Authors: Friedman S, Rotstein I, Libfeld H, Stabholz A, Heling I.
Title: Incidence of external root resorption and esthetic results in 58 bleached pulpless teeth.
Journal: Endod Dent Traumatol
Date: Feb 1988
Citation: 4(1):23-6
Category: Bleaching/Tooth Whitening
Evidence-based Ranking: 4
Purpose/Objectives: To examine the incidence of external root resorption in bleached pulpless teeth and its relation to various factors, as well as to assess the long-term esthetic results of bleaching.

Materials/Methods: 58 teeth in 46 patients were examined after periods of 1-8 years. All teeth were bleached with 30% hydrogen peroxide and a thermocatalytic technique under RDI. None of the teeth had placement of an intracoronal isolating base. All teeth were restored with composites. At recall, the data collected was history of trauma, response to percussion, mobility, sulcus depth, and appearance of the marginal gingiva. The color was classified according to the success of the treatment (A,B,C) and radiographs were taken.

Results: Advanced external resorption was seen in 2 of the 58 teeth ( 3.5%), and arrested resorption was found in additional 2 teeth. There was no history of trauma (pre or post) in any of the cases. 1 of the 4 cases received only the walking bleach technique. 50% of the teeth were absolutely satisfactory, and 29% were clinically acceptable. 21% were failing, of which 4 received full coverage restorations.

Author’s Conclusions. These results caution against indiscriminate use of bleaching with hydrogen peroxide, and emphasize the importance of preventive measures and postoperative follow-up of bleached pulpless teeth.

Reviewer’s comments: the author’s conclusion statement in his abstract does not reflect the tone of the article or the context of the discussion. The author also stated that 1 of the 4 resorption cases used the walking bleach technique, however in the materials and methods, the author mentions all were done with a thermocatalytic technique.