26 Esthetic Dentistry
Bleaching of Non-vital Discolored Teeth: Keys of Success Dr Mayada JemĂ˘a, Assistant Professor, Department of Dental Medicine, Military Principal Hospital of Instruction, Tunis, Tunisia. email@example.com Dr T. Ben Neji, Resident in Restorative Dentistry and Endodontics, Military Principal Hospital of Instruction, Tunis, Tunisia.
Pr N. Zokkar, Professor, Department of Restorative Dentistry and Endodontics, Dental Clinic, Monastir, Tunisia.
Dr H. Ouertani, Assistant Professor, Department of Dental Medicine, Military Principal Hospital of Instruction, Tunis, Tunisia.
Dr H. Jegham, Assistant Professor, Department of Dental Medicine, Military Principal Hospital of Instruction, Tunis, Tunisia.
Pr L. Bhouri, Professor, Department of Restorative Dentistry and Endodontics, Dental Clinic, Monastir, Tunisia.
Pr MB. Khattech, Professor, Department of Dental Medicine, Military Principal Hospital of Instruction, Tunis, Tunisia
Abstract Teeth discoloration is a fundamental aesthetic problem. It has a social impact on children, adolescents and adults. It is necessary for dentists to identify the etiology of teeth discoloration to establish an accurate and proper diagnosis. There are different options to treat discolored teeth such as restorative procedures, veneers, crownsâ&#x20AC;Ś Actually, bleaching of non-vital teeth is a routine conservative approach to have a suitable esthetic result for endodontically treated teeth. Various methods to bleach non-vital teeth have been proposed. Three techniques were described through the literature: the walking bleach technique, the inside/outside bleach technique and the in-office bleaching procedure. The most recommended one is the walking bleach technique since it is simple, safe, with lower risks and suitable for patients and dentists. Different bleaching agents were used such as sodium perborate, hydrogen peroxide and carbamide peroxide with various concentrations. Some side effects were reported like external root resorption, diminution of tooth resistance (fractureâ&#x20AC;Ś), morphological alteration of dental hard tissues and alteration of the characteristics of dental materials. The objectives of this article: - To describe the causes of discolored non-vital teeth, - To explain the protocol of the different bleaching procedures and the agents used for, - To report different clinical cases of discolored non-vital teeth treated in our service of Dental Medicine with internal bleaching procedures.
Dental News, Volume XXV, Number I, 2018
Key words Non-vital teeth, Discoloration, Bleaching, Carbamide peroxide, Hydrogen peroxide, Sodium perborate, Cervical root resorption.
Introduction In our daily dental practice, we observe the increasing demand for esthetics in all fields of dentistry. Esthetic procedures can vary from restorative techniques such as conventional crowns, veneers, or bonding to bleaching treatments. 26 Despite different methods that can improve esthetics; bleaching procedures are safe, minimally invasive, conservative, low cost and effective to treat discolored teeth. 11 Referring to Zarow et al. 2014, even the esthetic treatment plan is based on conservative or prosthodontic procedure; dentist should start with teeth bleaching. Referring to Rona et al. 2009, the discolored teeth can have an incidence on the self-confidence, self-image, attractiveness and employability of every one. 6 Actually, bleaching of non-vital teeth is considered as a popular procedure because of the continuous need for white teeth and good looks. 1 The internal tooth-bleaching is used to lighten a discolored tooth that was endodontically treated and the procedure consists of the placement of a chemical oxidizing agent within the cavity access chamber to remove discoloration. 25 The first reports concerning bleaching of discolored non-vital teeth were published in the middle of the 19th century. 2, 3