Comparison of the Bleached and Non-Bleached Teeth for the Adhesive Boosters for the Orthodontic Bonding: An Original Research

Introduction

The bleaching of the teeth is known to reduce the bonding of the orthodontic brackets. Hence, this in vitro study was piloted to analyze if there was any variance between the teeth that were and were not bleached when the adhesive boosters were used and for its effect on the shear bond strength.

Materials and Procedures

Hundred premolars (maxillary) that had been excised were randomly split into two groups: bleached teeth and unbleached teeth. The bleaching agent was gel composed of 22% carbamide peroxide. Maxillary premolar brackets were bonded, and each group was subdivided as control and adhesive booster Enhance LC groups. A universal testing device was used for debonding. The SBS thus recorded was compared for the subgroups and groups.

Results

Significant variance was obtained for between the groups and between the subgroups. Higher bond strength was for the non-bleached teeth than the bleached teeth and was seen in the adhesive booster subgroup than the control group.

Conclusion

In summary, adhesive boosters dramatically raised the shear bond strength of teeth irrespective of the bleaching. Further in vivo studies are suggested.

Moving beyond heritability in the search for coral adaptive potential

Global environmental change is happening at unprecedented rates. Coral reefs are among the ecosystems most threatened by global change. For wild populations to persist, they must adapt. Knowledge shortfalls about corals' complex ecological and evolutionary dynamics, however, stymie predictions about potential adaptation to future conditions. Here, we review adaptation through the lens of quantitative genetics. We argue that coral adaptation studies can benefit greatly from "wild" quantitative genetic methods, where traits are studied in wild populations undergoing natural selection, genomic relationship matrices can replace breeding experiments, and analyses can be extended to examine genetic constraints among traits. In addition, individuals with advantageous genotypes for anticipated future conditions can be identified. Finally, genomic genotyping supports simultaneous consideration of how genetic diversity is arrayed across geographic and environmental distances, providing greater context for predictions of phenotypic evolution at a metapopulation scale.

Bacterial Communities Vary from Different Scleractinian Coral Species and between Bleached and Non-Bleached Corals

Bleaching is one of the most relevant factors implicated in the integrity of coral reef ecosystems, with the increasing frequency and intensity of damaging events representing a serious threat to reef biodiversity. Here, we analyzed changes in coral-associated bacteria from three types of non-bleached and bleached scleractinian corals (Acropora digitifera, Galaxea fascicularis, and Porites pukoensis) in Hainan Luhuitou peninsula coastal areas. The community structure of symbiotic bacteria differed significantly among the three apparently healthy corals. The bleached corals had higher bacterial alpha diversity and some specific bacteria genera, including Ruegeria, Methyloceanibacter, Filomicrobium, Halioglobus, Rubripirellula, Rhodopirellula, Silicimonas, Blastopirellula, Sva0996 marine group, Woeseia, and unclassified_c_Gammaproteobacteria, were consistently increased in bleached groups. Network analysis revealed significantly different degrees of modularity between bleached and non-bleached groups at the bacterial genus level, and a higher proportion of links was dominated by positive co-occurrences. Functional prediction analysis illustrated that coral-associated bacteria remained relatively consistent in the bleached and non-bleached groups. Structure equation modeling revealed that the bacterial community diversity and function were directly influenced by host and environment factors. These findings suggested that coral-associated bacterial responses to bleaching occur in a host-dependent manner, informing novel strategies for restoring coral and aiding adaption to bleaching stress. IMPORTANCE Accumulating evidence indicates that coral-associated bacteria play an important role in the health of holobionts. However, the variability of the symbiotic bacterial community structure among coral species with different coral health statuses remains largely unknown. Here, we investigated three apparent non-bleached (healthy) and bleached coral species (sampled in situ), involving related symbiotic bacterial profiles, including composition, alpha diversity, network relationship, and potential function. Structural equation modeling analysis was used to analyze the relationship between coral status and abiotic and biotic factors. The bacterial community structure of different groups was shown to exhibit host-specific traits. Both host and environmental impacts had primary effects on coral-associated microbial communities. Future studies are needed to identify the mechanisms that mediate divergent microbial consortia.

One-Step Surface-Treatment Reagent (35% 3-O-Ethyl-l-ascorbic Acid Plus 50% Citric Acid Solution) Restores the Shear Bond Strength of Metal Brackets Bonded to Bleached Human Enamel: An In Vitro Study

This study investigates how a new substance, composed of ethyl ascorbic acid and citric acid, affects the shear bond strength (SBS) of metal brackets when bonded to bleached teeth. Forty maxillary premolar teeth were used and randomly placed into four groups (n = 10): the control group did not undergo bleaching; the remaining groups underwent bleached using 35% hydrogen peroxide. In group A, 37% phosphoric acid was applied after bleaching. In group B, 10% sodium ascorbate was used for ten minutes before 37% phosphoric acid. In group C, 35%3-O-ethyl-l-ascorbic acid plus 50% citric acid solution (35EA/50CA) was applied for 5 min. The subgroups were bonded immediately after bleaching. The SBS was determined with a universal testing machine and analyzed using one-way ANOVA and then Tukey's HSD tests. Adhesive remnant index (ARI) scores were determined with a stereomicroscope and analyzed with a chi-squared test. The significance level was 0.05. Group C demonstrated significantly higher SBS values than group A (p < 0.001), but was not significantly different than the control group or group C (p > 0.05). The ARI scores were significantly different among the groups (p < 0.001). In conclusion, enamel surface treatment using 35EA/50CA improved the reduced SBS to an acceptable clinical level and reduced the clinical chair time.

