无髓变色牙内漂白113例疗效观察

目的 评价应用Beyond冷光美白和30％过氧化氢加过硼酸钠漂白技术对无髓变色牙进行牙内漂白的临床疗效.方法 无髓变色牙患者113例随机分为3组,分别采用30％过氧化氢加过硼酸钠(A组)、Beyond冷光美白技术(B组)、Beyond冷光美白技术复合常规内漂白(C组)进行牙内漂白,观察其有效率.结果 第1次复诊时有效率,A组29.7％,B组48.6％,C组68.4％,C组有效率高于另A、B组(P＜0.05).第6次复诊时有效率,A组54.1％,B组76.3％,C组97.3％,C组有效率高于另A、B组(P＜0.05).牙齿变色后与开始牙内漂白的时间间隔越短,达到满意疗效的治疗次数越少,A、B、C组平均治疗次数分别为16次、12次和7次.结论 Beyond冷光美白技术复合常规牙内漂白对无髓变色牙有显著增白作用,常规Beyond冷光美白次之,30％过氧化氢加过硼酸钠漂白技术牙内漂白效果较差.     

出血变色的活髓牙的漂白法

创伤是导致牙变色的重要原因。严重的震荡损伤了牙髓血管,红细胞渗出进入牙本质小管。由于红细胞溶血,血红蛋白分解致使牙冠变色。源于牙髓出血的变色牙通常是死髓牙,它的治疗包括根管治疗以及其后的冠内漂白法。如果变色牙是活髓,那么根据治疗原则既可以脱色,也可以不做处理。对这种病例,常规的X线检查和活力检测是必要的。     

不同漂白药漂白变色牙的体外实验比较

创伤后牙髓出血,牙髓摘除或牙髓坏死,根管治疗药和根充材料均能引起牙变色。用漂白药物如草酸,次氯酸钙,过氧化氢漂白变色牙均获得了不同结果,本研究在于确定:①单用过硼酸钠漂白变色牙是否有效;②     

出血变色牙改良内漂白临床分析

创伤导致牙髓血管受损 ,红细胞渗出进入牙本质小管致牙齿变色。牙髓成分的坏死、分解亦造成牙变色的加重 ,故其着色多为牙髓出血和牙髓坏死的双重原因所致。死髓变色牙常规内漂白是体积分数为 30 %H2 O2 冠内封药。本文应用体积分数为 30 %H2 O2 、过硼酸钠及体积分数为 5 %H2 O2 改良法冠内漂白 ,其漂白效果、漂白时间及远期疗效均优于传统漂白法。1　临床资料与方法1.1　病例选择12 8例患者中 ,男 88例 ,女 40例 ,共计 2 48颗牙 ,其中上前牙 2 0 8颗 ,下前牙 40颗 ;患者年龄 18～ 5 4岁 ,40岁以下 191颗 ,均有外伤或咬合创伤史 ;变色时…     

61例牙外科正畸术后死髓变色牙漂白疗效观察

牙外科正畸术后有少数牙在不同时期发生牙髓坏死,牙冠变色影响美观,最好进行漂白治疗。因龋坏或外伤后前牙死髓变色的漂白治疗,文献已有报道。我们从1983年起,对牙外科正畸术后146颗死髓变色牙试行漂白治疗,现将已观察1～3.5年而有追踪结果的73颗牙(61例)漂白情况报告如下: 临床资料 1、61例中,男性23例,女性38例。年龄最小13岁,最大30岁,平均22岁。 2、死髓变色牙判断:肉眼见牙冠变色:X线片示根尖周围病变;牙髓活力电测阴性。 3、术后变色时间及变色度:最短1个月,最长3.5年,平均11个月。我们曾试用塑料牙比色板进行     

变色牙·着色牙·染色牙

牙齿失去本来的颜色 ,称为变色牙。牙齿变色的原因 ,大致可分为两类 :一是外源性的 :由饮茶、吸烟或涂擦某些药物 ,使色素沉积在牙齿表面 ,或是由于修复物、根管充填物、根管药物的色素从髓腔或窝洞内壁渗入牙本质所致。这一类变色牙 ,即所谓染色牙、着色牙 ,大多数通过机械加某些磨擦剂打磨或用漂白药物漂白 ,即可除去染色。二是内源性的 :牙齿在发育期间受某些药物的影响 ,例如服用四环素族药物而致的四环素变色牙(简称四环素牙 ) ,或在 7岁前饮用含氟量过高的饮水而致的氟牙症 (过去称氟斑牙 ) ;其次是无髓牙 ,因失去牙髓而牙变色 ;还有…     

