Bleaching an element
Bleaching an element can be divided into:
- Vital bleaching (externally), which falls out of the scope of these treatments
- Non vital bleaching (internally)
Non vital bleaching
Non vital element can lose colour due to all kinds of circumstances, like:
- pulpa remnants after endodontic treatment
- leaking filling in pulparoom
- substances from root canal cement
Before bleaching is undertaken, the following conditions have to be fulfilled:
- a good endodontic treatment should be done
- there should be a good closing off towards the root canals
- all old filling materials should be removed from the pulparoom
- the area f the pulpahorns should be sufficiently prepared and accessible
- the tooth should be free of caries and be filled in such a way that no leakage can arise
- the tooth should be clean and polished on the outside; only then we can identify the full extent of the fading
Bleaching
Sometimes the discoloration is superficial and small, and then the following procedure suffices:
- dcauterizing the cleaned pulparoom quite a long time with etch gel or etch liquid
- bleaching during a few minutes with hydrogen peroxide 30%, if desired with the help of a source of heat
- comparing the (not dried out) element with the neighbouring elements. If the colour is equal to or a little bit lighter than the neighbouring elements, the treatment can be finished. For that purpose the pulparoom is once again etched shortly and then bonding is placed in the usual way and the element is filled with composite. It is a must that the filling material fits the walls of the pulparoom snugly, otherwise the element will discolour again
If the element is still too dark, the continuation is:
- if desired once more etching
- enclosing a wet made natrium perborate during a week, of which sufficient should be placed in the pulparoom. Then comes a wet wad of cotton wool or a small sponge. As a temporarily closing off, Cavit suffices in most cases. Sometimes an extra thin coating of glasionomer cement is necessary to protect a temporary arrangement sufficiently
- checking the colour again after a week with due regard for the abovementioned conditions. If the colour is good, the treatment can be finished. If the colour is not yet satisfactory, natrium perborate is again enclosed for a week. Then the element is treated off in the abovementioned way
Almost every fading can be treated well in this way.
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Filling the canals
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Special treatments
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