ALBERTO CUÉLLAR GONZÁLEZ

BLANQUEAMIENTO
D E N TA L
 “The color of teeth is primarily
determined
by the dentine but influenced by the
color, thickness, translucency, and varying
degrees of calcification of enamel”

“An overview of tooth bleaching techniques: chemistry, safety & efficacy.”

Munther A.M. Sulieman
Periodontology 2000. Vol. 48, 2008.
“Any changes to these structures
during formation or throughout
development and post-eruption
can cause a change in light-
transmission”

“An overview of tooth bleaching techniques: chemistry, safety & efficacy.”

Munther A.M. Sulieman
Periodontology 2000. Vol. 48, 2008.
 CAUSAS
INTRÍNSECAS
“Intrinsic stains are located within the tooth and are
accessible only by bleaching”

“Intrinsic discoloration occurs following a change

to the structural composition or thickness
of the dental hard tissues during tooth development”
IATROGENIA
Consumo de Tetraciclina por:

Madres Embarazadas

Madres que amamantan

Niños menores de 12 años

 HEREDITARIO

Amelogénesis Imperfecta Dentinogénesis Imperfecta

TRAUMA
METABÓLICAS

Hiperbilirubinemia Porfiria Eritropoyética

Congénita Congénita
FLUOROSIS
Ingesta excesiva de agua
con fluór, mayor a 2ppm
ENVEJECIMIENTO

Proceso natural, el esmalte

se adelgaza con el uso,
mientras
que la dentina secundaria y
terciaria
son producidas.
 CAUSAS
EXTRÍNSECAS
DIRECTAS INDIRECTAS

“Cromógenos incorporados “Una mancha creada a

directamente partir de
en la película, resultando en la reacción química de
una mancha un compuesto
del color del mismo” con otro”
DIRECTAS
INDIRECTAS

Clorhexidina

Suplementos de hierro

Enjuagues con Sales de Cobre

LA PERCEPCIÓN VISUAL ES UN REQUISITO PARA UNA
APRECIACIÓN ESTÉTICA
 1800’s 1960
Cloruro de lima Peroxigel - Comercialización
Cloruro de alumina Dr. Klumsier
Ácido oxálico
Pyrozona
Peróxido de Sodio
Hipofosfato de Sodio
1989
Perónido de Hidrógeno Haywood and Heymann
Peróxido de Carbamida “Nightguard vital bleaching”
“White and Brite™”
Peróxido de Peróxido de
Carbamida Hidrógeno

10% ≈ 3%
20% ≈ 6%
30% ≈ 10%
“Bleaching is defined here as the chemical
degradation of the chromogens”
“the concentration and contact time of the bleaching agent to
the tooth are very important for the bleaching outcome.”

Tooth whitening: facts and fallacies.

Heymann HO
Br Dent J. 2005 Apr 23; 198(8):514.

“the contact time of the bleaching agent appears to be an

important factor; however, the concentration is not as
important as a factor for the bleaching outcome”

Eight in-office tooth whitening systems evaluated in vivo: a pilot study.

Matis BA, Cochran MA, Franco M, Al-Ammar W, Eckert GJ, Stropes M
Oper Dent. 2007 Jul-Aug; 32(4):322-7.
“researchers have stated that no acceleration or increase in
efficacy occurs when using light sources”
Current status of tooth whitening: literature review.
Boksman L
Dent Today. 2006 Sep; 25(9):74, 76-9; quiz 79.

“tooth dehydration that presumably is greater with

increased tooth heating on using light activation source.”
Colorimetric assessment of laser and home bleaching techniques.
Jones AH, Diaz-Arnold AM, Vargas MA, Cobb DS
J Esthet Dent. 1999; 11(2):87-94.
 Mayor concentración —> más rápido el efecto

Mayor concentración —> alta probabilidad de sensibilidad

Mayor tiempo de contacto —> más rápido el efecto

Mayor tiempo de contacto —> alta probabilidad de sensibilidad

“Light-activated whitening systems add cost, occupy operatory space, can
cause burning of the soft tissue, and can increase operatory temperature”
Clinical performance of vital bleaching techniques.
Bernardon JK, Sartori N, Ballarin A, Perdigão J, Lopes GC, Baratieri LN
Oper Dent. 2010 Jan-Feb; 35(1):3-10.

