Bleaching of root-filled teeth: a literature review

Abstract

In modern Dentistry, the smile aesthetics is more valuable every day, gaining importance and prominence. In this context, the beauty is influenced by contour, shape, alignment, symmetry and, specially, the color of the teeth. The bleaching of anterior endodontically treated darkened teeth has become a therapy very requested in the clinical practice of Dentistry, because stained teeth is of great concern for patients. This literature review has as objective to analyze the available data on this subject, since the association between internal bleaching and external cervical root resorption is an issue that still raises questions in dental practice. The internal bleaching has aesthetic success, however, this procedure is associated with a risk of external root resorption, which hinders or even makes impossible the maintenance of the tooth in the oral cavity. The etiology of the external root resorption related to the internal bleaching is complex, however it’s believed that the bleaching chemicals diffuse from the pulp chamber through patent dentinal tubules to the surrounding periodontal tissues, denatures dentin, which starts to be considered as a tissue with immunological differences, starting, then, to be recognized as a strange body, resulting in an inflammatory reaction which results, then, in the located loss of tissue. Another limitation of the internal bleaching of root-filled teeth is the discoloration. In spite of this procedure’s high success rate, the results are different from those seen at long-term follow-up, that is, the color regression is a fact that must be studied and better understood.