The Use of Toothpastes Containing Different Formulations of Fluoride and Bioglass on Bleached Enamel

To investigate the application of toothpaste either containing calcium sodium phospho-silicate bioglass (NovaMin) or calcium fluorosilicate bioglass (BioMinF) on the surface mineral composition and morphology of enamel after bleaching procedure. Methods: Thirty extracted noncarious human teeth were allocated into five groups (n = 6). Group 1: Bleaching using 40% hydrogen peroxide (HP) and fluoridated toothpaste containing bioactive glass (1450 ppm fluoride). Group 2: Bleaching using 40%HP and toothpaste containing calcium fluorosilicate bioglass (540 ppm fluoride). Group 3: Bleaching using 40%HP and fluoridated toothpaste (1450 ppm fluoride). Group 4: Bleaching alone using 40%HP. Group 5: Negative control with distilled water alone. The surface morphology was evaluated using Scanning Electron Microscope (SEM) and Scanning Probe Microscope (SPM). The concentration of elements as atomic percentages were determined by X-ray Photoelectron Spectroscopy (XPS) and Energy-Dispersive X-ray Spectroscopy (EDS). Results: This laboratory-based study reported that SPM and SEM detected minor changes on the surfaces of all toothpaste-treated enamel samples (Groups 1-3) after 45 days. Bioactive glass deposits were observed on enamel surfaces in Groups 1 and 2, whilst the bleaching-alone samples (Group 4) had rough enamel surfaces. XPS reported that toothpaste containing calcium fluorosilicate bioglass (Group 2) had a high atomic% of calcium and phosphate, whilst silicon values were high in the toothpaste containing bioactive glass and 1450 ppm fluoride (Group 1) after bleaching procedure when compared to other groups (p < 0.05). In addition, EDS detected the highest %F in Groups 1, 2 and 5. Conclusions: Within the limitations of this laboratory-based study, there was no significant decrease in the Ca%, P% values and surface properties of enamel after the bleaching procedure following the use of different formulations of toothpastes for a period of 45 days. However, the Ca% and P% values were significantly high for the toothpaste containing calcium fluorosilicate bioglass (BioMinF) on the bleached enamel. Clinical relevance: The bleaching process can provide optimum aesthetic outcomes, but the effect of peroxides on hard tissues is still in question. Toothpastes containing different formulations of fluoride and bioactive glass might have the potential to prevent mineral loss on bleached enamel. However, further laboratory-based studies and controlled double-blind randomised clinical trials are required to interpret the effects of toothpastes with different fluoride and bioactive glass formulations on enamel surfaces following bleaching procedures.

Effect of Different Mouthwashes on the Surface Microhardness and Color Stability of Dental Nanohybrid Resin Composite

BACKGROUND

Surface microhardness and color stability of dental restorative material should be sustained throughout its functional lifetime to maintain the esthetic quality of the restoration. However, the frequent application of mouthwash may affect their surface microhardness and color stability. The aim of this study was to evaluate the effects of different types of mouthwashes with different contents on surface microhardness and color stability of dental nanohybrid resin-based composite.

METHODS

Disc specimens of nanohybrid resin composite (Luna Nano-Hybrid Composite) were prepared according to manufacturing instructions; specimens were incubated for 24 h in three types of mouthwash (Chlorohexidine, Listerine Green Tea, and Colgate Optic White Whitening Mouthwash). Artificial saliva was used as a control group. Surface microhardness was evaluated using Vickers microhardness device. Color stability after and before immersion in the different mouthwashes was evaluated using extra-oral spectrophotometer; the values of color change (ΔE₀₀) were subsequently calculated. Data were analyzed using one-way ANOVA and post hoc test (p ≤ 0.05).

RESULTS

There was no significant difference between microhardness of resin composite immersed in artificial saliva, CHX, and Green Tea mouthwashes (78.5, 78.4, and 73.5, respectively) (p ≥ 0.1), while the bleaching mouthwash led to the lowest microhardness of resin composite, with significant difference compared to the three previous immersion media (p = 0.002). Moreover, there were significant differences in the color changes (ΔE₀₀) of resin composite exposed to the various immersion media (p = 0.0001).

CONCLUSIONS

The bleaching mouthwash led to a significant reduction in nanohybrid resin composite's microhardness compared to the chlorohexidine and Green Tea containing mouthwashes. The resin composite's color change was accepted in bleaching mouthwash but unaccepted in chlorohexidine and Green Tea containing mouthwashes.

