Bleaching is not a vanity procedure anymore: since many years, the benefit of non-invasive techniques has been put to proof and given amazing results when the indications are followed correctly.  The bleaching therapy to diminish and treat white spots has been subject to controversy, rejected by many and adopted by many others.
漂白已经不再是一种虚荣心了:自从许多年以来，非侵入性技术的益处已经被证明并在正确的情况下得到了惊人的结果。漂白疗法减少和治疗白斑一直受到争议，被许多人拒绝，许多人采用。
 

The Infiltration technique has been widely proven to eliminate unaesthetic enamel spots, if the depth is correctly evaluated and the indications followed correctly;  in other words, in deep lesions infiltration will not be very effective alone.
渗透技术已被广泛证实消除了不美观的釉质斑点，如果正确评价深度，正确跟踪指标;换句话说，在深层病灶的浸润中，并不是很有效。
 

In the author's experience, bleaching of white and amber spots before its treatment has been a winning strategy with the following affirmations:
在作者的经验中，白色和琥珀色斑点在治疗前的漂白是一个成功的策略，有以下的肯定:
 

Amber spots: Generally turn into white spots which are more subject to the acid treatment of the infiltration therapy
琥珀色斑点:通常变成白色斑点，更容易受到渗透治疗的酸处理
 

White Spots: Two phenomena happen, the first is the reduction in their opacity due to a balance in the refraction index of the disarranged prisms.  And the second, little or no bleaching happen to the white spot, blending better due to the low contrast between the newly bleached surrounding tissues and the white spot itself.
白点:两种现象发生，第一种是由于不排列的棱镜折射率的平衡，使其不透明度降低。其次，白色斑点很少或没有漂白，因为新漂白的周围组织和白色斑点本身的对比度较低。
 

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Img. 1 - Initial evaluation of the patient.  23 year old woman, very dissatisfied of the present situation and the aggressive treatment optioned shed had been proposed.
Img . 1 -患者初始评价。23岁的妇女，对现状非常不满，并提出了积极的治疗方案。
 

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Img. 2 - A CROSS-POLARIZED picture is taken to better asses the extent of the lesion.  On the other hand, TRANSILLUMINATION is used to estimate the depth of the lesion (not in pictures).  It is decided to start a bleaching therapy to try to minimize the contrast between the spots and the tooth and to bleach the amber spots which are generally not attackable.
Img . 2 -为了更好地评估病灶的程度，可以采用交叉极化的图像。另一方面，用透照法估计病变的深度(不在图片中)。它决定开始一种漂白疗法，以尽量减少斑点和牙齿之间的对比，并漂白那些一般不可攻击的琥珀色斑点。
 

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Img. 3 - Bleaching trays must be extremely precise, cervical sealing should be perfect in order to keep the bleaching product in place and safe of intraoral moisture.  Construction of the bleaching tray will be deeply discussed in upcoming articles.
3 -漂白托盘必须非常精确，宫颈密封应完美，以保持漂白产品到位，并保证口腔内的水分安全。在即将发表的文章中，将对漂白托盘的建造进行深入的讨论。
 

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Img. 4 - Fitting of the bleaching tray.  The selected bleaching therapy was Carbamide Peroxide 10% during 20 days (White Dental Beauty, Optident, UK) during the full sleep time.  No sensitivity was reported, and we are seeing this phenomenon more often with this new generation products.
Img . 4 -漂白剂托盘。在整个睡眠时间里，选择的漂白治疗方法是在20天内(白牙美容，Optident,UK)的漂白治疗。没有任何敏感性被报告，我们更经常看到这种现象与新一代产品。
 

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Img. 5 - After 20 days bleaching.  Picture with lateral flashes.
5 - 20天后漂白。图片与横向闪光。
 

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Img. 6 - Cross polarized image showing the new situation of the spots, some of them vanished, the amber turned into white and other spots softened its saturation.
Img 6 -交叉偏振光显示斑点的新情况，其中一些消失，琥珀变成白色，其他斑点软化其饱和度。
 

