CDEN0310

I 31 industry report _ Opalescence Treswhite Ortho I cosmeticdentistry 3_2010 Patients under orthodontic treatment are convinced they must maintain their oral health regarding colour and aesthetics. Dentists and patients understand that there is the possibility of generating gingival irritations and dental pig- mentation alterations caused by bacterial plaque accumulation around orthodontic devices, such as brackets, bands and arches, which adds to the processofdecalcificationandtolong-termadverse factors, such as a poor oral hygiene. Conventional home care includes tooth brushing (mechanical or manual), irrigation devices, fluoride mouth rinses, topical fluoride applications and dental floss. But even with all this armamentarium, there is low motivation on behalf of patients.5 The vast majority of these devices and tech- niques used for oral health and hygiene are not implemented by the majority of patients that go at least twice per year to the dental office, and therefore benefits and results are not really signif- icant. We should emphasise other alternatives that add to the above and that with patient awareness could help us improve the oral health of patients undergoing orthodontic treatment. _Health and aesthetics Oral health and hygiene are important factors to keep in mind for patients who are being treated with orthodontic devices; excellent oral hygiene is associated with the desire for appropriate dental aesthetics during and after treatment. By appeal- ing to this desire for optimal aesthetics, we can implement parallel treatments that will maintain optimal periodontal health and at the same time protectteethbyincreasingenamelmicro-hardness and making teeth less decay prone. Owing to the new dental whitening that contains fluoride and potassium nitrate ions, this is possible.5 For these patients, we helped developed a prod- uct called Opalescence Treswhite Ortho (Ultradent, Opal Orthodontics) that prevents decalcification resultingfrombacterialattack,whichisresponsible for carious lesions, and increases enamel micro- hardness. Treswhite Ortho is applied with an entrenched externaltray,whichholdsanotherveryflexibleone for home or in-office use, and is easily adaptable to teeth and brackets topography. This flexible tray contains an 8 % concentration of H2O2, fluoride and potassium nitrate. The flexible tray containing H2O2 shouldbekeptonthebracketsfor45minutes in order to achieve adequate contact time be- tween whitening gel, teeth and brackets. After each45-minutedailysession,thesofttrayiseasily removed from the mouth and discarded, and after that the patient removes any remnants of gel by brushing. Treswhite Ortho is the first dental whitening method that works on fixed orthodontic devices and on preventing enamel demineralisation. The use of H2O2 for bacterial and plaque removal, and gingival tissue healing or scarring removal was proved more than 35 years ago.6–9 Bacteria such Fig. 7_After ten days of whitening treatment we started the removal of the orthodontic devices. Fig. 8_Brackets over the teeth, ready to be removed. Fig. 9_Notice teeth colour in the area in which the bracket was located after the first bracket is removed. Fig. 10_Regular colour under bracket, no colour differences were found. Fig. 11_Colour matching using the VITA Easy Shade spectrophotometer. Fig. 12_Colour matched (B2) showing in the Easy Shade screen. Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12