无髓变色牙漂白治疗30例临床分析

目的:评价无髓变色牙漂白治疗的效果。方法:对30例33颗无髓变色、牙冠完整的前牙使用15%过氧化脲进行诊间和夜间漂白相结合、冠内和冠外联合漂白治疗,并与以30%过氧化氢冠内漂白组作为对照;同时,对实验组有效病例在治疗后1a复查,应用SPSS17.0软件包对所得数据进行统计学分析。结果:15%过氧化脲联合漂白组疗效显著高于30%过氧化氢冠内漂白组,2组差异有统计学意义。1a后复查牙颜色的色阶数值变化,无统计学意义。结论:15%过氧化脲进行诊间和夜间漂白相结合、冠内和冠外联合漂白,能有效治疗无髓变色牙。     

Beyond冷光美白术对无髓变色牙的临床疗效观察

目的:评价应用Beyond冷光美白技术采用内外联合漂白方式对无髓变色牙的临床疗效。方法:选择牙齿变色病人180例,随机分成3组,分别采用内漂白、外漂白、内外联合漂白技术进行治疗,观察其有效率;对进行内外联合漂白的外伤变色牙的外伤时间和漂白次数进行统计分析。结果:1周后,内外联合漂白有效率达到95%,4周后,内外联合漂白有效率达到98.3%,与其他组相比均具有统计学意义;外伤导致牙齿变色并进行内外联合漂白的病人,外伤时间与漂白次数成正比。结论:Beyond冷光美白技术采用内外联合漂白方式对无髓变色牙有明显的增白作用。     

活髓牙漂白后髓腔中过氧化氢的渗入情况

当今牙科,对于氟斑牙及四环素染色牙的治疗正朝着美容方向转化。尽管最近强调,用贴面来掩饰变色牙,但仍有许多人对漂白变色牙感兴趣。Walton等认为,漂白法对四环素着色牙毫无价值。而多数人认为,漂白变色牙安全、美观,偶尔牙髓出现短暂的炎症和过敏。对氟斑牙的治疗尤为适应。通常所用的30％H_2O_2加热漂白法,不能估计牙髓所受的     

无髓变色牙的漂白

目的：研究两种漂白剂对无髓变色牙的漂白效果，为临床应用提供参考。方法：将85例共96颗无髓变色牙随机分成A、B两组，分别用30％过氧化氢溶液和10％过氧化氢凝胶进行漂白治疗一个疗程，并比较其疗效。结果：A组良好率为89．58％，B组良好率为85．42％，两组有效率均为100％，漂白有效率差别没有统计学意义(P＞0．05)，结论：两种漂白剂作用效果大致相同，采用30％过氧化氢溶液和10％过氧化服凝胶进行漂白操作简单，效果显著。     

10%过氧化脲漂白无髓牙的临床研究

目的 :评价 10 %过氧化脲对变色无髓牙的漂白效果。方法 :对 8例患者的 8颗变色无髓牙 ,制作含储药池的扇形个别托盘 ,并开放舌侧髓室口 ,去除根充牙胶至釉牙骨质界下 2～ 3mm ,然后用玻璃离子覆盖 2～ 3mm。治疗中 ,患者临睡前将 10 %过氧化脲注入髓室及个别托盘的储药池内 ,从而同时从内外两侧对无髓牙进行漂白。患者晨起后 ,清洁牙齿 ,用无菌棉球充填髓室。治疗结束后 ,暂时充填髓腔 ,两周后改行光固化充填。结果 :8颗变色无髓牙在 3周内均获得满意效果。无髓牙漂白所用时间与着色时间成正比。结论 :10 %过氧化脲能有效地治疗变色无髓牙。     

牙齿增白涂膜漂白氟牙症效果的离体牙实验研究

观察高效型牙齿增白涂膜对离体氟牙症的漂白效果及酸蚀剂对漂白的辅助效果。方法：选离体的烟茶染色牙为１组，又将氟牙症按其着色深浅分为轻度、中度和和重度着色３组，共４组。同一牙面从中切开，左右随机对照，以牙齿增增白涂膜处理实验侧，每天涂膜３次，最多涂２５ｄ，与对照侧比较。另选３０个重度着色氟牙症从中切开，左右随机对照，实验侧在每次涂膜前用３７０ｇ／Ｌ磷酸处理１ｍｉｎ（治愈率为９３．３％，显效率为６．７％     

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提要：牙齿漂白的基本药剂成分为过氧化物,通过放置在牙体硬组织表面或置于无髓变色牙齿的髓腔内达到牙齿漂白的目的。漂白机制为隐藏学说和渗透学说。正确使用漂白技术有可靠的安全性,是一种不必切割牙体硬组织而改变牙齿颜色的美学途径。漂白效果是确定的,但受着色原因、个体牙齿结构等因素影响而有所差异。本文对牙齿漂白技术的历史和基础与实践的发展现状做一个阶段性的回顾。内容包括历史回顾、漂白原理、牙齿着色原因分析、适应证、漂白方式、效果评价、安全性以及以往研究,希望能够达到温故知新的效果,以期牙齿漂白技术得到更深入的研究和服务患者。     

