Éclaircissement des dents dépulpées et résorption cervicale externe : comprendre pour mieux prévenir

Although whitening of depulped teeth is an ancient therapy, today the use of this procedure has increased substantially; it is based on two types of bleaching agents: hydrogen peroxide, and sodium perborate. External cervical resorptions (ECRs) are complications that may occur sometimes (3.9% to 9.7% reported rates in published studies). The aetiology is complex, probably multifactorial, imperfectly known, and many hypotheses have been proposed to explain their occurrence (antigen-antibodies reaction to dentin denaturation, irritation and periodontal lesion, bacterial contamination, direct intervention within the osteoclastic differentiation procedure). Several combined parameters seem to be involved in ECR occurrence. Overall ECR classification includes: vulnerability factors (anatomy of the cementoenamel junction, history of dental events such as traumas, or therapies such as orthodontic procedures or surgery), and promoting factors (related to the endodontic therapy and/or to the whitening procedure protocol). It should be noticed that the use of hydrogen peroxide as active agent is a necessary but non sufficient condition for ECR triggering. The aim of the present paper is to highlight the aetiopathogenic mechanisms of those ECRs occurring consecutively to internal whitening in order to better identify the factors on which the practitioner may act to prevent their occurrence.