Opalescence Endo – Non-Vital “Walking Bleach”

Opalescence Endo
Opalescence Endo is a 35% hydrogen peroxide specially formulated for the medical “walking” bleach technique.

Use Opalescence Endo to whiten endodontically treated, internal discolored teeth caused by disease, injury, or medical treatment.

Procedure:

The most critical factor in non-vital bleaching is to not place whitening material below the alveolar crestal bone and to seal the obturating material to protect the endodontic seal.

  1. Examine the radiograph to establish adequate apical endodontic seal and the height of the alveolar crestal bone.
  2. Establish the expectations of the patient. Explainany esthetic limits before proceeding.
  3. Remove all filling material from the accessopening to the level determined from the radiograph. All restorative material, temporary and/ or endodontic filling material must be removed to allow bleaching agent to contact the internal tooth structure for optimal results.
  4. Mix conventional glass ionomer with a powder to liquid ratio that creates a firm putty (NOTE: It should be firm enough to roll between fingers and thumb). Place 1-2mm thick to assure a seal.
  5. Attach Black Mini tip to syringe and express Opalescence Endo into the pulp chamber avoiding soft tissues. Place tiny cotton pellet into gel.
    Leave 1.0 to 1.5mm of space to accommodate the provisional restoration. Do not place Opalescence Endo on oral tissues. Should contact occur, rinse immediately with lots of water.
  6. Place a noneugenol provisional restorative material to seal the access opening, Ultradent recommends using UltraTemp. Verify occlusal clearance in protrusive and laterotrusive movements. Premature occlusal contact may
    fracture the provisional restoration resulting in leakage and loss of bleaching material.
  7. Repeat the procedure every 3 to 5 days until the desired color change is achieved.
  8. Dispose of empty syringes properly.
  9. Wait 8-10 days before restoring the tooth. This will allow the shade of the tooth to stabilize.
  10. Remove provisional restorative material and bleaching material to level of glass ionomer sealing material. Rinse and clean access opening. Restore with adhesive dentistry procedures.

Precautions:

  1. Slightly over bleaching the tooth is recommended as some regression of whitening will occur.
  2. Understand each patient’s expectations before beginning treatment.
  3. Material is not to be injected.
  4. For dentist storage, material should be refrigerated to maintain shelf life. Keep Opalescence Endo out of heat and/or direct sunlight.
  5. Dispose of empty syringes properly.
  6. Keep out of reach of children.
  7. If patient has known allergy or chemical sensitivity to peroxides, carbopol, glycerine, etc, do not use Opalescence Endo.
  8. Keep Opalescence Endo away from soft tissues.
  9. Inform patients to be careful not to swallow gel. Product contains peroxide; swallowing large amounts can be harmful.

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