Bleaching Teeth Treated Endodontically: Long-Term Evaluation of a Case Series

By Amato M, Scaravilli MS, Farella M, and Riccitiello F

Date: 01/2006
Journal: JOE


To observe the long-term chromatic stability of internally bleached teeth


N= 50 non-vital, discolored teeth (no tetracycline stains included)

Isolation, access, removal of gutta percha 2- 3 mm and filled with zinc oxyphosphate cement, sodium perborate/hydrogen peroxide inserted into the pulp chamber and photocatalyzed at 50 % intensity, two more cycles of bleaching agent and photocatylization. Finally, bleach mixture without photoactivation sealed into the chamber with temporary cement (Coltosol). Procedure repeated once a week for 4 weeks or until the tooth was slightly lighter than the adjacent teeth. Weeks after last bleaching session, the tooth was restored with LC composite resin (Prodigy) of a lighter shade than the tooth. 16 year follow-up. Failure was defined as a color change of 2 or more units


  • 7 lost to follow-up, 14 required prosthetic following crown fracture, 1 required EXT following “crown or root” fracture
  • 62.9 % remained stable and similar to adjacent teeth; remaining 37.1 % failed due to color relapse
  • Of the failures, 46.2 % said they were satisfied and did not intend to bleach again; 53.8 % said they noticed the change, but did not seek more bleaching
  • None observed to have internal or external resorption

Clinical Significance:

16 year long-term stability following walking bleach procedures is observed, though it may make the tooth more susceptible to fracture