Clinical efficiency of a sodium perborate - hydrogen peroxide mixture for intracoronal non-vital teeth bleaching

Abstract

Introduction/Objective The aim was to evaluate initial efficiency of sodium perborate (tetrahydrate) and 30% hydrogen peroxide mixture for intracoronal non-vital teeth bleaching ("walking bleach" technique). Methods Forty patients with discolored teeth were included in the study. Based on their history and clinical examination, causes of discoloration were classified as necrotic pulp, "endo-sealer" or unknown. The "walking bleach" technique was performed by applying sodium perborate (tetrahydrate) and 30% hydrogen peroxide mixture intracoronally to cavity dentin walls. The mixture was renewed in seven-day intervals. Tooth color was assessed visually before, during, and after the procedure using the Vita Classical shade guide (Vita Zahnfabrik, Bad Säckingen, Germany). Numerical values or shade guide units (SGU) were assigned to Vita shade tabs on a bright-dark scale. Analysis of variance, t-test, correlation and regression analysis were used to analyze the data (p < 0.05). Results On average, 26 ± 9 days or 3-4 appointments were required for intracoronal bleaching to achieve the desired or best possible shade. Better clinical efficiency was found in the necrotic pulp group (17 ± 6 days; 8 ± 3 SGU) than in the "endo-sealer" group (42 ± 13 days; 4 ± 2 SGU) (p < 0.05). Age significantly influenced bleaching efficiency (p < 0.05). There was no significant correlation between bleaching efficiency and initial shade (p > 0.05). Conclusion Intracoronal, non-vital teeth bleaching ("walking bleach" technique) using sodium perborate (tetrahydrate) and 30% hydrogen peroxide mixture showed satisfactory clinical efficiency. Discoloration caused by pulp necrosis was treated more efficiently than that caused by endodontic sealers. Younger age had a positive effect and discoloration intensity had no effect on bleaching efficiency.

Clinical Testing of Walking Bleach, In-Office, and Combined Bleaching of Endodontically Treated Teeth

“…An important factor in the success of the bleaching treatment is the time the discoloration occurred. A shorter time of tooth discoloration has a better prognosis of bleaching, whereas the outcome of bleaching older discolorations is uncertain and oftentimes unsuccessful due to a more complex integration of color in the dentin [ 2 ]. The results of our research are in line with these facts.…”

“…The bleaching agent was applied in the pulp chamber. The excess fluid was removed with dry cotton balls [ 2 , 9 , 17 ]. The teeth were then sealed with glass ionomer cement Fuji IX (GC, Japan) until the next treatment.…”

“…An internal change in color may be caused by the application of various irrigants used for the chemical processing of canals, medications, and endo sealers. In the past, this type of discoloration was mainly treated by invasive prosthetic restoration [ 2 , 3 , 4 , 5 ].…”

“…This concept specifically refers to tooth discoloration treatment. The bleaching of teeth and restoration of their natural color helps save dental tissue and also provides an alternative solution to crowns [ 2 , 3 , 4 ].…”

Effects of whitening gels on color and surface properties of a microhybrid and nanohybrid composite

“…Whilst whitening agents have noticeable effects on vital and non-vital teeth 1,[5][6][7] , their effects on resin-based composites remain unclear in terms of color differences and surface changes. Most studies have found color differences of non-discolored composites reaching or surpassing the CIEDE2000 50:50% perceptibility (∆E 00=0.81) but below the 50:50% acceptability thresholds (∆E00=1.77) [8][9][10][11] , rarely color differences were shown to exceed the 50:50% acceptability threshold 12,13) .…”