External Bleaching Research Articles

Minimally invasive teeth whitening enhancements after orthodontic treatment with in-office bleaching: two case reports

Background: Teeth discoloration is one of the adverse effects of orthodontic treatment which causes aesthetic issues that effect on a person’s appearance. The management of teeth discoloration can be done with bleaching because it is easier to perform, faster, more effective, and more conservative than other treatments such as crowns and veneers. There are two types of bleaching techniques supervised by dentists: home bleaching and in-office bleaching. In-office bleaching is one of the most conservative and non-invasive treatment options to restore the aesthetics of discolored teeth. Purpose: This case report observes management of tooth discoloration after orthodontic treatment with in office bleaching using hydrogen peroxide 40%. Case 1: A 24-year-old woman came to Universitas Hasanuddin Dental and Oral Hospital with complaints of yellowish upper and lower teeth after removal of her fixed orthodontic appliance. Case 2: A 24 years old woman came to Universitas Hasanuddin Dental and Oral Hospital with complaints of upper and lower front teeth appearing yellowish in color, noticed from 2 years ago and had undergone orthodontic treatment for four years. Case Management: From clinical examination, both patients’ teeth have no history of caries, sensitive tooth and gingival recession. The Teeth were sensitive to vitality test. The discoloration was treated with external bleaching using 40% hydrogen peroxide. Conclusion: External Bleaching using 40% hydrogen peroxide have results in significant discoloration without changing the shape and arrangement of the patient’s teeth

In office external bleaching of teeth with discoloration: a case report

Background: Tooth discoloration is a prevalent issue that significantly impacts an individual's self-confidence. Fortunately, dentists offer highly effective and non-invasive teeth whitening techniques that use higher concentrations of hydrogen peroxide (HP) of around 35% to 40%. These techniques can help resolve the problem of teeth discoloration better than at-home methods designed to deliver faster results. This is particularly helpful when immediate whitening is required. Purpose: This case study aims to report cases of in-office external bleaching of discolored teeth. Case: A 29-year-old woman complained about the yellowish shade of her teeth, which made her feel less confident due to the yellowish color. Case Management: The management for discoloration of teeth was done with dental bleaching using 40% hydrogen peroxide. As a result of the treatment, the desired tooth color increased from 3M1 to 1M1 Vita 3D Master and from Opalescence no.6 to 4. Conclusion: In-office dental bleaching is a highly effective treatment option for correcting tooth discoloration that dental professionals widely use. The procedure can significantly improve the appearance of discolored teeth and increase self-confidence of the patient.

Effect of Bleaching on Resin-Infiltration-Masked Artificial White Spots In Vitro.

Resin infiltration is an effective method to mask vestibular white spots. If needed, external bleaching is usually recommended before infiltration, whilst in clinical practice, this sequence may not always be feasible. This in vitro study evaluated the effect of bleaching after resin infiltration regarding surface roughness and color using bovine incisors. Unlike for the untreated specimens (control, n = 25), artificial caries lesions were created within the test group (n = 25) using a demineralization solution at 37 °C for five days (pH = 4.95). The lesions were subsequently infiltrated using a resin infiltrant (Icon, DMG, Hamburg, Germany), followed by polishing. Afterwards, all specimens were bleached with a 10% carbamide peroxide gel (Opalescence, Ultradent, South Jordan, UT, USA) for 8 h/day over a ten-day period. Between bleaching treatments, specimens were stored in an opaque container with moistened paper tissues at 37 °C. Surface roughness was measured using a profilometer, and color in the L*a*b* space was assessed spectrophotometrically before and after bleaching. Bleaching increased the L*-values of both infiltrated (mean ± SD; ΔL* = 3.52 ± 1.98) and untreated (control) specimens (ΔL* = 3.53 ± 2.30) without any significant difference between the groups (p = 0.983). Bleaching also induced a significant increase in the mean surface roughness of both infiltrated (p < 0.001) and untreated (p = 0.0134) teeth. In terms of clinical relevance; it can be concluded that bleaching resin-infiltrated enamel is as effective as bleaching sound enamel.

