ВЛИЯНИЕ ВНУТРИКОРОНКОВОГО ОТБЕЛИВАНИЯ НА МИКРОТВЕРДОСТЬ ДЕНТИНА: КЛИНИЧЕСКИЙ СЛУЧАЙ С ОБЗОРОМ ЛИТЕРАТУРЫ

Abstract

Aim. Analysis of literature sources about the effect of intracoronal bleaching on the microhardness of dentin, as well as demonstration of a clinical case of successful correction of tooth discoloration caused by endodontic sealant using the method of intracoronal bleaching with a one-year follow-up period. Materials and methods. A search of literature sources was carried out in the PubMed, Google Scholar, CyberLeninka databases on September 24, 2023 using keywords. Articles in English and Russian were selected for analysis. Inclusion criteria: original articles, in vitro and in situ studies, studies on extracted human teeth, studies that assessed dentin microhardness. As a result of the search, 11 sources were found in the PubMed database, 171 in the scientific electronic library e-library, and 2 in the CyberLeninka database. After eliminating duplication and assessing the inclusion/non-inclusion criteria, 7 literary sources remained. The presented clinical case demonstrates the successful correction of discoloration caused by endodontic sealant using intracoronal bleaching with 35 % hydrogen peroxide gel. Results. When analyzing the literature, laboratory studies revealed various conditions that make it possible to reduce the negative effect of the bleaching agent on dentin tissue, namely activation with an ultraviolet lamp, addition of a dye, and treatment with fluoride varnish after bleaching. In the clinical case, the desired shade was achieved in three bleaching procedures, then the existing defective restoration was replaced with a new shade-matching one. During the year of observation, there was no return of color, the aesthetic result was assessed as stable, the patient expressed high satisfaction with the result obtained. Conclusion. The intracoronal bleaching procedure can have a negative effect of varying severity on dentin microhardness. Identifying approaches that reduce this impact is a promising direction for future research. The clinical case demonstrates that intracoronal bleaching provides acceptable esthetic results and high patient satisfaction.