External bleaching in dystrophic enamel changes: case report

Written by Buka Imola, Bocskay István

Aim: Demonstration through a clinical case, that in spite of efficacy of vital bleaching techniques in office and night guard (home) in some situations, like white spot lesions, supplementary efforts are needed. Material and methods: A combination of techniques were used in office bleaching with hydrogen peroxide 35% and night guard bleaching with carbamide peroxide 16%, followed by application of a paste with content of casein phosphopeptide and amorph calcium phosphate (CPP-ACP). Prior to the application with the biodisposable paste (CPP-ACP), the enamel prisms were exposed to phosphoric acid etching. Results: The treated teeth shade changed from A1 to lighter than B1. The white spots became less annoying for the patient, because of the lightening of the baseline shade surrounding the white spot lesions. These were still visible after bleaching, but they were not so distinctive after 20 days of remineralization paste application (CCP-ACP). After 3 month a return of white spots was recorded but not of the same intensity. Conclusions: The patient has chosen the most minim-invasive method to improve his smile. The results with combination of biomodification techniques were satisfactory.


Keywords: bleaching, white spots, biomodification.

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