Effect of Chitosan Nanoparticle as an Antioxidant Material on Shear Bond Strength of Composite Resin to Enamel after External Bleaching

Effect of Chitosan Nanoparticle as an Antioxidant Material on Shear Bond Strength of Composite Resin to Enamel after External Bleaching

Management of Trauma-induced External Root Cervical Resorption and Discolouration of the Maxillary Central Incisors: A Case Report with a Four-year Follow-up

Background: Clinicians often face a dilemma when determining the cause of a patient's tooth discolouration and how to treat it concurrently in the presence of trauma-induced external root cervical resorption. Objective: This case report describes the management of trauma-induced cervical resorption and discolouration of the maxillary central incisors with a four-year follow-up. Case Report: A 38-year-old gentleman requested that the shape and colour of his anterior teeth be restored. The patient had a history of a motorcycle accident 15 years ago, in 2003, that resulted in fractures in both maxillary central incisors. Clinical examination showed the presence of discoloured broken teeth 11 and 21, as well as a cervical defect in tooth 11 palatally. Upon radiographic examination, 11 and 21 were root canal treated, and there was cervical resorption related to 11. Treatment consisted of cervical resorption management, internal and external bleaching, and composite restoration of the maxillary central incisors. After a four-year follow-up, this report demonstrated the successful management of a complicated case involving trauma induced resorption and discolouration. The patient expressed satisfaction with the conservative strategy that was taken to treat his discoloured teeth. Conclusion: This clinical report, with a long follow-up record, helps to provide dental practitioners with a conservative, minimally invasive, patient-centred treatment alternative for a complicated tooth discoloration case.

BASIC DIRECTIONS IN FLUOROSIS TREATMENT

The territory of Poltava region belongs to the Buchatsky hydrogeological province, whose groundwater is characterized by an elevated fluorine level content. The cause of endemic dental fluorosis particularly in the children’s population of the region is water consumption with surplus concentration of this chemical element. Also, having fluorosis a condition that develops from a high fluoride concentration in drinking water- causes disorder of hard tooth tissues maturing, mineralizationand teeth germ development. This, in turn, has a negative influence on enamel amelogenin synthesis and violation of the crystals maturing, determines a surface porosity. The chalky spots, brown pigmentation, and enamel erosion destruction lesions are characterized the different severity manifestation of the fluorosis.&#x0D; The purpose of our research was to conduct a thorough analysis of all the material we found on this topic, gather all possible information on new trends in recent years in the treatment of dental fluorosis: what are the methods, their origins, indications for use, clinical stages and advantages.&#x0D; Dental enamel fluorosis requires different approaches to treatment depending on the severity of clinical manifestations. Obviously, as the leading method is remineralizing therapy. One of the method is offered by Nikolishina E.V. etc. [6], which is carried out in the following way: after carry out of the professional hygiene procedure, next step, individual caps were made of transparent silicone filled with 10% solution «Poltavsky Bishofit» and applied on the fluorosis teeth, daily course consist with 30 minutes and 10-20 procedures.&#x0D; Enamel microabrasion is the first minimally invasive treatment method of mild and moderate dental fluorosis using to removes opaque brown spots and surface roughness smoothing, providing a flat and shinier surface. The microabrasion technique involves etching with mild acid in combination with application of abrasive components. Resin infiltration has also become a popular treating dental fluorosis technique without loss of hard tissue.&#x0D; Resin infiltration is based on the application of hydrochloric acid to the hard tissues of the tooth and subsequent coating with a low-viscosity resin that penetrates into the microspaces of the tooth enamel. The cloaking effect is based on the refractive index. The optical properties of the affected enamel change and it looks like a healthy enamel surrounding. The indication to dental fluorosis treatment of severity forms in permanent teeth with mature roots is restoration of teeth, veneers, orthopedic crowns, if the microabrasive method hasn’t aesthetic effect efficiency.&#x0D; Thus, in cases of aesthetic changes due to fluorosis, minimally invasive restorative approaches that preserve dental hard tissue such as microabrasion method, external bleaching or resin infiltration should be considered before invasive restorative procedures. More invasive treatments may be considered if the results remain unsatisfactory.

The use of white pomegranate extract as a bleaching material for hardness, roughness, and calcium levels in the enamel tooth

Background: Bleaching is the procedure of re-whitening teeth that have darkened to a shade near to their natural hue. Due to the unfavorable impact of chemical bleaching materials on enamel demineralization, the quest for natural bleaching solutions that have the same whitening effect while minimizing the negative consequences is encouraged. The punica granatum fruit is one of the natural components that can be employed. Purpose: This study aims to analyze the application of white pomegranate extract as an external bleach on the physical properties of the enamel surface of the tooth. Methods: thirty post-extraction bovine teeth were divided into treatment and control groups, then enamel surface hardness was measured using a Micro Vickers Hardness Tester, enamel surface roughness using a Surface Roughness test, and calcium levels using an EDS SEM tool before application of white pomegranate extract which is performed for 2 hours a day for two weeks. After two weeks, the enamel surface hardness, enamel surface roughness, and calcium levels were measured again. Results: The results of the treatment group using white pomegranate extract showed that there was no decrease in enamel surface hardness (p&gt;0.05), a decrease in enamel roughness (p&lt;0.05), and no decrease in calcium levels (p&gt;0.05). The control group's results using 16% carbamide peroxide showed a decrease in the hardness and surface roughness of the enamel, but it did not decrease the calcium content. Conclusion: white pomegranate extract can be used as an external bleaching agent because of not reduce the surface hardness, reduce the surface roughness and not reduced the calsium of the enamel tooth