Calcium-Polyphosphate Submicroparticles (CaPP) Improvement Effect of the Experimental Bleaching Gels' Chemical and Cellular-Viability Properties

The aim of this research was to develop and characterize the chemical and cellular-viability properties of an experimental high-concentration bleaching gel (35 wt%-H2O2) containing calcium-polyphosphate particles (CaPP) at two concentrations (0.5 wt% and 1.5 wt%). The CaPP submicroparticles were synthesized by coprecipitation, keeping a Ca:P ratio of 2:1. The CaPP morphology, size, and chemical and crystal profiles were characterized through scanning and transmission electron microscopy, energy-dispersive X-ray analysis, and X-ray diffraction, respectively. The assessed bleaching gels were experimental (without CaPP); 0.5% CaPP; 1.5% CaPP; and commercial. The gels’ pH values and H2O2 concentrations (iodometric titration) were determined. The odontoblast-like cell viability after a gel’s exposure was assessed by the MTT assay. The pH and H2O2 concentration were compared through a repeated-measures analysis of variance (ANOVA) and a Tukey’s test and the cell viability through a one-way ANOVA and a Tukey’s test using a GraphPad Prism (α < 0.05). The CaPP particles were spherical (with Ca and P, 135.7 ± 80.95 nm size) and amorphous. The H2O2 concentration decreased in all groups after mixing (p < 0.001). The 0.5% CaPP resulted in more-stable pH levels and higher viability levels than the experimental one (p < 0.05). The successful incorporation of CaPP had a positive impact on the bleaching gel’s chemical and cellular-viability properties when compared to the experimental gel without these particles.

Impact of different intraorifice barriers on fracture resistance of non-vital bleached teeth

Background and Aim

This study aimed to evaluate the effects of bleaching agents on the fracture resistance of endodontically treated teeth using different intraorifice barrier (IOB) materials.

Materials and Methods

The endodontic treatment was performed for 160 mandibular premolars, and then, the teeth were divided into four groups according to the IOB: Ionoseal, Biodentine, ProRoot MTA, and TheraBase. Then, these teeth were subdivided into four subgroups (n = 10) based on the bleaching agents as distilled water (control), hydrogen peroxide 35% (HP), sodium perborate (SP), and carbamide peroxide 37% (CP). The access cavities were restored with composite resin after applying the bleaching agents for 7 days. The fracture resistance test was performed using a universal testing machine. Data were statistically analyzed, and the significance level was set at 5%. A scanning electron microscope was used to evaluate the effect of bleaching agents on the surfaces of IOBs.

Results

The highest fracture resistance values were observed in Biodentine groups with significant differences compared to Ionoseal and ProRoot MTA (P <.05). The distilled water groups showed significantly the highest fracture resistance compared to SP and HP groups (P <.05). There was no significant difference between SP, HP, and CP groups (P >.05). It was demonstrated that the morphological surface of the intact IOBs (control) was different from the surface of IOBs treated with bleaching agents.

Conclusion

The intracoronal bleaching procedures affected negatively the fracture resistance of the endodontically treated teeth.

The effect of bleaching on surface roughness and gloss of different CAD/CAM ceramic and hybrid ceramic materials

OBJECTIVE

To assess the effect of bleaching on surface roughness and gloss of different CAD/CAM ceramic materials.

METHODS

The ceramic materials included IPS e.max CAD (lithium disilicate), VITA ENAMIC (polymer infiltrated ceramic), and Celtra Duo CAD (zirconia reinforced lithium silicate). Samples of each material were randomly divided into four groups (n = 10); a control group immersed in distilled water, the second and third groups were treated with 20% carbamide peroxide (20% CP) and 35% carbamide peroxide (35% CP) bleaching agents for 4 h/day and 60 min/day respectively for 7 days. The fourth group was treated with 40% hydrogen peroxide (40% HP) applied twice, each turn for 20 min. After treatment, the surface roughness (using 3D non-contact profilometry) and surface gloss were assessed followed by imaging with a scanning electron microscope. The data were analyzed using multiple linear regression and Kruskal-Wallis one-way ANOVA tests (α = 0.05).

RESULTS

The surface roughness (p = 0.157) and gloss (p = 0.073) of IPS e.max CAD were not significantly affected by the different bleaching treatments. Similarly, no significant effect on surface roughness (p = 0.162) and gloss (p = 0.965) were shown for Celtra Duo CAD. On the other hand, VITA ENAMIC was significantly affected when treated with 20% CP and 35% CP showing increased roughness (p = 0.001) and gloss (p = 0.008).

CONCLUSIONS

Home bleaching treatments (20% CP and 35% CP) significantly affected the surface roughness and gloss of VITA ENAMIC while IPS e.max CAD and Celtra Duo CAD were not affected by the different bleaching treatments.

