Klinička efikasnost miksture natrijum-perborata i vodonik-peroksida za intrakoronarno izbeljivanje depulpisanih zuba

Introduction/Objective the aim was to evaluate initial efficiency of sodium perborate (tetrahydrate) and 30% hydrogen peroxide mixture for intracoronal non-vital teeth bleaching ("walking bleach" technique). Methods Forty patients with discolored teeth were included in the study. Based on their history and clinical examination, causes of discoloration were classified as necrotic pulp, "endo-sealer" or unknown. The "walking bleach" technique was performed by applying sodium perborate (tetrahydrate) and 30% hydrogen peroxide mixture intracoronally to cavity dentin walls. The mixture was renewed in seven-day intervals. Tooth color was assessed visually before, during, and after the procedure using the Vita Classical shade guide (Vita Zahnfabrik, Bad Säckingen, Germany). Numerical values or shade guide units (SGU) were assigned to Vita shade tabs on a bright-dark scale. Analysis of variance, t-test, correlation and regression analysis were used to analyze the data (p lt 0.05). Results on average, 26 ± 9 days or 3-4 appointments were required for intracoronal bleaching to achieve the desired or best possible shade. Better clinical efficiency was found in the necrotic pulp group (17 ± 6 days; 8 ± 3 SGU) than in the "endo-sealer" group (42 ± 13 days; 4 ± 2 SGU) (p lt 0.05). Age significantly influenced bleaching efficiency (p lt 0.05). There was no significant correlation between bleaching efficiency and initial shade (p > 0.05). Conclusion Intracoronal, non-vital teeth bleaching ("walking bleach" technique) using sodium perborate (tetrahydrate) and 30% hydrogen peroxide mixture showed satisfactory clinical efficiency. Discoloration caused by pulp necrosis was treated more efficiently than that caused by endodontic sealers. Younger age had a positive effect and discoloration intensity had no effect on bleaching efficiency.Cilj Cilj ovog rada je da ispita inicijalnu kliničku efikasnost miksture natrijum-perborata (tetrahidrata) i 30% vodonik-peroksida za intrakoronarno izbeljivanje depulpisanih zuba (,,šetajuća" tehnika). Metode U studiju je bilo uključeno 40 pacijenata sa prebojenim zubima. Na bazi anamneze i kliničkog pregleda, uzroci diskoloracije su klasifikovani kao "nekrotična pulpa", ,,endo-siler" ili ,,nepoznat". U intervalima od sedam dana mikstura natrijum-perborata i 30% vodonik-peroksida aplikovana je intrakoronarno na dentinske zidove kaviteta. Boja zuba je procenjivana vizuelnom metodom pre, tokom i posle tretmana primenom ključa boja Vita Classic (Vita Zahnfabrik, Nemačka). Numerička vrednost (jedinica nijanse) dodeljena je svakoj nijansi ključa Vita pomoću svetlo-tamne skale. Analiza varijanse, t-test, korelaciona i regresiona analiza su korišćene za statističku obradu podataka (p lt 0,05). Rezultati Prosečno 26 ± 9 dana ili 3-4 posete su bile neophodne da se intrakoronarnim izbeljivanjem postignu željena ili najsvetlija moguća nijansa. Bolja klinička efikasnost izbeljivanja zabeležena je u grupi ,,nekrotična pulpa" (17 ± 6 dana; 8 ± 3 nijansi) nego u grupi ,,endo-siler" (42 ± 13 dana; 4 ± 2 nijanse) (p lt 0,05). Uzrast pacijenta je značajno uticao na efikasnost izbeljivanja (p lt 0,05). Nije utvrđena značajna povezanost između efikasnosti izbeljivanja i početne nijanse (p > 0,05). Zaključak Intrakoronarno izbeljivanje depulpisanih zuba odnosno "šetajuća" tehnika izbeljivanja primenom miksture natrijum-perborata (tetrahidrata) i 30% vodonik-peroksida pokazala je zadovoljavajuću kliničku efikasnost. Diskoloracija usled nekroze pulpe je uspešnije izbeljena nego diskoloracija izazvana endodontskim pastama. Efikasnije izbeljivanje je zabeleženo kod mlađih pacijenata, dok intenzitet početne diskoloracije nije značajno uticao na efikasnost izbeljivanja