Penetration of 38% hydrogen peroxide into the pulp chamber in bovine and human teeth submitted to office bleach technique

This study evaluated the pulp chamber penetration of peroxide bleaching agent in human and bovine teeth after office bleach technique. All the teeth were sectioned 3 mm apical of the cement-enamel junction and were divided into 2 groups, A (70 third human molars) and B (70 bovine lateral incisors), that were subdivided into A1 and B1 restored by using composite resin, A2 and B2 by using glass ionomer cement, and A3 and B3 by using resin-modified glass ionomer cement; A4, A5, B4, and B5 were not restored. Acetate buffer was placed in the pulp chamber, and the bleaching agent was applied for 40 minutes as follows: A1-A4 and B1-B4, 38% hydrogen peroxide exposure and A5 and B5, immersion into distilled water. The buffer solution was transferred to a glass tube in which leuco crystal violet and horseradish peroxidase were added, producing a blue solution. The optical density of the blue solution was determined by spectrophotometer and converted into microgram equivalents of hydrogen peroxide. Data were submitted to analysis of variance and Dunnett, Kruskal-Wallis, and Tukey tests (5%). A higher level of hydrogen peroxide penetrated into the pulp chamber in resin-modified glass ionomer cements in bovine (0.79 +/- 0.61 microg) and human (2.27 +/- 0.41 microg) groups. The bleaching agent penetration into the pulp chamber was higher in human teeth for any experimental situation. The penetration of the hydrogen peroxide depends on restorative materials, and under the conditions of this study human teeth are more susceptible to penetration of bleaching agent into the pulp chamber than bovine teeth.     

Bleaching of discolored teeth. Examination and evaluation of the effect of various bleaching agents

Many patients suffer from tooth discoloration, a condition that produces more psychological distress than generally thought, especially when the anterior teeth are involused. In this study, tests were carried out to determine the effect of various agents applied discolored teeth for bleaching. Blood, colored tissue fluids I and II, attached to filter papers after being naturally exposed for a week were selected as object bleaching. Each subject was soaked in 30% hydrogen peroxide solution (30%H2O2), 3% hydrogen peroxide (3%H2O2), sodium hypochlorite solution (NaOCl), sodium perborate (NaBO3) and combination of them, then effect of agents were observed according to time-lapse. The following results were obtained. 1. NaOCl was most effective. 2. The action of 3%H2O2 was slow, showing only a slight bleaching effect after one week. 3. NaBO3 alone did not have any bleaching effect.     

Tooth Discoloration after the Use of New Pozzolan Cement (Endocem) and Mineral Trioxide Aggregate and the Effects of Internal Bleaching

Introduction

The aim of this study was to evaluate tooth discoloration after the use of mineral trioxide aggregate (MTA) and to examine the effect of internal bleaching on discoloration associated with MTA.

Methods

Thirty-two teeth were endodontically treated. Three-millimeter plugs of MTA, ProRoot, Angelus, or Endocem were placed on the access cavities of 24 teeth. Eight teeth served as the control group. After 24 hours, the access cavities were restored, and the tooth color was recorded at baseline and at 1, 2, 4, 8, and 12 weeks. After 12 weeks, the MTA materials were removed under a microscope, and an internal bleaching treatment was performed. After removal of the MTA materials and after a 1-week bleaching treatment, the color changes were measured, and the MTA-dentin interfaces were observed under a microscope.

Results

The ProRoot and Angelus groups displayed increasing discoloration during a period of 12 weeks. The discoloration associated with ProRoot and Angelus was observed at the MTA-dentin interface and on the interior surface of the dentin. However, the Endocem groups demonstrated no significant discoloration (P < .05). No marginal discoloration was observed around the material in the Endocem group. Removal of the discolored MTA was effective for resolving the discoloration in all of the experimental groups (P < .05). However, a subsequent internal bleaching treatment was not significantly effective compared with the removal of MTA.

Conclusions

ProRoot and Angelus caused tooth discoloration. However, Endocem did not affect the contacting dentin surface. Removing the discolored MTA materials contributed more to resolving the tooth discoloration than post-treatment internal bleaching.     

