Aesthetic treatment of severely fluorosed teeth with prefabricated composite veneers: a case report

Dental fluorosis was first described in 1916 by GV Black and FS McKay.4 The process occurs beginning with fluorides being absorbed via the stomach and small intestine, and then largely excreted via the kidneys. Any ingested fluoride is stored in the mineralized tissues – bone, teeth – and at a level that increases with age.5 Odontogenesis is a sequential process moderated by epithelial-mesenchymal interaction.6 The interactive processes result in the secretion of tissue specific proteins, the transport of ions, and then the precipitation of these ions in to enamel crystal form, viz amelogenesis. Ameloblasts in this process are responsible for the regulation of the mass transporting of ions from systemic circulation to local circulation, and back again. Ameloblasts are also responsible for both protease and protein synthesis. Amelogenin, ameloblastin, and enamelin are important examples of such proteins.7 These proteins are responsible for the tissue architecture which will result in enamel prism formation, and the orientation of the crystal structures within these. Proteases act on the secreted enamel proteins by creating soluble cleavage products, providing areas of the enamel structure to mineralize further. This mineralization is achieved by forming octa-calcium phosphate crystals, and thereafter by reinforcing these crystals in to sheet-like structures.8 Aesthetic treatment of severely fluorosed teeth with prefabricated composite veneers: a case report