Esthetic treatments for white and yellow/brown enamel stains




Tooth whitening; Enamel microabrasion; Esthetics Dental; Teaching.


In order to solve the dental aesthetic pattern of a patient, who has dental stains on the enamel surface, we carried out this case report where are presented the steps employed for bleaching of teeth with superficial yellow/brown enamel stains with carbamide peroxide and micrometric removal of hard white enamel stains using the enamel microabrasion technique. The worn of dental surface during enamel microabrasion technique was measured with a digital analysis, using a intraoral scanner.  It was observed a surprisingly esthetic outcome as the superficial enamel stains were camouflaged by the at-home dental bleaching. Only the superficial white enamel stains that remained evident were removed by enamel microabrasion technique with a minimal average wear of 118 um of the dental enamel on all anterior teeth, showing to be a conservative technique. Dental bleaching can solve the discoloration of vital teeth, such as the superficial yellow/brown hard enamel stains, as well as can mask the superficial white enamel stains. But when necessary, enamel microabrasion technique is an effective minimally-invasive option that can also be adopted.


Al-Angari, S. S., & Hara, A. T. (2016). A conservative approach to esthetically treat stained arrested caries lesions. Quintessence Int, 47(6), 499-504.

Al-Angari, S. S., Lippert, F., Platt, J. A., Eckert, G. J., González-Cabezas, C., Li, Y, & Hara, A. T. (2019). Bleaching of simulated stained-remineralized caries lesions in vitro. Clin Oral Investig, 223(4), 1785-1792.

Araújo, G. S. A., Naufel, F. S., Alonso, R. C. B., Lima, D. A., & Puppin-Rontani, R. M. (2015). Influence of Staining Solution and Bleaching on Color Stability of Resin Used for Caries Infiltration. Oper Dent, 40(6), E250-E256.

Atsu, S. S., Aka, P. S., Kucukesmen, H. C., Kilicarslan, M. A., & Atakan, C. (2005). Age-related changes in tooth enamel as measured by electron microscopy:implications for porcelain veneer. J Prosthet Dent, 94(4), 336-41.

Borges, A., Caneppele, T., Luz, M., Pucci, C., & Torres, C. (2014). Color stability of resin used for caries infiltration after exposure to different staining solutions. Oper Dent, 39(4), 433-40.

Celik, E. U., Yazkan, B., Yildiz, G., & Tunac, A. T. (2017). Clinical performance of a combined approach for the esthetic management of fluorosed teeth: Three-year results. Niger J Clin Pract, 20(8), 943-951.

Costa, J. L. S. G., Nogueira, B. R., de Oliveira Junior, O. B. & Pretel, H. (2021) Association of microabrasion and tooth whitening with LED/laser system in the treatment of incisor hypomineralization: 3-year follow-up. Photodiagnosis Photodyn Ther. 33, 102197.

Croll, T. P. . (1998). Esthetic correction for teeth with fluorosis and fluorosis-like enamel dysmineralization. J Esthet Dent, 10(1), 21-29.

de Geus, J. L., Wambier, L. M., Kossatz, S., Loguercio, A. D., & Reis, A. (2016). At-home vs In-office Bleaching: A Systematic Review and Meta-analysis. Oper Dent, 41(4), 341-56.

Donly, K. J., O'Neill, M., & Croll, T. P. (1992). Enamel microabrasion: A microscopic evaluation of the "abrosion effect". Quintessence Int, 23, 175-179.

Eimar, H., Siciliano, R., Abdallah, M. N., Nader, S. A., Amin, W. M., Martinez, P. P., & et al. (2012). Hydrogen peroxide whitens teeth by oxidizing the organic structure. J Dent, 40(2):25-33.

Fagrell, T. G., Dietz, W., Ja¨levik, B., & No´ren, J. G. (2010). Chemical, mechanical and morphological properties of hypomineralized enamel of permanent first molars. Acta Odontol Scand, 68(4), 215-222.

Franco, L. M., Briso, A. L., dos Santos, P. H., Sundfeld, R. H., Machado, L. S., & Neto, D. S. (2014). An effective external bleaching technique. Dent Today, 33(5), 156-7.

Garg, I., Kumar, A. & Kumar, A. (2022). Comparative Evaluation of Esthetic Improvement of Resin Infiltration (RI) In- office Bleaching (B) Enamel Microabrasion (M) and Resin Infiltration with Double Application of Infiltrant (2RI) on Non-pitted Fluorosis Stains: A Randomized Six-month Interventional Study. Int J Clin Pediatr. 15(1), 20-34.

Goldberg, M., Grootvelt, M., & Lynch, E. (2010). Undesirable and adverse effects of tooth-whitening products: A review. Clin Oral Investig, 14(1), 1-10.

Haywood, V. B., & Heymann, H. O. (1989). Nigthguard vital bleaching: how safe is it? Quintessence Int, 22(7), 515-20.

He, L. B., Shao, M. Y., Tan, K., Xu, X., & Li J. Y. (2012). The effects of light on bleaching and tooth sensitivity during in-office vital bleaching: a systematic review and meta-analysis. J Dent, 40(8), 644-53.

Joiner, A. (2017). Review of the effects of peroxide on enamel and dentine properties. J Dent, 35(12), 889-96.

Killian, C,M. (1993). Conservative color improvement for teeth with fluorosis-type stain. J Am Dent Assoc, 124(5),72-74.