Effect of Water Storage and Bleaching on Light Transmission Properties and Translucency of Nanofilled Flowable Composite

This study investigated the effect of water sorption and bleaching on light transmission properties (Straight-light transmission (G0), Light diffusion (DF) and Amount of transmitted light (AV)) and translucency parameters (TP) of nano-filled flowable composites. A total of 35 composite disks (0.5 mm thickness) were prepared using A2 shade of 5 nanofiller composites (n = 7/each); Beautifil Flow Plus X F03 (SHOFU INC), Clearfil Majesty ES Flow (Kuraray Noritake Dental), Estelite Universal Flow (EUF, Tokuyama Dental), Estelite Flow Quick (Tokuyama Dental) and Filtek Supreme Ultra Flowable Restorative (FSU, 3M ESPE). Then, they were cured by LEDs (VALO, Ultradent) on standard mood (1000 mW/cm2) for 20 s. Samples were tested for straight-line transmission (G0), diffusion (DF), the amount of transmitted light (AV) and (TP) immediately after 24 h (dry storage), after 1-week water storage and after each of the three cycles of in-office bleaching (HiLite, SHOFU INC). Result: G0, DF, AV and TP were significantly affected by different materials (p < 0.001). The AV of FSU increased significantly after the 1-week water storage, then after the second bleaching cycle (p < 0.001). The TP for EUF slightly decreased (p = 0.019) after 1-week water storage, then increased throughout bleaching. Conclusion: Ageing/bleaching conditions do not affect G0, DF, AV and TP. The compositional variation between nano-filler composites resulted in a significant difference between materials.

Effectiveness of Teeth Whitening after Regenerative Endodontics Procedures: An In Vitro Study

Discolouration resulting from regenerative endodontic procedures may have a negative impact on the quality of life of treated patients; therefore, it is recommended to minimize this risk by selecting appropriate scaffolds and barrier materials, and if discolouration occurs, the use of a simple, cost-effective and minimally invasive technique, such as whitening, should be considered. This in vitro study aimed to evaluate tooth discolouration after two- and single-visit regenerative endodontic procedures and the effectiveness of subsequent whitening procedures with carbamide peroxide. Two hundred bovine incisors were included in this study and divided into twenty groups based on the tested material combinations. Two groups were control groups, one with saline and the other group with blood. In the 12 groups, the experiment was designed to be consistent with the two-visit regenerative endodontic procedures. Triple antibiotic paste or calcium hydroxide were placed in the root canal, and then scaffolds (e.g., blood or platelet-rich fibrin) and barrier materials (Biodentine, OrthoMTA or MTA Repair HP) were applied after rinsing the disinfectant pastes. In the six groups that corresponded to the single-visit regenerative endodontic procedure, the use of a disinfectant paste was omitted. Subsequently, the specimens were bleached twice with carbamide peroxide at a 7-day interval. Colour change measurements were performed using a spectrophotometer (VITA Easyshade Compact 5.0, VITA Zahnfabrik, Bad Säckingen, Germany). Statistical analysis was performed with the Kruskal−Wallis H test, the independent t-test and t-test for related samples. Tooth discolouration was noticed after two- and single-visit regenerative endodontic procedures, except for the platelet-rich fibrin+MTA Repair HP group. After the first and second whitening procedures, all of the tested two- and single-visit regenerative endodontic procedures groups showed a change in the colour of the crown, which was noticeable to the naked eye (∆E > 3.3). When analysing the ∆E value between the first and second bleaching procedures, no changes in the colour of teeth were visually noticed in the calcium hydroxide and platelet-rich fibrin +MTA Repair HP groups (∆E < 3.3). Single-visit regenerative endodontic procedures are suggested if possible; however, if two-visit regenerative endodontic procedures are performed, it is recommended to use calcium hydroxide as the disinfectant paste because of the lower staining potential. In the context of discolouration, platelet-rich fibrin is advisable for use as a scaffold. The whitening procedure is worth considering, but does not guarantee a return to the original tooth colour, especially when triple antibiotic paste is used.

Tooth Bleaching of Discolorations Caused by Hydraulic Cements in Regenerative Endodontic Treatment: A 3-Year In Vitro Study

This study aimed to evaluate the color change caused by hydraulic cements after 3 years in vitro by simulating their use in regenerative endodontic treatment (RET) and to quantify the color change after external bleaching with 40% hydrogen peroxide at 1, 6, and 12 months of follow-up. Fifty teeth were treated simulating RET. Samples were distributed according to the hydraulic cement to be used (n = 10 per group): negative control (no cement), ProRoot-MTA, MM-MTA, TotalFill BC-RRM, or Biodentine. Three years after RET, two sessions of external bleaching with Opalescence Boost were performed. The color was measured in the cervical and incisal halves of the teeth at different time points: baseline, 3 years after performing RET, and after 1, 6, and 12 months after bleaching. The ΔL, Δa, and Δb were determined. A generalized linear model was used to compare color considering group and time. The ΔEab and the ΔE00 were calculated and the acceptability in color change was determined. Three years after RET, a reduction in lightness (negative ΔL values) was found in all groups. These values significantly increased 1 month after bleaching in all groups (p < 0.05) and reversed at 6 months. One month after bleaching, ΔE00 values (color difference tolerance (CIEDE2000)) ranged from very good (>3.6 ≤ 5.4) to excellent (>5.4). One year after bleaching, the color reverted to values similar to those found 3 years after RET. All groups became darker after RET. The color recovered and even improved compared with the baseline measurement after one month of bleaching but did not remain stable over time.

