Tooth whitening - devital teeth
Extensive restorations
In the recent past, discolored devital teeth were often covered with a crown to hide the staining. Unfortunately, this happened even for teeth maintaining the major portion of their structure. However, this procedure necessitates the removal of sound remaining tooth structure and it is more expensive for the patient.
Dr Deliperi has published clinical protocols for the reconstruction of devital and bleached teeth with tooth-colored resin composite fillings on peer reviewed journals. This protocol is appropriate even for severely compromised teeth that require extensive restorations. Extensive restoration are very complex restorations because they replace the major part of the tooth crown due to deep decay processes, fracture of the tooth or fracture of both the tooth and the existing restoration. The results of this conservative technique were presented in the most important dental research meetings both in Europe and in the United States. The advantages of a similar approach are multiple: preservation of sound tooth structure, just one visit to complete the restoration, chromatic and anatomic integration with residual tooth and reduced fee for the patient.
Please, read the attached PDF file and watch the Orlando 2006 video
Click on thumbnail to see 'before' and 'after'
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Before
Discolored non-vital right lateral and central incisors; centrals incisors underwent trauma with fracture of the crown in the past. Teeth were restored, but the filling on the right central incisor de-bonded; on the left central incisor, the margins of the existing filling are visible.
After
Both vital and devital teeth were bleached; the existing and missing fillings were replaced with tooth-colored composite restoration. The shade of devital teeth was perfectly matched to the shade of vital teeth and the new fillings look invisible. No additional removal of sound tooth structure was required. A vertical micro-crack from the dental trauma is more evident; it was covered by the yellow shade of the teeth before bleaching.
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Before
Three discolored non-vital teeth and multiple mismatched fillings are visible on the upper incisors.
After
Dr Deliperi bleached both vital and non-vital teeth; existing mismatched fillings were replaced with new tooth-colored restorations. The shade of devital teeth was perfectly matched to the shade of vital teeth and the new fillings look invisible once again.
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Before
The right central incisor suffered from trauma and the fracture was restored with a tooth-colored filling; in the next few years, the tooth lost his vitality and underwent to a progressive discoloration.
After
Root canal was performed and the tooth underwent to whitening; the existing filling was replaced with a new invisible one. Dr Deliperi also changed the shape of the two central incisors; dominance was created by closing the space between the two centrals.
Tooth whitening - devital teeth I
