Treatment of Discolouration Flashcards
what are the treatment options for discolouration
enamel microabrasion
bleaching
resin infiltration
localised composite restoration
veneers
what are the pre op records required for discoloured teeth
clinical photos
shade
sensibility testing
diagram of defect
radiographs if clinically indicated
patient assessment
what is the technique for controlled hydrochloric acid pumice microabrasion
sodium bicarbonate
HCL pumice slurry in slow rotating rubber cup
wash direct into aspirator
10 x 5 secs completed on 6 anterior teeth
fluoride varnish application
polish with sandpaper disc
polish with toothpaste
what are the function of sandpaper discs in microabrasion
changes the optical properties of the enamel so that areas of intrinsic discolouration become less perceptible
how many microns of enamel are lost with HCL microabrasion
100
what are the advantages of microabrasion
easily performed
conservative
inexpensive
teeth need minimal subsequent maintenance
fast acting
removes stains
effective
results are permanent
can use before or after bleaching
what are the disadvantages of microabrasion
removes enamel
HCL acids are caustic
requires protective apparatus
prediction of treatment outcome difficult
must be done in dental surgery
cannot be delegated
what are patient instructions after microabrasion
avoid highly coloured food and drinks for 24 hours
when do you follow up with patient after microabrasion
4-6 weeks afterwards
when is bleaching allowed in children as stated by the GDC
for treating or preventing disease
what are the bleaching options
vital or non-vital
what is the risk with in practice vital bleaching
greater soft tissue risk
what are the instructions to patients for at home bleaching
brush teeth thoroughly
apply gel to tray
set over teeth and press down
remove excess
rinse gently
wear overnight
remove. brush and rinse
how long is at home bleaching done
3-6 weeks
what does 10% carbamide peroxide give
3% hydrogen peroxide and 7% urea
what are the advantages of non-vital bleaching
simple
tooth conserving
original morphology
gingival tissues not irritated by restoration
adolescent gingiva level not a restorative consideration
no lab assistance for walking bleach
how do you select a tooth for non-vital bleaching
adequate root filling with no disease
anterior teeth without large restorations
not amalgam intrinsic discolouration
not fluorosis or tetracycline discolouration
what are the methods of non-vital bleaching
walking bleaching
inside out methods
what is the walking bleaching technique
remove root filling below gingival margin
use small adult bur head
clean with ultrasonic tip
bleaching agent on cotton wool
cover with dry cotton wool
seal with GIC
how often do you renew walking bleach
2 weeks with 6-10 changes in total
what is the inside out bleaching technique
access cavity open
custom made mouthguard
patient applies bleach to back of tooth and tray
patient keeps cavity clean
worn all the time except eating and cleaning
how do you restore the pulp chamber after bleaching
non-setting CaOH for 2 weeks
sela in GIC
white composite
composite resin
what are the complications of non-vital bleaching
external cervical resorption
spillage of bleaching agents
failure to bleach
over bleach
brittleness of tooth crown
how do you prevent external cervical resorption
layers of cement over GP
non-setting CaOH in tooth for 2 weeks before final restoration
what are the short term effects of bleaching on soft tissues
minor ulceration/irritation
plaque reduction
aids wound healing
what are the long term effects of bleaching on soft tissues
delayed wound healing
periodontal harm
mutagenic potential
when is tooth mousse recommended
2 weeks after bleaching
4 weeks after microabrasion
what is resin infiltration
infiltration of enamel lesions with low viscosity light curing resins
what is a disadvantage of enamel reduction
overcontouring increases plaque retention and stagnation at gingival margin
what is an advantage of enamel reduction
bond strength of composite resin to enamel is significantly increased after partial removal of buccal enamel
