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the treatment protocol for management of fluorosis is given in text book of bleaching techniques in restorative dentistry by Linda Greenwall… specially in macro n microabrasion chapter… it also has lots of published articles..
if we are planning best line of treatment, its not difficult to convince the patient for such decisions..

        

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titath. u have suggested crown.. but my friend its not as conservative…
in 80% of cases u will find mild to moderate stains that is deans fluorosis index 3-4-5, n for every case u cant for full crown if less destructive or rather more conservative options available..

first and foremost is the removal of superficial hypoplastic layer ( 0.5-1mm) through MICROABRASION technique. if u r not removing this layer and proceed for bleaching this porous layer will go on relapsing the whitening procedure as patient will have colored food or drinks..

secondly microabrasion followed by bleaching.

third bleaching followed by composite laminate.

in case of severe fluorosis crown..

        

[docyogeshr@gmail.com]

fluorosis is good topic and is still surrounded by lots of controversy…
well suggests by previous experts, i would like to comment on the suggested t/t options.
first for sushant as u mentioned fluoride tooth paste, they do lead fluorosis once tooth structure forms… it occurs only during tooth developing stage if the drinking water contains more fluoride content..

        

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if you are getting access through the mentioned approach, let me remind you should use 15-20 no. Ni-Ti files or precurve SS files to make the canals patent… then try to flare rc orifices and then proceed for shaping n cleaning using crown down or step back whichever u prefer …

        

[docyogeshr@gmail.com]

hi tirath…
these are good post op instructions to patients.. but placing open dressing is not recommended today unless there is frank active periapical lesion , as you know oral microflora get in and will lead to opportunistic infection in most cases. i think active (acute PA abscess) lesion is only indication for giving open dressing..

        

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hi im post graduate student in endodontics…
i think best way to treat such case is by gaining access to chamber through bucco-occlusal direction in which u can place head of handpiece in buccal vestibule or oral cavity if palatoocclusal direction is selected. For which a thorough radiographic examination required, if u find MB & DB canals more buccal side u can also explore them at the cervical level of tooth…

        

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