Guideline 3308, Information for the dentist Page 1 of 8 VISALYS Whitening The product VISALYS Whitening is a gentle, hydrogen-peroxide based two-chamber dental whitening system for use on vital and non-vital teeth. VISALYS Whitening bleaches vital and non-vital teeth particularly gently, using a variety of materials and techniques. VISALYS 7,5 and VISALYS 13,5 remove discoloration rapidly and permanently and are specially formulated for compatibility. Rare occurrences of tooth and mucosal irritation are reduced to a minimum. Along with the established products VISALYS 7,5 and VISALYS 13,5 a highly concentrated version of the classic in-office bleaching is available as of September 2008: VISALYS 30 CHAIRSIDE. VISALYS 30 CHAIRSIDE offers the option of whitening teeth in just one session. VISALYS Whitening must be applied under the supervision of a dentist. This is why patients, who have not yet considered this type of dental care, will be reassured about VISALYS Whitening treatment. Though all products are based on hydrogen peroxide, but the concentration as well as method and duration of application differ. Lasting, good results are achieved when teeth whitening is performed using a custom-made mouthpiece. It is particularly suitable for whitening complete dental arches and for patients with a high level of personal responsibility. VISALYS 7,5 which is preferably used at home under dental supervision, was designed for this purpose. The application possibilities of VISALYS 13,5 are very versatile. As an in-office option, it can be used as initial therapy in the form of a waiting room technique for subsequent at-home use with VISALYS 7,5. It can also be used for individual vital or non-vital teeth after appropriate gingival protection in the chairside and walking-bleach technique. It is recommended that in-office treatment be repeated on different days until the desired whiteness level is achieved. VISALYS 30 is ideal for patients who want quick and visible results without investing a lot of time. In the dental practice, both individual teeth and complete teeth arches can be effectively whitened in one session with the proper application of VISALYS Gingiva Protection (liquid cofferdam). Due to the higher concentration, VISALYS 13,5 and VISALYS 30 may only be applied professionally in dental practices (in-office). Freshening up is possible at any time. Constituents and components VISALYS 7,5 is a high viscosity dental whitening system in a two-chamber syringe for home application. One chamber contains stabilised hydrogen peroxide and the other contains activating components with additional gentle substances. After mixing, the concentration is approximately 7.5 % and is about as effective as a 22% carbamide peroxide one-component material.
Guideline 3308, Information for the dentist Page 2 of 8 Product details of VISALYS 7,5 Component 1: whitening gel Concentration: 15% stabilised hydrogen peroxide in aqueous solution Colour: clear Flavour: mint Component 2: activator Additive: potassium nitrate Colour: mother-of-pearl Flavour: mint VISALYS 13,5 is a highly effective whitening gel also supplied in a two-chamber syringe. One chamber contains stabilised hydrogen peroxide and the other contains carbamide peroxide. This results in a hydrogen peroxide concentration of approximately 13.5 % which is about the same as 35% carbamide peroxide. Product details of VISALYS 13,5 Component 1: whitening gel Concentration: approx. 16% stabilised hydrogen peroxide in aqueous solution Colour: clear Flavour: mint Component 2: whitening gel + activator Concentration: approx. 33 % carbamide peroxide Colour: mother-of-pearl Flavour: mint VISALYS 30 is a highly concentrated whitening gel in a 4:1 two-chamber syringe. A hydrogen peroxide concentration of 30% is present in the mixture. As with all gels of this concentration, it must be stored at 4 12 C. Product details of Visalys 30 Component 1: whitening gel Concentration: approx. 38% stabilised hydrogen peroxide in aqueous solution Colour: clear Flavour: neutral Component 2: polyglycole Colour: mother-of-pearl Flavour: neutral Mode of action The mode of action of dental whitening is based on the oxidation of colour pigments. Dental whitening involves releasing oxygen radicals which penetrate the tooth and obliterate the coloration of its pigments. The tooth structure is not attacked as only the pigments are modified. Many one-component materials extract water from the tooth during whitening. This can cause temporary sensitivity. The water and potassium nitrate content in VISALYS 7.5 minimises this side effect and guarantees excellent tolerability for the teeth and mucosa. The short treatment period required by VISALYS Whitening of only 2 x 30 minutes a day is also a positive aspect.
