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Correction of Stained Dentition via Minimally Invasive Treatment

The conservative correction of stained anterior dentition is well-suited to minimally invasive techniques that first incorporate in-office, light-activated bleaching, and take-home, dentist-monitored tray bleaching.  The second most conservative approach is the placement of direct composite restoratives, including recently introduced flowable varieties that help the clinician more precisely and predictably place these materials.  This podcast discusses a conservative treatment sequence for in-office bleaching and direct composite placement for the aesthetic correction of discolored anterior maxillary dentition.

*Private practice, St. Paul, MN.


Learning objectives:

This podcast discusses the use of bleaching and flowable composites for correcting tooth discoloration in the anterior maxilla.  Upon completing this podcast, the listener should:

  • Understand the importance of utilizing minimally invasive techniques to achieve patients’ aesthetic goals.
  • Recognize that a treatment sequence incorporating tooth bleaching and direct composites can be successful for whitening stained teeth.


Related Reading:

  1. Staehle HJ. Minimally invasive restorative treatment. J Adhes Dent 1999;1(3):267-284.
  2. Gerlach RW. Whitening paradigms 1 year later: Introduction of a novel professional tooth-bleaching system. Compend Contin Educ Dent 2002;23(1A):4-8.
  3. Watts A, Addy M. Tooth discoloration and staining: A review of the literature. Br Dent J 2001;190(6):309-316.
  4. Lowe E, Rego N, Rego J. A delayed subopaquing technique for treatment of stained dentition: Clinical protocol. Pract Proced Aesthet Dent 2005;17(1):41-48.
  5. Marshall MV, Cancro LP, Fischman SL. Hydrogen peroxide: A review of its use in dentistry. J Periodontol 1995;66(9):786-796.
  6. Haywood VB, Heymann HO. Nightguard vital bleaching. Quint Int 1989;20(3):173-176.
  7. Haywood VB, Leonard RH, Nelson CF, et al. Effectiveness, side effects and long-term status of nightguard vital bleaching. J Am Dent Assoc 1994;125(9):1219-1226.
  8. Sadan A, Lemon RR. Combining modalities for tetracycline-discolored teeth. Int J Periodont Rest Dent 1998;18(6):564-571.
  9. Rainey JT. Air abrasion: An emerging standard of care in conservative operative dentistry. Dent Clin North Am 2002;46(2):185-209.
  10. Terry DA, Leinfelder KF. An integration of composite resin with natural tooth structure: The Class IV restorations. Pract Proced Aesthet Dent 2004;16(3):235-242.
  11. Tavares M, Stultz J, Newman M, et al. Light augments tooth whitening with peroxide. J Am Dent Assoc 2003;134(2):167-75.
  12. Nathanson D. Vital tooth bleaching: Sensitivity and pulpal considerations. J Am Dent Assoc 1997;128(Suppl):S41-S44.
  13. Viscio D, Gaffar A, Fakhry-Smith S, Xu T. Present and future technologies of tooth whitening. Compend Contin Educ Dent 2000;(28):S36-S43.
  14. Luk K, Tam L, Hubert M. Effect of light energy on peroxide tooth bleaching. J Am Dent Assoc 2004;135(2):194-201.
  15. Chafaie A. Minimally invasive aesthetic treatment for discolored and fractured teeth in adolescents: A case report. Pract Proced Aesthet Dent 2004;16(4):319-324.
  16. Cavalli V, Reis AF, Giannini M, Ambrosano GM. The effect of elapsed time following bleaching on enamel bond strength of resin composite. Oper Dent 2001;26(6):597-602.
  17. Bonilla ED, Yashur M, Caputo AA. Fracture toughness of nine flowable composites. J Prosthet Dent 2003;89(3):261-267.
  18. Lee IB, Son HH, Um CM. Rheologic properties of flowable, conventional hybrid, and condensable composite resins. Dent Mater 2003;19(4):298-307.
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