What is tetracycline tooth and how should tetracycline tooth be treated?
1¡¢ Overview of diseases
Tetracycline is an antibiotic synthesized by chlortetracycline catalyzed Dehalogenation. It has low toxicity and has been used in clinic since 1948. In 1950, tetracycline drugs were reported to cause tooth coloring; It was reported that tetracycline was deposited on teeth, bones and even nails, and could also cause enamel hypoplasia. In this regard, it was not until the mid-1970s that attention was paid in China.
Tetracycline drugs, such as tetracycline, oxytetracycline, chlortetracycline, phloromycin, and doxycycline, can be combined into the tooth tissue during tooth development and mineralization to make the tooth color yellow brown or dark gray.
3¡¢ Clinical manifestations
1. It is yellow, showing bright yellow fluorescence under sunlight, and then gradually changing from yellow to brown or dark gray. This transition is slow and can be promoted by sunlight, so the labial surface of incisors changes color first.
2. The color of anterior teeth is more obvious than that of posterior teeth; The color of deciduous teeth is more obvious than that of permanent teeth, because the enamel of deciduous teeth is thin and transparent, and it is not easy to cover the color of tetracycline conjugates in dentin.
3. The degree of tooth coloring is related to the type, dosage and administration times of tetracycline. It is generally believed that tetracycline, nortetracycline and tetracycline hydrochloride cause more obvious coloration than oxytetracycline and chlortetracycline. In permanent teeth, the number of courses of tetracycline is directly proportional to the degree of staining, but the effect of a short-term high dose is greater than that of a long-term total dose.
4. Tetracycline can cause tooth coloration and enamel hypoplasia, which can only be seen during tooth development. Generally speaking, after the age of 6-7 years, the drug does not cause noticeable tooth discoloration.
4¡¢ Treatment
1. Visible light composite resin restoration method can refer to the treatment of dental fluorosis, but it can only remove 0.1 mm of labial enamel or no teeth, because tetracycline staining is mainly in the dentin. If the enamel layer is too much, or even the dentin is exposed, it will not only aggravate the background color, but also seriously affect the bonding firmness. For tetracycline stained teeth, this method is not satisfactory because of the poor shading effect.
2. The decolorization method can be used for those without enamel defect. It can be divided into external decolorization and internal decolorization.
(1) External decolorization: clean the tooth surface and apply vaseline to the gingival margin; The paper soaked in 30% hydrogen peroxide solution should be applied on the labial surface of the anterior teeth with a little distance from the gingival margin; Exposure to infrared or incandescent lamp for 10 minutes; The course of treatment was 5-8 times. The results showed that external decolorization could not weaken the stained fluorescent band of dentin, but the tooth color was improved by naked eye observation. Generally, the tooth color could recover after 0.5-1 year. Because of the high concentration of hydrogen peroxide solution, the enamel can be etched and demineralized, showing a chalky color, reducing the original transparency of the enamel, and reducing the reflection of the stained dentin; As time goes on, enamel remineralizes; The transparency increases and the color recovers, which is the important reason for the so-called color rebound.
(2) Internal decolorization method: pulpectomy is performed for the purpose of decolorization. After conventional pulpectomy, the root canal filling material is reduced to 2-3mm below the neck. When decolorizing, 30% hydrogen peroxide solution or paste made of 30% peroxide solution and sodium borate is sealed in the pulp chamber. The dressing was changed once every three days for about 4-6 times; When the color is satisfied, the cavity is filled with composite resin. This method can effectively remove or change the tetracycline content in dentin, the fluorescence level is significantly reduced, and the clinical effect is very satisfactory. This method can be used for those who are in urgent need of beauty and without enamel defect due to professional relationship. The disadvantage of this method is that it makes vital pulp teeth become pulpless teeth. Although the short-term effect is reliable, the long-term effect remains to be observed.
3. All ceramic crown or PFM crown.
4. Porcelain veneer.
Note: please consult a professional dentist for details.
