Whiteness Perborato is a whitening system developed exclusively for whitening of non-vital teeth through the application inside the pulp chamber (walking bleach technique). The product combines the action of powdered sodium perborate mixed with a solution of hydrogen peroxide at 20%, which together form a paste with excellent whitening power. Sodium perborate was one of the first whiteners used for non-vital teeth, and it has been classified as one of the safest means for this type of whitening. The difference of Whiteness Perborato is that it has the characteristic of forming a paste in the ideal consistency to be applied in the pulp chamber without the inconvenience of running and hindering the process of provisional sealing of the tooth.
Characteristics and Advantages
• Easy homogenization: the perborate powder is ground to be the finest on the market, and it has a thickener in its composition.
• Ease of application: ideal viscosity after homogenization.
• Effective: works effectively in removing unwanted pigments from non-vital teeth.
• Safety: sodium perborate-based products are recognized as safe for whitening non-vital teeth.
• Versatility in the formation of the paste: it can be mixed in the proportion of 1 part of powder to 1 part of hydrogen peroxide or 2 portions of powder to one drop of peroxide.
• Various mixing options: it can be mixed with hydrogen peroxide that comes with the product, with distilled water, or with saline.
• Whiteness Perborato is indicated for whitening of non-vital teeth that have become darkened, generally as a consequence of endodontic treatment or trauma. A careful evaluation of the endodontic treatment must be made, as to whether there is sufficient coronal structure for tooth whitening, absence of extensive restorations on the tooth to be whitened, adequate access to the pulp chamber, and absence of periodontal problems.
Step by Step
Make sure, clinically and radiographically, that the endodontic treatment is appropriate. Take the color of the tooth of the patient using a shade guide and/or photo before starting the whitening.
Make the opening of the pulp chamber and clean it thoroughly, removing all the restorative material.
Remove 3 to 4mm of filling material from the root canal and do cervical sealing of approximately 2mm – it is recommended to use glass ionomer (e.g. Maxxion R – FGM) or a zinc phosphate cement. The seal should be 1 to 2mm below the cervical margin and aims to prevent the passage of whitener to the periodontium. The cervical seal is a critical step in the process and must provide a perfect seal.
Prepare the Whiteness Perborato paste by mixing 2 level portions of powder (phase 1) with 1 drop of peroxide solution (phase 2).
1 – Alternatively, the liquid phase (peroxide at 20%) can be substituted for distilled water or saline – in this option, the product may be slightly slower, although the end result is the same;
2 – If you want a less viscous mixture, use a ratio of 1 part of powder to 1 part of liquid. Use a glass or plastic surface and a clean spatula for mixing.
Apply Whiteness Perborato inside the pulp chamber (directly from the applicator tip of the syringe) and prepare a small flattened ball (or web) of cotton a position it in the cavity over the whitener. Next, seal the cavity with restorative material. Check the patient’s occlusion in movements of protrusion and laterality. Premature contact may fracture the temporary restoration and/or tooth.
Evaluate the case after 3 or 4 days. If necessary, repeat the applications, reevaluating every 3 or 4 days. The number of application can be up to 8 times, depending on the development of the case.
1- Always observe the development of results after each application. If the results do not progress from one application to the next, then there is evidence that the whitening has reached its limit;
2 – If you have not obtained the results or if the progress of the whitening is very slow, check whether all the restorative material was effectively removed from the pulp chamber. Incomplete removal of restorative material inside the pulp chamber may prevent the action of the whitener, thus undermining the whitening.
After the whitening treatment is completed, it is recommended that you wait at least one week before performing the definitive restoration.
1 – Instruct the patient about the fragility of the non-vital tooth in treatment and prevent possible accidental fracture.
2 – For cases of non-vital teeth which are too weakened for removal of the dental structure, we recommend implantation of a reinforcing intraradicular post (Whitepost- FGM).
Whiteness Perborato is a whitening gel developed exclusively for whitening of non-vital teeth through the application inside the pulp chamber (walking bleach technique).
Whiteness Perborato is indicated for whitening of non-vital teeth that have become darkened, generally as a consequence of endodontic treatment or trauma.
You can perform a maximum of 8 applications.
Alternatively, the liquid phase (peroxide at 20%) can be substituted for distilled water or saline – in this option, the product may be slightly slower, although the end result is the same.
To form a more viscous paste, use the proportion of 1:1, and for a less viscous paste, use 2:1 (powder and liquid, respectively). The concentrations of peroxide are slightly altered, but the end result of whitening remains unchanged.
After 3 to 4 days. If needed, apply the product again.
Information for the Professional
• Use during pregnancy and breastfeeding is not recommended.
• The product is not recommended for patients who have a history of internal and/or external resorption.
• Always use X-rays to check the health condition of the dental element before starting treatment. If any anomaly is suspected, check whether it can be treated first.
• Do not use the technique and the product in cases of incomplete rhizogenesis.
• In cases of periapical lesions, there must be a supervision and evaluation by an endodontist.
• Teeth which have suffered trauma may suffer root resorption due to the effect of the trauma itself. Whitening of elements with this history should be done with particular attention and with the awareness that a failure in the whitening process may potentiate or trigger the resorption process.
• The product is not recommended for cases of calcification of the pulp chamber and the root canal.
• Pay special attention to obtaining an efficient cervical seal. This element will be responsible for preventing the peroxide from reaching the root portion of the tooth and, consequently, the periodontal ligaments. Failure in this seal may lead to root resorption processes.
• Use of direct heat for acceleration of the whitening process is not recommended. The combination of techniques of external use (whitening with hydrogen peroxide at 35%, for example) can be done, but each product must be applied according to its instructions.
• Use only the peroxide solution that comes with the product. Other more concentrated solutions or those with other additives may result in reactions other than those intended for the product and are not recommended.
• In cases of trauma, the color may return after whitening.
• Inform the patient about the possibilities of success and failure for the whitening. Prevent the possibility of frustrating the patient’s expectations.
• Teeth with specific colorations (intense brown, gray, or stained with tetracycline), as well as teeth of elderly patients, may have a slower or inferior response to the whitening process.
• Non-vital teeth in whitening treatment have their structure weakened due to the removal of the restorative material from inside the pulp chamber. Guide the patient to be careful and prevent accidental fracture of the element.
• It may cause irritation in case of contact with skin or eyes. Ingestion may cause gastric irritation.
• Wear gloves and safety glasses when applying the product. Prevent accidents.
• As with other whitening gels, Whiteness Perborato does not whiten restorative materials.
• Teeth with extensive destruction of the crown should not be subjected to whitening.
• During the treatment, a certain sense of pressure may occur inside the tooth, due to the formation of gases in the peroxide’s decomposition process.
• Incorrect cervical sealing of the root canal may allow peroxide to reach the periodontal ligaments, causing pain and even root resorption. • Instruct the patient to tell you of any sensation of pain in the element being treated, and correct or treat immediately in this case.
• Store the product at temperatures of 5 to 25° C.
• Do not freeze the product.
• Protect it from direct sun light.
• The validity period is 2 years from the date of manufacture.
• Do not use the product after its expiration date.