Two-Year Clinical Evaluation of Nonvital Tooth Whitening and Resin Composite Restorations

Abstract

Nonvital tooth whitening is responsible for a significant change in color of endodontically stained teeth. Successful nonvital tooth-whitening therapy allows for conservative tooth preparation, preserving and reinforcing sound tooth structure. The proper use of modern adhesive systems along with resin composite restorations precludes the use of more extensive restorative treatment, delaying expensive crown and bridge procedures.

12-Month color stability of enamel, dentine, and enamel–dentine samples after bleaching

“…Several laboratory and clinical studies have demonstrated carbamide peroxide or hydrogen peroxide bleaching solutions to be effective in whitening of discoloured teeth [2,4,6,16,26,27]. Thereby, efficacy might be related to the concentration of the active bleaching ingredient, the application time of the agents and the potential to penetrate dental hard tissues [10,15,22,23].…”

“…After an initial reduction of lightening possibly due to rehydration processes in the first weeks after bleaching [17,19,26] a further colour regression towards baseline shades might occur. Two-year evaluation of nonvital tooth whitening revealed a 19% reduction compared to tooth colour directly after bleaching [4]. Long-time follow-up of nightguard vital bleaching revealed colour regression in 37% of patients after 3 years and 58% after 7 years [14].…”

Direct Fiber-reinforced Composite Restoration in an Endodontically-treated Molar: A Three-year Case Report

“…1 The decay process and/or tooth fracture may be responsible for the structural weakening of non-vital teeth; the tooth preparation required for adequate endodontic treatment may also contribute to the increased fragility. 2 After endodontic therapy, selecting the appropriate reconstruction for each non-vital tooth should be based on the remaining hard tooth structure, the number and thickness of the residual cavity walls, the position of the tooth in the arch and the load implied. Resin bonded composite (RBC) restorations showed a strengthening effect on the tooth structure, with fracture resistance similar to that of unaltered teeth.…”

“…[8][9] With the use of improved adhesive systems in the last decade, clinicians started proposing alternative techniques to reconstruct severely damaged teeth; the main goal of the new build-up protocol is preservation and reinforcement of the remaining sound tooth structure. 2,[10][11] Although most of the coronal portion of the tooth is compromised, RBC restorations may serve to properly build-up anterior non-vital teeth by using adequate layering and curing techniques. 12 Conversely, RBC restorations are indicated in posterior teeth as long as sufficient tooth structure is preserved; more compromised teeth with missing marginal ridges and/or cusps may require placement of a post to gain additional retention of the core.…”

“…2,[10][11] Although most of the coronal portion of the tooth is compromised, RBC restorations may serve to properly build-up anterior non-vital teeth by using adequate layering and curing techniques. 12 Conversely, RBC restorations are indicated in posterior teeth as long as sufficient tooth structure is preserved; more compromised teeth with missing marginal ridges and/or cusps may require placement of a post to gain additional retention of the core. 13 Lately, prefabricated tooth-colored fiber posts have been introduced and have demonstrated advantages over conventional metal posts.…”