Esthetic Outcome of a Universal Shade Resin Composite Placed Before Nonvital Tooth Bleaching

SUMMARY Discoloration of endodontically treated teeth presents a common concern in dental practice. Attaining an accurate color match between discolored teeth and direct resin composite restorations is fraught with complications, particularly in cases where nonvital tooth bleaching is warranted. Specifically, when a resin composite restoration is required prior to the bleaching process, such as in instances of carious lesions or defective restorations, the eventual coloration of the tooth subsequent to bleaching procedures remains uncertain. Objective: In this case report, we describe the use of a universal shade resin composite to restore a discolored tooth before nonvital tooth bleaching. The intent of this procedure is to maintain an acceptable color match, eliminating the need for subsequent replacement of the restoration after bleaching. Methods: A substantial defective Class IV resin composite was removed from a discolored, endodontically treated tooth #8. The existing gutta percha was sealed with glass ionomer, and 35% Thanawat Ruaydee, DDS MSc, Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Nahon Pathom, Thailand hydrogen peroxide gel was applied in the access chamber. The access cavity was temporarily sealed with a flowable resin composite and the entire tooth was restored with a group-shade universal resin composite. After a two-week bleaching period, the bleaching gel and temporary filling in the access cavity were replaced with the same universal shade resin composite, without necessitating the complete replacement of the entire restoration. Results: A favorable outcome was noted during a one-year follow-up period, with the bleached tooth maintaining a harmonious color and the resin composite restoration exhibiting a stable and satisfactory condition. Conclusion: The clinical use of a universal shade resin composite before bleaching exhibited significant promise in facilitating an effective color match in a discolored tooth after bleaching. This method may substantially diminish the need for restoration replacement due to challenges associated with color discrepancies.