what's the prognosis of an internal bleaching for a chronic tooth?

[Sho-4]

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Hello ladies and gentlemen 🙂

One of my patient came with a chief complaint of a discolored anterior tooth, after taking the history .. he told me that he fell when he was approximately 10 years old (he's in his 30's now) . So the problem is obvious .. a necrotic tooth due to trauma that caused a tooth discoloration.

My plan is to do a root canal treatment and do an internal bleaching to the tooth.

my question is .. what's the prognosis of this method? someone told me the prognosis is so weak and the discoloration WILL come back again.

I was advised to make a crown for that tooth instead, but I don't find the idea very appealing since the patient has to make crowns or veneers on the adjacent teeth for the aesthetic purpose.

if the prognosis is good, what's the best bleaching material for this case?

 

[Big Time Hoosier]

The success is dependent on the cause of discoloration, i.e. pulpal necrosis vs. tetracycline staining. I've had good success when the discoloration is due to necrosis. I like using sodium perborate; it's pretty simple and safe to work with. I've also used Opalescence Endo gel. You may need to treat the tooth a few times with either for maximum results.

Regardless the tooth needs endo if it's necrotic, so internal bleaching is worth a shot. I tell my patients we may not get a perfect shade match, but if we can make a more seamless color transition they're happy with that's a success too.

Remember, trauma may also cause calcific metamorphosis leading to discoloration. You're not super likely to get a pulpal response to testing, and without symptoms that tooth does not need endo. But, I'm sure you've taken radiographs and confirmed your diagnosis.

Big Hoss