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Zahnmedizin up2date 2009; 3(5): 447-466
DOI: 10.1055/s-0029-1185872
Varia

© Georg Thieme Verlag KG Stuttgart · New York

Farbkorrekturen durch Bleichverfahren

Thomas Attin
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Publication History

Publication Date:
12 October 2009 (online)

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Einleitung

Aufhellungstherapien (Bleichtherapien) von Zähnen stellen einen Teil der ästhetischen Zahnbehandlung dar (Abb. [1]). Während durch Nahrungs- und Genussmittel ausgelöste externe Verfärbungen im Rahmen professioneller Zahnreinigungen entfernt werden können, stellten interne Diskolorationen vitaler oder avitaler Zähne in der Vergangenheit häufig eine Indikation zur restaurativen Versorgung (Überkronung, Veneer, Verblendung mit direkten Verfahren) dar. Als Alternativtherapie zur Korrektur von Zahnverfärbungen oder farbverändernden Strukturanomalien bietet sich in den letzten Jahren zunehmend das Bleichen einzelner oder mehrerer Zähne an, wobei grundsätzlich zwischen Methoden zur Bleichung vitaler (externes Bleichen) und avitaler Zähne (internes Bleichen) unterschieden wird.

Abb. 1 Das Bleichen von Zähnen gehört heute fest zum Repertoire der ästhetischen Zahnheilkunde. Bildquelle: Digital Vision, Symbolbild.

Beim Bleichen wird eine chemisch aktive Substanz verwendet, die die Farbe von Farbpigmenten durch eine Redoxreaktion abschwächt oder verändert. In der Regel handelt es sich bei den eingesetzten Präparaten um Wasserstoffperoxid (H2O2) oder Wasserstoffperoxid-abspaltende Substanzen. Das H2O2 kann in Radikale (H•, O•, OH•, HO2 •), Hydroxyl- (OH−) oder Perhydroxyl-Ionen (OOH−) zerfallen, die dann für die eigentliche chemische Reaktion mit einer farbgebenden Substanz verantwortlich sind [[1]]. Bei den ausgelösten chemischen Reaktionen kann es sich um Redox-Reaktionen handeln, bei denen Farbpigmente oxidiert oder reduziert werden und dadurch ihren Farbcharakter verlieren. Auch sind Spaltungen farbiger Moleküle möglich (z. B. Tetrazyklin). Ein weiterer Angriffspunkt der Peroxide sind ungesättigte C=C‐Doppelbindungen.

Merke: Die durch wasserstoffperoxidhaltige Substanzen ausgelöste Bleichreaktion wird durch Radikale gesteuert, die eine chemische Reaktion auslösen.

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Prof. Dr. Thomas Attin

Direktor der Klinik für Präventivzahnmedizin, Parodontologie und Kariologie der Universität Zürich

Plattenstr. 11

CH-8032 Zürich

Schweiz

Phone: 00 41/4 46 34 32 70

Email: thomas.attin@zzmk.uzh.ch