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??Objective    To evaluate the relationship between the injury time of traumatic discolored tooth and the efficacy of intracoronal bleaching. Methods    Choose 90 cases of maxillary incisor discoloration caused by trauma ??90 teeth??. The colorimetric method was used to evaluate the changes of the color of the maxillary central incisors before and after the treatment for the discolored teeth by using Olympus Crystalege spectrophotometer. Observe the effect of bleaching treatment in different regions and the average number of visits due to discolored teeth at different time of injury. Results       The impact of duration of trauma on the tooth crown discoloration was not big??and there was no statistically significant difference ??P > 0.05??. The appointment number of patients with different injury time was statistically different ??P < 0.05??. On 1st and 5th visit??the effectiveness rate of body 1/3 and incisal sites 1/3 were higher than that of cervical 1/3??the difference being statistically significant??P < 0.05????in body and incisal sites the effect differences had no statistical significance??P > 0.05??. Conclusion    Injury time traumatic discolored teeth is not related to the degree of the tooth crown discoloration. The longer the time of injury??the more the number of return visits. In trauma discolored teeth??the effective of intracoronal bleaching in body 1/3 and incisal sites 1/3 is better than that of cervical 1/3.     

Intracoronal bleaching of discolored non-vital teeth

This clinical study compared the effectiveness of bleaching non-vital teeth with an open pulp chamber during bleaching using 10% carbamide peroxide compared to the modified walking bleach technique and extracoronal bleaching. Sixty discolored, non-vital teeth were treated. They were divided into three groups. Each group was treated with one of the bleaching materials and methods: extracoronally using 10% carbamide peroxide for two weeks as negative control (Group A), intracoronally using sodium perborate mixed with 3% hydrogen peroxide (modified walking bleach technique) (Rotstein, Mor & Friedman, 1993) for four weeks (Group B) and intracoronally and extracoronally using 10% carbamide peroxide for two weeks (Group C) (Liebenberg, 1997). Tooth color was measured at baseline, (BL), immediately post-bleaching (IP) and six months post-bleaching (SP) with a colorimeter (Castor, Sigma, Germany) using a tooth-positioning jig. The color was determined according to the CIELAB system, which records lightness as L* and chromaticity coordinates as a* and b*. The difference in L* and b* among the three groups was significant between BL and IP examination. The post-bleaching, whitening effect in Group C was significantly better, but after six months, in Group C, it was as effective as in Group B.     

Treatment of tooth discoloration after the use of white mineral trioxide aggregate

Introduction

A number of vital pulp therapy techniques have been recommended to preserve pulp vitality in teeth with complicated crown fractures, especially in young patients. Calcium hydroxide has been the gold standard as a pulp capping material, but recently mineral trioxide aggregate (MTA) has been recommended. This case report describes the treatment of tooth discoloration caused by white MTA (WMTA) used for the management of a complicated crown fracture.

Methods

A partial pulpotomy was performed with the use of WMTA after a complicated crown fracture of the upper right central incisor. Seventeen months later, the WMTA was removed because of tooth discoloration, and internal bleaching was performed.

Results

Upon access, the WMTA was completely discolored. After it was removed, a significant color change was observed in the tooth crown, which was further improved with internal bleaching. The tooth remained vital, and a dentin bridge was confirmed clinically and radiographically.

Conclusions

The recommendation to use WMTA for vital pulp therapy in the esthetic zone may need to be reconsidered. Should discoloration occur with the use of WMTA, the technique described may be used to improve the esthetics.     

EFFECTIVENESS OF CARBAMIDE PEROXIDE AND SODIUM PERBORATE IN NON-VITAL DISCOLORED TEETH

Objective: To evaluate the efficacy of 16% carbamide peroxide gel (CP16%), tetrahydrate sodium perborate (SP) and mixture (CP16% + SP), in walking bleaching of non-vital discolored teeth. Materials and methods: Sixty single-rooted human premolars with intact crowns were used and initial color was assessed using Vita shade guide and standardized photos. The teeth were stained using rabbit fresh blood for 18 days and photos of discolored teeth and color evaluation were performed. The teeth were divided into 4 groups (n = 15), according to bleaching agent used: G1) CP16% gel; G2) CP16% gel + SP; G3) SP + distilled water; G4: control. The bleaching agents were replaced twice at 7-day intervals for 21 days. All teeth were evaluated by two endodontists at days 0, 7, 14 and 21 and the color changes were assessed using Vita shade guide and standardized photos. The results were analyzed by Kruskal-Wallis and Dunn''s tests (p=0.05). Results: The experimental groups presented statistically similar bleaching results (p>0.05) at the end of 7, 14 and 21 days. These groups presented significantly higher bleaching efficacy than control group (G4) (p<0.05). The mixture CP16% + SP promoted return of original color in 100% of teeth at the end of 21 days. Conclusion: It was concluded that three bleaching agents were effective in bleaching of stained teeth with blood products, especially at the end of 21 days.