User Report – BRILLIANT Lumina
INNOVATIVE TECHNOLOGY FOR BRIGHTENING A SMILE PROF. GIANNA MARIA NARDI - Associate Professor, Sapienza University, Rome MANUELA PIPICELLI - Dental hygienist FEBRUARY 2025 Health-sector operators devoted to healthcare often find themselves having to choose clinical operating protocols which have to combine health and a beautiful smile, which is an important factor in interpersonal relations. You absolutely must explain to the patient the importance of achieving effective levels of oral health management in order to proceed with cosmetic treatments that improve the radiance of the smile. Gradual yellowing of tooth surfaces is considered to be a physiological change that occurs with the passage of time. The need for the patient to maintain a pearly, radiant smile means that a motivational approach to proper oral hygiene routines and eating habits must be provided, together with detection of any dental enamel lesions. Therefore, the first step of a cosmetic treatment is for the patient to undergo a thorough dental examination in order to assess their state of health. Once the diagnosis and indication has been received, the dental hygienist can prepare a personalised preventive treatment plan based on clinical needs and select the most appropriate cosmetic treatment.
The patient we are considering is a 55-year-old woman who is a non-smoker in good health, with vestibular gingival recession in various locations and significant sensitivity. Her request was that she wanted to have a more radiant smile for her daughter's wedding photos. During the objective examination, slowly progressive stage II grade A periodontitis was diagnosed, without any loss of dental elements, and recession type 2, without any involvement of the interdental papillae and/or bone loss. Gingival recession is defined as the apical migration of the gingival margin, leaving the root of the tooth exposed and often causing sensitivity.
Its cause may be either physiological or traumatic, with this being determined through close analysis of the clinical case and based on the history-taking. Lifestyle, oral hygiene habits, previous illnesses, current illnesses and heredity are key factors determining correct diagnosis and selection of the most appropriate rehabilitation
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treatment. The patient reported it having been proposed by the periodontist that she undergo mucogingival periodontal surgery, as per the diagnosis and the operating plan. Furthermore, home treatment was suggested, based on desensitising and remineralising products to be applied to the exposed surfaces.
In addition, we explained the importance of following the maintenance protocols scheduled by the specialist staff and the importance of undergoing regular checkups. The patient refused to undergo gum grafting and decided to opt for palliative support therapy, frequent check-ups and non-invasive local densensitising techniques. After performing the objective examination of the oral cavity and noting the clinical indices, we then moved on to the motivational approach. After applying the three-tone plaque disclosing gel, we showed the patient the topography of the bacterial biofilm and she agreed to pay close attention to the most retentive sites. We assessed the degree of dental sensitivity by means of the air blast test and tactile stimulation, obtaining a score of 2 on the Schiff scale and 7 on the visual analogue scale. We carried out decontamination of the oral cavity using an air polishing handpiece and subsequently removed the tartar in soft mode in order to avoid increasing the sensitivity of the exposed areas. This enabled both effective and careful movements to be performed, thereby reducing the extent of the ultrasound oscillations, notably reducing the perceived sensitivity. (mectron combi touch)