Recurrent Discoloration After Internal Bleaching Postregenerative Endodontics

Regenerative endodontic therapy (RET) has become a preferred treatment for immature necrotic teeth. However, one of the undesirable outcomes is tooth discoloration, which can significantly affect esthetics. Internal bleaching is commonly used, but success rates can vary due to several factors, including the type of materials used during the procedure.

We report a case of a 15-year-old female patient with severe tooth discoloration following RET on a maxillary central incisor. Initial internal bleaching provided satisfactory results, but the discoloration recurred within a few months. Additionally, the tooth developed an abscess, complicating the clinical management. Endodontic retreatment was performed, but apical access was challenging. Despite successful management of the infection, the tooth discoloration persisted. The persistence of discoloration was attributed to the materials used during the RET, specifically MTA, which has been known to cause color changes over time.

This case highlights the challenges of managing tooth discoloration post-RET and the limitations of internal bleaching as a treatment. It underscores the importance of considering preventive strategies during the RET procedure to minimize discoloration. Alternative esthetic approaches may be necessary when bleaching fails to meet the patient's expectations.