Bleaching of the maxillary right and left incisor teeth with 15% carbamide peroxide (Opalescence 15%).įigure 5. Bleaching was performed on all teeth in the maxillary and mandibular arches using a bleaching agent with 15% carbamide peroxide (Opalescence 15% ).įigure 4. Periapical radiographic of maxillary right and left central incisors demonstrated complete pulpal obliteration without evidence of periapical pathology.įigure 3. Maxillary right and left central incisor teeth presenting generalized yellow-brown discolorations associated with coronal trauma.įigure 2. The patient was instructed to place a small drop of the bleaching product into the spaces in the tray corresponding to his teeth, using the trays 4 hours daily for 3 weeks.įigure 1. This was accomplished by first taking alginate impressions, then fabricating custom bleaching trays for the maxillary and mandibular arches.
Initially, bleaching was performed on all teeth in the maxillary and mandibular arches using 15% carbamide peroxide (Opalescence 15%) (Figure 3). Prophylactic root canal treatment was not done therefore, annual clinical and radiographic controls were recommended due to the risk for developing pulpal necrosis (Figure 2). Radiographic examination verified the presence of complete pulpal obliteration without any evidence of periapical pathology and, during this time, the patient did not exhibit any painful symptoms. The following clinical case will demonstrate an improvement in color achieved by using supervised at-home dental bleaching (Opalescence 15% ) combined with in-office bleaching (Opalescence XTRA Boost PF 38% ) of the teeth that suffered coronal trauma resulting in complete pulpal obliteration and teeth discoloration.ĬASE REPORT A 48-year-old patient showed generalized yellow-brown discolorations associated with coronary trauma in the right and left maxillary central incisors (Figure 1). When correctly administered by a patient or a professional, both are safe, effective, and conservative aesthetic procedures. The appearance of these discolored teeth can be improved by dental bleaching using carbamide peroxide with a relatively low concentration (10% to 20%), delivered in a custom-fabricated tray, or via in-office bleaching with a high concentration of hydrogen peroxide (35% to 38%). 1 The clinical and radiographic presence of calcific metamorphosis of pulp indicates a history of previous dental trauma. It produces severe coronal discoloration that, through higher dentin thickness and the form of disorganization with which that dysplastic dentin is deposited, transmits through the relatively thin and translucent enamel as a very dark yellowish shade. Initially, the yellow shade is subtle, but with time it can become more perceptible and disturbing to the patient. These teeth can develop a calcific metamorphosis of pulp that, in addition to presenting radiographically as calcification of the pulp chamber, creates a yellow shade. In this context, we turn attention to teeth that have suffered coronal trauma and subsequently a gradual change of color. One possible treatment is dental bleaching, which is more conservative and less expensive than prosthetic procedures. INTRODUCTION The occurrence of tooth discoloration in one or more anterior teeth can significantly impair smile aesthetics, prompting patients to seek cosmetic dental treatment.
0 kommentar(er)
