Spectrophotometric analysis of internal bleaching of traumatized teeth with coronal discoloration following regenerative endodontic procedures

Authors

DOI:

https://doi.org/10.20396/bjos.v21i00.8665232

Keywords:

Tooth bleaching, Regenerative endodontics, Tooth discoloration

Abstract

Aim: The objective of this study was to describe a case series concerning internal bleaching of anterior traumatized teeth that underwent regenerative endodontic procedures (REP). Methods: Seven non-vital maxillary anterior teeth discolored after regenerative endodontic procedures were included and divided into two groups according to the medication protocol used in the REP: (1) Triple antibiotic paste (TAP) group (n=4); (2) Calcium hydroxide and 2% chlorhexidine gel (HC+CHX) (n=3). The bleaching technique used was walking bleach, where sodium perborate associated with distilled water was used. Bleaching agent was replaced weekly until the darkened tooth was slightly lighter than the adjacent tooth. The color was recorded with the aid of a digital spectrophotometer in two moments (T1: prior the first session of bleaching, T2: fourteen days after the last session of bleaching). The change in color after the procedure (ΔE) was calculated and reported in a descriptive analysis. Results: The ΔE for all teeth showed color differences exceeding the perceptibility threshold (ΔE > 3.7). Both groups showed similar ΔE (TAP: 18.3 ± 11.5; HC+CHX: 14 ± 11.2) at the end of the treatment. The average number of sessions needed to achieve satisfactory results was 1.7 ± 0.6 for HC+CHX group and 2.3 ± 0.5 for TAP group. Conclusion: Internal bleaching with sodium perborate associated with distilled water is effective in treating discolored teeth after regenerative endodontic procedures.

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Author Biographies

Jaqueline Lazzari, University of Campinas

PhD candidate from the Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas; Piracicaba, São Paulo, Brazil.

Walbert Vieira, University of Campinas

Master's Student from Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas; Piracicaba, São Paulo, Brazil.

Vanessa Pecorari, Paulista University

PhD from the Department of Dentitry, Paulista University, São Paulo, SP, Brazil.

Brenda Paula Figueiredo de Almeida Gomes, University of Campinas

Teacher from the Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas; Piracicaba, São Paulo, Brazil.

José Flávio Affonso de Almeida, University of Campinas

Teacher from the Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas; Piracicaba, São Paulo, Brazil.

Adriana De-Jesus-Soares, University of Campinas

Teacher from the Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas; Piracicaba, São Paulo, Brazil.

References

Pereira AC, Oliveira ML, Cerqueira-Neto ACCL, Gomes BPFA, Ferraz CCR, Almeida JFA, et al. Treatment outcomes of pulp revascularization in traumatized immature teeth using calcium hydroxide and 2% chlorhexidine gel as intracanal medication. J Appl Oral Sci. 2020 Sep 25;28:e20200217. doi: 10.1590/1678-7757-2020-0217.

Kim SG, Malek M, Sigurdsson A, Lin LM, Kahler B. Regenerative endodontics: a comprehensive review. Int Endod J. 2018 Dec;51(12):1367-88. doi: 10.1111/iej.12954.

Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod. 2004 Apr;30(4):196-200. doi: 10.1097/00004770-200404000-00003.

Nagata JY, Soares AJ, Souza-Filho FJ, Zaia AA, Ferraz CC, Almeida JF, et al. Microbial evaluation of traumatized teeth treated with triple antibiotic paste or calcium hydroxide with 2% chlorhexidine gel in pulp revascularization. J Endod. 2014 Jun;40(6):778-83. doi: 10.1016/j.joen.2014.01.038.

Albuquerque MT, Evans JD, Gregory RL, Valera MC, Bottino MC. Antibacterial TAP-mimic electrospun polymer scaffold: effects on P. gingivalis-infected dentin biofilm. Clin Oral Investig. 2016 Mar;20(2):387-93. doi: 10.1007/s00784-015-1577-2.

Mohammadi Z, Jafarzadeh H, Shalavi S, Yaripour S, Sharifi F, Kinoshita JI. A review on triple antibiotic paste as a suitable material used in regenerative endodontics. Iran Endod J. 2018;13(1):1-6. doi: 10.22037/iej.v13i1.17941.

