Cases reported "Tooth Discoloration"

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1/50. zirconium oxide post and core system for the restoration of an endodontically treated incisor.

    Due to their enhanced optical properties (eg, translucency, value, chroma), ceramic systems can provide natural aesthetics for restorations placed in the anterior segment. In endodontically treated teeth with stained dentin, however, the use of translucent ceramic materials may be contraindicated unless the underlying discoloration can be masked. This article describes the use of a zirconium oxide post and core system with an all-ceramic crown for the restoration of an endodontically treated anterior tooth. This contemporary system allows optical and mechanical requisites to be resolved simultaneously.
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2/50. A scanning electron and confocal laser microscope investigation of tetracycline-affected human dentine.

    Because of the well reported dental side-effects of tetracycline administration, the drug should not be administered to children. However, it and its derivatives are often administered over a prolonged period for treatment of acne in young adults. Dental side effects are also noticed in these patients. The aim of this study was to examine with scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) the root dentine of a tooth from a young adult affected by tetracycline therapy. The palatal root of an upper third molar, demonstrating distinct areas of tetracycline staining, was removed from the crown and sectioned longitudinally to produce two samples. The pulp tissue was peeled off the dentine and any remaining non-mineralized tissues were removed with sodium hypochlorite. One sample was prepared for SEM and the other as a ground section which was examined with a CLSM. It was demonstrated by SEM that the mineralizing front of unaffected dentine was of a normal calcospherite appearance; in contrast, the mineralizing front of the tetracycline-affected dentine was devoid of calcospherite formation and many surface defects were apparent. In addition, the number of dentinal tubules associated with the defects was reduced. It was shown by CLSM that tetracycline bands were made up of numerous smaller bands and that peritubular dentine not associated with fluorescent bands had incorporated tetracycline. The CLSM examination of the mineralization front of the affected dentine revealed that fluorescence of dentine was restricted to the peritubular dentine. The results confirm that dentine mineralization is affected by systemic tetracycline therapy and that tetracycline can be incorporated into peritubular dentine after mineralization of the primary dentine matrix.
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3/50. Carbamide peroxide whitening of nonvital single discolored teeth: case reports.

    patients who present with a single discolored tooth represent a significant restorative challenge. These case reports describe an economic and conservative treatment option for these patients. The situations presented demonstrate techniques for bleaching with carbamide peroxide in a traditional nightguard or with an inside-outside technique to achieve acceptable esthetic results on isolated nonvital discolored teeth. Although these techniques may not be effective in all cases, they do not compromise or eliminate any future treatment options.
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4/50. Nightguard vital bleaching beneath existing porcelain veneers: a case report.

    Dentist-prescribed, at-home bleaching with 10% carbamide peroxide was used to lighten the apparent color of teeth with preexisting porcelain veneers. Veneers had been placed over unprepared, tetracycline-stained teeth; the translucency of the veneers over the discolored teeth resulted in a graying of the veneers. A custom-fitted tray with no reservoirs and no gingival scalloping was fabricated. A 10% carbamide peroxide material was applied nightly for 9 months to achieve the maximum change in the underlying tooth color. The patient was pleased with the apparent color change. Tooth sensitivity during treatment was minimal (lasting 4 days total); the patient treated sensitivity by brushing with a potassium nitrate-containing toothpaste or applying fluoride in the tray.
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5/50. Microabrasion of teeth with discoloration resembling hypomaturation enamel defects: four-year follow up.

    Microabrasion with 18% HCl and pumice to remove enamel dysmineralization and improve esthetics is an accepted and effective treatment. This technique can probably be extended even to generalized defects resembling hypomaturation amelogenesis imperfecta that appear on all erupted teeth. Five children aged 9 to 11 with two types of enamel-hypomaturation probably due to developmental defects were treated successfully by microabrasion, with marked improvement of the discoloration. The patients were followed for up to four years. During this period, no tooth-sensitivity or staining was noted. The teeth looked healthier and shinier.
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6/50. enamel microabrasion: a new approach.

    enamel microabrasion is a proven method of removing superficial intrinsic enamel discoloration defects. The method is safe, easily performed, and causes no discomfort for the patient. A new commercially available microabrasion system has been introduced by Ultradent Products Inc. In addition, a new tooth isolation material is available, along with a visible light-activated in-office hydrogen peroxide solution. This article describes these new products and documents tooth-color correction for two young patients using this new tooth-color correction approach.
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7/50. An innovative chairside bleaching protocol for treating stained dentition: initial results.

    For years, investigators have attempted to develop a predictable means of bleaching pathologically and nonpathologically stained dentition. While previous efforts have modified the concentration of the bleaching material, the duration of the procedure, and the manner by which the bleaching agent is activated, the ability to affect a significant shade improvement remains an elusive objective. This article demonstrates an innovative technique used to influence the penetration of oxygen ions into the tooth enamel, which may resolve this clinical dilemma.
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8/50. An unusual staining of the tooth roots: a case report with histological and micro-analytical studies.

    The discoloration of tooth roots is rare. We report here a 22-year-old Japanese woman with blackish-brown staining of the roots of the upper and lower third molars. Staining was found in the dentin and cementum. Electron probe X-ray microanalysis showed no significant difference in the composing elements between the stained tooth root and control tooth. Fluorescent bands coincided with staining in the dentin of the root and cementum along the incremental lines under confocal laser-scanning microscope.
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9/50. Combined apexification and orthodontic intrusion of a traumatically extruded immature permanent incisor.

    A patient with a traumatic extrusion of the maxillary right central incisor was referred to the Pedodontic Clinic of Gazi University faculty of dentistry after 15 days. Orthodontic repositioning of the tooth was planned in 6 months. At the beginning of orthodontic therapy it was observed that the tooth was necrotic and needed an apexification procedure. The apexification procedure and orthodontic intrusion were successfully performed at the same time. In addition, a "walking bleach" was performed after the orthodontic and endodontic procedures were completed. At the 3-year recall, the tooth appeared normal in all respects.
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10/50. Greening of the tooth-amalgam interface during extended 10% carbamide peroxide bleaching of tetracycline-stained teeth: a case report.

    At-home bleaching with 10% carbamide peroxide in a custom-fitted tray has been shown to have some minor effects on certain brands of amalgam, pertaining to mercury release, but generally, effects on amalgam are not considered clinically significant. However, in this case report, a greening of the tooth structure in certain areas immediately adjacent to amalgam restorations in the maxillary and mandibular first molars occurred during tooth whitening. Other amalgam restorations in mandibular and maxillary second molars in the same mouth did not demonstrate any green discoloration of the teeth. Upon removal of the affected amalgam restorations, recurrent decay was present in the areas of tooth greening but not in other areas adjacent to the restoration. The teeth were restored with posterior composite restorations. Whether the green discoloration was a result of some loss of material from a particular brand of amalgam, indicating leakage, or indicative of original or recurrent tooth decay is unclear in this single-patient situation. Other patients in the same study did not demonstrate this occurrence. dentists should be ready to replace amalgam restorations should this green discoloration in adjacent tooth structure occur during bleaching, in case decay is present. CLINICAL SIGNIFICANCE: The unusual discoloration cited suggests that amalgam restorations in potentially esthetic areas, including the lingual of anterior teeth, should be replaced prior to bleaching, to avoid the problem of difficult stain removal or translucency allowing restoration visibility following bleaching.
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