Discoloured Incisors

Question 1

Advantages of microabrasion

Answer 1

Easy
Conservative
Inexpensive
Fast acting
Permanent results
Minimum maintenance

Question 2

Disadvantages of microabrasion

Answer 2

Removes enamel - sensitivity/staining
HCl acid caustic
Need protective PPE pt dentist nurse
Cannot be delegated
Must be done in dental surgery

Question 3

Steps to microabrasion

Answer 3

• PPE + clean tooth with pumice + water
• Soft tissue protection petroleum jelly + dam

Sodium bicarbonate guard for gingival protection

HCL pumice slurry in slowly rotating rubber cup for 10s

Max 10x5 second applications

Wash direct into aspirator after every second application

FV not duraphat

Polish with sandpaper disc then toothpaste

Review in 4-6wks

Question 4

2 non vital bleaching techniques

Answer 4

Inside out
Walking bleach

Question 5

Side effects of bleaching

Answer 5

Gingival irritation
Sensitivity

Question 6

Potential complications of non vital bleaching

Answer 6

External cervical resorption
Overbleach
Failure of bleach
Brittleness of crown
Spilling bleach contents

Question 7

How is external cervical resorption avoided?

Answer 7

Layer of cement over GP

nsCAOH placed before final resto (reverses any acidity)

Question 8

Walking bleach steps

Answer 8

Oxidising process - builds gradually over days

Remove insufficient GP

Root filling removed below CEJ

Clean with US

Bleaching agent 10% carbamide on cotton pledget

Cover with dry cotton wool seal in with GI

Restore pulp chamber nsCAOH for 2 weeks then white GP + Comp resin to allow rebleaching