Custom Fit Bleaching Tray


This video will demonstrate the
fabrication of a custom-fit bleaching tray with reservoirs. We will be using a stone model of the dentition. Since it will be placed on a vacuum
former we do not need a base for this model. The
model can be in a horseshoe-shape as demonstrated here. Excess stone must
be trimmed from the alveolar ridges using the model trimmer. This will help the vacuum former to
adapt the tray material closely to the teeth. For the maxilla a hole can also be
drilled in the palette. The trimmed models
should look like these. Apply block-out resin to the facial
surfaces of the maxillary teeth only. This is to
avoid orthodontic forces on the mandibular
teeth. Squeeze out a 1 millimeter thick layer a resin on each tooth, but do not cover the entire tooth
surface. Stay 1 millimeter away from the gingival margin and avoid covering the incisal and occlusal edges. Avoid filling the interproximal
surfaces. Use a fine brush if necessary to spread the resin. You have unlimited
working time to apply the resin because it will not set until cured with
a curing light. Cure the block-out resin for 10 seconds
per tooth with the curing light. Protective eyewear must be used while
curing. After the curing is complete wipe the
resin with a damp towel to remove the residue. Center the model on the vacuum former. Lift the frame and insert the tray
material. Clamp the frame shut to secure the material. Swing the
heating element into place above the tray material. Turn on the
heater. While heating do not touch the clamp
area with your hands. Allow the tray material
to heat until it sags to 1 inch below the
edge of the frame. Immediately turn off the heater and swing it away from the tray
material. Turn on the vacuum and push the clamp down onto the vacuum,
and leave for 30 seconds. Air pockets and folds can be pushed out using a damp paper towel and your
fingers. Do not touch the hot tray material
directly with your fingers. Allow the tray to
cool for 1 minute. The tray can also be cooled under running
water. Using a pen trace the line of the gingival margin on the facial
surfaces of the tray. Do not trace above the gingival margin. This will be the cutting line. On the
palatal surface draw a straight line at the gingival
margin. You will not be scalloping these edges. After removing the tray from the model cut along the pen lines using the curved
scissors. Scallop around the papillae. On the palatal surface cut along the straight line at the
gingival margin. Check that all the edges of the tray are
smooth. Wipe off the pen marks with alcohol soaked gauze. Spray the tray with disinfectant and
rinse well before trying in the patient’s mouth. When the patient is ready to use the
tray for bleaching a dot of bleach is added to the facial
surfaces up the tray. More bleach material does not result in faster bleaching. In
fact it can result in gingival sensitivity as the excess bleach is pushed out
apically.

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