Efficiency of Teeth Bleaching after Regenerative Endodontic Treatment: A Systematic Review

Abstract

The aim of this review is to evaluate of effectiveness of bleaching procedures used to treat discolored teeth subsequent to regenerative endodontic procedures (REPs) based on the review of in vitro and in vivo studies. This literature review was carried out according to the PRISMA guidelines. Four databases (PubMed, Scopus, the Cochrane Library, and Web of Science databases) were searched electronically, until 30 January 2020 without a year limit. The quality of studies was assessed using a modified methodological index for non-randomized studies. After analyzing 1405 studies, 6 in vitro and 9 in vivo studies were eligible for this review. In in vitro studies, effectiveness of bleaching was assessed in teeth discolored by antibiotic pastes, blood, and barrier materials in various combinations. In all analyzed studies, bleaching was effective in teeth discolored by antibiotic pastes as well as by blood and barrier materials. Of 26 treated teeth in the in vivo studies, 17 teeth were bleached successfully. In six cases, there was improvement of the shade. In three cases, bleaching was not sufficient. Bleaching material, techniques, and times differed between studies. Whitening of discolored teeth after REPs is achievable. However, to establish precise guidelines, further long-term clinical studies should be performed.

Vital Pulp Therapy in Aesthetic Zone-Identifying the Biomaterial That Reduces the Risk of Tooth Discolouration

“…Regenerative endodontics studies the potential for the regeneration of damaged pulp as well as the creation and delivery of replacement pulp-dentin tissues, and belongs in category of stem cell induction therapies. A blood clot formed inside the canal could affect the colour of the teeth [54,55]. The use of platelet-rich concentrates and transplanting stem cells into the tooth cavity can also have a significant impact on tooth discoloration, but this requires confirmation by research.…”

Effect of internal bleaching on the reversal of coronal discoloration induced by triple‐antibiotic‐paste or Biodentine use in regenerative endodontic procedures

“…Yasa et al reported that 35% hydrogen peroxide is more effective than sodium perborate in the whitening of teeth discolored by antibiotic pastes 26 . A recent systematic review 27 was not able to make a suitable conclusion because further studies are required for the creation of precise guidelines that would define the appropriate bleaching technique, material, and duration in discolored teeth after REPs.…”

Action mode of ursolic acid as a natural antioxidant and inhibitor of superoxide dismutase: In vitro and in silico study

“…[ 1 ] One of the methods used to whiten the teeth is bleaching. [ 2 ] The study showed that antioxidants play a role in the effect of tooth bond strength caused by bleaching method those can produce free radicals that are left in the tooth structure; therefore, antioxidants are needed as free radical scavengers to increase the strength of dental restoration materials bonding to the substrate. [ 3 ] An antioxidant is a substrate or molecule that can inhibit free radical reactions and is available in synthetic or natural forms since natural antioxidant is hardly safer than a synthetic antioxidant.…”