Differences of Enamel Microhardness Post External Bleaching After Application with Casein Phosphopeptide Amorphous Phosphate (CPP-ACP) and 5% Sodium Fluoride (NAF)

Background: Bleaching is an effort to lighten the color of teeth through the application of chemicals. One of the side effects of bleaching is that it causes demineralization so that the hardness of the enamel will decrease. The hardness of the enamel can be returned back through the mineral laying process, namely remineralization. Objective: The purpose of this study was to determine whether there were differences in post-bleaching enamel hardness after Casein Phosphopeptide Amorphous Phosphate (CPP-ACP) or 5% sodium fluoride (NaF) application. Methods: In this in-vitro research, bleaching was applied to 30 lower premolars that were divided into three groups, the first group without remineralization, the second group remineralization with CPP-ACP, and the third group remineralization with NAF. Enamel microhardness was measured using Vickers Hardness Tester Machine before bleaching, immediately after bleaching, after application of remineralization pastes, and after 7 days. The teeth were bleached with 40% hydrogen peroxide and underwent remineralization for 7 days. Results: The results showed differences in enamel microhardness after using CPP-ACP or 5% sodium fluoride (NaF) application, and the highest post-bleaching enamel hardness was after 5% NaF application. The data were analyzed and tested using ANOVA to measure the differences in hardness between more than 2 groups, and using the post hoc student t-test to measure the differences in violence between the 2 groups. Natural remineralization can occur with saliva but not optimally; therefore, additional remineralizing agents are needed. Conclusion: The conclusion of this study was that 5% NaF used as a remineralization agent after in-vitro bleaching could increase enamel microhardness more than CPP-ACP after 7 days of application.

The Impact of Simulated Bruxism Forces and Surface Aging Treatments on Two Dental Nano-Biocomposites-A Radiographic and Tomographic Analysis.

Background and Objectives: Nowadays, indication of composite materials for various clinical situations has increased significantly. However, in the oral environment, these biomaterials are subjected (abnormal occlusal forces, external bleaching, consumption of carbonated beverages, etc.) to changes in their functional and mechanical behavior when indicated primarily for patients with masticatory habits. The study aimed to recreate in our lab one of the most common situations nowadays-in-office activity of a young patient suffering from specific parafunctional occlusal stress (bruxism) who consumes acidic beverages and is using at-home dental bleaching. Materials and Methods: Sixty standardized class II cavities were restored with two nanohybrid biocomposite materials (Filtek Z550, 3M ESPE, and Evetric, Ivoclar Vivadent); the restored teeth were immersed in sports drinks and carbonated beverages and exposed to an at-home teeth bleaching agent. The samples were subjected to parafunctional mechanical loads using a dual-axis chewing simulator. A grading evaluation system was conducted to assess the defects of the restorations using different examination devices: a CBCT, a high-resolution digital camera, and periapical X-rays. Results: Before mechanical loading, the CBCT analysis revealed substantially fewer interfacial defects between the two resin-based composites (p > 0.05), whereas, after bruxism forces simulation, significantly more defects were identified (p < 0.05). Qualitative examination of the restorations showed more occlusal defects for the Evetric than the other nanohybrid composite. Conclusions: There were different behaviors observed regarding the studied nanocomposites when simulation of parafunctional masticatory forces was associated with aging treatments.

