Bleaching

 

Etiologi

Pewarnaan Instrinsik

Pre Eruptive

• Penyakit

  • Alkaptonuria

    • Dark brown pigmentation
    • Gigi sulung
    • Gangguan autosomal recessive

  • Hematological disorder

    • Erythroblastic fetalis

      green, brown discoloration

    • Congenital poryphyria

      red, brownish dicoloration

    • Sickle cell anemia

      hampir sama erythro namun lebih parah

  • Gangguan enamel dan dentin

    • Gangguan Enamel

      Gangguan yang terjadi pada tahapan histodiferensiasi, aposisi, dan kalsifikasi selama tahapan pertumbuhan gigi

      • Amelogenesis imperfecta

        • sensitivity

        • no dark brown

        • high risk caries

        • enamel loss

          enamel hypokalsifikasi

          enamel hypoplasia

          enamel hypomaturasi

          

      • Fluorosis

        bercak warna

        • No sensitivity
        • Dark brown
        • Low risk caries
        • No email loss

        

      • Mineral and vitamin deficiency

      • Chromosomal abnormalities

    • Gangguan Dentin

      • Dentinogenesis imperfecta
        • gangguan perkembangan autosomal dominan
        • gigi berwarna biru keabuan atau kuning kecoklatan dan tembus cahaya
        • shiny, bright
      • Erythropoietic porphyria
      • Hyperbirulinemia
• Obat-obatan
  • Tetracycline and Minocycline (Antibiotics)
  • Tetracycline
  • Fluorosis

Post eruptive

• perubahan pulpa

  • bakteri
  • mekanik
  • kimia yang mengiritasi pulpa

  → nekrosis pulpa → diskolorasi

• trauma

  pendarahan pulpa → RBC/ Sel darah merah lisis dan pembebasan iron sulphide → masuk ke dalam tubuli dentin → Gray discoloration (Abu2)

  

• hiperkalsifikasi dentin

• karies gigi

• material restorasi

• usia

Pewarnaan ekstrinsik

• Faktor luar
  • Plaque
  • Makanan
  • Minuman
  • Tobacco
  • OH buruk
• Kimia
  • Chlorhexidine
  • Pewarnaan metal

Bleaching

• Bahan Bleaching
  • Carbamide Peroxide (CH6N2O3)
  • Hidrogen peroksida
  • Natrium perborat
  • Karbamid peroksida
  • Piroson

Bleaching Technique

• Vital Teeth (Bleaching Externa)

  • Home bleaching/ Nightguard Vital Bleaching
  • In-Office Bleaching
  • Microabrasion

• Non Vital Teeth (Bleaching interna)

  • Thermocatalytic Bleaching
  • Walking Bleach/ Intracoronal Bleaching
  • Inside/ Outside Bleaching
  • Closed chamber bleaching/ extracoronal bleaching
  • Laser assisted bleaching

• Effect of bleaching

  • Toxicity
  • carcinogenity
  • cervical resorption
  • mucossal iritation
  • tooth hypersensitiviy
  • effect on material restorastion
  • effect of