CONSERVATIVE & ENDODONTICS

Damage to Restorations

• Bleaching with hydrogen peroxide may affect bonding of composite resins to dental hard tissue. This presents a clinical problem when immediate esthetic restoration of the bleached tooth this required.
• It is therefore recommended that residual hydrogen peroxide be totally eliminated prior to Composite placement i.e. it should be done at least after 2 weeks.

Suggestions for Safer Bleaching

• Isolate the tooth effectively.
• Protect the oral mucosa
• Verify adequate endodontic obturation
• Use protective barriers
• Avoid acid etching-(irritation to PD)
• Avoid strong oxidizers – Sod. Perborate sh/be use
• Avoid heat with strong oxidizers
• Recall periodically- 6 months after bleaching.

Post – Bleaching Tooth Restoration

• The pulp chamber and access cavity should be carefully restored with a light cured acid etched composite resin, which is light in shade.
• It should be placed at a depth that seals the cavity and provides some incisal support.
• Curing is recommended from labial aspect to reduce the shrinkage of the composite.
• Placing a white cement beneath the composite restoration is recommended.
• Filling the chamber completely with composite resin may cause loss of translucency and difficulty in distinguishing between Composite and tooth structure during rebleaching.