Scribd Logo
Upload

Welcome to Scribd!

  • 122 views

    Management of Discoloured Tooth

    Uploaded by

    Anurtha Anu
    This document summarizes different techniques for bleaching discoloured teeth, including home bleaching, in-office bleaching, laser-assisted bleaching, and bleaching of non-vital teeth. It discusses the mechanisms of bleaching agents like hydrogen peroxide and their effects. It also outlines techniques like microabrasion and describes indications and contraindications for different bleaching methods. Finally, it provides an overview of veneers, including types, indications, and direct and indirect fabrication techniques.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Management of Discoloured Tooth

    Uploaded by

    Anurtha Anu
    122 views8 pages
    This document summarizes different techniques for bleaching discoloured teeth, including home bleaching, in-office bleaching, laser-assisted bleaching, and bleaching of non-vital teeth. It discusses the mechanisms of bleaching agents like hydrogen peroxide and their effects. It also outlines techniques like microabrasion and describes indications and contraindications for different bleaching methods. Finally, it provides an overview of veneers, including types, indications, and direct and indirect fabrication techniques.

    Original Title

    BLEACHING WORD

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document summarizes different techniques for bleaching discoloured teeth, including home bleaching, in-office bleaching, laser-assisted bleaching, and bleaching of non-vital teeth. It discusses the mechanisms of bleaching agents like hydrogen peroxide and their effects. It also outlines techniques like microabrasion and describes indications and contraindications for different bleaching methods. Finally, it provides an overview of veneers, including types, indications, and direct and indirect fabrication techniques.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    122 views8 pages

    Management of Discoloured Tooth

    Uploaded by

    Anurtha Anu
    This document summarizes different techniques for bleaching discoloured teeth, including home bleaching, in-office bleaching, laser-assisted bleaching, and bleaching of non-vital teeth. It discusses the mechanisms of bleaching agents like hydrogen peroxide and their effects. It also outlines techniques like microabrasion and describes indications and contraindications for different bleaching methods. Finally, it provides an overview of veneers, including types, indications, and direct and indirect fabrication techniques.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 8

    MANAGEMENT OF

    DISCOLOURED TOOTH
    BLEACHING
    Procedure which involves lightening if the color of the tooth through application of a chemical agent to oxodise the
    organic pigmentatiion in the teeth.

    Goal of bleaching is to restore the normal color of a tooth by decolorizing the satin with a powerful oxidising agent
    known as bleaching agent.

    Mechanism of action

    Degradation of high molecular weight complex organic molecules that reflect a specific wavelength of light, that is
    responsible for color of stain.
    Resulting products are low molecular weight and composed of less complex molecules that reflect less light resulting
    in a reduction of discoloration.

    CONTRAINDICATIONS
    Poor case selection
    Dentin hypersensitivity
    Extensively restored teeth.
    Teeth with hypoplastic marks and cracks.
    Defective and leaky restoration .
    Bleaching agents
    Hydrogen peroxide
    Sodium perborate
    Carbamide peroxide

    EFFECTS OF BLEACHING AGENT


    Tooth hypersensitivity-higher incidence of tooth sensitivity (67-78%) are seen after in office bleaching with h2o2
    On enamel-10% carbamide peroxide cause significantly decreased enamel hardness
    On dentin-cause uniform change in color through dentin
    On pulp-3% solution of H2O2 can cause transient reduction in pulpal bloodflow and occlusion of pulp blood vessels

    Effects on restorative material(on composite)


    Increased surface hardness
    Surface roughening
    Increased microleakage
    Decrease in tensile strength
    On other materials
    No effect on gold
    Microstructural changes in amalgam
    Alteration in matrix of glass ionomers
    Mucosal irritation-may cause burns and bleaching of gingiva
    Genotoxicity and carcinogenicity-hydrogen peroxide releases frre radicals are capable of attacking DNA

    TECHNIQUES

    For vital teeth


    Home bleaching or night guard bleaching technique
    In office bleaching
    Thermocatalytic
    Nonthermocatalytic
    microabrasion
    For nonvital teeth
    Thermocatalytic in office bleaching
    Walking bleach or intracoronal bleaching
    Inside or outside bleaching
    Closed chamber or extracoronal bleaching
    Laser assisted bleaching

