Internal tooth bleaching, braces
Childhood baseball trauma corrected with braces and internal tooth bleaching
This patient had been hit with a baseball as a child, and the front left central incisor was damaged: the color turned dark, the enamel became brittle and thin, and the tooth got slightly jammed into the socket higher than the adjacent tooth. In order to treat the darkness of the front tooth, root canal therapy and internal bleaching would be a conservative initial approach to whiten the tooth.
To solve the cosmetic defect of the tooth misalignment, we also needed to address the lower teeth: note in the pre-treatment photo the way the lower central incisor below the dark upper one is quite a bit further forward… In order to move the upper central incisor in line with the other teeth on the upper arch, we would first need to move the lower tooth back into alignment with the others in the lower arch.
The patient underwent 11 months of braces followed by some very minor tooth reshaping – mainly to make his canine teeth appear less pointy. The dark color of the tooth was made less obvious by performing root canal therapy with internal tooth bleaching.
Pre-treatment photo: Front.
Pre-treatment photo: Left.
Ortho start: Front.
Ortho start: Left.
Ortho final: Front.
Ortho final: Left.
Post-treatment photo: Front.
Post-treatment photo: Left.
The patient is strongly considering a single veneer to cover and protect this tooth. Check back for changes!
For more cases like this, see our FlickR page at https://www.flickr.com/photos/drcaughey/sets/