Dentistry Live: Icon resin infiltration questions that decide cases

Does whitening always need to come before Icon resin infiltration? Not necessarily, but knowing when it does can be the difference between a predictable result and sealing discolouration into the tooth.

It was one of several practical clinical questions dentist Cat Edney answered during a Dentistry Live question-and-answer session following her live Icon demonstration. After the procedure, she worked through the decisions that shape real cases: whitening, rubber dam, composite combinations, orthodontic patients and the growing role of interproximal Icon.

Does whitening always come first?

On whether whitening should always come before Icon, Edney was clear: ‘Actually, no, it doesn’t have to.’

However, she said it could make treatment more predictable by revealing the full extent of the lesion before infiltration.

‘It can make the results more predictable if you whiten before Icon, purely because you’re seeing the full extent of a dehydrated lesion,’ she said.

Colour changes the calculation. Edney said tooth whitening was ‘absolutely mandatory’ before Icon resin infiltration if there was ‘any color involved in the lesion’. Placing a clear resin over brown, white or orange discolouration risks sealing that colour into the tooth.

Why rubber dam is essential

Moisture control was another key theme.

‘Moisture control is absolutely essential, because if we have any liquid in that air bubble, it’s going to disrupt our light refractive index once we resin infiltrate,’ Edney said.

She explained that even ‘humidity from breath’ could alter the result and make it less predictable, particularly if the tooth dehydrates later.

When Icon needs composite

Edney also explained when Icon may need to be combined with composite, including darker lesions, cases requiring a small enamoplasty, or teeth where previous composite masking has to be removed.

‘Obviously, with Icon, we’re talking about enamel only, we never go into dentine,’ she said.

Where Icon resin infiltration fits beyond white spots

Orthodontic patients were identified as strong candidates, particularly where white spot lesions had developed around brackets or attachments. Edney said these cases were often straightforward to treat, usually requiring ‘one, maximum two rounds of etch’.

She also highlighted interproximal Icon for early carious lesions.

‘It’s very rewarding,’ she said. ‘We see time and time again patients who are not suffering with progression of decay, because we’ve managed to treat early enough that we’ve avoided putting a drill into that patient’s tooth.’

Watch the full Dentistry Live session, including the complete Icon procedure, clinical workflow and question-and-answer session with Cat Edney, on demand now.

Follow Dentistry.co.uk on Instagram to keep up with the latest news and trends.