Differences of Enamel Microhardness Post External Bleaching After Application with Casein Phosphopeptide Amorphous Phosphate (CPP-ACP) and 5% Sodium Fluoride (NAF)

Background Bleaching is an effort to lighten the color of teeth through application of chemicals. One of the side effects of bleaching is that it cause demineralization so that the hardness of the enamel will decrease. The hardness of the enamel can be returned back through mineral laying process, namely remineralization. Objective: The purpose of this study was to determine whether there were differences in post-bleaching enamel hardness after Casein Phosphopeptide Amorphous Phosphate (CPP-ACP) or 5% sodium fluoride (NaF) application. Method: In this in-vitro research bleaching was applied to 30 lower premolars that were divided into three groups, the first group without remineralization, the second group remineralization with CPP-ACP, and the third group remineralization with NAF. Enamel microhardness was measured using Vickers Hardness Tester Machine before bleaching, immediately after bleaching, after application of remineralization pastes, and after 7 days. The teeth were bleached with 40% hydrogen peroxide and underwent remineralization for 7 days. Results: The results showed differences in enamel microhardness after using CPP-ACP or 5% sodium fluoride (NaF) application and the highest post-bleaching enamel hardness was after 5% NaF application. The data were analyzed and tested using ANOVA to measure the differences in hardness between more than 2 groups, and using the post hoc student t-test to measure the differences in violence between the 2 groups. Natural remineralization can occur with saliva but not optimally; therefore, additional remineralizing agents are needed. Conclusion: The conclusion of this study was that 5% NaF used as remineralization agent after in-vitro bleaching could increase enamel microhardness more than CPP-ACP, after 7 days of application.

Comparative Evaluation of the Increase in Enamel Hardness Post-External Bleaching after Using Casein Phosphopeptide Amorphous Calcium Phosphate Fluoride (CPP-ACPF) and 5% Sodium Fluoride (NaF) Remineralizing Agents.

The purpose of this study was to analyze the increase in enamel hardness post-external bleaching after remineralized with casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) and 5% sodium fluoride (NaF) and the difference in increased enamel hardness between CPP-ACPF and NaF materials. The study was true experimental in vitro using 30 samples of mandibular premolars. All samples were bleached using 40% hydrogen peroxide. The samples were divided into three groups of 10 samples each; group I as a control without application of remineralization material, group II was given an application of CPP-ACPF (GC Tooth Mousse Plus: GC Europe, Lot #201130B), and group III was given an application of 5% NaF (Clinpro White Varnish: 3M ESPE, Lot #NA62322) Then the entire samples were stored in artificial saliva. The hardness of the samples was measured using a Vickers hardness tester before bleaching, after bleaching, and after remineralization for 7, 14, and 21 days. Analysis of the data used was an analysis of variance test to assess differences in the increase in enamel hardness between groups and paired t-tests and to determine differences in enamel hardness in each group. This study showed that there was an increase in the enamel hardness after bleaching which was remineralized with CPP-ACPF and 5% NaF. There was a difference in the increased enamel hardness between teeth remineralized with CPP-ACPF and 5% NaF. The enamel hardness of CPP-ACPF was higher compared with 5% NaF after remineralization of 7, 14, and 21 days. There was an increase in the enamel hardness after external bleaching that was remineralized with CPP-ACPF and 5% sodium fluoride (NaF). There was a difference in the increased enamel hardness between teeth remineralized with CPP-ACPF and 5% sodium fluoride (NaF). CPP-ACPF showed a higher enamel hardness value than 5% NaF.

Effectiveness and satisfaction of home-based external bleaching

Hydrogen peroxide is the main ingredient in bleaching products (BP), and based on the settings of the reaction, can produce (per-)hydroxyl anions, superoxide anions, and other radicals. The radical-related oxidative mechanism can trigger the breakage of molecular bonds in enameller and dentinal stains, while the exact process is not entirely grasped. Products as a consequence look less colorful. The amount of the active bleaching component, the likelihood of BP interaction with discolorations, and the contact duration all affect the effectiveness of the bleaching treatment. Effectiveness also depends on a number of variables, including the individual's age, the type of staining, and the number of bleaching treatments. A significant number of local adverse effects have been recorded with over-the-counter items due to poorly fitted tray, adjuvants such as binders, preservatives, and flavors as well as a low pH, coexisting gingivitis, abrasion, and erosion. In cases of the coupled utilization of tobacco and excessive alcohol intake because tobacco users demonstrate lower levels of hypersensitivity to the BP and may be heavily influenced by the positive cosmetic effects, they must particularly be counseled against getting bleaching done as the combination has been found to pose elevated oral carcinoma risk. Overall, current literature has found a positive relation between procedure efficacy and patient satisfaction.

