TOOTH TOOTH WHITENING/BRIGHTENING WHITENING/BRIGHTENING

PROCEDURESPROCEDURES

The lightening of the color of a tooth The lightening of the color of a tooth through the application of a chemical agent through the application of a chemical agent

to oxidize the organic pigmentation in the to oxidize the organic pigmentation in the tooth is referred to as bleaching.tooth is referred to as bleaching.

Degradation of high molecular weight Degradation of high molecular weight complex organic molecules that reflect complex organic molecules that reflect specific wave length of light responsible for specific wave length of light responsible for the color of the stain into lower molecular the color of the stain into lower molecular weight and less complex molecules that weight and less complex molecules that reflect less light is called lightning.reflect less light is called lightning.Bleaching is used as sole treatment of choice or in conjunction with other treatment modalities to brighten a whole smile.

HISTORYHISTORY

Bleaching was unsuccessfully used in the Bleaching was unsuccessfully used in the middle agesmiddle ages

Modern bleaching technique began in Modern bleaching technique began in 1918.Abbot used the combination of 1918.Abbot used the combination of superoxol and heat.superoxol and heat.

1958—Prarson—intra pulpal bleach1958—Prarson—intra pulpal bleach

1967--Nutting and Por—walking bleach1967--Nutting and Por—walking bleach

1978—superoxol +heat + light1978—superoxol +heat + light

1989—Haywood .& Hayman (night guard 1989—Haywood .& Hayman (night guard vital bleaching,10% carbimide peroxide)vital bleaching,10% carbimide peroxide)

1996—laser tooth whitening officially 1996—laser tooth whitening officially started with the approval of ion laser started with the approval of ion laser technology Argon and CO2 lasers to be technology Argon and CO2 lasers to be used with a potential system of chemicalsused with a potential system of chemicals

BLEACHING MATERIALSBLEACHING MATERIALS

Oxidizing agentsOxidizing agentsHydrogen peroxide bleaching solution and gels.

Ph : highly acidic Conc 3-3.5%

Carbamide peroxide based bleaching agents Carbamide peroxide based bleaching agents also called also called

Urea hydrogen peroxide,Urea hydrogen peroxide,Carbamyl peroxide, Carbamyl peroxide, Perhydrol ureaPerhydrol urea

Conc : 3-45%Conc : 3-45%Ph :5-6.5Ph :5-6.5

HOW WOULD YOUR PATIENTS LIKE THEIR SMILE ?

A SMILE CONNECTS

More and more people would like lighter teeth. Not surprising –as nothing can improve a smile like bright white teeth

IN OFFICE VITAL TOOTH IN OFFICE VITAL TOOTH BLEACHINGBLEACHING

Vital tooth bleaching is Vital tooth bleaching is one of the least one of the least invasive, most invasive, most conservative and most conservative and most effective procedure to effective procedure to dramatically improve dramatically improve the esthetic the esthetic appearance of patient appearance of patient smile and self-smile and self-confidence.confidence.

Light enamel discolorationsLight enamel discolorationsMild tetracycline discolorationsMild tetracycline discolorationsEndemic fluorosis discolorationsEndemic fluorosis discolorationsAge related discolorationsAge related discolorations

IndicationsIndications

Severe dark discoloration

Severe enamel loss

Hypersensitive teeth

Presence of caries

Large/poor coronal restoration

Contraindications

Familiarize the patient with Familiarize the patient with – Probable cause of discolorationProbable cause of discoloration– Procedure to be followedProcedure to be followed– Expected out comeExpected out come– Possibility of future re-discolorationPossibility of future re-discoloration

Take radiographsTake radiographs– Detect all carious lesionsDetect all carious lesions– Defective restorations and proximity of pulp Defective restorations and proximity of pulp

hornshorns

Procedural stepsProcedural steps

Evaluate tooth color Evaluate tooth color – With shade guide With shade guide – Take clinical Take clinical

photographs before photographs before and through out and through out treatment.treatment.

Apply a protective Apply a protective cream to the cream to the surrounding gingival surrounding gingival tissues and isolate tissues and isolate the tooth with a the tooth with a rubber dam and rubber dam and waxed dental floss waxed dental floss ligature.ligature.

Do not inject local Do not inject local anesthetic.anesthetic.

APPLICATION OF 30% CARBAMIDE PEROXIDE ON THE TOOTH SURFACE

MATERIAL IS ALLOWED TO STAY FOR 15-20 MINUTES

PRE AND POST OPERATIVEPRE AND POST OPERATIVE

BEFORE

BEFORE

AFTER

AFTER

NIGHT GUARD BLEACHING/ HOME NIGHT GUARD BLEACHING/ HOME BLEACHING TECHENIQUEBLEACHING TECHENIQUE

Introduced by Haywood Introduced by Haywood and Haymann in 1989and Haymann in 1989

Dentist prescribed Dentist prescribed home bleach technique.home bleach technique.

Bleaching tray ,/ Bleaching tray ,/ material prepared and material prepared and dispensed along with dispensed along with follow up appointment follow up appointment for check up.for check up.

MATERIALS USEDMATERIALS USED

Tray :step by stepTray :step by step

Alginate impression of Alginate impression of the arch to be taken.the arch to be taken.