Effect of Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) Laser Enamel Pre-Treatment on the Whitening Efficacy of a Bleaching Agent

BACKGROUND

There are a number of different substances and treatments that are effective in mitigating the negative effects of tooth bleaching. It is essential, however, to consider whether or not the presence of these factors affects the efficiency of the bleaching agent.

AIM

The purpose of this study is to determine how the pretreated enamel with a Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) laser affects the bleaching effect of hydrogen peroxide at a concentration of 35%.

METHODS AND MATERIALS

Thirty samples were prepared from human-extracted permanent anterior teeth and stained using a tea solution. Based on the pre-treatment protocol, the samples were split into two equal groups (n = 15): In Group I, samples were submerged in saline solution for five minutes, while in Group II, Nd:YAG laser treatment was performed. Following pretreatment, samples from both groups were bleached with 35% hydrogen peroxide. Colour analysis of all samples was done before and after bleaching using a spectrophotometer. For the colour analysis, the CIE L*a*b* (Commission Internationale de l'Eclairage) System of colour measurement was used. For statistical analysis, Student t-tests (two-tailed, unpaired) were used to compare the means of two groups on a continuous scale.

RESULTS

Samples from both groups became lighter in colour following bleaching. After bleaching, there was no discernible difference in the total colour change between the two groups.

CONCLUSION

The application of the Nd:YAG laser before bleaching did not influence the whitening efficacy of 35% hydrogen peroxide.

Effects of the Preferential Oxidation of Phenolic Lignin Using Chlorine Dioxide on Pulp Bleaching Efficiency

Chlorine dioxide is widely used for pulp bleaching because of its high delignification selectivity. However, efficient and clean chlorine dioxide bleaching is limited by the complexity of the lignin structure. Herein, the oxidation reactions of phenolic (vanillyl alcohol) and non-phenolic (veratryl alcohol) lignin model species were modulated using chlorine dioxide. The effects of chlorine dioxide concentration, reaction temperature, and reaction time on the consumption rate of the model species were also investigated. The optimal consumption rate for the phenolic species was obtained at a chlorine dioxide concentration of 30 mmol·L^-1, a reaction temperature of 40 °C, and a reaction time of 10 min, resulting in the consumption of 96.3% of vanillyl alcohol. Its consumption remained essentially unchanged compared with that of traditional chlorine dioxide oxidation. However, the consumption rate of veratryl alcohol was significantly reduced from 78.0% to 17.3%. Additionally, the production of chlorobenzene via the chlorine dioxide oxidation of veratryl alcohol was inhibited. The structural changes in lignin before and after different treatments were analyzed. The overall structure of lignin remained stable during the optimization of the chlorine dioxide oxidation treatment. The signal intensities of several phenolic units were reduced. The effects of the selective oxidation of lignin by chlorine dioxide on the pulp properties were analyzed. Pulp viscosity significantly increased owing to the preferential oxidation of phenolic lignin by chlorine dioxide. The pollution load of bleached effluent was considerably reduced at similar pulp brightness levels. This study provides a new approach to chlorine dioxide bleaching. An efficient and clean bleaching process of the pulp was developed.

Present status and future directions - Managing discoloured teeth

Managing tooth discolouration involves a range of different protocols for clinicians and patients in order to achieve an aesthetic result. There is an increasing public awareness in the appearance of their teeth and management of tooth discolouration may be inter-disciplinary and involve both vital and nonvital teeth. Vital teeth can be easily treated with low concentration hydrogen peroxide products safely and effectively using an external approach and trays. For endodontically treated teeth, the walking bleach technique with hydrogen releasing peroxide products is popular. However, there is an association with external cervical root resorption with higher concentrations of hydrogen peroxide of 30%-35%. There are also regulatory considerations for the use of hydrogen peroxide in certain jurisdictions internationally. Prosthodontic treatments are more invasive and involve loss of tooth structure as well as a life cycle of further treatment in the future. This narrative review is based on searches on PubMed and the Cochrane library. Bleaching endodontically treated teeth can be considered a safe and effective protocol in the management of discoloured teeth. However, the association between bleaching and resorption remains unclear although there is likely to be a relation to prior trauma. It is prudent to avoid thermocatalytic approaches and to use a base/sealer to cover the root filling. An awareness expectations of patients and multidisciplinary treatment considerations is important in achieving the aesthetic result for the patient. It is likely that there will be an increasing demand for aesthetic whitening treatments. Bleaching of teeth has also become increasingly regulated although there are international differences in the use and concentration of bleaching agents.