    HOME BLEACHING TECHNIQUE

    Indications
    Mild generalised staining
    Age related discoloration
    Mild fluorosis
    Satins of smoking tobacco
    Mild tetracycline staining
    Contraindication
    Teeth with insufficient enameL
    Severe fluororsis and pitting hypoplasia
    Fractured or malaligned teeth
    Opaque white spots
    Pregnant or lactataing patient

    COMMONLY USED SOLUTIONS


    10%carbamide peroxide with or without carbopol
    15%carbamide peroxide
    Hydrogen peroxide(1-10%)
    PROCEDURE
    Patient is instructed to brush before tray application
    Place enough bleaching material into the tray
    Wearing the tray during day time allows replenishment of the gel after 1-2 hrs for maximum concentration
    While removing tray asked to remove from the second molar region and rinse off
    Additional rebleaching can be done every 3-4 years

    ADVANTAGES
    Simple method for both patient and dentist
    Less chair time and cost effective
    Patient can bleach at their convenience

    DISADVANTAGES
    Patient compliance is mandatory
    Color change is dependent on amount of time the trays are worn
    Chance of abuse by using excessive amount of bleach

    IN- OFFICE BLEACHING

    Thermocatalytic vital tooth bleaching


    Equipment needed for in office bleaching are,
    Power bleach material
    Tissue protector
    Energising source
    Mechanical timer
    Light sources used for in office bleach
    Conventional bleaching agent
    Tungston halogen curing light
    Xenon plasma arc light
    Argon and CO2 lasers
    Diode laser light

    INDICATIONS
    Superficial staining
    mild to moderate staining

    CONTRAINDICATIONS
    Tetracycline stains
    Extensive restorations
    Severe discolorations
    Extensive caries
    Patient sensitive to bleaching agent
    PROCEDURE
    Clean the tooth surface
    Isolate the tooth
    Saturate the cotton with bleaching solution 30-35% and place it on the tooth
    Depending upon light ,expose the tooth,temperature should be maintain between 52 -60 c
    Change the solution between every 4 and 5 minutes
    Remove the solution and irrigate with warm water
    Polish the teeth and apply flouride gel
    Second and third visit is given after3-6 weeks

    NON THERMOCATALYTIC BLEACHING- STEPS


    Isolate the teeth with rubber dam and apply bleaching agent for 5 minutes
    Wash with warm water reapply the bleaching agent until the desired color is achieved
    Wash and polish

    CONTRAINDICATIONS
    Age related staining
    Deep enamel hypoplastic lesion
    Tetracycline lesions

    PROCEDURE
    Clean the teeth and apply petroleum jelly and isolate with rubber dam
    Apply microabrasion compound to areas in 60 sec intervals
    Rinse teeth for 30 sec.
    Apply flouride for 4 minutes.

    BLEACHING OF NONVITAL TEETH

    THERMOCATALYTIC TECHNIQUE
    Isolate the tooth and place bleaching agent.
    Heat the bleaching solution
    Repeat the procedure till the desired color is achieved
    Wash the tooth and seal with cotton
    Recall after 1-3 weeks
    Do permenent restoration
    INTRACORONAL BLEACHING.
    It involves use of chemical agents within the coronal portion of endodontically treated tooth dicoloration.

    INDICATIONS
    Discolorations of pulp chamber origin
    Moderate to svere tetracycline origin
    Dentin discolration

