Volume 2 - Issue 1 (Nov-Jan) - IJMD

Case reportEsthetic Enhancement of Discolored Teeth by MacroabrasionMicroabrasion and its psychological impact on patients - A case seriesPratima Shenoi*, Archana Kandhari**, Mohit Gunwal**AbstractArt of dentistry has long been part of quest to achieve a beautiful smile. In today’s exceedingly competitive world, estheticsplays a major role in personal grooming and presentation. The ‘first impression’ craze has continually impressed upon theyounger generation, the importance of a bright white smile. In this era of highly sophisticated technological marvels thistechnique will help to fulfill our social obligation to the underprivileged with the improvement in the psychological status ofpatient after treatment so as they can overcome low confidence in public appearance.Key words: Esthetics, macro and microabrasionArt of dentistry has long been part of quest toachieve a beautiful smile. In today’s highlycompetitive world, esthetics plays a majorrole in personal grooming and presentation. The ‘firstimpression’ craze has continually impressed upon theyounger generation, the importance of a bright whitesmile. The need of this smile is no longer the privilegeof the rich. Even the commoner and also the ruralpopulation have become increasingly aware of thepower of smile. The media has added fuel to fire andthe quest of a perfect smile goes on.Discolored teeth are considered as major impairmentin esthetics. An array of treatment alternatives likeceramics or composite veneering, bleaching, fullcoverage crowns macroabrasion and microabrasionare available. Most of these treatment modalities areexpensive, need exclusive materials and the need ofspecialized laboratories.In India discolored teeth with fluorosis are seen in villagepopulation where drinking water is still consumed fromwells in the house. Though the revolution in media hasmade them aware of beauty of white sparkling smile;*Professor and Head**PG StudentDept. of Conservative Dentistry and EndodonticsVSPM’s Dental College and Research Centre, Digdoh Hill, NagpurAddress for correspondenceDr. Pratima Shenoi301, Abhinav Residency, B-1, Laxminagar,Nagpur-440022, MaharashtraE- mail: prshenoi@gmail.commost available treatment is much beyond their financiallimits and remains neglected coupled with the paucityof experts in the neighborhood.Macroabrasion along with microabrasion is beenin practice since early 19 th century. It’s a combinedchemomechanical approach for esthetic managementof superficial enamel defects. It is least invasive estheticprocedure which unfortunately has been over shadowedby other means of restorations like composite, veneersor crown. In our nation, it could serve as a magic wandand help the fraternity to serve the poor and needy inmost esthetic, conservative and inexpensive way.Review of Macro-and Micro-abrasionChapman in 1877, who was the first to bleach theteeth affected with fluorosis using oxalic acid. The firstrecorded use of hydrochloric acid to remove fluorosisstains was done by Kane and Spring in 1916. Kaneapplied hydrochloric acid on the affected surfaces andapplied direct flame from an alcohol torch to accelerateacid penetration. Later, Kane dispensed with the use ofthe flame and only applied the hydrochloric acid andwas able to eliminate the fluorosis stains. 1However, McCloskey continued the work taken up byKane and used 18% HCl with good results without anydamage to the teeth. Later, McCloskey used 18% HClwith pumice applying the solution for five seconds andthen cleaning with water jet for 10 seconds. Croll andCavanacegh utilized McCloskey’s technique extensivelyand achieved very good results with no deleteriouseffects on the pulps or the surrounding tissues. 1388Indian Journal of Multidisciplinary Dentistry, Vol. 2, Issue 1, November 2011 to January 2012