Effect of External Bleaching on Color Change of Single Shade Resin Composite Versus Nano-Filled Resin Composite in Class V: In Vitro Study

Aim: This study investigated the effect of bleaching on color change of the single shade universal composite (Omnichroma) versus nano-filled resin composite (Z350 XT). Materials and Methods: Twenty premolars of shade A3 were used for the study. Standardized class V cavities were prepared on the cervical third of the buccal surface of all teeth. After that, teeth were randomly divided into two groups of 10 teeth each according to the type of resin composite used. After composite application, all teeth were stored individually in distilled water for 24 hours. Evaluation of the restoration color was done using VITA Easyshade. The teeth were bleached and stored again for another 24 hours. Re-evaluation of the restoration color was done at 24 hours, one week and one month after bleaching. Results: There was no statistically significant difference between the two restorative materials at 24 hours and after one week. While there was a statistically significant difference between the two restorative materials after one month. Conclusion: Omnichroma single shade universal restorative material demonstrates structural color change post-bleaching procedure

Tooth Bleaching of Discolorations Caused by Hydraulic Cements in Regenerative Endodontic Treatment: A 3-Year In Vitro Study.

This study aimed to evaluate the color change caused by hydraulic cements after 3 years in vitro by simulating their use in regenerative endodontic treatment (RET) and to quantify the color change after external bleaching with 40% hydrogen peroxide at 1, 6, and 12 months of follow-up. Fifty teeth were treated simulating RET. Samples were distributed according to the hydraulic cement to be used (n = 10 per group): negative control (no cement), ProRoot-MTA, MM-MTA, TotalFill BC-RRM, or Biodentine. Three years after RET, two sessions of external bleaching with Opalescence Boost were performed. The color was measured in the cervical and incisal halves of the teeth at different time points: baseline, 3 years after performing RET, and after 1, 6, and 12 months after bleaching. The ΔL, Δa, and Δb were determined. A generalized linear model was used to compare color considering group and time. The ΔEab and the ΔE00 were calculated and the acceptability in color change was determined. Three years after RET, a reduction in lightness (negative ΔL values) was found in all groups. These values significantly increased 1 month after bleaching in all groups (p &lt; 0.05) and reversed at 6 months. One month after bleaching, ΔE00 values (color difference tolerance (CIEDE2000)) ranged from very good (&gt;3.6 ≤ 5.4) to excellent (&gt;5.4). One year after bleaching, the color reverted to values similar to those found 3 years after RET. All groups became darker after RET. The color recovered and even improved compared with the baseline measurement after one month of bleaching but did not remain stable over time.

Management of teeth discoloration with external bleaching treatment: a case report

The objective of this article is management of teeth discoloration with external bleaching used bleaching agent hydrogen pe-roxide (H2O2) 40% on a 28-year-old woman came to the Hasanuddin University RSGMP with complaints of yellowish teeth. The patient wants her teeth looks brighter. In-office bleaching procedure was performed by initial color determination score 8 with opalescence boost shade guide. Dental optragate was placed in the patient’s mouth, cleanedthe surface of the teeth with a brush and pumice, application of astringent, gingival barrier in upper and lower teeth. Application of 40% H2O2 bleaching agent for20 minutes then cleaned, desensitizing agent application, and final color adjustment. This research results a significant color change from score 8 to 2 using opalescence boost shade guide and concludes that treatment of teeth discoloration using 40% H2O2 provides significant teeth color changes in a short time and considered as an effective method.

Patient-reported outcome measures for children and adolescents having dental bleaching in the UK

PurposeDental bleaching in paediatric patients can be used to address discolouration of teeth due to trauma, endodontic treatment, or enamel and dentine defects. Despite being a minimally invasive and successful treatment, the use of bleaching products in children and young people remains controversial. This evaluation was designed to provide insight into the child’s perspective on dental bleaching and the influence that this treatment has upon their life.MethodA dental bleaching patient reported outcome measure (PROM) was developed and piloted in 2019. Data were collected from 3 UK units (January–March 2020). Children attending these units for bleaching reviews were invited to complete the PROM.ResultsTwenty seven PROM questionnaires were completed including 19 courses of external bleaching and 8 courses of internal/external bleaching. The average age was 14 years old (9–17 years). The common indications for bleaching were Amelogenesis Imperfecta, dental trauma and Molar Incisor Hypomineralisation. Patients reported improvements in their appearance (89%) and self-confidence (81%). Sensitivity was the most common side effect, reported in 63% of cases.ConclusionThis PROM supports the use of dental bleaching in children and young people when treating dental disease that causes discolouration. Bleaching not only improved the appearance of teeth, but also patients’ self-confidence. Sensitivity is a common side effect and clinicians should discuss this common risk and its management with patients and their families.

Management of Pulp Canal Obliteration-Systematic Review of Case Reports.

