Changing the color of tooth enamel in the process of orthodontic treatment

Teeth discoloration is a rare orthodontic complication during orthodontic treatment. We present 6-year clinical observation conducted from January 2010 till December 2016. The eighteen orthodontic patients with teeth discoloration took part in this observation. Four patients were excluded from the observation as their teeth discoloration were under orthodontic treatment. During clinical observation period, discovered discoloration was evaluated as «improved» in 4 out of 14 teeth (28.5 %), as «maintained» in 10 teeth (71.4 %). Electroodontodiagnosis conducted during the initial detection period of discoloration showed 14.3 % positivity, which improved to 21.4 % at the final follow-up. The radiological pictures of the teeth showed no abnormalities. Thus, we can assume that teeth with one wide long root canal are more prone to damage to the pulp blood supply. Discoloration is also more frequent in the maxillary teeth, possibly due to the overjet relationship, which may increase susceptibility to trauma in the maxillary teeth. We should keep dynamical observation in the orthodontic practice as teeth color could reverse to the initial without additional interference. 1f discoloration does not improve even after sufficient observation, it is necessary to start orthodontic treatment (endodontic, prosthetic) or bleaching. A patient should be informed that discoloration does not always indicate devitalization or pulp necrosis. Instead of "devitalization" or "pulp necrosis" we recommend to use the term "discoloration".

teeth discoloration, ERT, dynamical observation, pulp, orthodontic treatment, transliteral discolor

1. Chahande RK, Patil SS, Gade V, Meshram R, Chandhok DJ, Thakur DA. (2017). Spectrophotometric analysis of crown discoloration induced by two different sealers: An in vitro study. Indian J Dent Res, 28 (1), 71-75. doi: 10.4103/ijdr.IJDR_630_16.

2. Cho JJ, Efstratiadis S, Hasselgren G. (2010). Pulp vitality after rapid palatal expansion. Am J Orthod Dentofacial Orthop, 137, 254-258.

3. Devji TJ. (2017). Dentifrices specifically formulated for tooth whitening reduce extrinsic toothsurface discoloration Am Dent Assoc. pii: S0002-8177(17)30596-2. doi: 10.1016/j.adaj.2017.06.037.

4. Gonzalez OL, Vera J, Orozco MS, Mancera JT, Gonzalez KV, Malagôn GV. (2014). Transient apical break down and its relationship with orthodontic forces: a case report. JEndod, 40, 1265-1267.

5. Kumar A, Kumar V, Singh J, Hooda A, Dutta S. (2012). Drug-induced discoloration of teeth: an updated review. Indian Clin Pediatr (Phila), 51 (2), 181-185. doi: 10.1177/0009922811421000. Epub 2011 Sep 13.

6. Sano Y, Ikawa M, Sugawara J, Horiuchi H, Mitani H. (2002). The effect of continuous intrusive force on human pulpal blood flow. Eur J Orthod, 24, 159-166.

7. Santos LG, Felippe WT, Souza BD, Konrath AC, Cordeiro MM, Felippe MC. (2017). Crown discoloration promoted by materials used in regenerative endodontic procedures and effect of dental bleaching: spectrophotometric analysis. J Appl Oral Sci, 25 (2), 234-242. doi: 10.1590/1678-77572016-0398.

8. Todd M, Brackett W, Romero M. (2017). Correction of a single discolored anterior tooth due to internal resorption: a clinical report. Compend Contin Educ Dent, 38 (5), 13-16.

9. Xavier SR, Pilownic KJ, Gastmann AH, Echeverria MS, Romano AR, Geraldo Pappen F. (2017). Bovine tooth discoloration induced by endodontic filling materials for primary teeth. Int J Dent, 7401962. doi: 10.1155/2017/7401962.