The clearing house is to clarify a devitalized tooth "from within".
Often devitalized teeth are stained darker, which can be unsightly in the case of a maxillary central incisor. In this case we may, after ensuring that the root filling was very tight, place a suitable product on the inside of the tooth, and leave it for a week. We can possibly renew the product several times, until you reach the desired shade. This treatment may be repeated later if necessary.
The teeth whitening should be scrutinized to eliminate the cons-indications. The quality of endodontic treatment should be checked. If necessary treatment will be repeated. Pictures can be made before initial treatment. The preparation of the tooth will be to rectify the access cavity, remove filling the root canal up to 2 mm of the cementoenamel junction. Then, the neck at this level will be insulated with a material acting as a protective barrier. This base coat prevents the diffusion of hydrogen peroxide at the apical region and at the on ¬ outer surface of the root.
Different materials have been proposed: the glass ionomer cement,
Super EBA cement oxyphosphate zinc eugenol or the Cavit.
If no significant difference was found between the different materials to some authors, Cavit, the zinc oxide eugenol cement and MRI appear to be slightly more effi ¬ cient for d other. A thickness of 2 mm for the Cavit seem to be a good way to isolation.
The method thermo catalytic, very fast and efficient, which involved heating a cotton pellet soaked with hydrogen per- drogue to 110 volumes, should be permanently discontinued because it is causing complications.
Currently, two techniques are used:
Techniques that utilize the sodium perborate
Sodium perforate is a white, thin, antiseptic, chemically stable when dry. Dissolved in water, it slowly decomposes into sodium met borate, hydrogen peroxide and nascent oxygen.
When sodium perforate is diluted in distilled water, it takes three molecules to release an oxygen molecule, while the mixture with hydrogen peroxide requires only two molecules.
In 1961, Spasser recommended the use of sodium perborate mixed with distilled water to achieve the internal bleaching. In 1963, Nutting and Poe have substituted distilled water by hydrogen peroxide at 30% to achieve the whitening treatment. This is an ambulatory method which consists in depositing the pulp chamber in a pasty mixture containing sodium perorate and water, and seal the cavity with a waterproof dressing. The product is renewed every ten days, until the desired clarification. The reaction can be accelerated by the combination of hydrogen peroxide 30% sodium perorate.
Technologies using carbamide peroxide
Another method is to use carbamide peroxide at concentrations of 10 to 35%. This product is considered less aggressive due to the indirect production of hydrogen peroxide.
Some authors have proposed the use of carbamide peroxide 10% formamide (34), and in their study, the results after three sessions of money for 14 days were lower than those obtained with sodium perborate mixed with peroxide hydrogen at 30%.
Carbamide peroxide at concentrations of 35% was equal ¬ ment was assessed in vitro, and showed a profit equal to that obtained with hydrogen peroxide at 35%. The carbamide peroxide releases 35% 12% hydrogen peroxide.
Satisfactory results in vivo were also obtained with carbamide peroxide. In vitro peroxide carba ¬ mide to 35% seems to be a safe technique because it has not - started resorption.
How to Restore the access cavity after bleaching
The marginal seal may be affected by the treatment of lightning ¬ cissement, increasing the microleakage of fluids and bacteria in the pulp chamber and contributing to treatment failure.
For some authors, nascent oxygen after treatment clarification may persist for up to two weeks in the enamel and dentin and interfere with adherence. To avoid these effects, the restoration should be postponed at least two weeks.
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