In this clinical case we will treat in-office whitening for young patients with Whiteness HP Automixx 6% with a brush tip, in a safe and efficient way.
Authors: Dra. Alessandra Reis, Dr. Alessandro Loguercio, Dr. Michael Favoreto e Dra. Taynara Carneiro
15-year-old female patient.
Chief Complaint: Yellow teeth
During the anamnesis, the patient reported being dissatisfied with the color of her teeth, demonstrating great interest in dental whitening. When performing a clinical examination, using the shade guide, C2 was observed in the middle third of the upper right canine.
Observing the age of the patient and aiming to reduce tooth sensitivity, with the use of low concentration of whitening gel, with a smaller amount of gel applied on the tooth surface, in-office whitening was proposed with Whiteness HP AutoMixx 6% of hydrogen peroxide, using a tip with a brush.
Treatment performed with Whiteness HP Automixx
The proposed treatment started with previous prophylaxis and photographic protocol. The initial shades were taken. The Arcflex labial retractor was installed and the mucous tissue was protected with Top dam green gingival barrier, according to the manufacturer’s recommendations. However, due to the low concentration used for in-office whitening and considering that this concentration is also used for at-home whitening, its use without a gingival barrier could be indicated.
The Whiteness HP AutoMixx 6% whitening gel was then applied, using a tip with a brush attached, which allows application of a thin and homogeneous layer of the gel. Initially, a little of the product was dispensed to promote the correct self-mixing of the gel, before application on the dental surface
The gel was applied and kept in position for 50 minutes, without the need to replace the gel, due to its good properties and stable pH during application. After the predetermined time, the whitening gel was removed by aspiration and abundant washing with water. Then, the gingival barrier and the labial retractor were removed. 3 sessions of 50 minutes were performed, with intervals of 7 days between them to guarantee a significant shade change.
The shade was evaluated one month after the end of the treatment to verify the change. Carrying out the whitening procedure using a low concentration of whitening gel and with a tip attached to a brush seems promising in young patients, since the demand in this age group is increasing more and more, due to the esthetic demand influenced by social media.
This protocol provides a low risk of tooth sensitivity, since due to the smaller amount of whitening gel to be applied with the brushshaped tip, low amounts of hydrogen peroxide are observed in the pulp chamber1. The result presented promoted patient satisfaction. The profitability with this brush is a positive factor, since a smaller amount of gel is used.
Step by step
1 | Initial appearance of the smile.
2 | Prophylaxis prior to the procedure.
3 | Initial shade taking.
4 | Labial retractor in position and application of the Top dam Green gingival barrier.
5 | Application of Whiteness HP Automixx 6% whitening gel.
6 | Tip with attached brush promoting the application of a thin and homogeneous layer of whitening gel.
7 | Demonstration of not using the gingival barrier for Whiteness HP AutoMixx 6%.
8 | Registration of the final shade, after 1 month of the whitening procedure.
9 | Final appearance of the smile.
- Bernardi LG, Favoreto MW, Carneiro TS, Mena-Serrano A, Borges CPF, Reis A, Loguercio AD. Use of an applicator brush with high concentration bleaching gels. Clin Oral Investig. 2022 Oct;26(10):6387-6395. doi: 10.1007/s00784- 022-04594-8. Epub 2022 Jul 1. PMID: 35776203.