Combining vital and non-vital tooth whitening: a case sequence.
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Composite and porcelain veneers offer a conservative method of masking discolouration of the teeth of younger patients. Composite veneers are the less destructive of tooth tissue, but also the less durable. This two-part article reviews the use of veneers in treating the adolescent patient. Part 1 examines indications for treatment and gives a step-by-step guide to the clinical procedure for veneering with composite. Next month, Part 2 will cover porcelain veneers and draw some overall conclusions.
Many clinicians advocate etching the teeth before vital bleaching as a way to enhance the permeability of the tooth surface to hydrogen peroxide and thus to enhance the bleaching effect. However, no studies have been published to date to document the effect of etching on vital bleaching. In this study, ten patients received a bleaching treatment regimen of several appointments. Half of the teeth in one arch of each patient were etched with phosphoric acid for 20 seconds before they were bleached with 35% hydrogen peroxide. The teeth in the other half of the same arch were treated with tap water prior to bleaching. Evaluations of the patients after 3 and 6 weeks failed to confirm any enhanced lightening effect from etching.
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The bleaching of non vital teeth that is described in this article has demonstrated to give good clinical results, and because of its easy way to apply we believe that it is the option for the treatment of this teeth, as long as we have a good an realistic diagnostic considering the results we may obtain. One the selection has been made we proceed to the bleaching, the substances that we use are easily obtain, superoxol and sodium perborate. The preparation of the tooth began with the removal of any restauration or decayed tissue that is may present after this we remove the material from the pulp chamber 1 mm below the gingival margin, then clean perfectly the chamber, then we deshidrate the tubulae, then put a pellet of cotton on the vestibular wall of the chamber, put some superoxol in the cotton, heat it up, remove the cotton, put some sodium perborate and hidroge peroxide paste in the chamber and seal it with cavit, and wait from 3 to 7 days for results.
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A case with unusual iatrogenia due to dental attention is introduced, as well as the first steps made to solve the situation. Some conclusions obtained from the treatment are also summarized.
Mottling of teeth can have significant psychological impact on patients--particularly on adolescents, who may be subjected to much unkind teasing. A number of procedures have been suggested for removal of mottling and stains. The authors describe a simple and quick technique using a paste of hydrochloric acid and pumice, and on the basis of their clinical and laboratory experience suggest it as a treatment of first choice.
New dental materials and their combinations increase the aesthetic and functional quality of treatment. A great improvement in the aesthetic treatment of discoloured teeth is the use of dental ceramic combined with composites.