Effects of At-Home and In-Office Bleaching Agents on the Color Recovery of Esthetic CAD-CAM Restorations after Red Wine Immersion

The aim of this study was to evaluate the effects of at-home and in-office bleaching agents on esthetic CAD-CAM materials after red wine immersion by measuring their optical properties. Sixty specimens were prepared out of three esthetic CAD-CAM materials: Vita Enamic, Celtra Duo, and Ceresmart (n = 20). All specimens were immersed in a red wine solution, and color measurements were performed. Specimens were randomly divided (n = 10) according to the bleaching procedure (in office, at home), bleaching durations were set to 3 time points, and color measurements were performed. According to the Commission Internationale de l’Eclairage (CIE) L* a* b* parameters, CIEDE2000 color differences (ΔE00), translucency parameters (TP00), and whiteness index values (ΔWID) after wine staining and after bleaching were calculated. Data were analyzed using the Mann−Whitney U-test, the Kruskal−Wallis test, and a two-way analysis of variance (ANOVA) (α = 0.05). ΔE00, ΔTP00, and ΔWID decreased with an increase in bleaching treatment. ΔE00 after the final bleaching treatment of in-office bleaching ranged from 1.7 to 2.0, whereas those of in-office treatment ranged from 0.4 to 1.1. All ΔTP00 and ΔWID after the final treatment were below the 50:50% perceptibility thresholds (ΔTP00 < 0.6, and ΔWID < 0.7). Significant differences in ΔE00, ΔTP00, and ΔWID among esthetic CAD-CAM materials were found between CD and CE. In the present study, color recovery after at-home and in-office bleaching appeared to be material-dependent. In-office bleaching showed more effective recovery comparing to at-home bleaching.

The Effect of Home and In-Office Bleaching on Microhardness and Color of Different CAD/CAM Ceramic Materials

The aim of this study is to assess the effect of different bleaching agents on microhardness and color of CAD/CAM ceramics including IPS e.max CAD (lithium disilicate), VITA ENAMIC (polymer-infiltrated ceramic), and Celtra Duo CAD (zirconia-reinforced lithium silicate). Materials' samples were divided into three groups (n = 10) and each received a different bleaching treatment; 20% carbamide peroxide, 35% carbamide peroxide, and 40% hydrogen peroxide. A fourth group was stored in water acting as a control. Vickers microhardness and spectrophotometric color measurements were taken at baseline and after bleaching. IPS e.max CAD showed a significant reduction (about 14%), while VITA ENAMIC showed a significant increase (about 78%) in microhardness after bleaching (p ˂ 0.001). Celtra Duo CAD did not demonstrate a significant change in microhardness (p ≥ 0.609). The color difference (ΔE_ab) after bleaching was 0.29 (±0.08), 2.84 (±0.64), and 1.99 (±0.37) for IPS e.max CAD, VITA ENAMIC, and Celtra Duo CAD, respectively. It could be concluded that the effect of bleaching on color and microhardness was mainly material-dependent. Bleaching significantly affected the microhardness of IPS e.max CAD and VITA ENAMIC. The color difference was within the clinically imperceptible range for IPS e.max CAD, while VITA ENAMIC and Celtra Duo CAD demonstrated perceptible color change.

Effect of Bleaching and Hot-Pressing Conditions on Mechanical Properties of Compressed Wood

This paper reports on multiple stage bleaching and its effect on the mechanical and swelling properties of compressed wood (CW). The natural wood specimen was bleached with NaClO₂ in five steps and three hot-pressing conditions. Their effects were investigated in morphologies: lignin content, alpha-cellulose content, compression ratio, mechanical properties, swelling and, water contact angle. After compression, the wood specimens became dense and the most porous structures collapsed. The lignin content decreased as the bleaching steps progressed, and the highest alpha-cellulose content was observed at the third bleaching step. This CW showed the best mechanical properties: bending strength was 240.1 ± 35.7 MPa, and Young’s modulus was 23.08 ± 0.89 Gpa. The CW swelling decreased as the bleaching step progressed, and was associated with the density decrease and the compression ratio increase with the bleaching step. The B3 is an optimum bleaching step that accounts for the best mechanical properties, which might be associated with the highest alpha-cellulose content.

The Self-Bleaching Process of Microcystis aeruginosa is Delayed by a Symbiotic Bacterium Pseudomonas sp. MAE1-K and Promoted by Methionine Deficiency

Various interactions between marine cyanobacteria and heterotrophic bacteria have been known, but the symbiotic relationships between Microcystis and heterotrophic bacteria remain unclear. An axenic M. aeruginosa culture (NIES-298) was quickly bleached after exponential growth, whereas a xenic M. aeruginosa culture (KW) showed a normal growth curve, suggesting that some symbiotic bacteria may delay this bleaching. The bleaching process of M. aeruginosa was distinguished from the phenomena of previously proposed chlorosis and programmed cell death in various characteristics. Bleached cultures of NIES-298 quickly bleached actively growing M. aeruginosa cultures, suggesting that M. aeruginosa itself produces bleach-causing compounds. Pseudomonas sp. MAE1-K delaying the bleaching of NIES-298 cultures was isolated from the KW culture. Bleached cultures of NIES-298 treated with strain MAE1-K lost their bleaching ability, suggesting that strain MAE1-K rescues M. aeruginosa from bleaching via inactivation of bleaching compounds. From Tn5 transposon mutant screening, a metZ mutant of strain MAE1-K (F-D3) unable to synthesize methionine, promoting the bleaching of NIES-298 cultures but capable of inactivating bleaching compounds, was obtained. The bleaching process of NIES-298 cultures was promoted with the coculture of mutant F-D3 and delayed by methionine supplementation, suggesting that the bleaching process of M. aeruginosa is promoted by methionine deficiency.

