Dental Tribune Pakistan Edition No.2, 2016

Editor - Online Haseeb Uddin CLINICAL PRACTICE6 DENTAL TRIBUNE Pakistan Edition March 2016 he desire for whiter teeth has considerably increased in the last few years. The demand for tooth bleaching as a cosmetic treatment is increasing more and more, despite the recession, which only marginally affected aesthetics and cosmetics. Nowadays, we live in a world where appearance is extremely important in any field; according to independent studies conducted for the American Association of Cosmetic Dentistry: . 99.7 % of Americans are convinced that a bright smile is an important social factor; . 96 % of adults are convinced that an unpleasant smile may have a negative influence on career opportunities; . 74 % of adults think that an unpleasant smile may have a negative influence on career opportunities. We are also aware that the desire of having a bright smile with white teeth has existed for centuries, but the research in this sector has only stepped notably forward during the past few decades. We are also aware that the desire of having a bright smile with white teeth has existed for centuries, but the research in this sector has only stepped notably forward during the past few decades. This happened especially at the end of ‘80s, thanks to Dr Eyneman and Dr Aiwood,[1–4] who conceived the idea of home bleaching treatment with the use of the well-known bleaching trays, customized or not, adequately filled with low-percentage hydrogen peroxide and worn for some hours a day or even all night long. Afterwards, the companies of the dental field worked hard to improve these procedures, such as designing pre-filled trays or changing the flavour of the gel. The method is substantially the same, only the percentage of hydrogen peroxide (also available as carbamide peroxide) may vary from 10 % to 30 %.[6,7] This influenced the contact period, which is at least from a couple of hours a day (for percentages that are onlyallowed for cosmetic bleaching) to all night long. All of them start from a single assumption: the bleaching action of peroxide needs a variable contact period to penetrate through the enamel prisms and the dentinal tubules, releasing active oxygen and allowing the free radicals to attack the chromophobe particles and reach the desired effect.[9] Materials and methods After years of attempts and experimentations used to improve the current methods and the result, I have managed to refine a new method, making it easy and above all reducing the daily duration of the treatment to only two minutes instead of 6–8 hours of the traditional cosmetic home bleaching: I have optimised the method in an extreme way. After several tests, I deduced that peroxide, if activated by a special accelerator (XS 151) could penetrate in a faster way, exploiting the action of mechanical pressure generated by a special toothbrush with nozzle-doser and a dispenser filled with this special bleaching substance (Fig. 1). This special bleaching toothbrush has been designed with a smaller head if compared to the most common toothbrushes in order to reduce the contact with oral mucosa. Soft blunted bristles activate the accelerator (XS 151) contained in the gel while brushing and guarantee a faster absorption of the bleaching gel; it also improves the procedure by drastically reducing the application time: from 6–8 hours to two minutes per day! The advantages are amazing, because reducing the contact period means reducing enormously the undesirable effects[8]: inflammation of soft tissues, hypersensitivity, risk of swallowing the gel and so on. There is also an improvement of some Technologicalinnovationinprofessionalhome bleaching: The ENA White 2.0 system in only 2 minutes per day without tray Fig. 7: Check after 12 days.Fig. 5: Check after 7 days. Fig. 6: Check after 10 days. Fig. 4: Check after 4 days.Fig. 3i: Brush again for further 30 seconds and rinse accurately. Fig. 3h: Rinse the bristles with running water. Fig. 1: Bleaching system ENA White 2.0: toothbrush with dispenser containing hydrogen peroxide bleaching gel with special activator XS 151, which increases its absorption rate exponentially. Fig. 2: 30-year-old male patient with discolouration on the central and lateral teeth; shade A3 of VITA shade guide. Fig. 3a: Unscrew and remove the cap of the toothbrush. Fig. 3b: Unscrew the toothbrush and remove it from the dispenser. Fig. 3d: Screw the toothbrush again. Fig. 3c: Remove the seal from the base of the toothbrush with tweezers. Fig. 3g: The patient must brush the teeth to be bleached for about 30 seconds with horizontal movements, avoiding contact with the gums as much as possible. Fig. 3f: It is necessary to use a small lentil-sized dose of the gel. Fig. 3e: Rotate the ring anti- clockwise towards the direction ‘UP’ until the gel comes out from the hole among the bristles. DT International By Dr Luigi Leonardi, Italia T

Dental Tribune Pakistan Edition No.2, 2016

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