- Authors: Nutting EB, Poe GS.
- Title: A new combination for bleaching teeth.
- Journal: J So Calif Dent Assoc
- Date: Sep 1963
- Citation: 31(9): 289-291
- Category: Bleaching/Tooth Whitening
- Evidence-based Ranking: 5
- Purpose/Objectives: To present a new technique for the bleaching of discolored endodontically treated teeth, the cause of discoloration of pulpless teeth, considerations in case selection, and currently popular bleaching agents and methods.
Etiology: Most responsible etiologic factor is the necrotic pulp. Pulpal hemorrhage is often responsible. Hemoglobin releases iron which forms a black compound when in combination with hydrogen sulfide. Necrotic tissue contains various protein degradation products which may also create the grayish-black discoloration. The length of time between death of the pulp and inception of treatment will directly relate to the degree of discoloration (longer more discoloration). Poorly executed RCT can also discolor teeth. Missed tissue, filling material excess and medicaments have discoloration potential.
Case Selection: An adequate root canal filling should precede treatment. The crown to be treated must also be questioned. If excessive restorations exist, bleaching may not work.
Bleaching Agents: Aqueous solution of 30% H2O2 (Superoxol) and 25% H2O2 in 75% ether (Pyrozone no longer used b/c of associated hazards) .
Bleaching Methods: 1) seal a C.P. saturated with Superoxol into the pulp chamber (Walking Bleach technique) 2) Adding sodium perborate with Superoxol to form a paste 3) technique access, take start shade, isolate, clean, place bleaching material, seal with Cavit, monitor q 3-5 days and compare shade, replace bleach prn, remove bleach, restore
Summary: An approach to bleaching endodontically treated teeth without the use of a lamp using a paste of Sodium Perborate and Superoxol has been presented.
Reviewers Comments: 1963!