3. Degradation of high molecular weight
complex organic molecules that reflect
specific wave length of light responsible for
the color of the stain into lower molecular
weight and less complex molecules that
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.
4. HISTORY
Bleaching was unsuccessfully used in the
middle ages
Modern bleaching technique began in
1918.Abbot used the combination of
superoxol and heat.
1958—Prarson—intra pulpal bleach
1967--Nutting and Por—walking bleach
5. 1978—superoxol +heat + light
1989—Haywood .& Hayman (night guard
vital bleaching,10% carbimide peroxide)
1996—laser tooth whitening officially
started with the approval of ion laser
technology Argon and CO2 lasers to be
used with a potential system of chemicals
6. BLEACHING MATERIALS
Oxidizing agents
Hydrogen peroxide bleaching solution and gels.
Ph : highly acidic
Conc 3-3.5%
Carbamide peroxide based bleaching agents
also called
Urea hydrogen peroxide,
Carbamyl peroxide,
Perhydrol urea
Conc : 3-45%
Ph :5-6.5
7. HOW WOULD YOUR PATIENTS LIKE THEIR SMILE ?
A SMILE CONNECTS
8. More and more people would like lighter teeth. Not
surprising –as nothing can improve a smile like
bright white teeth
9. IN OFFICE VITAL TOOTH
BLEACHING
Vital tooth bleaching
is one of the least
invasive, most
conservative and
most effective
procedure to
dramatically improve
the esthetic
appearance of patient
smile and self-
confidence.
10. Light enamel discolorations
Mild tetracycline discolorations
Endemic fluorosis discolorations
Age related discolorations
Indications
11. Severe dark discoloration
Severe enamel loss
Hypersensitive teeth
Presence of caries
Large/poor coronal restoration
Contraindications
12. Familiarize the patient with
– Probable cause of discoloration
– Procedure to be followed
– Expected out come
– Possibility of future re-discoloration
Take radiographs
– Detect all carious lesions
– Defective restorations and proximity of pulp
horns
Procedural steps
13. Evaluate tooth color
– With shade guide
– Take clinical
photographs before
and through out
treatment.
14. Apply a protective
cream to the
surrounding gingival
tissues and isolate
the tooth with a
rubber dam and
waxed dental floss
ligature.
Do not inject local
anesthetic.
17. PRE AND POST OPERATIVE
BEFORE
BEFORE
AFTER
AFTER
18. NIGHT GUARD BLEACHING/ HOME
BLEACHING TECHENIQUE
Introduced by
Haywood and
Haymann in 1989
Dentist prescribed
home bleach
technique.
Bleaching tray ,/
material prepared and
dispensed along with
follow up appointment
for check up.
21. Tray :step by step
Alginate impression
of the arch to be
taken.
Model prepared
Block resin applied
on the labial surface
of the teeth to be
bleached to form a
small reservoir for the
bleaching agent.
22. BIOSTAR MODEL AND TRAY
MATERIAL IN POSITION
MOULDED TRAY BLEACHING TRAY MATRIX
25. Familiarize the patient
with the use of bleaching
agent and wearing the
guard, instruct the patient
that this procedure should
be performed 3-4 hours
per day or over night.
Recall the patient every 2
weeks to monitor stain
lightening.10%
carbamide peroxide is
used for this technique
,this can be later
increased to 16%,or up to
20% as per the case
reqirements.
28. 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 ?
37. Advantages
professional 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
39. Radiographically assess the status of the
periapical tissues and the quality of
endodontic obturation.Endodontic failures
or questionable obturation ,should always
be retreated prior to bleaching.
Technique
41. Isolate the tooth
All restorative material from the
access cavity removed to expose
dentin and refine the access.
42. Cavit and GIC
base at least 2
mm thick to
cover the
endodontic
obturation.
43. Pack the pulp
chamber with 30%
carbamide peroxide
Seal the access with
IRM at least 3mm for
a good seal.
Recall after 2 weeks.
Instruct the patient
47. 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.
48. 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.
49.
50. SLIGHT ETCHING; STRONG BOND
Retentive pattern is produced on the enamel using
37% phosphoric acid.
54. 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
55. 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.
