title: Nonvital tooth bleaching: a review of the literature and clinical procedures.
abstract: Tooth discoloration varies in etiology, appearance, localization, severity, and adhesion to tooth structure. It can be defined as being extrinsic or intrinsic on the basis of localization and etiology. In this review of the literature, various causes of tooth discoloration, different bleaching materials, and their applications to endodontically treated teeth have been described. In the walking bleach technique the root filling should be completed first, and a cervical seal must be established. The bleaching agent should be changed every 3-7 days. The thermocatalytic technique involves placement of a bleaching agent in the pulp chamber followed by heat application. At the end of each visit the bleaching agent is left in the tooth so that it can function as a walking bleach until the next visit. External bleaching of endodontically treated teeth with an in-office technique requires a high concentration gel. It might be a supplement to the walking bleach technique, if the results are not satisfactory after 3-4 visits. These treatments require a bonded temporary filling or a bonded resin composite to seal the access cavity. There is a deficiency of evidence-based science in the literature that addresses the prognosis of bleached nonvital teeth. Therefore, it is important to always be aware of the possible complications and risks that are associated with the different bleaching techniques.
authors: Department of Endodontics, Catholic University of Sacred Heart, Rome, Italy. gplotino@fastwebnet.it
authors: Gianluca
authors: G
authors: Plotino
authors: Laura
authors: L
authors: Buono
authors: Nicola M
authors: NM
authors: Grande
authors: Cornelis H
authors: CH
authors: Pameijer
authors: Francesco
authors: F
authors: Somma
mesh_terms: D001881:Borates / Q000627:therapeutic use; D000077463:Carbamide Peroxide; D004338:Drug Combinations; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D006861:Hydrogen Peroxide / Q000627:therapeutic use; D006472:Oral Hemorrhage / Q000150:complications; D016877:Oxidants / Q000627:therapeutic use; D010545:Peroxides / Q000627:therapeutic use; D012387:Root Canal Filling Materials / Q000009:adverse effects; D012391:Root Resorption / Q000209:etiology; D014073:Tooth Bleaching / Q000009:adverse effects / Q000379:methods*; D014075:Tooth Discoloration / Q000209:etiology / Q000628:therapy*; D019553:Tooth, Nonvital; D014508:Urea / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D001881:Borates; D004338:Drug Combinations; D016877:Oxidants; D010545:Peroxides; D012387:Root Canal Filling Materials; D000077463:Carbamide Peroxide; D014508:Urea; D006861:Hydrogen Peroxide; C027707:sodium perborate