Color alteration of upper incisors by white spots often has a psychological impact. The dentist, under increasing pressure from patients with esthetic concerns, must offer an appropriate solution to these problems.
Nowadays, a dramatic change has evolved from the traditional “drill and fill” paradigm to a more conservative approach, namely non-invasive or minimally invasive.
The presence of a white spot lesion is due to diminishment of the mineral phase in the enamel. The microporosity within enamel is either filled with organic fluids or air which has different refractive indices than that of healthy enamel causing light to scatter forming an “optical maze” perceived as white.
Different WSL etiologies are initial caries, fluorosis, traumatic hypomineralization, and MIH. Each has a different prognosis for success of treatment according to the hardness and thickness of the surface layer, the topographic subsurface angle, and the depth of the lesion. Proper diagnosis leads to better understanding of the lesion, thereby ensuring an appropriate choice of treatment.
Resin infiltration concept involves erosion of the surface layer to fill the micropores with a highly liquid resin with a refractive index close to that of healthy enamel.
Deep resin infiltration concept is a modified protocol for deeper lesions which involves initial mild removal of lesion surface using abrasive procedures before proceeding with infiltration; to gain access to deep lesion body allowing thorough infiltration of resin.
Resin infiltration is a reliable and conservative tool for management of esthetically- compromised WSL.