“Temperatures elevated to an uncomfortable levels may result

in tooth sensitivity or even irreversible pulpal inflammation"

Albers H, Lightening Natural Teeth

ADEPT, Report 1991;2:1-24
 Mayor concentración —> Mayor sensibilidad

Mayor Concentración —> Mayor rapidez

Mayor tiempo de contacto —> Mayor efecto

10% carbamide peroxide should be used 8 h per day,

and the 15–20% carbamide peroxide 3–4 h per day
 BLANQUEAMIENTO
INTERNO DE
D I E N T E S NO V I T A L E S
“Within 1 to 5 years, only 35% to 50% teeth
maintain their esthetically pleasing
appearance”

Hargreaves, K. M., Cohen, S., Berman, L. H., & Rotstein, I.

(2016). Cohen's pathways of the pulp. St. Louis: Elsevier.
 “Whitening can be accomplished by physical removal of
the stain or a chemical reaction to lighten the tooth color”
 MICRO ABRASIÓN

ÁCIDO HIDROCLÓRICO 6% + ABRASIVO + COPA DE HULE

MACRO ABRASIÓN
Bibliografía:
Tooth Whitening: What We Now Know
Clifton M. Carey
J Evid Based Dent Pract. Author manuscript; available in
PMC 2015 Jun 1.
Published in final edited form as: J Evid Based Dent Pract.
2014 Jun; 14
Current status of tooth whitening: literature review.
Boksman L
Dent Today. 2006 Sep; 25(9):74, 76-9; quiz 79.
Tooth-bleaching procedures and their controversial effects:
A literature review
Mohammed Q. Alqahtani
Saudi Dent J. 2014 Apr; 26(2): 33–46. Published online 2014
Mar 12. doi: 10.1016/j.sdentj.2014.02.002
Clinical performance of vital bleaching techniques.
Bernardon JK, Sartori N, Ballarin A, Perdigão J, Lopes GC,
Baratieri LN
Oper Dent. 2010 Jan-Feb; 35(1):3-10.
Tooth whitening: facts and fallacies.
Heymann HO
Br Dent J. 2005 Apr 23; 198(8):514.
Colorimetric assessment of laser and home bleaching techniques.
Jones AH, Diaz-Arnold AM, Vargas MA, Cobb DS
J Esthet Dent. 1999; 11(2):87-94.
Albers H, Lightening Natural Teeth
ADEPT, Report 1991;2:1-24
Baroudi, K., & Hassan, N. A. (2014). The effect of light-activation sources
on tooth bleaching. Nigerian Medical Journal: Journal of the Nigeria
Medical Association, 55(5), 363–368. http://doi.org/
10.4103/0300-1652.140316
Eight in-office tooth whitening systems evaluated in vivo: a pilot study.
Matis BA, Cochran MA, Franco M, Al-Ammar W, Eckert GJ, Stropes M
Oper Dent. 2007 Jul-Aug; 32(4):322-7.
“An overview of tooth bleaching techniques: chemistry, safety &
efficacy.”
Munther A.M. Sulieman
Periodontology 2000. Vol. 48, 2008.
 ANDRÉS DÁVILA SÁNCHEZ AND CAMILO PULIDO
WHITE SPOTS, BLEACHING AND MICRO-ABRASION
Clinical Case. Accesado el 17 de Marzo 2017, Summitt, J. B., Robbins, J. W., Hilton, T. J., & Schwartz, R. S.
disponible en (2011). Fundamentals of Operative Dentistry: a Contemporary
http://www.styleitaliano.org/white-spots-bleaching- Approach. Berlin: Quintessenz Verlag.
and-micro-abrasion

KILIAN MOLINA
BLEACHING - SHADEGUIDES
Hargreaves, K. M., Cohen, S.,
EXTERNAL TOOTH WHITENING
Berman, L. H., & Rotstein, I.
Clinical Case, Accesado el 17 de Marzo 2017, disponible en:
(2016). Cohen's pathways of the
http://www.styleitaliano.org/external-tooth-whitening
pulp. St. Louis: Elsevier.