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Considerations in intracoronal bleaching.

K C Lim1

  • 1Department of Restorative Dentistry, Faculty of Dentistry, National University of Singapore, Singapore.

Australian Endodontic Journal : the Journal of the Australian Society of Endodontology Inc
|September 24, 2004
PubMed
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Intracoronal bleaching effectively whitens discolored root-filled teeth. Use a 2mm base cement to prevent root resorption and delay composite restoration for three weeks to ensure bond strength.

Area of Science:

  • Restorative Dentistry
  • Endodontics
  • Dental Materials Science

Background:

  • Discolored root-filled teeth require aesthetic restoration.
  • Intracoronal bleaching is a viable option for non-extensively restored teeth.
  • Extraradicular diffusion of hydrogen peroxide poses a risk of external root resorption, especially with pre-existing periodontal inflammation.

Purpose of the Study:

  • To outline a safe and effective protocol for intracoronal bleaching of discolored root-filled teeth.
  • To emphasize methods for minimizing extraradicular hydrogen peroxide diffusion.
  • To provide guidance on material selection and timing of subsequent restorations.

Main Methods:

  • Application of an intracoronal bleaching agent (35% carbamide peroxide suggested).

Related Experiment Videos

  • Placement of a protective intermediate base cement (minimum 2 mm thickness) at the cemento-enamel junction over the root filling.
  • Delayed placement of the final composite restoration (at least three weeks post-bleaching).

    • Main Results:

    • The use of a 2mm intermediate base cement effectively limits extraradicular hydrogen peroxide diffusion below safety limits.
    • 35% carbamide peroxide offers a balance of safety and efficacy for intracoronal bleaching.
    • Delaying composite restoration preserves the bond strength of adhesive systems affected by bleaching agents.

    Conclusions:

    • Intracoronal bleaching is a successful procedure for discolored root-filled teeth when performed with appropriate safety measures.
    • Adequate coronal seal with an intermediate base cement is crucial to prevent external root resorption.
    • A waiting period before composite restoration is necessary to ensure optimal bond strength and long-term restoration success.