tooth bleaching non vital.pdf

Non Vital Tooth Bleaching content INTRODUCTION CLASSIFICATION of NONVITAL BLEACHING INDICATION CONTRAINDICATION ADVANTAGE AND DISADVANTAGE PRELIMINARY TREATMENT WALKING BLEACHING TECHNIQUE INSIDE/OUTSIDE BLEACHING LASER BLEACHING THERMOCATALYTIC TECHNOQIUE COMPLICATIONS AND RISKS RECENT ADVANCEMENTS...

Non Vital Tooth Bleaching content INTRODUCTION CLASSIFICATION of NONVITAL BLEACHING INDICATION CONTRAINDICATION ADVANTAGE AND DISADVANTAGE PRELIMINARY TREATMENT WALKING BLEACHING TECHNIQUE INSIDE/OUTSIDE BLEACHING LASER BLEACHING THERMOCATALYTIC TECHNOQIUE COMPLICATIONS AND RISKS RECENT ADVANCEMENTS CONCLUSION REFFERENCE 2 Presentation title 20XX Introduction Aesthetics is a field of growing importance An aesthetic smile It has a psychosocial impact and influences the individual’s esthetic self-perception 3 DEFINITION "The lightening of the color of a tooth through the application of a chemical agent to oxidize the organic pigmentation in the tooth is referred to as Bleaching" 4 Presentation title 20XX Difference between vital and nonvital bleaching Vital bleaching Nonvital bleaching Applied by dentist or by patient (using home bleaching techniques) Applied by the dentist. Applied mainly inside thepulp chamber. Endodontically treated root canal must be protected using GI or RMGI to prevent leakage of the bleaching material. Applied on - external tooth structure only Protection of the gingival tissues is of main importance 5 Presentation title 20XX CAUSES Non-vital tooth discoloration may have many causes, I. Dental trauma-Necrotic pulp II. Root canal treatment III. Blood decomposition in pulp chamber presence of necrotic debris on the pulp horns and dentinal tubules, poor irrigation, or sealing materials located in the pulp chamber or chamber walls. The most commonly described cause is intracoronal blood decomposition. Hemolysis of erythrocytes in the dentin tubules is accompanied by the release of iron. This, combined with hydrogen sulfate, forms ferric sulfide, a black compound, responsible for the discoloration of the tooth 6 Presentation title 20XX There are several internal tooth bleaching techniques, the most common being the walking-bleach technique, first described by Spasser , in 1961. Other techniques include thermocatalytic technique and inside-outside technique. Commonly used Bleaching agents I. Hydrogen peroxide, II. Carbamide peroxide III. Sodium perborate These three agents promote reversion of the chromatic change through oxidative reactions 7 Presentation title 20XX CLASSIFICATION I. The walking bleach II. Inside-outside bleaching III. Thermocatalytic IV. Laser bleaching Internal tooth bleaching is a minimally invasive, conservative, relatively simple, effective, and low-cost method in the treatment of discolored endodontically treated teeth INDICATION A sealed root-canal filling is an important requirement for allowing an endodontically treated tooth to be bleached. The tooth must be symptom-free, but a waiting period is called for in the case of a radiologically detectable periapical radiolucency. Such lesions should be observed to determine whether the alteration is increasing or if a healing process is apparent. In every case, the root-canal filling material should be sealed with a base material, in order to prevent penetration of the bleaching agent into the periodontal space or root canal. The ubiquitous cements used to close perforations must also be covered with a base. Prior to bleaching, insufficient coronal restorations must be replaced by restorations providing an excellent marginal seal. 9 Presentation title 20XX INDICATION Discolored non vital teeth 10 Stable restoration After intentional RCT of abutment tooth Esthetic requirements-for non vital teeth Presentation title Patient compliance 20XX The indication for nonvital bleaching, also known as internal bleaching, is primarily for teeth that have become discolored due to factors within the tooth, such as pulp tissue damage, root canal therapy, or the presence of blood byproducts. Here are the key indications for nonvital bleaching: Discolored Non-Vital Teeth: The primary indication for nonvital bleaching is discolored, non-vital teeth. This discoloration is often due to: Pulp Necrosis: When the pulp (nerve) of a tooth dies or becomes non-vital due to infection or trauma, it can lead to discoloration over time. Root Canal Treatment: Teeth that have undergone root canal therapy can develop internal staining because the pulp chamber and root canal system are sealed off from the bloodstream, causing the tooth to darken. 11 Presentation title 20XX Stable Restorations: Nonvital bleaching is most effective on teeth with stable restorations, such as crowns or fillings, as the restorations do not respond to bleaching agents. The restorations should match the shade of the surrounding natural teeth before bleaching. Patient Desire for Aesthetics: When patients with discolored non-vital teeth desire an improvement in the aesthetics of their smile, nonvital bleaching can be a suitable treatment option. Patient Compliance: Patients should be willing to comply with the treatment process, which may involve multiple appointments and good oral hygiene practices during and after the bleaching. 12 Presentation title 20XX CONTRAINDICATION What are the contraindications for internal bleaching The most important factor in bleaching effectiveness seems to be precise removal of all restorative materials from the access cavity without additional dentin elimination. Dentin has to be cleaned in order to facilitate diffusion of the bleaching agent through the dentinal tubules. If a fiber post was cemented in the root canal and the pulp chamber was filled with composite resin, removing the restorative material and post can compromise the amount of sound dentin. Therefore, such a case calls for careful evaluation of aesthetic benefits vs. structural sacrifice. 13 Presentation title 20XX CONTRAINDICATION VITAL TEETH UNRESOLVED PERIAPICAL PATHOLOGY UNSTABLE RESTORATION SEVERE STRUCTURAL DAMAGE PULPAL INFLAMMATION PREGNANCY SEVERE ALLERGY OR SENSITIVITY YOUNG PATIENTS WITH DEVELOPING TEETH Other contraindications for internal bleaching include: – discolourations caused by amalgam or other metallic materials (not bleachable) – Significant dentin loss in the cervical portion (risk of fracture and leakage of bleaching agent) – Extensive restorations – Visible cracks, especially with subgingival extension (risk of bleaching agent penetrating towards periodontal ligaments) – Young patients (