Dental Education Lecture: Bleaching before Crown

One of Mr. Deng's front teeth looks pretty dark with a large chip (9 in Fig.1).  It appears that the tooth needs a crown.  Mr. Deng wants to whiten the tooth before crown, because he finds out that the dark tooth may look bad with a white transparent porcelain crown.  The tooth may become darkening after injury, deep cavity and/or improper root canal (treatment).

For Mr. Deng's tooth no.9 , we remove part of root canal filling and some of dead nerve left over inside the tooth and start in office internal and external bleaching.  The tooth becomes whitening instantaneously (Fig.2). To prolong bleaching effect, bleaching agent is placed (bluish in Fig.2) inside the tooth and sealed with whitish temporary filling.  So that he can go home to continue so-called walking bleaching process.  Unfortunately the temporary filling and bleaching agent is lost soon (Fig.3).  After discussion, Mr. Deng begins take-home bleaching.  Two or three weeks later, he returns for crown impression (Fig.4).   A filling is placed for the tooth #8 (Fig.5);  after using the whitest filling material and grinding, the tooth #9 is ready for impression.  After crown cementation, the tooth looks pretty good (Fig.6).   A year later, everything is alright with Mr. Deng's front teeth.

Xin Wei, DDS, PhD, MS 1st edition 11/15/2009, last revision 01/03/2011