Reabilitação estética de um elemento dentário anterior com conduto obliterado e escurecimento: um relato de caso.
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Data
2023-12
Tipo de documento
Estudo de Caso
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Modalidade de acesso
Acesso aberto
Editora
Autores
BEZERRA, Ana Beatriz Miranda Costa
ROMÃO, Neuza Ruth Ferreira
Orientador
LIMA, Rodolfo Xavier de Sousa
Coorientador
Resumo
Introdução: A tonalidade escurecida dos dentes anteriores tem um impacto estético significativo na vida dos pacientes, causando limitações sociais e prejudicando a autoestima dos mesmos, devido ao aumento da visibilidade ao sorrir e ao falar. As causas mais frequentes do escurecimento dentário incluem ausência de vitalidade dentária, nutrição, mal desenvolvimento dentário, sendo o traumatismo em dentes anteriores um dos mais frequentes por motivo de serem anatomicamente mais expostos. A obliteração do canal radicular tem consequências tanto estéticas quando anatômicas, causando o escurecimento do elemento dentário e impossibilitando o tratamento endodôntico. Um possível tratamento para dente com canal radicular obliterado é a utilização de técnicas de aplicação de resina composta, capaz de devolver a estética ao sorriso do paciente e preservar o elemento dentário tratado. Objetivo: Descrever um relato de caso de um tratamento estético em um dente anterior com canal obliterado e escurecimento dental causado por trauma, utilizando técnicas de clareamento associada a faceta direta em resina composta. Relato de Caso: O paciente relatou limitações sociais devido à descoloração do dente escurecido, que, juntamente com o diastema, afetava seu sorriso. Para diagnóstico endodôntico foi realizada tomografia computadorizada do tipo cone beam. Diante da incapacidade de clareamento interno, pois o canal se encontra obliterado, optou-se por realizar duas sessões de clareamento externo, com aplicações de 20 minutos com o gel clareador de peróxido de hidrogênio a 35% Whiteness HP (FGM, Joinville, SC, Brasil) associado ao clareamento caseiro supervisionado durante 7 dias, por 2 horas diárias, utilizando o gel clareador da Polanight (SDI, Victoria, Australia), com sua composição de peróxido de carbamida a 10%. Na sequência foi feito tratamento restaurador do tipo faceta direta e fechamento de diastema nos elementos dentários 11 e 21. Um preparo foi realizado visando reduzir a vestibular. Foram utilizadas em todo tratamento as resinas Trans 30 Empress direct (Ivoclar Ultradent, Barueri, SP, Brasil), parede palatina e efeito, BL-XL Dentina Empress Direct (Ivoclar Ultradent, Barueri, SP, Brasil), em dentina, DBL2 (Víttra APS - FGM, Joinville, SC, Brasil), Halo incisal e efeito brancos proximais, WE Filtek Z350XT (3M, Sumaré, SP, Brasil), esmalte vestibular e para opacificar o substrato escurecido foi utilizada a resina Opaquer – Forma (Ultrapack – Ultradent, Indaiatuba, São Paulo, Brasil). Por fim, realizado ajuste oclusal, acabamento e polimento. Ao final do tratamento, a função, a estética e a reinserção social do paciente foram restauradas. Conclusão: A associação de técnicas de clareamento e de resinas compostas pode ser eficaz para tratar dentes unitários anteriores escurecidos.
