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Kury M, de Oliveira Ribeiro RA, de Souza Costa CA, Florez FLE, Cavalli V. Co-doped titanium dioxide nanoparticles decrease the cytotoxicity of experimental hydrogen peroxide gels for in-office tooth bleaching. Clin Oral Investig 2024; 28:550. [PMID: 39320486 DOI: 10.1007/s00784-024-05916-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 09/06/2024] [Indexed: 09/26/2024]
Abstract
OBJECTIVE To evaluate the efficacy and cytotoxicity of experimental 6% and 35% hydrogen peroxide gels (HP6 or HP35) incorporated with titanium dioxide nanoparticles (NP) co-doped with nitrogen and fluorine and irradiated with a violet LED light (LT). METHODS Bovine enamel-dentin disks adapted to artificial pulp chambers were randomly assigned to bleaching (n = 8/group): NC (negative control), NP, HP6, HP6 + LT, HP6 + NP, HP6 + NP + LT, HP35, HP35 + LT, HP35 + NP, HP35 + NP + LT, and commercial HP35 (COM). Color (ΔE00) and whiteness index (ΔWID) changes were measured before and 14 days after bleaching. The extracts (culture medium + diffused gel components) collected after the first session were applied to odontoblast-like MDPC-23 cells, which were assessed concerning their viability, oxidative stress, and morphology. The amount of HP diffused through the disks was determined. Data were analyzed by generalized linear models or Kruskal Wallis Tests (α = 5%). RESULTS: HP6 + NP + LT exhibited ΔE00 and ΔWID higher than HP6 (p < 0.05) and similar to all HP35 groups. HP6 + NP + LT showed the lowest HP diffusion, and the highest cell viability (%) among bleached groups, preserving cell morphology and number of living cells similar to NC and NP. HP6 + LT, HP6 + NP, and HP6 + NP + LT exhibited the lowest cell oxidative stress among bleached groups (p < 0.05). HP35, HP35 + LT, and HP35 (COM) displayed the lowest cell viability. CONCLUSION HP6 achieved significantly higher color and whiteness index changes when incorporated with nanoparticles and light-irradiated and caused lower cytotoxicity than HP35 gels. The nanoparticles significantly increased cell viability and reduced the hydrogen peroxide diffusion and oxidative stress, regardless of HP concentration. CLINICAL SIGNIFICANCE Incorporation of co-doped titanium dioxide nanoparticles combined with violet irradiation within the HP6 gel could promote a higher perceivable and acceptable efficacy than HP6 alone, potentially reaching the optimal esthetic outcomes rendered by HP35. This approach also holds the promise of reducing cytotoxic damages and, consequently, tooth sensitivity.
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Affiliation(s)
- Matheus Kury
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, 901 Limeira Avenue, Areião, Piracicaba, SP, 13414-903, Brazil
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, SP, Brazil
| | | | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Fernando Luís Esteban Florez
- Department of Restorative Sciences, Division of Dental Biomaterials, College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Vanessa Cavalli
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, 901 Limeira Avenue, Areião, Piracicaba, SP, 13414-903, Brazil.
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Favoreto MW, Cordeiro DCF, Centenaro GG, Bosco LD, Arana-Gordillo LA, Reis A, Loguercio AD. Evaluating color change and hydrogen peroxide penetration in human and bovine teeth through in-office bleaching procedures. J ESTHET RESTOR DENT 2024; 36:1171-1178. [PMID: 38353378 DOI: 10.1111/jerd.13207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE Assess color alteration and hydrogen peroxide (HP) penetration in human and bovine teeth using various in-office bleaching protocols with different application times. MATERIALS AND METHODS Thirty healthy human premolars and 30 healthy bovine incisors were divided into five groups and subjected to different bleaching protocols: 2 × 15 min, 1 × 30 min, 2 × 20 min, or 1 × 40 min, with a control group for each tooth type. All teeth were treated with 35% HP gel. Color alteration was measured using digital spectrophotometry before and 1 week after bleaching. HP concentration within the pulp was determined via UV-Vis spectrophotometry. Statistical analysis included one-way ANOVA, Tukey's, and Dunnett's tests (α = 0.05). RESULTS All groups exhibited significant color alteration, with no statistically differences among them (p > 0.05). However, significant differences were observed when compared with their respective control groups (p < 0.05). HP penetration into the pulp was evident in all bleached teeth compared to the control groups (p < 0.05), with the 2 × 20 group showing the highest HP levels within the pulp cavity, irrespective of tooth type (p < 0.05). CONCLUSION A simplified 1 × 30-min protocol can be recommended as it effectively maintains color alteration and HP penetration, irrespective of whether human or bovine teeth. CLINICAL SIGNIFICANCE This study suggests that an in-office dental bleaching protocol using a 1 × 30-min session is recommended, as it ensures both effective color change and no increase in the amount of HP penetration.
