Considerations in intracoronal bleaching

Intracoronal bleaching is a simple, useful procedure for restoring the colour of discoloured root-filled teeth that are not extensively restored. It is important to minimise the extraradicular diffusion of hydrogen peroxide, as excessive levels of hydrogen peroxide in conjunction with existing inflammatory changes in the periodontium predispose the tooth to external root resorption. To keep the levels of extraradicular diffusion of hydrogen peroxide below the safety limit, it is imperative that an effective intermediate base cement of at least 2 mm be placed at the level of the buccal cemento-enamel junction over the root-filling prior to bleaching. The use of 35%2carbamide peroxide as the intracoronal bleaching agent seems to combine the safety of sodium perborate together with the efficacy of 35%2hydrogen peroxide. As bleaching agents may reduce the composite-tooth bond of some adhesive systems, the post-bleaching composite restoration should be delayed for at least three weeks.