Case Studies

Intracoronal Bleaching Case Study

Patient age	23
Patient sex	Male
Tooth	21
Chief complaint	My tooth is sore and changing colour
Medical history	Nothing of note
Dental history	Patient sustained a knock to the tooth during a brawl over 4 months prior
Clinical evaluation	Virgin tooth that is tender to percussion & palpation. No response to sensibility testing

Diagnosis	Necrotic pulp and acute apical periodontitis
Treatment planned	Orthograde root canal treatment and intracoronal bleaching
Alternatives	Orthograde root canal treatment and veneer to mask discolouration
Prognosis	Good

Treatment	Orthograde root canal treatment over two visits
Chemomechanical debridement	Instrumentation with k-file to produce a reproducible glide path, rotary NiTi to finish the preparation & irrigation with NaOCl. MAF X2 (ProTaper Next)
Dressing	Ca(OH)2 for 1 week
Obturation	With GP & AH Plus sealer. Warm vertical condensation technique.
Orifice barrier	GIC
Bleach	Sodium perborate for 2 weeks