![]() The patient did not report pain or sensitivity to temperature changes or percussion. Case reportĪ 35-year-old man complained about discoloration of his maxillary left central incisor (Figure 1A). This approach may reduce the amount of unnecessary laminate veneers or root canal treatments performed before internal bleaching in refractory cases to external bleaching. The presented case report offers a conservative approach for treating discoloration due to pulp chamber obliteration. Second, since there is calcific metamorphosis, there is a risk for crown or root perforation while trying to find or negotiate the calcified canal space. First, the endodontic treatment can be a costly procedure as well as being irreversible. However, this method for bleaching of a tooth with a calcified pulp chamber has two main disadvantages. This approach is also used to reduce tetracycline and other sources of discoloration (Abou-Rass 1982). The high success rate and simplicity of non-vital tooth bleaching technique requires endodontic treatment prior to initiating internal bleaching (Rotstein, Zalkind, et al., 1991 Amato, Scaravilli, et al., 2006). The technique requires modifying the bleaching tray in order to make space for the bleaching agent and limit its action to the discolored tooth. External bleaching of a single tooth is carried out by using 20% carbamide peroxide gel for a period of 4 to 6 weeks or until the single tooth matches all the adjacent teeth. External bleaching techniques involve the use of a customized mouth tray with carbamide peroxide gels as the bleaching medium (Fasanaro 1992 Haywood 1992 Haywood 1992 Kielbassa, Attin, et al., 1995 Attin, Paque, et al., 2003). Using external vital tooth bleaching procedure for color change secondary to a calcified pulp chamber has limited efficacy. However, these options result in irreversible removal of tooth structure and may present barriers in expense and esthetics. The common and often most predictable technique involves tooth preparation for a laminate veneer or full porcelain crown (Chen and Raigrodski, 2008 Jun and Wilson, 2008 Sadighpour, Geramipanah, et al., 2009 Freire and Archegas 2010 Alghazzawi, Lemons, et al., 2012 Beier, Kapferer, et al., 2012). There are several approaches to deal with this esthetic problem. Consequently, there is a decrease in the translucency of the tooth resulting in a yellowing to dark discoloration (Abbott, 1997). This pulp chamber calcification is caused by excessive dentin apposition by the odontoblasts that may be accelerated because of trauma to the tooth (Abbott and Heah, 2009). However, it is not uncommon to have a discolored vital anterior tooth due to pulp chamber calcification (Abbott and Heah, 2009). Internal bleaching is a well-known commonly used clinical procedure for the treatment of discoloration of endodontically treated anterior teeth (Rotstein, Zalkind, et al., 1991 Amato, Scaravilli, et al., 2006). The esthetic results are consistent with non-vital tooth internal bleaching yet pre-bleaching root canal treatment is not requested. The presented technique offers a comparatively conservative approach in the treatment of anterior tooth discoloration associated with pulp chamber obliteration. The patient preferred to avoid the option of external bleaching or tooth preparation for laminate veneer. There was also no response to cold stimulation, and the periodontal ligament was radiographically continuous and normal in width. This article presents a case demonstrating a new and conservative approach for bleaching anterior teeth with yellowish-brown discoloration secondary to pulp chamber calcification. solve a common endodontic problem in a conservative way Abstract
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