In-Office Teeth Whitening

Clinical Seminar

Factors that Affect Bleaching Surface debridement Hydrogen peroxide concentration Temperature PH : optimum ph for hydrogen peroxide is pH = 9.5~10.8 Time Sealed environment Proper light source

Contraindications Poor oral hygiene With braces Just completed gum surgery Decayed teeth T-M joint problems Periodontal disease Allergies to peroxide Age under 18 Pregnant women Lactating women

Oral Examination Take photograph Remove Superficial stain Check for caries Note poor restoration Examine the enamel Examine the gingiva Radiograph

Effect of Light Energy on Tooth Bleaching

Light Source Tooth Thickness Bleaching Agent Time Temperature

LITEXTM 685wPLASMA ARC CURING AND WHITENING SYSTEMSpecial wider wavelength design from 400 to 540 nm.

Everbrite Everbrite TMTM

In-office Tooth Whitening Kit In-office Tooth Whitening Kit For Professional Use OnlyFor Professional Use Only

Hydrogen Peroxide

In acidic pH :H2O2 → H2O + O`

pH = 9.5 ~ 10.8 : H2O2 → H + HO2` Strong free radical

In the presence of catalysts and enzymes : 2H2O2 → 2H2O + O2

In pure aqueous form , H2O2 is weakly acidic

Patent whitening arch designed to whiten whole anterior area

Time

The maximum energy applied to a tooth should

not exceed 25 joules per cycle

1 joule = 1000mW/cm2/sec

Arch: 80mW/cm2/sec X 30 sec ＜ 25 joules

30 sec light on + 10 sec light off, 15 cycles, four times

Time (min)

Temp raise on outer enamel surface( )℃

Temp raise in pulp chamber( )℃

Cycle 1 Cycle 2 Cycle 1 Cycle 21 1.2 1.2 0.2 0.32 1.9 2.0 0.6 0.83 2.4 2.6 1.0 1.24 2.8 3.1 1.4 1.55 3.1 3.5 1.6 1.96 3.3 3.8 1.9 2.27 3.4 4.0 2.1 2.48 3.5 4.2 2.3 2.69 3.6 4.4 2.4 2.8

10 3.7 4.5 2.5 3.0

Temperature

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

1 2 3 4 5 6 7 8 9 10

Cycle 2 outer enamel surface

Cycle 2 inner pulp chamber

Cycle 1 outer enamel surface

Cycle 1 inner pulp chamber

Arch type:10 minutes outer enamel 3.7~4.5oC, inner pulp chamber 2.5~3.0oC

Advice for the doctor Always use the shade guide before and after. Always taking a photo before and after. Don't exaggerate the result of whitening

treatment. Thickness of enamel. Degree of calcification of dentin. Reasonable charge for whitening treatment.

VITA Shade Order

by Lightness(L*)

B1 A1 B2 D2 A2 C1 C2 D4 A3 D3 B3 A3.5 B4 C3 A4 C4

CASE REPORT