Background and Objectives: This systematic review aimed to assess the literature focusing on the clinical management of traumatized teeth with Pulp Canal Obliteration (PCO) and propose an updated clinical decision-making algorithm. The present review follows the PRISMA guidelines and was registered on PROSPERO database (CRD42020200656). Materials and Methods: An electronic search strategy was performed in Pubmed, EBSCOhost and LILACS from inception to March 2021. Only anterior permanent teeth with PCO due to dental trauma were included. Regarding clinical approaches, only teeth managed with a “watchful waiting” approach, tooth bleaching or root canal treatment (RCT) were included. Quality assessment was performed using the JBI Critical Appraisal Tool for Case Reports. Results: Twenty case reports were selected, resulting in a total of 27 patients. The number of traumatized teeth diagnosed with PCO was 33. The “watchful waiting” approach was the most implemented clinical strategy. Discolored non-symptomatic PCO teeth were mostly managed with external bleaching. The prevalence of pulp necrosis (PN) was 36.4%. For teeth diagnosed with PN, non-surgical RCT was performed in 10 teeth and surgical RCT in one tooth. Guided endodontic technique was performed in six of those teeth. Conclusions: For discolored non-symptomatic PCO teeth, external bleaching is advocated and the RCT approach should not be implemented as a preventive intervention strategy. Symptomatic PCO teeth should follow regular endodontic treatment pathways. Clinical approach of teeth with PCO should follow a decision-making algorithm incorporating clinical and radiographic signs and patient-reported symptoms.

Role of enamel and dentin on color changes after internal bleaching associated or not with external bleaching.

Objective To evaluate the effect of the association between external and internal tooth bleaching on color changes in dentin and enamel, individually or recombined, previously stained with triple antibiotic paste (TAP).Methodology Forty enamel-dentin specimens from bovine incisors were separated into ten blocks according to similarity in their whiteness index (WID). Three specimens within each block were stained by dentin exposure to TAP, and the remaining specimen was used as control to estimate color changes. Specimens were sectioned to separate tissues, and dentin and enamel colors were measured individually and after being recombined. Alterations in color (CIEDE2000 - ΔE00) and translucency parameter (TP) resulting from staining were estimated by color difference between stained and control specimens. The contribution of each tissue to the color change (CTCC) was also calculated. Non-sectioned stained specimens were bleached by applying sodium perborate on dentin, associated or not with 35% hydrogen peroxide on enamel. Color changes caused by bleaching procedures were estimated and data were analyzed using the paired t-test or Two-way repeated measures ANOVA.Results TAP caused more pronounced changes in dentin, but enamel color was also affected. Both protocols presented a similar ΔE00, and dentin showed the greater color change. After exposure to TAP, we observed a reduction in WID; WID values were the same for bleached and control specimens regardless of protocol. We found no significant effect of substrate and bleaching technique on TP. Enamel played a more critical role in color changes caused by either staining or bleaching procedures.Conclusion Enamel color played a greater role on tooth color changes than dentin. External and internal bleaching association did not improve bleaching effect on specimens stained with TAP.

Association between bleaching techniques for the treatment of teeth with chromatic alteration - Case report

Dental trauma is one of the most common causes of post-eruptive intrinsic color changes in teeth. The dissatisfaction with smile aesthetics is one of the main motivators for seeking dental procedures such as tooth bleaching, which stands out for being a little-invasive procedure with immediate and satisfactory aesthetic results. The objective of this paper is to describe a case report of a 24-year-old patient who attended the Postgraduate Program in Dental Clinic Practice at the Piracicaba Dental School – University of Campinas, which involved as main complaint tooth darkening after trauma in childhood. Internal bleaching of a dental element was performed using sodium perborate and distilled water associated with in office external bleaching with 37% hydrogen peroxide to provide a more harmonious smile to the patient. The association of bleaching techniques is an alternative widely indicated and effective in cases where it is desirable to maintain the integrity of dental elements, especially in young patients, avoiding more invasive restorative procedures and resulting in patient satisfaction.

Role of enamel microabrasion associated with external bleaching in the management of patients with dental fluorosis

La fluorose dentaire est une anomalie de développement qui affecte l'aspect esthétique des dents. L'association de la micro-abrasion à l'éclaircissement externe a montré des résultats satisfaisants pour l'amélioration de l'esthétique des dents atteintes de fluorose légère. L'objectif de ce travail est de mettre le point sur l'intérêt de cette association ainsi que sur ses différents effets sur la surface amélaire.