Tooth Discoloration Research Paper

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Restoring a single discolored tooth in the anterior region and achieving ideal esthetics is a demanding task and a clinical challenge for the dental practitioner. Tooth discoloration can be caused by various reasons including intra-pulpal hemorrhage, dental trauma or endodontic treatment and can be confronted with different treatment plans1. Tooth whitening, home or in-office bleaching for vital teeth and internal bleaching for non-vital teeth, should be the first choice of treatment, being the least invasive techniques2. However, if a bleaching procedure cannot be implemented or has been applied without a satisfactory outcome, other conservative options should be considered, such as resin composite or ceramic veneers. The improved mechanical…show more content…
The patient reported dental trauma as the cause of the discoloration which had occured almost 15 years ago. According to the acquired dental history of the patient, an external bleaching procedure had been performed almost a decade ago, with custom-made trays, but the shade rebound lead to a gradual unpleasant outcome. Clinical examination confirmed the vitality of the right central incisor. An external in-office bleaching procedure was initially suggested to the patient, following the philosophy of minimal tooth intervention.The patient refused to follow any re-bleaching treatment. She was determined to have a direct and permanent esthetic solution for her upper front teeth. Therefore, the final treatment plan included the direct veneering of the central and the reshaping of the lateral incisors, with the use of a nanocomposite system (Filtek Supreme Ultra, 3M ESPE AG, Seefeld, Germany). Tooth shade selection was performed before field isolation to avoid color mismatches due to teeth’ dehydration (Figure 3.a,b). The right central incisor had a disto-palatal inclination of 0,6 mm. Therefore, the tooth needed to be prepared only mesially (0,3 mm), using a cylindrical round-ended diamond rotary…show more content…
Translucent shade (Filtek Supreme Ultra, 3M ESPE AG) and blue tint (Venus, Heraeus Kulzer, Hanau, Germany) were applied incisally. A thin portion of A2 body shade (Filtek Supreme Ultra, 3M ESPE AG) was spread along the incisal edge in order to reproduce the “halo effect” optical phenomenon (Figure 5.a). Shade modifiers (Ice and Chroma Effect Shades, Inspiro, Edelweiss DR AG, Mercandor, Switzerland) were also placed incisally and light-cured for 20 seconds to emulate the chromatic characterizations of the adjacent central incisor. The reproduction of the enamel layer was recreated with a 0,3 mm of A1 Enamel shade (Filtek Supreme Ultra, 3M ESPE AG),(Figure

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