Aly MM, Taha SEE, El Sayed MA, Youssef R, Omar HM. Clinical and radiographic evaluation of Biodentine and Mineral Trioxide Aggregate in revascularization of non-vital immature permanent anterior teeth (randomized clinical study). Int J Paediatr Dent. 2019 Jul;29(4):464-73. doi: 10.1111/ipd.12474.

Nagata JY, Gomes BP, Rocha Lima TF, Murakami LS, de Faria DE, Campos GR, et al. Traumatized immature teeth treated with 2 protocols of pulp revascularization. J Endod. 2014 May;40(5):606-12. doi: 10.1016/j.joen.2014.01.032.

Santos LGPD, Chisini LA, Springmann CG, Souza BDM, Pappen FG, Demarco FF, et al. Alternative to avoid tooth discoloration after regenerative endodontic procedure: a systematic review. Braz Dent J. 2018 Sep-Oct;29(5):409-18. doi: 10.1590/0103-6440201802132.

Oliveira LSJ, Silva PFD, Figueiredo FED, Brito-Junior M, Sousa-Neto MD, Faria-E-Silva AL. In vitro evaluation of tooth discoloration induced by regenerative endodontic therapy and the effectiveness of the walking bleach technique. Int J Esthet Dent. 2019;14(3):300-9.

Fundaoğlu Küçükekenci F, Çakici F, Küçükekenci AS. Spectrophotometric analysis of discoloration and internal bleaching after use of different antibiotic pastes. Clin Oral Investig. 2019 Jan;23(1):161-7. doi: 10.1007/s00784-018-2422-1.

Tripathi R, Cohen S, Khanduri N. Coronal tooth discoloration after the use of white mineral trioxide aggregate. Clin Cosmet Investig Dent. 2020 Sep 30;12:409-14. doi: 10.2147/CCIDE.S266049.

Marciano MA, Costa RM, Camilleri J, Mondelli RF, Guimarães BM, Duarte MA. Assessment of color stability of white mineral trioxide aggregate angelus and bismuth oxide in contact with tooth structure. J Endod. 2014 Aug;40(8):1235-40. doi: 10.1016/j.joen.2014.01.044.

Marques Junior RB, Baroudi K, Santos AFCD, Pontes D, Amaral M. Tooth discoloration using calcium silicate-based cements for simulated revascularization in vitro. Braz Dent J. 2021;32(1):53-8. doi: 10.1590/0103-6440202103700.

Yoldaş SE, Bani M, Atabek D, Bodur H. Comparison of the potential discoloration effect of bioaggregate, biodentine, and white mineral trioxide aggregate on bovine teeth: in vitro research. J Endod. 2016 Dec;42(12):1815-8. doi: 10.1016/j.joen.2016.08.020.

Guimarães BM, Tartari T, Marciano MA, Vivan RR, Mondeli RF, Camilleri J, et al. Color stability, radiopacity, and chemical characteristics of white mineral trioxide aggregate associated with 2 different vehicles in contact with blood. J Endod. 2015 Jun;41(6):947-52. doi: 10.1016/j.joen.2015.02.008.

Plotino G, Buono L, Grande NM, Pameijer CH, Somma F. Nonvital tooth bleaching: a review of the literature and clinical procedures. J Endod. 2008 Apr;34(4):394-407. doi: 10.1016/j.joen.2007.12.020.

Abbott P, Heah SY. Internal bleaching of teeth: an analysis of 255 teeth. Aust Dent J. 2009 Dec;54(4):326-33. doi: 10.1111/j.1834-7819.2009.01158.x.

Santana TR, BraganÇa RMF, Correia ACC, Oliveira IM, Faria-E-Silva AL. Role of enamel and dentin on color changes after internal bleaching associated or not with external bleaching. J Appl Oral Sci. 2020 Dec;29:e20200511. doi: 10.1590/1678-7757-2020-0511.

Fagogeni I, Falgowski T, Metlerska J, Lipski M, Górski M, Nowicka A. Efficiency of teeth bleaching after regenerative endodontic treatment: a systematic review. J Clin Med. 2021 Jan;10(2):316. doi: 10.3390/jcm10020316.

