Power bleaching enhances resin infiltration masking effect of dental fluorosis. A randomized clinical trial

J Dent. 2018 Dec;79:77-84. doi: 10.1016/j.jdent.2018.10.005. Epub 2018 Oct 18.


Objectives: Patients with moderate dental fluorosis often feel esthetically compromised. Aim of this RCT was to evaluate the objectively and self-assessed masking effect of resin infiltration alone or in combination with in-office bleaching on dental fluorosis in adults.

Methods: Twenty-seven patients (9 male, 18 female, 24.81 ± 3.7 yrs) with 410 fluorotic teeth (TF 1-4) were randomly assigned to a treatment (BLI) or control group (NBLI). Patients underwent in-office bleaching (25% H2O2) in the BLI or a placebo bleaching (ACP gel) in the NBLI group followed by resin infiltration after two weeks. Standardized digital photographs were obtained at baseline; after bleaching; before and after resin infiltration and after 1, 3, and 6 months. Color differences (ΔE) between sound and fluorotic areas were calculated and patient satisfaction was evaluated using a VAS (1-10).

Results: Statistical analysis revealed significant differences in the mean ΔE values 6 months after resin infiltration between the BLI (ΔE = 1.41) and the NBLI group (ΔE = 4.33) (p = 0.024). VAS values increased after resin infiltration (p < 0.05) in both groups. After 3 months patients in the BLI group had higher VAS values than in the NBLI group (p = 0.029).

Conclusions: Findings of this study suggest that resin infiltration alone can effectively mask mild to moderate dental fluorosis in young adults. In-office bleaching with 25% H2O2 before resin infiltration provides significantly better masking effects.

Clinical significance: Resin infiltration is a safe and efficient treatment option for masking fluorotic opacities. A priori in-office bleaching with 25% H2O2 enhances the masking effect. This controlled clinical trial is registered in the German Clinical Trials Register #DRKS00010465.

Keywords: Dental fluorosis; Hydrogen peroxide; Opacities; Resin infiltration; Tooth whitening.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Color
  • Female
  • Fluorosis, Dental*
  • Humans
  • Hydrogen Peroxide
  • Male
  • Tooth Bleaching Agents*
  • Tooth Bleaching*
  • Tooth Discoloration*
  • Young Adult


  • Tooth Bleaching Agents
  • Hydrogen Peroxide

Associated data

  • DRKS/DRKS00010465