RESULTS OF INTRACROWN WHITENING DEPULPED TEETH

Abstract

A change in the color of a depulped tooth is a very common and multifactorial phenomenon according to etiology, which is a frequent reason for going to the dentist, especially if the darkened tooth is in the smile line. The color of teeth, in turn, along with their shape and optical properties, is the most important aesthetic criterion of modern man. The natural color, transparency and brilliance of the teeth in the smile area are important components of dental health, aesthetic and psychological balance and social comfort of a modern person. One way to correct the color of such teeth is intracrown whitening. But many dentists often refuse this method of treatment in favor of making a veneer or a metal-ceramic crown, as this method is often considered unpredictable and dangerous. Objective: to evaluate the effectiveness of intracrown whitening and restoration of the fluorescent properties of the devitalized teeth, depending on the type of sealer used for endodontic treatment and the cause of the depulpation. Materials and research methods. To study the effectiveness of intracoronary bleaching of re teeth, 194 teeth were whitened to 190 patients who applied to the VSMU Clinic and the Department of Therapeutic Dentistry «VSMU» in the period 2014–2018 with complaints of a change in the color of the teeth after endodontic treatment. The average age of patients was 34.6±8.2 years. To assess the causes of tooth discoloration and treatment results, a developed dental patient whitening card was used, according to which information about the cause and duration of tooth depulpation, the type of root sealer and mouth fill, the number of whitening procedures carried out and the result, as well as the original color of the devitalized tooth and final color after bleaching. Before whitening, the possibility of this procedure was evaluated, the absence of contraindications. An x-ray study of the depulped tooth was carried out, the quality of root canal obturation, the absence of periapical changes and signs of root and neck resorption were evaluated. Before the procedure of intracoronal bleaching of the pulpless teeth, mouth fillings were applied to isolate the bleaching agent from the root canal and periodontal tissues. Access to the root canal after our laboratory studies of the micropreadability of materials for the make of wellhead insulating gaskets was closed with self-adhesive self-etching composite cement. The results of the study. By whitening, the restoration of the fluorescent properties to the original characteristics of the vital tooth was achieved in 72 of 194 teeth (37.11%). In 122 teeth (62.89%), after bleaching, it was not possible to obtain a full recovery of the fluorescent light. In 122 teeth (62.89%), the necessary whitening and fluorescence recovery did not occur. Of these, 68 teeth were partially bleached (35.05%), 54 teeth were not bleached (27.84%). In teeth, root canals of which were occluded by materials based on eugenol, 50% of cases were restored to color and fluorescent parameters. During the obturation of the root canals of the pulsed teeth with a siller based on resorcinformalin, the restoration of color and fluorescence did not occur in any of the cases. No dependence was found on the effectiveness of bleaching of the pulpy teeth on the cause of the discolorite. However, the most common cause of a change in the color of a devitalized tooth was complicated caries. Perspectives of research. Further research on the effectiveness of intracoronary bleaching of depulped teeth, as well as the development of methods to improve the aesthetic restoration of tooth color after endodontic treatment, will help improve the quality of dental care in general, as well as in each specific clinical case.