Timmerman A, Parashos P. Bleaching of a discolored tooth with retrieval of remnants after successful regenerative endodontics. J Endod. 2018 Jan;44(1):93-7. doi: 10.1016/j.joen.2017.08.032.

Kirchhoff AL, Raldi DP, Salles AC, Cunha RS, Mello I. Tooth discolouration and internal bleaching after the use of triple antibiotic paste. Int Endod J. 2015 Dec;48(12):1181-7. doi: 10.1111/iej.12423.

Antov H, Duggal MS, Nazzal H. Management of discolouration following revitalization endodontic procedures: a case series. Int Endod J. 2019 Nov;52(11):1660-70. doi: 10.1111/iej.13160.

Johnston WM, Kao EC. Assessment of appearance match by visual observation and clinical colorimetry. J Dent Res. 1989 May;68(5):819-22. doi: 10.1177/00220345890680051301.

American Association of Endodontists. AAE Clinical considerations for a regenerative procedure. 2018 Jan 4 [cited 2021 May 25]. Available from: https://f3f142zs0k2w1kg84k5p9i1o-wpengine.netdna-ssl.com/specialty/wp-content/uploads/sites/2/2018/06/ConsiderationsForRegEndo_AsOfApril2018.pdf.

Hursh KA, Kirkpatrick TC, Cardon JW, Brewster JA, Black SW, Himel VT, et al. Shear bond comparison between 4 bioceramic materials and dual-cure composite resin. J Endod. 2019 Nov;45(11):1378-83. doi: 10.1016/j.joen.2019.07.008.

Pereira AC, Pallone MV, Marciano MA, Cortellazzi KL, Frozoni M, Gomes BP, et al. Effect of intracanal medications on the interfacial properties of reparative cements. Restor Dent Endod. 2019 May;44(2):e21. doi: 10.5395/rde.2019.44.e21.

de Oliveira DP, Teixeira EC, Ferraz CC, Teixeira FB. Effect of intracoronal bleaching agents on dentin microhardness. J Endod. 2007 Apr;33(4):460-2. doi: 10.1016/j.joen.2006.08.008.

Kinomoto Y, Carnes DL Jr, Ebisu S. Cytotoxicity of intracanal bleaching agents on periodontal ligament cells in vitro. J Endod. 2001 Sep;27(9):574-7. doi: 10.1097/00004770-200109000-00005.

Santos LG, Felippe WT, Souza BD, Konrath AC, Cordeiro MM, Felippe MC. Crown discoloration promoted by materials used in regenerative endodontic procedures and effect of dental bleaching: spectrophotometric analysis. J Appl Oral Sci. 2017;25(2):234-42. doi: 10.1590/1678-77572016-0398.

Shokouhinejad N, Razmi H, Farbod M, Alikhasi M, Camilleri J. Coronal tooth discoloration induced by regenerative endodontic treatment using different scaffolds and intracanal coronal barriers: a 6-month ex vivo study. Restor Dent Endod. 2019 Jul;44(3):e25. doi: 10.5395/rde.2019.44.e25.

Belobrov I, Parashos P. Treatment of tooth discoloration after the use of white mineral trioxide aggregate. J Endod. 2011 Jul;37(7):1017-20. doi: 10.1016/j.joen.2011.04.003.

Shokouhinejad N, Khoshkhounejad M, Alikhasi M, Bagheri P, Camilleri J. Prevention of coronal discoloration induced by regenerative endodontic treatment in an ex vivo model. Clin Oral Investig. 2018 May;22(4):1725-31. doi: 10.1007/s00784-017-2266-0.

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Published

2021-08-24

How to Cite

1.
Lazzari J, Vieira W, Pecorari V, Gomes BPF de A, Almeida JFA de, De-Jesus-Soares A. Spectrophotometric analysis of internal bleaching of traumatized teeth with coronal discoloration following regenerative endodontic procedures. Braz. J. Oral Sci. [Internet]. 2021Aug.24 [cited 2021Oct.16];21(00):e225232. Available from: https://periodicos.sbu.unicamp.br/ojs/index.php/bjos/article/view/8665232

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