Kwon, S. R., & Wertz, P. W. (2015). Review of the Mechanism of Tooth Whitening. J Esthet Restor Dent, 27(5), 240-57.

Leonard, R. H., Haywood, B., Caplan, D. J., & Tart, N. D. (2003). Nightguard vital bleaching of tetracycline-stained teeth: 90 months post treatment. J Esthet Restor Dent, 15(3), 142-52.

Luque-Martinez, I., Reis, A., Schroeder, M., Muñoz, M. A., Loguercio, A. D., Masterson, D., et al. (2016). Comparison of efficacy of tray-delivered carbamide and hydrogen peroxide for at-home bleaching: a systematic review and meta-analysis. Clin Oral Investig, 20(7), 1419-33.

Machado, L. S., Anchieta, R. B., dos Santos, P. H., Briso, A. L., Tovar, N., Janal, M. N., et al. (2016). Clinical Comparison of At-Home and In-Office Dental Bleaching Procedures: A Randomized Trial of a Split-Mouth Design. Int J Periodontics Restorative Dent, 36(2), 251-60.

Marouane, O., & Douki, N. (2019). The use of transillumination in detecting subclinical extensions of enamel opacities. J Esthet Restor Dent, 31(6), 595-600.

Matis, B. A., Cochran, M. A., & Eckert, G. (2009). Review of the effectiveness of various tooth whitening systems. Oper Dent, 34(2):230-5.

Matis, B. A., Wang, Y., Eckert, G. J., Cochran, M. A., & Jiang, T. (2006). Extended bleaching of tetracycline-stained teeth: a 5-year study. Oper Dent, 31(6), 643-51.

Pavani, C. C., Sundfeld, D., Schott, T. C., Bertoz, A., Bigliazzi, R., & Sundfeld, R. H. (2018). Home Dental Bleaching Monitored With Microelectronic Sensors to Record the Wearing Times of an Acetate Tray/Bleaching Product. Oper Dent, 43(4), 347-352.

Román-Rodríguez, J. L., Agustín-Panadero, R., Roig-Vanaclocha, A., & Amengual, J. (2020). A tooth whitening and chemical abrasive protocol for the treatment of developmental enamel defects. J Prosthet Dent, 123(3), 379-383.

Schincaglia, J. C.., Macedo, I. L., Corrêa, M. L. B., Imparato, J. C. P., & Rezende, K. M. (2021). Dental microabrasion for esthetics in teeth with dental fluorosis in a child: case report. Research, Society and Development, 10(14), e07101421759.

Segura, A., Donly, K.J., & Wefel, J.S. (1997). The effects of microabrasion on demineralization inhibition of enamel surfaces. Quintessence Int, 28, 463-466.

Sundfeld, D., Pavani, C.C., Pini, N., Machado, L.S., Schott, T.C., & Sundfeld, R.H. (2019). Enamel Microabrasion and Dental Bleaching on Teeth Presenting Severe-pitted Enamel Fluorosis: A Case Report. Oper Dent, 44(6), 566-573.

Sundfeld, D., Pavani, C. C., Schott, T. C., Machado, L. S., Pini, N. I. P., Bertoz, A. P. M., & Sundfeld, R. H. (2019). Dental bleaching on teeth submitted to enamel microabrasion 30 years ago-a case report of patients' compliance during bleaching treatment. Clin Oral Investig, 23(1), 321-326.

Sundfeld, R. H., Croll, T. P., Briso, A. L., de Alexandre, R. S., & Sundfeld, Neto D. (2007). Considerations about enamel microabrasion after 18 years. Am J Dent, 20(2), 67-72.

Sundfeld, R. H., Franco, L. M., Machado, L. S., Pini, N., Salomao, F. M., Anchieta, R. B., & Sundfeld, D. (2016). Treatment of Enamel Surfaces After Bracket Debonding: Case Reports and Long-term Follow-ups. Oper Dent, 41(1), 8-14.

Sundfeld, R. H., Rahal, V., Croll, T. P., De Alexandre, R. S., & Briso, A.L. (2007). Enamel microabrasion followed by dental bleaching for patients after orthodontic treatment--case reports. J Esthet Restor Dent, 19(2), 71-7.

Sundfeld, R. H., Sundfeld-Neto, D., Machado, L. S., Franco, L. M., Fagundes, T. C., & Briso, A. L. (2014). Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups. J Appl Oral Sci, 22(4), 347-54.

Sundfeld, D., Pavani, C. C., Pavesi, P. N. I., Machado, L. S., Schott, T. C., Bertoz, A. P. M., et al. (2019). Esthetic recovery of teeth presenting fluorotic enamel stains using enamel microabrasion and home-monitored dental bleaching. J Conserv Dent, 22(4), 401-405.

Zimmerli, B., Jeger, F., & Lussi, A. (2010). Bleaching of nonvital teeth. A clinically relevant literature review. Schweiz Monatsschr Zahnmed, 120(4), 306-20.




How to Cite

PAVANI, C. C.; HOSHINO, I. A. E. .; FAGUNDES, T. C. .; GUARNIERI, F. D. F. .; VIEIRA, L. R. .; SUNDFELD, R. H. Esthetic treatments for white and yellow/brown enamel stains. Research, Society and Development, [S. l.], v. 11, n. 7, p. e56311730190, 2022. DOI: 10.33448/rsd-v11i7.30190. Disponível em: Acesso em: 26 may. 2024.



Health Sciences