Model preparedModel prepared

Block resin applied on Block resin applied on the labial surface of the the labial surface of the teeth to be bleached to teeth to be bleached to form a small reservoir form a small reservoir for the bleaching agent.for the bleaching agent.

BIOSTAR MODEL AND TRAY MATERIAL IN POSITION

MOULDED TRAY BLEACHING TRAY \ MATRIX

BRUSHING FLOSSING

APPLICATION OF BLEACHINGMATERIAL

INSERTION STORAGE

Familiarize the patient with Familiarize the patient with the use of bleaching agent the use of bleaching agent and wearing the guard, and wearing the guard, instruct the patient that this instruct the patient that this procedure should be procedure should be performed 3-4 hours per performed 3-4 hours per day or over night.day or over night.

Recall the patient every 2 Recall the patient every 2 weeks to monitor stain weeks to monitor stain lightening.10% carbamide lightening.10% carbamide peroxide is used for this peroxide is used for this technique ,this can be later technique ,this can be later increased to 16%,or up to increased to 16%,or up to 20% as per the case 20% as per the case reqirements. reqirements.

AFTER

AFTER

BEFORE

BEFORE

Vivastyle paint on

THE PROFESSIONAL VARNISH SYSTEM FOR WHITENING TEETH

Vivastyle paint on is insoluable in water. Consequently, the varnish is not prematurely washed off the teeth by saliva.

Vivastyle paint on contains 6% carbamide peroxide when applied. This component releases oxygen , which gently lightens stains. Once it has dried, its concentration is about five times higher.

Why use a varnish system ?

STEPS OF APPLICATION

Available as standing tube with brush and dispensing dish for single use

Brushing and flossing of teeth before application of varnish

DRYING WITH BLOTTING PAPER

APPLYING PROTECTIVE GEL

Vivastyle paint on is applied directly to the teeth with a brush and allowed to dry for 30 seconds

The dried varnish remains on the teeth for 20 minutes and is subsequently removed with a toothbrush.

APPLICATION OPTIONS

Once daily for 20 min. over a period of 14 days.

Twice daily for 20 min. over a period of 7 days

CLINICAL RESULTS

-Noticeable whitening of teeth after just a few days

-Less irritation

Significant whitening of teeth after treatment with Vivastyle Paint on

Advantagesprofessional tooth whitening without a tray, as– Patients find tray application uncomfortable – Patients are looking for a more cost-effective

alternative

smooth integration into daily schedule

gentle application

touching up of previously whitened teeth

NON VITAL BLEACHINGNON VITAL BLEACHING

Intra coronal bleaching of Endodontically Intra coronal bleaching of Endodontically treated toothtreated tooth

Radiographically assess the status of the Radiographically assess the status of the periapical tissues and the quality of periapical tissues and the quality of endodontic obturation.Endodontic failures endodontic obturation.Endodontic failures or questionable obturation ,should always or questionable obturation ,should always be retreated prior to bleaching.be retreated prior to bleaching.

TechniqueTechnique

Evaluate tooth color with a shade guide and Evaluate tooth color with a shade guide and take a clinical photographtake a clinical photograph

Isolate the toothIsolate the tooth

All restorative material from the All restorative material from the access cavity removed to expose access cavity removed to expose dentin and refine the access.dentin and refine the access.

Cavit and GIC Cavit and GIC base at least 2 base at least 2 mm thick to mm thick to cover the cover the endodontic endodontic obturation.obturation.

Pack the pulp Pack the pulp chamber with 30% chamber with 30% carbamide peroxidecarbamide peroxide

Seal the access with Seal the access with IRM at least 3mm for IRM at least 3mm for a good seal.a good seal.

Recall after 2 weeks.Recall after 2 weeks.

Instruct the patient Instruct the patient

PRE AND POST OPERATIVEPRE AND POST OPERATIVE

Diamonds are forever,

Skyce is just for cosmetics.

MEDICAL EXPERTISE ON COSMETIC PROCEDURES

Dentists of today are finding that more and more people who consult them are no longer really patients. They are individuals who desire perfectly aligned, sparking white teeth, and who may even ask for tooth jewellery. These cosmetic procedures have to be accomplished by professionals with professionals products.

Vivadent has developed the skyce system of tooth jewellery, which enables dentists to satisfy this cosmetic demand according to dental requirements.

STUNNING JEWELLERY ON HEALTHY TEETH

Patients want a sparking smile and dentists want teeth to be healthy. Dentists are committed to maintaining the health of teeth at all costs.

The dental jewellery is bonded onto the tooth in the same way as an orthodontic bracket.

SLIGHT ETCHING; STRONG BOND

Retentive pattern is produced on the enamel using 37% phosphoric acid.

Placement of flowable composite, the right consistency

Lifting the skyce using a probe tip with bonding agent

Skyce bonded to the tooth with flowable composite

Skyce is bonded to the tooth with the transparent Flowable composite Skyce must be encircled by a little Flowable composite to ensure micromechanical retention.

Skyce

Flowable Composite

Tooth

TWO COLOURS; TWO SIZES

Skyce is made of crystal glass.

It is available in two different colours and sizes: “crystal” and sapphire blue”, 1.8 mm or 2.5 mm in diameter.