Abstract
ABSTRACT This study goal is to present a case report of tooth bleaching treatment with the combination of the custom tray and in-office techniques, and to discuss about the considerations for result maintenance. A treatment approach was planned involving exogenous bleaching with custom trays with 7.5% hydrogen peroxide, and in-office bleaching with 35% hydrogen peroxide. The in-office bleaching agent was applied in two 15-minute applications, without led light. The patient was instructed to use the custom trays only a day after, with one drop of the bleaching agent for each tooth space. After the application of the bleaching agent, the patient used the trays for 1 hour per day, continuously for 30 days, 15 days for each arch. Considering the executed treatment approach, we may conclude that when correctly indicated, tooth bleaching with the combination of the in-office and custom trays techniques can be an acceptable choice of treatment, capable of enhancing the smile esthetics with a simple technique that preserves the sound dental structure. The patient should be instructed for the maximum color preservation and esthetic result maintenance, and should be advised that retreatments may become necessary depending on the oral hygiene and frequence of coloured food and drinks intake.
Highlights
Tooth bleaching is a very popular esthetical treatment since it does not require any wear of the dental structure and is able to produce immediate esthetical results
The appearance and color of teeth are a common concern for patients and are associated with an increased desire for treatments that improve dental aesthetics, including tooth whitening [5]
The combined approach with custom trays and in-office bleaching [3] should be an option when the professional realizes that the patient has a difficult daily routine that could slow up the result and is not motivated to use the custom trays for many days
Summary
Tooth bleaching is a very popular esthetical treatment since it does not require any wear of the dental structure and is able to produce immediate esthetical results. The first portion of the 35% hydrogen peroxide bleaching agent self-mixture was disposed (Whiteness HP Maxx AutoMixx, FGM, Joinville, Brazil) and the application was done for 15 minutes without led light (figure 2). After the bleaching agent removal, the gingival barrier was removed and a desensitizing gel with potassium fluoride (Desensibilize KF 2%, FGM, Joinville, Brazil) was applied on the surface for 10 minutes After this period the desensitizing gel was removed and the dental surface was polished with a feltrum disk in a low rotation counter angle, to minimize the suface roughness. The patient was instructed to start using the customized trays for bleaching the following day She received oral and written instructions regarding the dosage of the 7.5% hydrogen peroxide bleaching agent (WhiteClass 7.5%, FGM, Joinville, Brazil), which was one drop for each tooth space in the custom tray (figure 3).
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