Overcoming challenges in teeth whitening: tetracycline staining.
Author: Dr. Isabel Giraldez
Patient
63-year-old female patient.
Complaint
Patient wanted to whiten her teeth without having to resort to veneers.
Radipgraphic exam
Teeth showing a grade 2 tetracycline with brown and yellow bands. The most saturated shade of the bands corresponded to the 3R 2.5 of the VITA 3D MASTER shade guide
Treatment
Due to the etiology of the staining, we opted for supervised at-home whitening with the use of 16% carbamide peroxide (Whiteness Perfect) in custom trays for 3 to 4 hours per day for 2 months. The photographs show that in one month of treatment the shade of 2L 1.5 was reached with much lighter bands. At 2 months, the result was a shade corresponding to 0M 2 and the bands became practically unnoticeable.
Fig. 1: Initial smile.
Fig. 2: Initial intraoral appearance.
Fig. 3: Initial shade taking.
Fig. 4: Instructing the patient to useWhiteness Perfect 16% in the trays for 4 weeks for 3 to 4 hours per day.
Fig. 5: Follow-up after 4 weeks of treatment, showing an improvement in the shade. Facing the report of the absence of sensitivity, the patient was instructed to continue treatment with Whiteness Perfect 16%, for 3 to 4 hours per day.
Fig. 6: Final shade taking after 2 months of treatment.
Fig. 7: Final intraoral aspect.
Fig. 8: Final smile
Fig. 9: Comparison of the final result with the initial shade guide highlighting the excellent degree of whitening achieved.
