International Congress of Contemporary Pediatric Dentistry, 11 - 13 Ekim 2024, ss.51
A 13-year-old female patient presented with discoloration of her anterior teeth. Her medical history revealed no systemic diseases or long-term medication use. The affected tooth had previously undergone root canal treatment and was restored with composite resin. Clinical examination indicated good oral hygiene with no pathological findings on the enamel or root surfaces. Radiographic assessment confirmed the absence of pathological changes, validating the success of the root canal therapy. Following an informed consent regarding potential complications, the decision was made to proceed with bleaching. A rubber dam was used to isolate the teeth and protect the gingiva. The access cavity was cleaned of restorative materials and remnants up to 2-3 mm below the cervical margin. Canal orifices were sealed with conventional glass ionomer cement (Ketac Cem, 3M ESPE, Germany) to preserve dentinal tubules and the external epithelial attachment. A 35% hydrogen peroxide solution (Opalescence Endo, Ultradent, South Jordan, UT) was placed in the pulp chamber, covered with cotton, and sealed with resin-modified glass ionomer cement (Fuji II Capsule, GC Europe, Japan). The patient was recalled after three days; as the bleaching effect was inadequate, the bleaching agent was reapplied, and the patient was scheduled for further evaluation. After achieving satisfactory whitening, the pulp chamber was cleaned, and calcium hydroxide paste was applied for one week. Subsequently, the temporary restoration was removed, the pulp chamber was irrigated with saline, and the cavity was restored with hybrid composite resin (A2 Filtek Ultimate Universal Restorative, 3M ESPE, Neuss, Germany). One year post-treatment, there were no signs of discoloration, sensitivity, or pathological changes in the gingival or apical regions, and the patient reported high satisfaction with the outcomes.