INTERNAL TOOTH WHITENING: A COMPREHENSIVE REVIEW

Abstract

Internal tooth whitening, also known as non-vital bleaching, is a widely used technique to address intrinsic discoloration in non-vital teeth caused by trauma, pulpal necrosis, endodontic materials, or other factors. Unlike external whitening, this procedure targets stains within the tooth structure, offering a minimally invasive solution to improve aesthetics. This review explores the history, techniques, materials, efficacy, and complications associated with internal bleaching, with an emphasis on evidence-based practices and advancements in the field. Techniques such as the walking bleach method, in-office bleaching, and combined approaches are discussed, highlighting their effectiveness and limitations. Key materials, including sodium perborate, hydrogen peroxide, and carbamide peroxide, are evaluated for their bleaching efficacy, safety, and risks. Potential complications, such as external cervical resorption and structural weakening, are addressed, along with strategies to mitigate these risks, including the use of intraorifice barriers. Recent innovations, such as biocompatible bleaching agents and digital monitoring tools, have further enhanced the safety and predictability of internal tooth whitening. The review also examines the application of internal bleaching in pediatric and adolescent patients, emphasizing the need for cautious and tailored approaches. Overall, internal tooth whitening remains a reliable and minimally invasive option for restoring the aesthetics of discolored non-vital teeth, provided clinicians adhere to modern protocols and evidence-based practices.