Perfection and comfort in teeth whitening

Shadeguides - Bleaching
15 Jan 2016

The desire for having white teeth has been phrased for a long time. The light and bright tooth color has even been a very essential aesthetic aspect when the teeth alignment and symmetrical appearance was not of primary importance. A beautiful smile does not only reflect neatness but also helps people feel more confident and has a very significant role in socialization.
The technical and technological development of the dental profession has enabled us to change the natural teeth color by non-invasive, chemical methods. Bleaching materials and techniques have gone through several generations and they are considered to be conservative and tolerant methods in fulfilling the desire for white teeth. Due to the above-mentioned circumstances tooth whitening has gained ground in the treatment profile of the dental offices.
In the earlier times the “Nightguard”, later the techniques known as at-home tooth whitening systems used a gel of 10-20% carbamide peroxide with individual tooth whitening trays. Then lower concentration (6-8%) materials and absolutely universal tray setups appeared.
The improvement in the tooth whitening home kits focused on increasing convenience and decreasing using time. Based on the achieved results these are considered to be the most tolerant kits nowadays. However, sensitivity attributed to these systems could not been successfully eliminated. As regards the individual structural distinctiveness of the dental enamel, sensitivity has been described from moderate to certain feel of pain character. Almost all the patients complained of sensitivity discomfort during the use of the tooth whitening home kit and some days after the treatment as well.
The past tooth whitening products containing hydrogen peroxide have been replaced by products containing carbamide peroxide but this fact has not solved the problem.

Unfortunately the aetiology of bleaching-related tooth sensitivity is neither well understood nor easily measured; however the hydrodynamic theory is a mechanism frequently cited to explain it. According to this model, peroxide solutions introduced into the oral environment contact available dentinal surfaces and cause retraction of odontoblastic processes, resulting in rapid fluid movement inside the dentinal tubules. This ultimately manifests in stimulation of mechanoreceptors at the pulp periphery, with the resultant feeling of pain when such teeth are exposed to cold or pressure, or even when they are at rest.

As a result of the latest improvements a new bleaching product has appeared. Its molecule eliminates the tooth sensitivity problem. This is the WHITE DENTAL BEAUTY with an active ingredient called NOVON. This patented active ingredient has a novel inherent feature, in that it remains stable at neutral pH in the syringe, yet upon dilution a rapid pH increase occurs. This pH increase, from neutral to alkaline, produces an enhanced release of perhydroxyl ions resulting in a more effective bleaching action.
Novon’s unique formula gives White Dental Beauty gel an unsurpassed accelerated bleaching action which is safe, effective and kind to the teeth.

TESTING WHITE DENTAL BEAUTY:

The testing procedure of this product was carried out among my patients under regular professional control in the office. The patients were asked to give detailed feedback related to the standardized application process. Ten patients participated in the testing process; all of them had in-office tooth whitening before. The previous treatment took place more than 5 years ago with a solution containing sensitivity assuasive effect material (35% H2O2). Half of the patients complained of acute tooth sensitivity while the other half considered the resulting pain as tolerable.
When testing the new material I used bleaching material of 5%CP carbamide peroxide (White Dental Beauty WDB) and 6%HP hydroxid peroxide(WDB). The “sensitive” patients were treated with the 5% CP material, while the rest with 6% HP respectively.
The tooth whitening procedure underwent using the StyleItaliano protocol.
The change of tooth color was checked every third day in the dental office. The patients were asked to journalize the universal activities; they documented the frequency of the usage (every day or eventually the missed a day out) or whether they ran out of the time suggested as well as their own experience related to the wearing.
Before the bleaching procedure I took extra- and intraoral pictures to document the basic condition and I recorded the teeth colors with cross polarization technique (Smile Lite). I repeated these steps under the same circumstances and adjustments after the tooth whitening treatment ended.
In case of the test group the tooth whitening procedures carried out based on the same protocol resulted in the following achievements. Average wearing time: 10 days; average daily wearing time: 32 minutes; average change in tooth colour: 5 shades. The most outstanding result beside the general satisfaction of the subjects was the disappearance of the tooth sensitivity during the acting period and as well as during the days following the treatment.

Fig. 1

Taking photos – camera: Nikon D7000; flash: Nikon R1C1; studio light: Mikrosat Digital 5R (500Ws).

Fig. 2

Taking impression with a special high-brim impression tray. The use of this type of impression tray makes possible to pour the impression without bases in order to remove the baseless model without any damage we need to use extra strong white dental plaster (e.g. Kerr – Snow White Plaster 1) for pouring.

Fig. 3

Preparing a foil with the in-office vacuum forming machine. Skipping the dental technician intervention the period between the decision for and the start of the treatment shortens. This is very advantageous and beneficial for the patient.

Fig. 4

The base-free model makes possible to fabricate a more precise custom tray (e.g. SCHEU – BIOPLAST bleach), with the in-office vacuum machine (SCHEU – TWINSTAR V). The gingival margin that is distinctly visible this way allows to position the margins of the foil on the surface of the tooth. This helps lessening the irritative discomfort.

Fig. 5

Treatment strategy:
Product: White Dental Beauty 6%HP
Days of treatment: 10
Initial color: C3 Vita Shade
Final color: B2 Vita Shade
Age: 28; Female
Sensitivity: 0 (scale: 0-10).

Fig. 6

Treatment strategy:
Product: White Dental Beauty 5%CP
Days of treatment: 10
Initial color: D2 Vita Shade
Final color: A1 Vita Shade
Age: 27; Female
Sensitivity: 0 (scale: 0-10).

Fig. 7

Treatment strategy:
Product: White Dental Beauty 6%HP
Days of treatment: 12
Initial color: A3 Vita Shade
Final color: B1 Vita Shade
Age: 29; Male
Sensitivity: 0 (scale: 0-10).

Fig. 8

Treatment strategy:
Product: White Dental Beauty 6%HP
Days of treatment: 12
Initial color: A2 Vita Shade
Final color: 0M1 Vita Bleachedguide 3D Master
Age: 32; Female
Sensitivity: 0 (scale: 0-10).

Fig. 9

www.whitedentalbeauty.com

 

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