Intracoronal Bleaching

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

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