Samreena Kalander, Aravind R Kudva, M S Prathap, Nihala Mariyam, Aysath Aphiya A
Localized trauma-associated developmental enamel defects and non-cavitated enamel opacities in the anterior dentition can produce marked esthetic concerns, particularly when associated with childhood trauma to primary teeth and subsequent defects in permanent successors. Conventional restorative treatment may require unnecessary removal of sound enamel, whereas minimally invasive approaches aim to preserve tooth structure while improving optical integration. This case report describes two de-identified male patients aged 17 and 18 years who presented with whitish-brown discoloration and uncomplicated crown fractures involving maxillary anterior teeth. Both patients reported a history of childhood trauma, and clinical examination revealed localized enamel hypoplasia affecting teeth 21 and 22, associated with Ellis Class I and II fractures. A staged esthetic treatment protocol was performed using rubber dam isolation, enamel microabrasion with 6.6% hydrochloric acid slurry containing silicon carbide microparticles, resin infiltration and selective direct composite restoration where required. Etch-dry cycles were repeated according to the clinical optical response before resin infiltration. Five cycles were performed in Case 1, whereas in Case 2 the sequence was repeated according to the residual opacity, although the exact number of repetitions was not documented. In both cases, the combined approach produced immediate reduction in opacity, improved enamel masking, restoration of natural morphology, and satisfactory esthetic integration with adjacent enamel. Follow-up showed stable esthetic outcomes without postoperative sensitivity, pain, or periodontal complications, and both patients reported satisfaction with the esthetic outcome of treatment. These cases demonstrate that enamel microabrasion combined with resin infiltration and selective composite augmentation can be an effective minimally invasive option for managing traumatic localized enamel hypoplasia in the esthetic zone.