8 Important Setps to Remember Before Nonvital Tooth Bleaching

8 Important Setps to Remember Before Nonvital Tooth Bleaching

Step 1:

(i) Check the vitality of tooth with thermal or electric pulp testing. Sometimes the access cavity preparation without anesthesia is used to determine the vital status of tooth.

(ii) If the tooth is previously endodontically treated, check the adequacy of obturation and health of surrounding bone.

Step 2:

Through prophylaxis of nonvital tooth and the adjacent healthy tooth helps in revealing the true color of the tooth. Shade is recorded with the help of shade guide for future reference.

Step 3:

(i) Isolate only the tooth to be bleached or the two adjacent teeth as well for comparison of shade.

(ii) Ligate the cervical region of tooth with floss to protect the gingival region and it also permits the accurate observation of the critical cervical region of tooth during bleaching process.

Step 4:

(i) Endodontic access cavity is prepared according to normal guidelines. And after the obturation, the access cavity is thoroughly cleaned to remove the any remaining root canal filling material and endodontic sealer.

(ii) Place the barrier material either Gl or Cavit against the gutta percha and condense it thoroughly so that no voids remain in between them.

Step 5:

(i) Place the bleaching solution inside the prepared cavity. A cotton pellet saturated with Superoxol or a syringe of 35 endodontic hydrogen peroxide is placed on to the labial wall or in the pulp chamber.

(ii) Thermocatalytically activate the bleaching solution with heated instrument. If free bleach liquid is present inside the prepared cavity, don’t use the heated pluggger as excess temperature may make the solution to boil out of the access cavity.

(iii) Cotton saturated with the solution is pressed against the cavity wall with the help of heated pluggger.

Step 6:

(i) Thermocatalytic and walking bleach may be used separately or in combination.

(ii) At the end of heating, rinse the cavity thoroughly and place the walking bleach inside the cavity.

(iii) Solution used is a thick mix of sodium perborate and superoxol or sodium perborate and water inside the cavity and press against the wall

(iv) Evaluate after 3-7 days and repeat the procedure if necessary.

Step 7:

Seal the access cavity with temporary and leave it for 2-7 days.

Step 8:

When the desired results are achieved, remove the material from the access cavity and restore the tooth with permanent filling material.