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Img. 7 - Side to side comparison, note the amber spot.
Img . 7 -侧比较，注意琥珀色斑点。
 

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Img. 8 - Mirror like comparison
Img . 8 -镜子比较
 

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Img. 9 - Mirror-like comparison of before bleaching (low) and after (up) with Deep-view contrast
Img . 9 -类似于在漂白前(低)和后(向上)与深视对比
 

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Img. 10 - After bleaching evaluation, the patient starts the treatment with resin infiltration.  The first step, rubber dam isolation.
10 -在漂白后，患者开始进行树脂浸润治疗。第一步，橡胶坝隔离。
 

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Img. 11 - 15% HYDROCHLORIC acid application for 2 minutes (ICON ETCH, DMG, Germany), this step can be repeated up to 4 times.  Applying it more times comes with the risk of deeply eroding the teeth.
Img . 11 - 15%盐酸应用程序2分钟(图标ETCH,DMG，德国)，此步骤可重复4次。使用它的次数越多，牙齿就会被严重腐蚀。
 

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Img. 12 - Air drying, note how the spots become tremendously white.
12 -空气干燥，注意斑点如何变得非常白。
 

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Img. 13 - Preview with alcohol (ICON dry, DMG, Germany).  Manufacturer suggests a 30 seconds application of this agent.  This is the result after 30 seconds
Img . 13 -预览与酒精(ICON dry,DMG，德国)。制造商建议在30秒内使用该代理。这是30秒后的结果
 

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Img. 14 - In the author's experience, this product applied for 2 minutes gives a better penetration and thus a better preview of the real outcome.  Is in this step where the clinician should decide if repeating the full erosion cycle or starting the resin infiltration.
Img . 14 -在作者的经验中，该产品应用2分钟，提供更好的渗透，从而更好的预览真实的结果。在这个步骤中，临床医生应该决定是否重复完整的侵蚀循环或开始树脂浸润。
 

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Img. 15 - Air dry of the alcohol is very easy and, if the last step was succesful, is time to infiltrate.
15 -酒精的空气干燥很容易，如果最后一步是成功的，那么是时候渗透了。
 

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Img. 16 - Many times erosion is even visible, especially when doing 4 cycles or more.
Img 16 -很多次的侵蚀都是可见的，特别是在做4个周期或更多的时候。
 

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Img. 17 - Resin infiltration.  This resin of extremely low density and solvent free is able to penetrate as much as the alcohol did.  It is advisable to keep the lights low and allow the infiltrant to penetrate for about 3 minutes;  failure in doing so may end up in an incomplete infiltration and a different result than the one obtained in the preview with the ICON dry.
17 -树脂浸润。这种极低密度和无溶剂的树脂能够像酒精一样渗透。最好将灯保持低，让渗透物渗透约3分钟;这样做的失败可能会导致一个不完全的渗透，和一个不同的结果，而不是在与图标干燥的预览中得到的结果。
 

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Img. 18 - After infiltration, a small layer of enamel is placed to cover up the erosion caused during therapy.
Img . 18 -浸润后，放置一层瓷釉，以掩盖治疗过程中产生的侵蚀。
 

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Img. 19 - Polishing is mandatory with or without the use of a final composite layer.
Img . 19 -抛光是强制性的，或不使用最终复合层。
 

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Img. 20 - Final result after 3 weeks
Img . 20 - 3周后的最终结果
 

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Img. 21 - Cross polarization image, shows a good result, which is not excellent, but not visible to plain sight.
21 -交叉极化图像，显示出良好的效果，不太好，但肉眼看不到。

 

Img. 22 - Deep-view contrast of the final situatuion (contrast increase, brigtness dicrease of the digital image) help very much in the picture analysis and true estimation of the remaining lesions.
Img。22 -深度视图对比的最后情况(对比度增加，数字图像的brigUNK di折痕)有助于图像分析和对其余病变的真实估计。