IMPORTANCE Cyanobacterial blooms in freshwaters represent serious global concerns for the ecosystem and human health. In this study, we found that one of the major species in cyanobacterial blooms, Microcystis aeruginosa, was quickly collapsed after exponential growth by producing self-bleaching compounds and that a symbiotic bacterium, Pseudomonas sp. MAE1-K delayed the bleaching process via the inactivation of bleaching compounds. In addition, we found that a metZ mutant of strain MAE1-K (F-D3) causing methionine deficiency promoted the bleaching process of M. aeruginosa, suggesting that methionine deficiency may induce the production of bleaching compounds. These results will provide insights into the symbiotic relationships between M. aeruginosa and heterotrophic bacteria that will contribute to developing novel strategies to control cyanobacterial blooms.

Influence of violet LED associated or not with peroxide gel on inflammation, mineralization, and collagen fiber maturation in dentin and pulp tissue

OBJECTIVES

To evaluate the influence of violet LED, associated or not with a 17.5% hydrogen peroxide (HP) bleaching gel, on inflammation, mineralization in pulp tissue, and collagen fiber maturation in dentin and pulp tissue.

MATERIALS AND METHODS

The maxillary molars of eighty Wistar rats were distributed into four groups (n = 10): CONT - without treatment; HP - 30-minute application of 17.5% HP; LED - 20-minute application of violet LED; and HP+LED - application of PH and violet LED. Rats were euthanized and jaws were processed for histologic and immunohistochemical evaluation (IL-17, IL-23, and osteocalcin) and picrosirius red immediately after (T0), and at 7 (T1), 15 (T2), and 30 days (T3) post-treatment, with Wilcoxon, Mann-Whitney, paired T-test, and T-test (α = 0.05).

RESULTS

HP and HP+LED presented necrosis and severe inflammatory infiltrate. When compared to CONT group, LED presented severe osteocalcin (OCN) immunostaining in T2 and less immature fibers in T2 and T3.

CONCLUSION

The violet LED caused no severe damage to the pulp tissue, increased IL-17 and IL-23 expression in T0 when associated with HP, and had no influence on pulp tissue mineralization, besides accelerating the maturation of collagen fibers of dentin.

CLINICAL RELEVANCE

Violet LED therapy induced no inflammation in the pulp tissue of rats and played no role in pulp tissue fibrosis, besides accelerating the maturation of dentin collagen fibers.

Clinical and dermoscopic evaluation of melanocytic nevi changes during diode laser hair removal: A prospective study

BACKGROUND

Laser hair removal (LHR) is a common practice with increasing use worldwide. Clinical and dermoscopic changes in melanocytic nevi after LHR have been reported but prospective studies are lacking.

OBJECTIVE

To describe dermoscopic changes of melanocytic nevi at different time points after LHR.

METHODS

Prospective study in a cohort of female patients undergoing diode LHR. Dermoscopic follow-up of at least three nevi on the legs that underwent hair removal. We included three nonexposed nevi on the arms as controls. Two blinded investigators analyzed dermoscopic images, according to variables selected based on the available literature.

RESULTS

Thirty-four patients were included with a total of 148 nevi on the legs and 112 nevi on the arms (controls). 47.9% (71/148) of the nevi on the legs had evidence of dermoscopic changes at the sixth hair removal session, compared to 9.8% (11/112) on controls (p < 0.001). The most frequent change was "bleaching" (41.9%, 62/148). Also, we observed "irregular hyperpigmented areas," and "regression structures" in 5.4% (8/148) and 4.7% (7/148) of the cases at the sixth session, respectively. Neither of these structures were observed in the controls (p < 0.05).

LIMITATIONS

Only females were included; we did not perform histopathological evaluation nor reflectance confocal microscopy of changing nevi.

CONCLUSION

Melanocytic nevi frequently change after diode LHR. The changes cannot always distinguish between LHR induced and melanoma, so we advise avoiding nevi during laser therapies with melanin targets.

Can the hydrogel form of sodium ascorbate be used to reverse compromised resin infiltrant penetration after bleaching?

Aims

The aim of this study was to investigate the effects of an antioxidant on the bleaching-induced reduction in the penetration depth of infiltrant resins.

Materials and Methods

White spot lesions (WSLs) were created on 105 bovine tooth samples, each measuring 6 × 4 × 4 mm. Five samples were randomly selected for the examination of lesion characteristics. The remaining 100 samples were then divided into four groups (n = 25). In Group I, the WSLs were treated with resin infiltration (RI) only. RI was performed on Group II immediately after bleaching. In Group III, an antioxidant was applied for 2 h after bleaching, and this was immediately followed by RI. The Group IV samples were treated with RI at the end of a 1-week waiting period after bleaching. The penetration depths were evaluated through confocal laser scanning microscopy.

