions and decalcified spots. Recently I started implementing DMG's ICON treatment. It’s resin infiltration that “fills in” the de-calcified areas leading to the white spots.

One of the most rewarding parts of the dental profession is being able to give our patients a more confident smile. Icon provides a minimally invasive treatment to give patients a reduction in their white spot lesions without sensitivity. The Icon treatment is backed by science and proven effective; therefore this unique technology should be offered to every patient affected by white spot lesions.

References
1. Khoroushi M, Kachuie M. Prevention and Treatment of White Spot Lesions in Orthodontic Patients. Contemp Clin Dent. 2017;8(1):11–19. doi:10.4103/ccd.ccd_216_17

Dmg Icon Sds

2. Meligy OAESE, Ibrahim STE, Alamoudi NM (2018) Resin Infiltration of Non-Cavitated Proximal Caries Lesions: A Literature Review. J Oral Hyg Health 6: 235. DOI: 10.4172/2332-0702.1000234

3. American Dental Hygienists’ Association. (rev: April 2016). Dental Hygienists Restorative Duties
by State. Retrieved from https://www.adha.org/sites/default/files/7516_Restorative_Duties_by_ State_0.pdf.

4. Dental Assisting National Board, Inc. Meet State Requirements. Retrieved from https://www.danb. org/en/Meet-State-Requirements/State-Specific-Information.aspx.

RESIN INFILTRATION OF WHITE-SPOT LESIONS

WHAT IS ICON? Resin infiltration is a minimally invasive restorative treatment for post-ortho white-spot lesions (WSLs) and certain congenital hypocalcified enamel lesions (“hypo” spots). WSLs are associated with subsurface enamel porosities caused by a cyclical imbalance between demineralization and remineralization of the enamel, resulting from poor hygiene and associated plaque, bacteria and acids. With time, reminerlization at the outer surface of the tooth decreases the access of calcium and other ions to deeper portions of the enamel, eventually arresting the lesion. The lesions look white because there is a scattering of light at the subsurface of the demineralized enamel. Hypo spots, or enamel bruising, are congenital enamel defects often caused by trauma or infection involving the primary teeth.

* photos are actual ACDS patients, not stock photography Mac games free. download full version.

Example cases of congenital hypo lesions

Example cases of post-orthodontic white spot lesions

· First described 40 years ago
· Low viscosity, unfilled resin
· Penetrates demineralized enamel and fades the appearance of WSLs and hypo spots
· Optical properties similar to those of natural enamel, so it matches the natural shade of the tooth

THE PROCEDURE

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· no “shots” or numbing
· no drilling
· plain pumice is used to clean the teeth
· lesions etched 3×2 minutes – this removes the outer remineralized layer of enamel that had previously been blocking calcium and other ions from entering the tooth
· finishing bur on any surfaces that do not indicate an improved appearance
· application of drying agent (ethanol)
· application of the resin infiltrant
· material soaks in for 3 minutes (allowing for capillary action)
· remove excess material with cotton rolls, micro-brushes & floss
· light cure the material
· material added again for 1 minute, excess removed, and cured
· finish with polishing discs or burs
· temporary blanching of gums can occur in lesions close to the gumline
* total process takes approximately 45 minutes to 1 hour *

BENEFITS

· much less invasive and less expensive than the alternatives of fillings or veneers
· can be done sooner than other cosmetic options like veneers that you have to wait until growth is complete
· Untreated hypo spots often look worse after bleaching. Hypo spots treated with Icon will whiten similarly to the natural to

2021.03

Dmg Icon White Spot Treatment

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