Case series of combined microabrasion, home bleaching and resin infiltration for moderate-to-severe dental fluorosis

Fluorosis is a common dental condition with a high prevalence rate, significantly impacting both aesthetics and psychological health. Traditional treatment methods often show limited results and may carry certain side effects. This study aimed to investigate the short- and medium-term clinical efficacy of a combined treatment protocol including enamel microabrasion, at-home bleaching, and resin infiltration for the management of moderate to severe dental fluorosis. A total of 74 fluorosed teeth in five patients were included in this study and classified as moderate fluorosis ( n = 29) and severe fluorosis ( n = 45). All patients received a three-step sequential treatment protocol consisting of enamel microabrasion, at-home bleaching, and resin infiltration. Follow-up assessments were conducted after one week and three years of treatment. Treatment outcomes, tooth sensitivity, and patient satisfaction were evaluated using the visual analogue scale (VAS). Changes in tooth appearance were summarized within each patient, and exploratory patient-level comparisons between T1 and T2 were performed separately for moderate and severe fluorosis using two-sided exact Wilcoxon signed-rank tests. One week post-treatment, both moderate and severe fluorosed teeth exhibited notable improvements in both white spots and yellow stains. At three-year follow-up, only a slight decrease in aesthetic improvement was observed in a small number of teeth. Exploratory patient-level analyses detected no significant changes between the two time points in either severity group (all exact P ≥ 0.500). No discomfort or sensitivity was reported during microabrasion, resin infiltration or post-treatment. The combination of microabrasion, at-home bleaching, and resin infiltration offered a minimally invasive and effective approach for moderate-to-severe dental fluorosis, yielding high levels of patient satisfaction. Clinical follow-up over the medium-term demonstrated the stability and safety of this combined protocol.