Opalescence™ PF 16%

Case report by Dr. Clarissa Jänig

Cosmetic tooth whitening is increasing in popularity and is a frequent topic on social media. Increasingly, on their own initiative, patients request information about tooth whitening. Depending on the individual patient case, I recommend different products from the Opalescence™ range: the most suitable product for the patient is selected according to the shape of the dental arch, the personal preferences of the patient – with regard to the wearing times of the trays, their reusability for future "refreshment" treatment – and, last but not least, the financial resources available. 

In every whitening procedure my aim is for a safe procedure, which is closely monitored, and where the gel used strengthens and protects the enamel due to the potassium nitrate and fluoride content.

In this documented patient case, the 28-year-old patient attended our practice for a prosthetic single-tooth restoration in the anterior region. When selecting the tooth shade for his full ceramic single-tooth crown, the patient asked me about whitening the entire row of teeth.

Owing to the corona pandemic, the patient took part in more video conferences at work and noticed a “yellow tinge” of his teeth compared to his colleagues. This led to his desire for a whiter tooth shade and a “bright white smile”. In addition to a brighter tooth shade, he also wished for a procedure that was both simple and safe, that was convenient and could be used at home, as well as being a procedure that was designed for the long term and which he repeat as needed.

The patient has an irregular upper arch with protruding lateral incisers, and as he wishes to whiten his teeth repeatedly – especially as the crown in the posterior region was specifically matched to the new tooth shade – tooth whitening with individual trays and the 16% Opalescence PF gel proved to be particularly appropriate.

Fig. 1: 16% Opalescence™ PF material for use in conjunction with individually manufactured tooth whitening trays.

The individual trays were prepared in the practice laboratory. The initial tooth shade was determined together with the patient at his next appointment: A3

Fig. 2: 28-year-old patient with a nested maxillary front and initial tooth shade A3.

After jointly determining the initial tooth shade, the patient was instructed in the handling of the trays and the material to ensure safe application and tooth whitening.

Fig. 3: Customized trays for the patient, prepared in our own practice laboratory.

Fig. 4: Demonstration and instructions for using the trays and the 16% Opalescence™ PF material.

First, the patient received instruction explaining how he can differentiate between the trays for the upper and lower arch on the basis of the different tooth shapes to ensure correct, self-administered application of the trays in the corresponding arch.

The patient was shown how the gel-like material – in the form of a thin thread – can be applied to the inside of the vestibular surfaces and incisal edges of the trays: a thread of the material in the trays is sufficient for each application.

When the trays are inserted , the material is distributed across the surfaces of the teeth, and is penetrating the tooth surfaces resulting in an even whitening effect after as little as 24 hours.

To ensure that the patient can master handling and filling of the trays, the patient performs the first application in the dental practice, filling the tray with the gel thread and carefully inserting it himself.

It is not necessary to press the trays down in the mouth. The viscous gel exhibits excellent adhesion to the tooth surface the whitening gel from coming into contact with the mucosa as a result of excess gel being pressed out of the custom tray.

Fig. 5: The patient fills the tray by himself and places it in his mouth.

Fig. 6: The patient wears the trays filled with 16% Opalescence™ PF material.

The patient should wear the trays at home for between 4 and 6 hours a day. The average duration of use is 5 to 10 applications, depending on how long the trays are worn each day and the individual tooth substance. Should sensitivities occur, which are always reversible, the patient should discontinue the application for one day and continue after a pause on the following day.

Following a demonstration and self-application of the trays in the practice, the patient removes the trays, rinses his mouth well and then brushes his teeth thoroughly to remove any remaining gel residue from the teeth. Then the patient is discharged with three syringes of Opalescence PF material (16%) and given an appointment for a post-application follow-up.

Fig. 7: The patient removes the tray from the upper arch.

Fig. 8: The patient removes the tray from the lower arch.

After his vacation, the patient presented brimming with enthusiasm at the follow-up appointment in the practice, stating that he found handling uncomplicated and easy, that no sensitivities had occurred and that he had often been asked by friends about his bright teeth.

The patient recounted that he had taken his trays with him on vacation and had used the outward journey in the car to wear the trays. While wearing the trays for several hours on the trip, he was able to talk to his fellow passengers without any difficulties and did not find the trays disturbing or unpleasant. In total, he wore the trays on six consecutive days for about four hours each time – and the results are impressive: tooth shade B2.

Fig. 9: The result and the new tooth shade are evaluated with the patient: B2.

Fig. 10: Result after six applications: B2.

Fig. 11: Result after six applications: B2.

The patient was highly satisfied with the result, which was so obvious that he was asked about the brighter tooth shade by colleagues in subsequent video conferences and several of his friends had also asked him about the application and the product because of his whiter teeth. He was particularly enthusiastic about the product's ease of use, the positive results of his tooth whitening having been noticed by other people, and the multiple positive feedback from his friends and colleagues.

Learn more about Opalescence^TM at www.ultradent.com/eu

About the author

• Study of dentistry in Bonn, Germany
• Employed dentist since 2012
• Specialized in orthodontics

Dr. Clarissa Jänig

Cologne, Germany