    CONTRAINDICATIONS
    Superficial enamel discolorations
    Defective enamel formation
    Presence of caries
    PROCEDURE
    Take radiograph to assess the quality of obturation
    Evaluate quality and shade of restoration
    Evaluate tooth color with shade guide
    Isolate the tooth with rubber dam
    Prepare the access cavity,remove guttapercha expose the dentin and refine the cavity
    Place mechanical barriers of 2mm thick like GIC ,zinc phosphate etc.
    Mix sodium perborate with inert liquid and place this paste in pulpchamber
    After removing excess place temporary restoration
    Recall the patient after 1to 2 weeks repeat the treatment until desired shade is achieved
    Restore with composite after 2 weeks
    LASER ASSISTED BLEACHING TECHNIQUE
    Power bleaching process with the help of efficient energy source with minimum side effects
    Laser whitening gel contains thermally absorbed crystals,fumed silica,35%H2O2
    Gel is applied and activated by light source like
    Argon laser
    Co2 laser
    Gallium aluminium arsenic laser
    MICROABRASION
    It is procedure in which a microscopic layer of enamel is simultaneosly eroded and abraded with a special compound
    leaving a perfectly intact enamel surface behind.

    INDICATIONS
    Developmental intrinsic stains and discolaration limited to superficial enamel only
    In case of hypo/hyper mineralisation
    Areas of enamel flourosis

    VENEERS
    Definition A veneer is a layer of tooth-colored material that is applied to a tooth to restore localized or generalized
    effects and intrinsic discolorations.

    INDICATIONS

    Common indications for veneers include teeth with facial surface are as follows

     Tooth malformation
     Discolored teeth
     Abraded or eroded facial surfaces
     Faulty restorations.

    TYPES OF VENEERS

    1) Based on the extent of the tooth involved, veneers can be classifieds as:
    i) Partial veneers: Partial veneers are indicated for the restoration of localized defects or areas of intrinsic
    discoloration.
    ii) Full veneers: Full veneers are indicated for the restoration of generalized defects or areas of intrinsic staining
    involving most of the facial surface of the tooth. Full veneers can be further subdivided based on the
    preparation design as:
    a) Window preparation
    b) Butt joint incisal preparation
    c) Incisal overlap preparation

    2) Based on the type of material employed, veneers can be classified as:


    i) Directly applied composite veneer
    ii) Processed composite veneer
    iii) Porcelain or pressed ceramic veneers
    3) Based on the mode of fabrication, veneers can be classified into:
    i) Direct veneers
    a) Direct partial veneers
    b) Direct full veneers
    ii) Indirect veneers
    a) No prep-veneers
    b) Etched porcelain veneers
    c) Pressed ceramic venees

    I Direct Veneer Technique

    1) Direct Partial Veneers


    Small localized intrinsic discoloration or defects that are surrounded by healthy enamel are ideally treated
    with direct partial veneers.
    Preliminary steps include cleaning, shade selection and isolation with cotton rolls or rubber dam.
    Anaesthesia usually is not required unless the defect is deep, extending into dentin.
    If the entire defect or stain is removed, a microfilled or nanofilled composite is recommended for restroring
    the preparation

    2) Direct Full Veneers

    II Indirect Veneer Techniques

    Indirect veneers are primarily made of (i) processed composite, (ii) feldspathic porcelain, and (iii) cast or pressed
    ceramic. Because of superior strength, durability and conservation of the tooth structure, fieldspathic porcelain bonded
    to intra-enamel preparations has historically been the preferred approach for indirect veneering techniques used by
    dentists.

    I. No-Prep Veneers
    Concept
    One approach being used for indirect veneers is to place them on teeth with no tooth preparation.
    Indications
    No-prep veneers are best used when teeth are inherently under contoured when interdental spaces or open
    incisal embrasures are present, or when both conditions exist.

    II. Etched Porcelain Veneers


    Concept
    The preferred type of indirect veneer is the etched porcelain (i.e. feldspathic) veneer. Porcelain veneers etched
    with hydrofluoric acid are capable of achieving high bond strengths to the etched enamel via a resin-bonding
    medium. Etched porcelain veneers are highly esthetic, stain resistant and periodontally compatibl.

    III. Pressed Ceramic Veneers


    Concept
    In contrast to etched porcelain veneers that are fabricated by stacking and firing feldspathic porcelain, pressed
    ceramic veneers are literally cast using a lost wax technique (e.g. IPS Empress or e.max {Ivoclar Vivadant}).
    REFERENCE
    # Sturdevants art & science of operative dentistry
    # internet

    You might also like