Abstract
Background:
Intrinsic tooth discoloration, particularly dental fluorosis, is a common esthetic concern in pediatric patients and may adversely affect psychosocial well-being. Minimally invasive treatment approaches aim to improve esthetics while preserving enamel structure.

Aim:
To present and clinically evaluate lesion-specific minimally invasive treatment approaches for the management of intrinsic tooth discoloration in pediatric patients. This retrospective clinical case series assessed conservative treatment outcomes in young permanent dentition.

Case description:
Nine patients aged 8–15 years presenting with intrinsic tooth discoloration were treated using individualized conservative treatment protocols based on lesion characteristics, enamel surface integrity, and fluorosis severity assessed using the Thylstrup–Fejerskov Index (TFI). Treatment modalities included Etch–Bleach–Seal (EBS), in-office hydrogen peroxide bleaching, sodium perborate bleaching, night-guard bleaching with carbamide peroxide, resin infiltration, enamel microabrasion, combined microabrasion and EBS, macroabrasion, and direct composite veneering. All cases were followed for 6 months.

Results:
All treatment modalities demonstrated satisfactory esthetic improvement with preservation of enamel architecture and favorable optical blending. Minimal postoperative sensitivity and stable short-term color outcomes were observed during follow-up. Lesion-specific conservative interventions effectively managed superficial, subsurface, and structurally compromised enamel discolorations while minimizing invasive restorative procedures.

Conclusion:
A minimally invasive and lesion-oriented treatment approach may provide satisfactory esthetic improvement in pediatric intrinsic tooth discoloration while preserving sound enamel structure. Conservative biomaterial-based interventions may reduce the need for aggressive restorative procedures in young permanent dentition.

Key words: Dental Fluorosis,Etch–Bleach–Seal,Hydrogen peroxide,Sodium Perborate,carbamide peroxide,Microabrasion,Macroabrasion,Composite Veneering,Resin infiltration