BY: D R . Z AWA R A M A R I A M

BLEACHING

BLEACHING

DEFINTION:- The lightening of the color of the tooth

through the application of a chemical agent to oxidize the organic pigmentation in the tooth is referred to as bleaching.

CLASSIFICATION:-

VITAL NON-VITAL

IN-OFFICE

NIGHT GAURD

IN-OFFICE

WALKING BLEACH TECHNIQUE

NON- VITAL BLEACHING

This technique describes the bleaching of teeth that have become discolored by the diffusion into the dentinal tubules of hemoglobin breakdown products from necrotic pulp tissues

INDICATIONS:-1) Discolored non-vital teeth2) Well condensed GP root filling3) No clinical or radio graphical signs of periapical

disease CONTRA INDICATIONS:-

1. Heavily restored tooth2. Staining due to amalgam

PROCEDURE

Place rubber dam to isolate the teeth

Clean the teeth with pumice

Remove coronal restoration and pulp chamber restoration

Remove root filling 1-2mm apical of the clinical crown

Place RMGIC liner to seal the GP

Replace the sodium perborate dressing weekly

After successful bleaching place 2mm of Ca(OH)2 and cavit

2 weeks later remove cavit and Ca(OH)2

Restore the tooth with composite

Blend sterile saline with sodium perborate and fill the pulp chamber within 2mm of cavosurface margin

Blot the mixture with cotton pellet

Place temporary sealing material

Area must remain isolated to evaluate the adequacy of the seal for 5 min

Remove rubber dam

VITAL BLEACHING:- In-Office

This technique involves the external application of hydrogen peroxide to the surface of tooth followed by its activation with a heat source.

Indications:- very mild tetracycline staining without obvious

banding Mild flourosis Yellowing due to ageing Single teeth with sclerosed pulp chamber and canals

PROCEDURE: IN-OFFICE

Place Vaseline on lips and gingival tissues

Isolate the teeth with rubber damMaintain adequate seal by ligation of

dam with waxed dental tape.Apply the H2O2 containing paste/gel

on the teethHalogen light to generate heat to

accelerate the oxidation Rinse the teeth and remove the

rubber damTreatment done weekly for 2-6 weeks

VITAL BLEACHING:-Night gaurd

This technique involves the daily placement of carbamide peroxide gel into a custom fitted tray of either the upper or lower jaw

Indications:- Mild flourosis Moderate flourosis as adjunct to hydrochloric acid Yellowing due to ageing

Reaction:- Carbamide peroxide(10%) breaks down to form H2O2

(3%) and urea(7%) Urea and H2O2 due to their low MW diffuse through

enamel and dentine

TECHNIQUE

Take an alginate impression and make working model

Make a splint and instruct patient on how to apply gel into the mouth guard and after insertion wiping out of excess material

Worn at night and remove in the morning

Clean the splint with brush and store it in container

After 2 weeks check that the patient is comfortable.

THANKYOU FOR YOUR PATIENCE