Tetracycline is an antibiotic synthesized by chlortetracycline catalyzed Dehalogenation. It has low toxicity and has been used in clinic since 1948. In 1950, tetracycline drugs were reported to cause tooth coloring; It was reported that tetracycline was deposited on teeth, bones and even nails, and could also cause enamel hypoplasia. In this regard, it was not until the mid-1970s that attention was paid in China.
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Tetracycline drugs, such as tetracycline, oxytetracycline, chlortetracycline, phloromycin, and doxycycline, can be combined into the tooth tissue during tooth development and mineralization to make the tooth color yellow brown or dark gray.
3¡¢ Clinical manifestations
1. It is yellow, showing bright yellow fluorescence under sunlight, and then gradually changing from yellow to brown or dark gray. This transition is slow and can be promoted by sunlight, so the labial surface of incisors changes color first.
2. The color of anterior teeth is more obvious than that of posterior teeth; The color of deciduous teeth is more obvious than that of permanent teeth, because the enamel of deciduous teeth is thin and transparent, and it is not easy to cover the color of tetracycline conjugates in dentin.
3. The degree of tooth coloring is related to the type, dosage and administration times of tetracycline. It is generally believed that tetracycline, nortetracycline and tetracycline hydrochloride cause more obvious coloration than oxytetracycline and chlortetracycline. In permanent teeth, the number of courses of tetracycline is directly proportional to the degree of staining, but the effect of a short-term high dose is greater than that of a long-term total dose.
4. Tetracycline can cause tooth coloration and enamel hypoplasia, which can only be seen during tooth development. Generally speaking, after the age of 6-7 years, the drug does not cause noticeable tooth discoloration.
4¡¢ Treatment
1. Visible light composite resin restoration method can refer to the treatment of dental fluorosis, but it can only remove 0.1 mm of labial enamel or no teeth, because tetracycline staining is mainly in the dentin. If the enamel layer is too much, or even the dentin is exposed, it will not only aggravate the background color, but also seriously affect the bonding firmness. For tetracycline stained teeth, this method is not satisfactory because of the poor shading effect.
2. The decolorization method can be used for those without enamel defect. It can be divided into external decolorization and internal decolorization.
(1) External decolorization: clean the tooth surface and apply vaseline to the gingival margin; The paper soaked in 30% hydrogen peroxide solution should be applied on the labial surface of the anterior teeth with a little distance from the gingival margin; Exposure to infrared or incandescent lamp for 10 minutes; The course of treatment was 5-8 times. The results showed that external decolorization could not weaken the stained fluorescent band of dentin, but the tooth color was improved by naked eye observation. Generally, the tooth color could recover after 0.5-1 year. Because of the high concentration of hydrogen peroxide solution, the enamel can be etched and demineralized, showing a chalky color, reducing the original transparency of the enamel, and reducing the reflection of the stained dentin; As time goes on, enamel remineralizes; The transparency increases and the color recovers, which is the important reason for the so-called color rebound.
(2) Internal decolorization method: pulpectomy is performed for the purpose of decolorization. After conventional pulpectomy, the root canal filling material is reduced to 2-3mm below the neck. When decolorizing, 30% hydrogen peroxide solution or paste made of 30% peroxide solution and sodium borate is sealed in the pulp chamber. The dressing was changed once every three days for about 4-6 times; When the color is satisfied, the cavity is filled with composite resin. This method can effectively remove or change the tetracycline content in dentin, the fluorescence level is significantly reduced, and the clinical effect is very satisfactory. This method can be used for those who are in urgent need of beauty and without enamel defect due to professional relationship. The disadvantage of this method is that it makes vital pulp teeth become pulpless teeth. Although the short-term effect is reliable, the long-term effect remains to be observed.
3. All ceramic crown or PFM crown.
4. Porcelain veneer.
Note: please consult a professional dentist for details.