Use of ultrasound Doppler to determine tooth vitality in a discolored tooth after traumatic injury: its prospects and limitations
A 22-year-old female patient visited our department to have her teeth bleached. She thought her teeth were generally yellowish, and she was especially unsatisfied with the shade of tooth #11, which showed yellowish brown discoloration (). She reported experiencing trauma to her anterior teeth when she was in primary school, and she had finished orthodontic treatment approximately 7 years before presentation. However, she did not know exactly when tooth #11 started to become discolored. In the radiograph, the coronal pulp space was obliterated, whereas the pulp space was present in the root area. There was no radiolucency in the periapical region, but the root apex was slightly shortened (). In the cold test, tooth #11 did not show any response, although she occasionally displayed a delayed response. The tooth did not respond to the EPT. In the ultrasound Doppler test, tooth #11 showed an image and sound typical of a vital tooth (). We decided to perform vital tooth bleaching first and then re-evaluate the color to decide whether restorative treatment was needed. Home bleaching was started using 15% carbamide peroxide gel (Opalescence, Ultradent, South Jordan, UT, USA). Additional home bleaching was continued only for tooth #11 after she was satisfied with the shade of her other teeth. After approximately 2 months of bleaching, she was satisfied with the shade of tooth #11 and did not want any further treatment ().