Introduction: The darkened shade of anterior teeth has a significant aesthetic impact on patients' lives, causing social limitations and damaging their self-esteem, due to increased visibility when smiling and speaking. The most common causes of tooth darkening include lack of tooth vitality, nutrition, poor tooth development, with trauma to anterior teeth being one of the most frequent because they are anatomically more exposed. Obliteration of the root canal has both aesthetic and anatomical consequences, causing darkening of the tooth and making endodontic treatment impossible. A possible treatment for a tooth with an obliterated root canal is the use of composite resin application techniques, capable of restoring aesthetics to the patient's smile and preserving the treated tooth. Objective: To describe a case report of an aesthetic treatment on an anterior tooth with an obliterated canal and tooth darkening caused by trauma, using whitening techniques associated with a direct composite resin veneer. Case Report: The patient reported social limitations due to the discoloration of the darkened tooth, which, together with the diastema, affected his smile. For endodontic diagnosis, cone beam computed tomography was performed. Given the inability to bleach internally, as the canal is obliterated, it was decided to carry out two sessions of external bleaching, with 20-minute applications using the Whiteness HP 35% hydrogen peroxide bleaching gel (FGM, Joinville, SC, Brazil) associated with supervised home whitening for 7 days, for 2 hours a day, using the Polanight whitening gel (SDI, Victoria, Australia), with its composition of 10% carbamide peroxide. Following this, direct facet restorative treatment and diastema closure were performed on dental elements 11 and 21. Preparation was carried out to reduce the buccal gap. The resins Trans 30 Empress direct (Ivoclar Ultradent, Barueri, SP, Brazil), palatal wall and effect, BL-XL Dentine Empress Direct (Ivoclar Ultradent, Barueri, SP, Brazil), in dentin, DBL2 (Víttra APS - FGM, Joinville, SC, Brazil), incisal halo and proximal white effect, WE Filtek Z350XT (3M, Sumaré, SP, Brazil), vestibular enamel and to opacify the darkened substrate, Opaquer – Forma (Ultrapack – Ultradent) resin was used , Indaiatuba, São Paulo, Brazil). Finally, occlusal adjustment, finishing and polishing were carried out. At the end of the treatment, the patient's function, aesthetics and social reintegration were restored. Conclusion: The combination of whitening techniques and composite resins can be effective in treating darkened anterior single teeth.
Introduction: The darkened shade of anterior teeth has a significant aesthetic impact on patients' lives, causing social limitations and damaging their self-esteem, due to increased visibility when smiling and speaking. The most common causes of tooth darkening include lack of tooth vitality, nutrition, poor tooth development, with trauma to anterior teeth being one of the most frequent because they are anatomically more exposed. Obliteration of the root canal has both aesthetic and anatomical consequences, causing darkening of the tooth and making endodontic treatment impossible. A possible treatment for a tooth with an obliterated root canal is the use of composite resin application techniques, capable of restoring aesthetics to the patient's smile and preserving the treated tooth. Objective: To describe a case report of an aesthetic treatment on an anterior tooth with an obliterated canal and tooth darkening caused by trauma, using whitening techniques associated with a direct composite resin veneer. Case Report: The patient reported social limitations due to the discoloration of the darkened tooth, which, together with the diastema, affected his smile. For endodontic diagnosis, cone beam computed tomography was performed. Given the inability to bleach internally, as the canal is obliterated, it was decided to carry out two sessions of external bleaching, with 20-minute applications using the Whiteness HP 35% hydrogen peroxide bleaching gel (FGM, Joinville, SC, Brazil) associated with supervised home whitening for 7 days, for 2 hours a day, using the Polanight whitening gel (SDI, Victoria, Australia), with its composition of 10% carbamide peroxide. Following this, direct facet restorative treatment and diastema closure were performed on dental elements 11 and 21. Preparation was carried out to reduce the buccal gap. The resins Trans 30 Empress direct (Ivoclar Ultradent, Barueri, SP, Brazil), palatal wall and effect, BL-XL Dentine Empress Direct (Ivoclar Ultradent, Barueri, SP, Brazil), in dentin, DBL2 (Víttra APS - FGM, Joinville, SC, Brazil), incisal halo and proximal white effect, WE Filtek Z350XT (3M, Sumaré, SP, Brazil), vestibular enamel and to opacify the darkened substrate, Opaquer – Forma (Ultrapack – Ultradent) resin was used , Indaiatuba, São Paulo, Brazil). Finally, occlusal adjustment, finishing and polishing were carried out. At the end of the treatment, the patient's function, aesthetics and social reintegration were restored. Conclusion: The combination of whitening techniques and composite resins can be effective in treating darkened anterior single teeth.
Palavras-chave
dente escurecido, cavidade pulpar, diastema, resinas compostas, peróxido de carbamida, peróxido de hidrogênio