ENDO BLEACHING (WHITENING OF DEVITAL TEETH)

The aesthetics of the front teeth have become more important day by day. For this reason, the yellow color of a tooth is very annoying for our patients. Generally, when there is a need for root canal treatment due to a fracture or decay in the front teeth due to trauma, that is, due to an impact, an accident, the root canal treatment material used during root canal treatment or bleeding inside the tooth causes the tooth to stain the color of the tooth in purple-yellow color over time. This is actually due to the structure of the inner surface of the tooth. In other words, the purple effect or yellow effect caused by the bleeding in the internal structure of the tooth that somehow turns purple or yellow can be lightened by a whitening method in the same way. The most important factor here is whether the tooth has root canal treatment after trauma. If there is no root canal treatment on the tooth and it is purple in color, it is first necessary to perform root canal treatment on the tooth. There is no harm in performing a bleaching procedure inside the tooth after a well-performed root canal of a tooth filled to the root tip.

For the whitening process we will do during the day, it is essential that the root canal treatment is done well and completely occludes the root of the tooth. After that, the dentist looks at the closure of your tooth with the lower tooth and should determine whether there is any problem with this closure and whether there is a crack or fracture in your tooth. If there is any crack or fracture in the tooth, the dentist can correct this situation by taking protective measures.

WHAT ARE THE CAUSES OF DISCOLORATION?

WHAT ARE THE REASONS RELATED TO THE PATIENT?

Death of the living part of the tooth

Intrapulpal hemorrhage

Hypercalcification inside the tooth, that is, inside the dentin layer

Yellowing caused by the loss of tooth vitality that occurs with age

Developing defects

A discoloration against the channel paste used

Our patient’s systemic disorders cause discoloration of the teeth.

DEATH OF THE LIVING PART OF THE TOOTH (PULP NECROSIS)

It can be caused by bacteria inside the tooth, or by mechanical impact and fracture of the tooth, or by chemical irritation, which can cause necrosis of the pulp of the tooth. And tissue breakdown products are produced. These tissue residues settle into the small tubules in the soft area called dentin inside the tooth and cause discoloration of the tooth tissue. According to the degree of discoloration, it is possible to estimate how long the pulp has been dead. The longer the period of time, the more severe and darker the discoloration becomes and even continues towards the root of the tooth.

BLEEDING INSIDE THE PULP

When there is bleeding inside the tooth as a result of a trauma, this bleeding spreads inside the tooth and enters the tubules of the layer we call dentin in the same way, causing discoloration or bruising. If the pulp is lifeless, the discoloration is permanent and usually reaches all the way to the root. If the pulp heals, the tooth can return to its normal color. In cases where it does not heal, there is definitely a putrid layer inside the tooth and root canal treatment is required.

HYPOCALCIFICATION OF DENTIN

Increased calcification of the inner part of the dentin. As a result of an impact or injury to the tooth, the pulp chamber fills the root canals with an excessive layer of dentin. Since the tooth is a transparent organ, the yellow color of this area inside the tooth is reflected differently from other teeth and the tooth becomes dull and yellow.

COLORATION OF THE INSIDE OF THE TOOTH WITH AGE

The thinning of the enamel in the tooth with age and the exposure of the dentin layer underneath it causes the tooth to have a more yellow and dull appearance. The tooth physiologically changes color and becomes darker. Due to cracks in the enamel and other changes, this area becomes discolored up to an amber color in elderly patients.

DEVELOPMENTAL DEFECTS OF THE TOOTH

It causes defects and discoloration of the enamel structure of the tooth and the underlying dentin formation. Defects in enamel formation; defects in enamel formation are hypercalcific or hypoplastic. That is, enamel hypercalcification is a specific area of white or brown and is commonly found on the facial surface of the affected crown. There are both brown spots and sometimes white spots. These are small eroded areas. What distinguishes enamel hypoplasia, or white or brown discoloration within the enamel, from enamel hypocalcification is that the enamel is defective and porous. And this causes the tooth to change color from time to time by drying out or taking in water or being stained by food residues.

SYSTEMIC DISEASES

In systemic diseases that affect the general health of the person, tooth discoloration is seen. Depending on the drugs used, especially tetracycline group antibiotics cause brown yellowish coloration in the internal structure of the tooth. In this type of discoloration, especially in tetracycline discoloration, depending on the use of tetracycline and depending on time, discolorations appear in colors that look brown, yellow or even gray.

WHAT ARE THE REASONS RELATED TO THE DENTIST?

Tooth discoloration, especially the discoloration of the inner part of the tooth, can also occur with dentistry applications. These are during root canal treatment;

• Residues of pulp tissue
• Drugs found inside the canal
• Channel filling materials
• Amalgams
• Composites
• The pins placed inside the tooth are posts.

In the discoloration that occurs following endodontic treatment, the residues of the pulp tissue color the inside of the tooth and cause a permanent color change in the tooth.

In endo bleaching, after an ideal root canal treatment is performed after the removal of the elements that cause this stinking in the canal and discoloration in the tooth, a drug is placed inside the tooth with or without laser support. Sometimes medication is applied for one or two sessions to dissolve the discoloration inside the tooth. Sometimes heat sources are used. In cases where all the teeth are colored, a special whitening method is used to lighten both all the teeth and the color of the single tooth there.

IS THE BLEACHING PROCEDURE UNSUCCESSFUL?

In rare cases, the bleaching process can be colored again in cases that are resistant. However, there is no color change in the bleaching process in a pulp chamber that is ideally closed, covered and cleaned. The color change continues for many years in a whitened way.

WHAT ARE THE MATERIALS USED IN BLEACHING?

Hydrogen peroxide is usually used for this. Or sodium perborate is used. Sometimes it can be used in materials developed for this process produced entirely by companies.