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

Abstract

Objective. The causes of internal posteruptive discoloration of teeth are bleeding, necroses, infections, and endodontic filling materials. The aim of this study was to establish the results of bleaching endodontically treated teeth using walking bleach, in-office, and combined techniques, using 30% carbamide peroxide and 35% hydrogen peroxide, as well as the effect of etiological factors, and the time elapsed after endodontic treatment on the success of bleaching. Materials and Methods. The research involved 30 endodontically treated teeth in healthy patients. Retroalveolar X-rays were taken to check the quality of root canal obturation. Endodontic treatment and obturation were carried out on the discolored non-vital teeth without any previous endodontic treatment. Before bleaching, two millimeters of the filling were removed from the root canal and the very entry into the canal was protected with glass ionomer cement. The teeth were divided into three groups, depending on the bleaching technique: walking bleach technique (10 patients), in-office technique (10 patients), and combined technique (10 patients). The teeth were bleached with 30% carbamide peroxide and 35% hydrogen peroxide. The bleaching procedure was repeated in all the patients three times. The color of all teeth was determined based on the Vita Classic guide before and after bleaching. The Χ² square and Kruskal–Wallis tests were used to identify differences in teeth bleaching results. Results. A statistically significant difference (p < 0.05) was established between bleaching success and the time elapsed after endodontic treatment. There were no statistically significant differences observed between the bleaching success and etiological factors, bleaching techniques, or bleaching agents. Conclusions. The effectiveness of non-vital tooth bleaching is affected by the time elapsed after endodontic treatment.

In Vitro Color Stability of Bleached Teeth Using Peroxide-Free Bleaching Gel, Carbamide Peroxide and Hydrogen Peroxide

“…The similar levels of tooth discoloration observed from 22% and 16% carbamide peroxide treatments can be attributed to various factors supported by existing literature. A study by Knežević et al ( 2022) has highlighted the e ciency of carbamide peroxide in improving permeability and penetrating deeper into tissues, facilitating the reversal of chromatic discoloration through oxidation reactions [15]. Another study has emphasized the effectiveness of carbamide peroxide in home bleaching, indicating its potential for discoloration based on a literature review [16].…”