Resin Infiltration Versus Microabrasion With CPP-ACP for Fluorotic White Spot Lesions

This was a prospective, controlled, two‐arm randomized clinical trial conducted at theDental Clinic of the University of Medicine and Pharmacy Hospital, Hue University,Vietnam, between June 2023 and June 2025. Patients with fluorotic white spot lesions onpermanent anterior teeth were enrolled. Eligible lesions were shallow, chalky‐whiteenamel opacities confined to the outer enamel and clinically consistent with dentalfluorosis.Randomization was performed at the tooth level. A total of 60 eligible teeth wereallocated in a 1:1 ratio to one of two treatment groups: resin infiltration or enamelmicroabrasion followed by CPP‐ACP application. Allocation was concealed usingsequentially numbered, opaque, sealed envelopes. All procedures were performed by oneoperator under standardized clinical conditions.In the resin‐infiltration group, the lesion surface was treated with 15% hydrochloricacid, rinsed and dried, followed by ethanol application. A low‐viscosity resin infiltrantwas then applied and light‐cured according to the study protocol.In the microabrasion plus CPP‐ACP group, the labial enamel surface was treated with ahydrochloric‐acid and silicon‐carbide microabrasion material using repeated polishingcycles. CPP‐ACP paste was then applied to the treated surface for 5 minutes.Two co‐primary outcomes were evaluated from standardized clinical photographs: the colordifference between the lesion and adjacent sound enamel, expressed as ΔE in the CIELab*color space, and the lesion‐area ratio, expressed as the percentage of the visible labialtooth surface occupied by the lesion. Images were obtained under reproducible lighting,magnification, camera‐positioning, and patient‐positioning conditions.Color measurements were obtained from sampled points within the lesion and adjacent soundenamel. Lesion area and total labial‐surface area were outlined and measured usingimage‐analysis software. Outcome assessments were performed by an independent examinerwho was blinded to treatment allocation using coded image files. Measurements wereobtained before treatment and at prespecified post‐treatment and follow‐up assessmentsthrough 6 months.