Guideline 3308, Information for the dentist Page 3 of 8 VISALYS Whitening has a two-chamber system, which does not mix the two components until immediately prior to application. The result: the effectiveness of VISALYS is increased and its shelf life extended. Advantages Gentle, fast and durable With VISALYS Whitening, dentists count on a particularly high-performance, hydrogen peroxidebased system that distinguishes itself through numerous advantages: VISALYS 30 CHAIRSIDE Controlled application in the dental office with quick results Flexible light-curing gingival mask protects the gums from damage VISALYS 13.5 PROFESSIONAL The multi-purpose material is particularly suitable as initial therapy for subsequent at-home use Gives reliable results in the walking-bleach technique in combination with the waiting-room technique VISALYS 7.5 PATIENT KIT Gentle formulation of water and potassium nitrate is particularly gentle on the teeth Patient-friendly application of only 2 x 30 minutes per day, flexible application everywhere All three products are offered in modern two-chamber syringe systems. The two components are only mixed directly prior to application. This enhances the effect of the hydrogen peroxide and guarantees longer product usability. The world of VISALYS Whitening products VISALYS 30 CHAIRSIDE For whitening vital and non-vital teeth. To be performed exclusively by dental professionals Contents: 1x5 g whitening gel, 2 mixing tips, 1x3g Gingiva Protection, 2 mixing tips. VISALYS 13.5 PROFESSIONAL For severely stained teeth. For in-office use by dentists only. Contents: 1 x 4 g syringe, 6 mixers VISALYS 7.5 PATIENT KIT Ideal for home use. First appointment in the dental office then easily applied at home. Contents: 4 x 4 g syringes, 4 mixers, 2 x vacuum-forming foils (ø 12 cm, 1 mm colourless, transparent) 1 patients booklet, 1 shade chart VISALYS 7.5 SINGLE PACK To ensure that the whitening effect lasts especially long, it is advisable to repeat the whitening process after a certain period. Contents: 1 x 4 g syringe, 1 mixer
Guideline 3308, Information for the dentist Page 4 of 8 VISALYS vacuum-forming foil This particularly soft and adaptable material is 1.0 mm thick and adapts to the teeth for increased patient comfort. Once the teeth have been whitened, the custom tray can be used for fluoridation. Contents: 50 single foils (diameter 12 cm, strength 1 mm, colourless, transparent; or 50 single foils (square 127 mm x 127 mm)) Field of application VISALYS Whitening is a dental whitening gel for professional use against discolouration caused by foodstuffs, tobacco and age as well as genetic or iatrogenic staining (e.g. after endodontic treatment and antibiotics). VISALYS 7.5 is intended for whitening vital teeth and must only be used at home as instructed by a dentist and using a custom tray. VISALYS 13.5 is indicated for whitening vital and non-vital teeth in-office only and may be applied during an initial appointment with subsequent home use or during a series of appointments in the dental practice. Due to the higher hydrogen peroxide concentration of 30%, VISALYS 30 CHAIRSIDE leads to quick results in just one session and may only be applied under professional supervision in the dental office. Range of indications Duration of application - VISALYS 7.5 For perfect results, the teeth should be whitened twice daily with VISALYS 7.5. It is advisable to apply it mornings and evenings for 30 to 60 minutes. At least two hours must pass between the two applications. The application time depends on the desired shade. The patient set contains enough whitening gel for 12 days. Any additional whitening must be discussed with a dentist. Should the teeth suffer slight hypersensitivity; the whitening can be reduced to one application per day. If the treatment is interrupted, it must be prolonged accordingly. Duration of application - VISALYS 13.5 VISALYS 13.5 can be applied with or without a tray. If the chairside technique is used without a tray, the gingiva must be protected (e.g. fluid dam). Then, a small amount of whitening gel is applied to the labial surface of the tooth and spread evenly with a suitable instrument to produce an approximately 1 mm thick layer. The gel is then allowed to react for between 30 minutes and 1 hour before being rinsed thoroughly with water
Guideline 3308, Information for the dentist Page 5 of 8 and aspirated. As VISALYS 13.5 is less concentrated than other in-office gels; several sessions may be required on different days to obtain the desired results. Duration of application - VISALYS 30 VISALYS 30 is suited for quick results. The practitioner and the patient should wear safety goggles during treatment. Appropriate gingival protection such as VISALYS Gingiva Protection is required for chairside application. The gel is applied in a uniformly thick layer on the labial surface of the teeth and is stirred every 10-15 min. on the tooth surface. This process can be repeated 3 times to achieve the desired whitening result as long as the total application time does not exceed 60 minutes. Subsequent remineralization with fluoride varnish/gel will prevent sensitivity. Unused gel in the syringe can be applied further. Internal whitening of non-vital teeth (Walking-Bleach technique) After completing endodontic treatment, wait at least one week before commencing whitening. To protect the adjacent teeth, place a rubber dam around the non-vital tooth. Gain access to the pulp cavity. Remove the root canal filling to within approx. 2 mm of the cementoenamel junction. Cover the root canal filling with an approx. 2 mm thick layer of cement base, e.g. glass ionomer cement, with integral margins. Do not seal with composite as this could adversely affect the internal whitening. The cavity margins must be conditioned before placing the whitening gel in the root canal this allows the temporary seal to be resin-bonded, preferably using composite. Then extrude the whitening gel out of the syringe directly into the root canal and seal it. The whitening gel should be replaced every 1-3 days. To prevent excessive whitening, the patient should check the tooth shade daily and attend the dental practice once the desired shade has been achieved. Once the whitening procedure has been completed, the access cavity should be filled with composite resin-bonded to the enamel and dentine. Tips for tooth whitening: - Cover exposed cervical areas with a dentine adhesive. - Fluoridation should be carried out on hypersensitive teeth after completing treatment. - Wait at least 2 week before placing a composite filling, as residual peroxide impairs the bond of the composite. - Whitening should only be carried out on young people s teeth after their teeth have matured sufficiently to allow safe crown preparation. - A reservoir is not required in the bleaching tray for the whitening gel. - Scaling and polishing required for tooth whitening should be completed at a separate appointment. Contraindications: Do not use if the patient is pregnant or breast-feeding. Do not use on patients allergic to hydrogen peroxide or carbamide peroxide.
