"vital bleaching" and tetracycline?

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youngman

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i was reading the Stedman's 2000 medical dictionary. it has a picture of "vital bleaching" of tetracycline stained teeth before and after. the teeth became totally bright white.

from what i have asked before, it seems that no one can get rid of the tetracycline effectly. so i am just wondering what this "vital bleaching" is, is it really effective without destroying the enamel?

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It can work to a certain extent. Vital bleaching is just using trays over-night. I have seen first hand how vital bleaching was able to remove maybe 70-80% of the staining due to tetracycline.
 
youngman said:
i was reading the Stedman's 2000 medical dictionary. it has a picture of "vital bleaching" of tetracycline stained teeth before and after. the teeth became totally bright white.

from what i have asked before, it seems that no one can get rid of the tetracycline effectly. so i am just wondering what this "vital bleaching" is, is it really effective without destroying the enamel?

While I was in my last year of dental school, I took advantage of the reduced rate that the Patterson company offered to dental students and bought 9 polanight bleaching kits (at 40$ Canadian per kit). These are vital bleaching kits which contain 16% carbamide peroxide as the active ingredient. One takes an impression and makes customized bleaching trays from the models. I bleached my own teeth, my dad's and a bunch of friends. I charged for the material and nothing for the service ( which can range $300-500 in private practice :eek: ). It was a lot of fun! :D

In any case, one of my friends had tetracycline stained teeth. I warned her that the results of the bleaching were not predictable and that in her case (she had grayish-blue stained teeth with banding) some results would be noticeable but most likely she would also need veneers as grayish staining has the worse response to vital bleaching. I don't know how her teeth turned out because I haven't seen her since I moved away but apparently she noticed some changes.

From what I recall , tetracycline staining is due to the chelation of tetracycline with calcium in enamel and dentin during the mineralization stage of tooth development. There are various patterns of tetracycline staining The discoloration can be yellow, yellow-brown, brown, gray, grayish-blue and blue. It can also have diffuse or banding distribution. Apparently, the yellow, yellow-brown and brown respond better to vital bleaching than the blue and blue-gray pattern.

In response to your other question, vital bleaching involves the external bleaching of vital teeth (with home customized bleaching trays) (non-endodontically treated) while non-vital bleaching is the internal bleaching of endodontically treated teeth. That is the simplest explanation. I won't get into any more details- you should be learning about this in your operative dentistry courses (materials, technique etc.)
 
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