Bleaching teeth discolored by tetracycline therapy.
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This three-month, single-blind clinical study compared two whitening treatments, at-home with 10% carbamide peroxide and in-office with 35% hydrogen peroxide, for the degree of color change of teeth, color relapse and tooth and gum sensitivity. The degree of color change and color relapse was evaluated by using a colorimeter, shade guide and color slide photography. Teeth and gum sensitivity were self-evaluated by the subjects, who recorded daily the tooth and gum sensitivity they experienced during the two weeks of treatment and one week post-treatment. A 14-day at-home treatment was compared with 60 minutes of in-office treatment (two appointments, each with three 10-minute applications). The at-home treatment produced significantly lighter teeth than the in-office treatment during all active-treatment periods and follow-up visits according to all three-color evaluation methods. Color relapse for both treatments stabilized by six weeks. At-home treatment resulted in statistically significant higher gum sensitivity than in-office treatment during the latter part of the first week. For tooth sensitivity there were no significant differences between the treatments. Eighty four percent of the subjects reported at-home treatment to be more effective and 16% found no difference between the treatments. There were no subjects who reported the in-office treatment to be superior in tooth whitening to the at-home treatment.
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UNLABELLED: Discolored teeth can be treated with resin veneers, but their color changes when confronted with staining solutions. Polishing procedures can provide a remedy for highly stained composites, but they tend to remove some materials as well. However, bleaching procedures are an effective, nondestructive method for solving the problem. The aim of this study was to compare the color change of three veneer composites exposed to staining solutions and to evaluate the effectiveness of a 15% hydrogen peroxide bleaching agent and three polishing systems to remove the stain. Forty-five disks (12 x 2 mm) each of Clearfil ST (Kuraray Co. Ltd., Osaka, Japan), Esthet-X (Dentsply/Caulk, Milford DE, USA), and Filtek A110 (3M ESPE, St. Paul, MN, USA) were prepared. The specimens were polished with Sof-Lex (3M ESPE), Enhance (Dentsply/Caulk), or PoGo (Dentsply/Caulk). Five specimens for each material-polishing system combination were immersed in coffee (Nescafe Classic, Nestle SA, Vevey, Switzerland) or tea (Earl Grey, Lipton, Blackfriars-London, England) for 7 days. The remaining disks were stored in water. Color measurements were made with a spectrophotometer (X-Rite Seroice SP78, Loaner, Köln, Germany) at baseline; after 1, 3, 5, and 7 days; and after bleaching and repolishing. After 1 week, one side of the specimens was bleached with Illuminé-office (Dentsply De Trey GmbH, Konstanz, Germany) for 1 hour, and the other side was repolished for 30 seconds. All comparisons of color change for the polishing systems, times, and staining solutions were subjected to repeated measurements of analysis of variance. Paired t-test was used to examine whether significant color differences (deltaE*) occurred during immersion at the specified time intervals (p < or = .05). Filtek A110 was the least stained resin composite. Its color remained under a deltaE* value of 2 during the study. Clearfil ST exhibited the most color change after 1 week. All specimens polished with Enhance showed less staining, whereas those polished with the Sof-Lex system demonstrated the most color change. Water did not cause a variance in the deltaE*. There was no difference in the staining potential of coffee and tea. Bleaching and repolishing were effective in removing the stains. The resin composites tested reversed nearly to baseline color with the bleaching and to less than values at 1 day of staining with repolishing. The coffee and tea brands tested stained the composites used in this study equally. In-office bleaching was found to be more effective than repolishing in the restitution of the color. CLINICAL SIGNIFICANCE: The results of this study suggest that the discoloration of resin veneers can be partially removed by in-office bleaching and repolishing procedures.
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PURPOSE: To report the results obtained with an at-home bleaching product in the removal of enamel surface stains. MATERIALS AND METHODS: An individualized vacuum-formed mouthguard was fabricated and scalloped so that the terminal portion of the mouthguard ended approximately 1.0 mm from the gingiva. The patient was instructed to brush his teeth with Rembrandt Whitening Toothpaste prior to and after using the Rembrandt Gel Plus bleaching gel. In addition, the patient was informed as to the proper method of placing the gel in the mouthguard, and inserting the mouthguard into his mouth. The mouthguard was to be worn for 2-3 hours a day for a 2-week period. RESULTS: At the end of 2 weeks, the enamel surface stains were removed through the bleaching process.
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For years, investigators have attempted to develop a predictable means of bleaching pathologically and nonpathologically stained dentition. While previous efforts have modified the concentration of the bleaching material, the duration of the procedure, and the manner by which the bleaching agent is activated, the ability to affect a significant shade improvement remains an elusive objective. This article demonstrates an innovative technique used to influence the penetration of oxygen ions into the tooth enamel, which may resolve this clinical dilemma.
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A fifteen-year-old Chinese girl presented with unerupted maxillary permanent canines impacted against the roots of the central incisors, causing malalignment of the maxillary incisors. The canines were fully formed and their apices closed. The potential path of eruption of the canines contraindicated surgical exposure, followed by orthodontic traction. It was decided to transplant the impacted canines to their normal positions, and then align the maxillary anterior teeth, using a fixed orthodontic appliance. The transplantations and the orthodontic treatment were successful, and neither transplant showed signs of root resorption, periodontal pockets, mobility, or pain, three years after surgery. Root canal therapy was performed on the canines after transplantation, because their apices were closed. They were stained by the amalgam in the access cavities, but both responded well to nonvital bleaching using 30 percent H2O2.
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