Guideline 3308, Information for the dentist Page 6 of 8 Do not use on diabetics. Do not use on adolescents under 18 years. Do not use on discoloured areas which could be removed by scaling and polishing. Do not use on patients hypersensitive to whitening gels. Do not use VISALYS 30 for the walking-bleach technique with multiple-day inlay Teeth whitening with VISALYS 30 is contraindicated under anesthesia Possible side-effects: Temporary irritation of the mucosa. Temporary hypersensitivity of the teeth. Temporary reduction in translucency of the teeth. Temporary reduction in fracture-resistance of the teeth. Temporary reduction of composite bond strength. For this reason, adhesive restorations should not be fitted within 14 days of whitening the teeth. If the root canal filling is not perfect, internal whitening may cause cervical resorption. It cannot be ruled out that sensitive persons may react allergically to this product. Temporary side-effects can be alleviated with simple dental measures (e.g. fluoridation). Working stages A few steps to perfectly white teeth Visalys 7,5 using a tray Step 1: Take the tooth shade and determine the amount of whitening required using a shade guide. Step 2: Take an impression of the patient s upper and lower jaws e.g. with Kettosil and fabricate a stone model e.g. with Tewerock /Tewestone. The stone model should be trimmed back to within 2 4 mm of the gingival margin. Step 3: Fabricate a bleaching tray with VISALYS vacuum-forming foil. The 1 mm thick foil is designed for vacuum forming bleaching trays. Adhere to the manufacturer s instructions for use when using the vacuum-forming unit. The foil is usually warmed for ca. 55 seconds until it sags about 15 mm. Allow the vacuum-forming foil to cool for at least 5 minutes before trimming it. Step 4: After removing the foil from the model, roughly trim it to the required shape. Shorten the tray to within approx. 1-2 mm of the gingival margin. Check that the tray fits properly. Step 5: Complete initial filling of the tray together with the patient. Only put a small drop of gel into each tooth impression in the tray. Each graduation mark on the VISALYS syringe is at least enough to fill one complete tray. Step 6:
Guideline 3308, Information for the dentist Page 7 of 8 Insert the tray filled with gel into the patient s mouth. Remove excess gel from the tray to prevent irritation of the mucosa. Step 7: The tray remains in the mouth for 30 minutes and the patient should not eat, drink or smoke during this time. Step 8: Remove the bleaching tray from the patient s mouth, clean the tray and teeth. A VISALYS patient box is provided for storing the tray. Visalys 30 for the use in the dental office Step 1: Documentation of the initial colour, determination of colour. Step 2: Apply VISALYS Gingiva Protection in a uniformly thick layer for optimal cover. Step 3: VISALYS Gingiva Protection should be cured for approx. 5-10 seconds using a polymerization lamp. Step 4: Apply VISALYS 30 Chairside and spread a uniform layer of approx. 1-2 mm with a suitable instrument. Step 5: Stir the teeth whitening gel every 10-15 min. Step 6: Suck the teeth whitening gel out thoroughly and rinse with water. Step 7: Lift the gingival protection from the edge with a blunt instrument. Step 8: Perform subsequent remineralization with fluoride gel. Step 9: The result after a successfully performed teeth whitening. Instead of Visalys 30 also Visalys 13.5 can be applied directly as chairside material. In this case the application steps are identical. Until the desired result will be achieved, the treatment has to be repeated for several days. Visalys 13.5 is more suitable as initial treatment for a further home application or for whitening non-vital teeth up by means of walking bleach, for which lower concentrations are more favorable. VISALYS Marketing tools at a glance Give your patients as much information as possible about tooth bleaching to encourage them to have their teeth whitened with VISALYS Whitening. We will provide support in the practice with a range of highly attractive, impressive advertising materials and comprehensive information about VISALYS. Poster A glance at the poster will give your patients an idea of how good it feels to have healthy white teeth by using VISALYS Whitening. Patient brochure
Guideline 3308, Information for the dentist Page 8 of 8 The patient brochure for the waiting room answers the most important questions about tooth whitening in a simple, understandable way. Table display The table display impressively demonstrates the before and after effect of VISALYS Whitening. VISALYS on the Internet Further information on VISALYS are available on the Internet: www.visalys.com