Whiteness HP Maxx

Perform prophylaxis of the teeth making the dental surface to be whitened free of biofilm. Take and register the shade of patient's teeth using a shade guide and/or photograph before starting the whitening.

Insert the Arcflex lip retractor (FGM) to facilitate access and manipulation of the oral cavity and then apply Desensibilize KF 2% for 10 minutes on the teeth to be whitened.

After desensitization, remove the gel and dry teeth and gums with air jets. Perform relative isolation by applying the Top dam light-curing gingival barrier (FGM).

Using the mixing plate that comes with the kit, mix the Peroxide phase (phase 1) with the thickener phase (phase 2) in the proportion of 3 drops of peroxide to 1 drop of thickener. The mixture of 3 drops of peroxide to 1 drop of thickener is sufficient for an application on a tooth. For smile lines (20 teeth) generally 18 drops of peroxide for 6 drops of thickener are sufficient. Shake the thickener bottle vigorously before using it to homogenize its contents. Failure to homogenize the thickener can result in a low viscosity gel (insufficient viscosity).

Apply the gel to the teeth to be whitened using a spatula, usually from 1° or 2° premolar to the other. Cover the buccal surface of the teeth with a layer of gel as thin as possible. The gel coating can be extended to the small area of the incisal/occlusal surface of the teeth. If you want to use a light source equipment, start using it right after applying the gel. For each equipment there is a specific protocol for time of light exposure. Follow the manufacturer's instructions for the time of application of the light, but respect the protocol for the time of application of the product on the teeth.

Let the gel on the dental surface for 15 minutes from the beginning of its application. During this time you can move the gel with an explorer probe or disposable micro-applicator, for example, Cavibrush (FGM) to remove air bubbles and renew the contact of the gel with the teeth. At the end of the recommended time, remove the gel with a fine suction cannula and wipe teeth with gauze to make them ready to receive a new portion of gel. Repeat steps 4 to 6 for up to two more times (maximum) in the same session, if necessary according to the evolution of the results and monitoring of the patient's sensitivity.

At the end of the session, remove the gel with a fine suction cannula and wash the teeth abundantly. The removal of the gingival barrier can be performed with an exploratory probe or similar. It is recommended to polish the teeth with felt disks, such as Diamond (FGM), Diamond Flex (FGM) and Diamond Excel polishing paste (FGM).

The patient's return appointment should be performed at intervals of 7 days, allowing an effective assessment of the shade of the teeth. If necessary, more whitening sessions can be carried out according to the steps described above. Usually, 2 to 3 whitening sessions are suggested to achieve good results.

To prevent possible dental hypersensitivity during and after treatment, Desensibilize KF2% (FGM) (5% potassium nitrate and 2% sodium fluoride) may be used before the whitening, in a prophylactic way. The option of applying the desensitizer after whitening is also valid, but less effective in certain cases. In both cases (before or after application of the whitening gel), Desensibilize KF2% (FGM) must be applied to the teeth for 10 minutes. In cases of high hypersensitivity after the session, Desensibilize 0.2% (FGM) (desensitizer for at-home use) may be applied by the patient in the tray and used for 10 minutes daily until the symptoms subside.

Monitor the patient throughout the whitening procedure for dental hypersensitivity and possible peroxide irritation spots in soft tissues. Enamel cracks or dentin exposure can lead to sharp and severe pain. In these cases, it is recommended to interrupt the treatment and seek corrective treatment before continuing.

If the result obtained does not meet the expectations and if the patient does not present hypersensitivity or any other contraindication, the reapplication of the product can be done for up to two more sessions, totaling three sessions. If more than one session is required, a minimum interval of 7 days between sessions should be considered.

If the whitening product is being stored under refrigeration, remove it at least 30 minutes before starting the application.

Whitening of non-vital teeth: Before starting the whitening treatment, X-ray the tooth to be whitened to evaluate its condition. Treatment must be within acceptable endodontic standards.

Take and register the shade of patient's teeth using a shade guide and/or photograph before starting the whitening.

Access the pulp chamber by removing all the restorative material, exposing the entrance to the canals with gutta percha. With a clean pulp chamber, deepen the canal entrance by removing approximately 3mm of filling to make the cervical selaing in order to prevent the whitening gel from penetrating into the root canal and diffusing to the periodontium. It is recommended that the cervical selaing is done with a glass ionomer or flowable composite.

Perform absolute or relative isolation with Top dam (FGM) and mix the phases of the Whiteness HP Maxx in the proportion of 3 drops of phase 1 (peroxide) to 1 drop of phase 2 (thickener). Usually 6 drops of peroxide for 2 drops of thickener are sufficient for one application. Shake the thickener bottle vigorously before using it to homogenize its contents. Failure to homogenize the thickener can result in a low viscosity gel (insufficient viscosity).

Apply Whiteness HP Maxx to the buccal surface and inside the pulp chamber with the help of a brush. A layer of approximately 1mm thick is sufficient.

Leave the gel in contact with the dental surface for 15 minutes from the beginning of its application. If you want to use a light source equipment, start using it immediately after applying the gel. For each equipment there is a specific protocol for the time of light exposure. Follow the manufacturer's instructions for the time of application of the light, but respect the protocol for the time of application of the product on the teeth.

Remove the gel with a fine suction cannula before reapplying the product. Up to three gel applications can be done in the same session. After completing the applications, wash and dry the tooth. Temporarily restore the cavity and follow the whitening result for at least a week. If necessary, repeat the applications up to 4 times.

At the end of the whitening process, perform definitive restoration of the whitened tooth. It is recommended to wait a minimum of 7 days before carrying out the restoration (time for tooth color stabilization and elimination of residual oxygen).

The non-vital tooth that was provisionally restored has a weakened crown due to the lack of dental structure inside. Instruct the patient to take care not to fracture the crown of the weakened tooth..

Optionally, after removing Whiteness HP Maxx, you can use the Whiteness Super-endo (FGM) whitening gel (37% carbamide peroxide for internal use) and continue tooth whitening during the interval between sessions with Whiteness HP Maxx.