Results

The lowest penetration rate, which was approximately 57%, was observed in Group II. This was followed by Group III (87%), Group IV (90%), and Group I (92%). Group II, in which the samples were infiltrated immediately after bleaching, had the lowest mean penetration percentage. All the bleached groups exhibited significantly lower penetration percentages than the nonbleached group (Group I) (P < 0.05). Antioxidant application increased the penetration significantly (P < 0.05).

Conclusion

Application of sodium ascorbate was found to reverse the reduced resin penetration depth and penetration percentages resulting from bleaching. The postponement of adhesive procedures after bleaching yielded similar results.

A Fast and Automated Melanin-bleaching Method for Histopathologic Evaluation of Pigmented Melanoma Tissues

Histopathologic examination of highly pigmented melanoma tissues has always been a challenge for pathologists. The high concentration of melanin pigment is an obstacle for immunohistochemistry and the ensuing evaluation. Therefore, removing melanin has become a crucial step for processing heavily pigmented melanoma samples. Several bleaching techniques have been proposed in the past, however, the most commonly used methods are time-consuming and poorly standardized. In this study, we propose a new fast and fully automated bleaching method applicable to validated immunohistochemical panels already used in the diagnosis of melanocytic tumors. The proposed bleaching protocol is based on sample pretreatment with 0.5% hydrogen peroxide and a Tris base pH 10 solution for 8 minutes at 80°C before antigen retrieval. Immunohistochemistry with HMB45, MART-1, Ki-67, SOX10, S-100, Tyrosinase, and BRAF(V600E) antibodies showed that this pretreatment removed excess melanin without affecting the tissue antigenicity and cytoarchitecture. In conclusion, we propose a new fast and automated bleaching protocol, easily transferable to a routine setting with efficient results in specimens in which the melanin pigmentation could blunt the histopathologic examination.

Newer Technique of Extra-Coronal Bleaching with Sodium Perborate on Non-Pitted Fluorosis Stains in Permanent Anterior Teeth

Variety of treatment approaches have been proposed for esthetic management of dental fluorosis. Microabrasion, bleaching using hydrogen peroxide, and etch bleach seal are commonly used methods. Bleaching using sodium perborate has been used for intracoronal bleaching. Till now, no study has used sodium perborate for extracoronal bleaching of discolored stained teeth.

OBJECTIVES

To evaluate the esthetic improvement of non-pitted fluorosis stains using sodium perborate and compare with etch bleach seal, microabrasion and in-office bleaching with 30% H2O2 on visual assessment scale VAS (primary objective) and to assess any untoward effects including staining, sensitivity, gingival problems within the course of study (secondary objectives).

STUDY DESIGN

A randomized control trial with 6 months follow up. Methodology- Twenty children aged 8 to 12 years with non-pitted fluorosis in upper anterior teeth were divided into 4 groups with 5 patients in each group.

RESULTS AND DISCUSSION

All of the techniques showed improvement in esthetics with VAS. However, microabrasion and bleaching using sodium perborate had significantly better results than other 2 techniques.

CONCLUSION

Sodium perborate showed excellent results in extracoronal bleaching of fluorosed teeth. However a randomized study with large sample size is required to draw a definitive conclusion regarding superiority of one technique over others.

Does polishing of bleached enamel affect roughness and tooth color stability after exposure to coffee?

OBJECTIVE

This laboratory randomized study was designed to evaluate the effect of polishing on roughness and color stability of bleached teeth after coffee immersion.

MATERIALS AND METHODS

Ninety bovine crowns were randomly allocated to six groups (n = 15), according to bleaching protocols: At-home: standard protocol using 10% hydrogen peroxide (HP) or In-office: standard protocol using 35% HP; and with polishing protocols: (1) no polishing, (2) bleached enamel polished with #0.5 μm or (3) #2-4 μm diamond particles grit pastes. Samples were daily immersed into coffee solution for 45 min followed by mechanical brushing simulation (30 s) for 30 days. The surface roughness (Ra) and color alteration, expressed by ΔEab , ΔE00 , and whitening index (WI) were analyzed at baseline, after bleaching/polishing protocols and after coffee solution staining. The surface from each group was examined using a scanning electron microscope. Data were analyzed by two-way repeated measure analysis of variance followed by the Tukey test (α = 0.05).

RESULTS

Staining increases Ra, ΔEab , ΔE00 , and decreases WI values. Polishing after bleaching did not prevent staining, however, tooth polished with #0.5 μ-grit polishing paste showed better performance than #2-4 μ-grit (ΔEab : p = 0.001/ΔE00 : p = 0.003). Scanning electron microscope revealed a more irregular surface after coffee staining for all groups regardless bleaching/polishing protocols.

CONCLUSIONS

Using #0.5 μ-grit diamond paste to polish 35%HP in-office bleached enamel reduces the roughness and tooth staining. However, polishing after 10%HP at-home bleached enamel neither affects roughness nor improves tooth color stability after exposure to coffee.

CLINICAL SIGNIFICANCE

Polishing after at-home bleaching does not have benefits but after 35% hydrogen peroxide in-office bleaching, the polishing with #0.5 μ-grit polishing paste is indicated to reduce roughness and the tooth staining over time.