This 22-year-old male patient came to the clinic complaining of pain and esthetic dissatisfaction following orthodontic treatment with fixed appliances. The patient said that his orthodontic treatment lasted more than 4 years. Upon clinical examination, the patient presented with mild to moderate post orthodontic white spot lesions (WSL) affecting the two upper central incisors. Tooth #21 exhibited yellowish discoloration compared to the adjacent teeth. Tooth #21 was also sensitive to percussion, with no response to thermal testing and electric pulp testing (EPT). Orthopantomogram (OPG) and CBCT were taken and showed extensive root canal calcification in tooth #21 with intact lamina dura and normal periodontal ligament space. Root canal treatment was done on tooth #21, followed by internal bleaching (non-vital walking bleaching) using 35% hydrogen peroxide. Then, both teeth with white spot lesions were treated using the resin infiltration technique to improve the esthetic outcome. By understanding patient expectations, conducting comprehensive assessments, ensuring informed decision-making, and personalizing treatment plans, the best outcomes could be achieved.