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Affiliation(s)
| | | | | | - Leonardo Dal Bosco
- Department of Restorative Dentistry, State University of Ponta Grossa, Parana, Brazil
| | | | - Alessandra Reis
- Department of Restorative Dentistry, State University of Ponta Grossa, Parana, Brazil
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Kury M, Esteban Florez FL, Tabchoury CPM, Cavalli V. Effects of experimental in-office bleaching gels incorporated with co-doped titanium dioxide nanoparticles on dental enamel physical properties. Odontology 2024:10.1007/s10266-024-00976-4. [PMID: 38963521 DOI: 10.1007/s10266-024-00976-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 06/24/2024] [Indexed: 07/05/2024]
Abstract
To evaluate the physical properties of enamel submitted to hydrogen peroxide (HP) incorporated with titanium dioxide nanoparticles (NP) co-doped with nitrogen and fluorine and irradiated with violet LED light (LT). Enamel-dentin disks were randomly allocated (T0) into groups, according to HP (HP6, HP15, or HP35) and NP (no NP, 5NP, or 10NP) concentrations, and irradiated or not with LT. A negative control (NC) group was set. After three bleaching sessions (T1, T2, and T3), specimens were stored in saliva for 14 days (T4). Enamel surface microhardness number (KHN), surface roughness (Ra), cross-sectional microhardness (ΔS), energy-dispersive spectroscopy (EDS), scanning electron (SEM), and polarized light (PLM) microscopies were performed. Surface KHN was significantly influenced by NP over time, independently of LT irradiation. At T3 and T4, gels with 5NP and 10NP exhibited no KHN differences compared to NC and baseline values, which were not observed under the absence of NP. NP incorporation did not statistically interfere with the ΔS and Ra. PLM images exhibited surface/subsurface darkening areas suggestive of demineralizing regions. SEM demonstrated some intraprismatic affection in the groups without NP. EDS reported a higher enamel calcium to phosphorus ratio following 10NP gels applications. Gels with NP maintained the enamel surface microhardness levels and seemed to control surface morphology, upholding the mineral content. None of the proposed experimental protocols have negatively influenced the enamel surface roughness and the cross-sectional microhardness.
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Affiliation(s)
- Matheus Kury
- Operative Dentistry Division, Department of Restorative Dentistry, Piracicaba School of Dentistry, University of Campinas, 901 Limeira Av., Areião, Piracicaba, SP, 13414-903, Brazil.
- Dental Research Division, Paulista University, 1212 Doutor Bacelar St., Indianópolis, São Paulo, SP, 04026-002, Brazil.
| | - Fernando Luís Esteban Florez
- Dental Materials Division, Department of Restorative Sciences, Oklahoma University Health Sciences Center College of Dentistry, 1201 N Stonewall Ave, Oklahoma City, OK, 73117, USA
| | - Cínthia Pereira Machado Tabchoury
- Biochemistry Division, Department of Physiological Sciences, Piracicaba School of Dentistry, University of Campinas, 901 Limeira Av., Areião, Piracicaba, SP, 13414-903, Brazil
| | - Vanessa Cavalli
- Operative Dentistry Division, Department of Restorative Dentistry, Piracicaba School of Dentistry, University of Campinas, 901 Limeira Av., Areião, Piracicaba, SP, 13414-903, Brazil
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Carneiro TS, Favoreto MW, Mena-Serrano A, Wendlinger M, Forville H, Reis A, Ceballos L, Loguercio AD. In vitro evaluation of the effect of different bleaching varnishes: Hydrogen peroxide penetration into the pulp chamber and color change. J ESTHET RESTOR DENT 2024; 36:402-409. [PMID: 37681984 DOI: 10.1111/jerd.13133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/09/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To evaluate the penetration of hydrogen peroxide (HP) into the pulp chamber and the color change of different bleaching varnishes in low concentrations used for at-home bleaching. MATERIALS AND METHODS Ninety healthy premolars were used, randomly distributed into nine groups (n = 10) according to bleaching varnish (PL, PolaLuminate; VS, VivaStyle Paint On Plus; CA, Cavex Bite&White whitening pen and; AW AlignerWhite) and time (10 and 30 min), and a control group (no bleaching). The penetration of HP was evaluated by UV-Vis spectroscopy. To evaluate the color change (ΔEab , ΔE00 , ΔWID ) a digital spectrophotometer was used (α = 0.05). RESULTS The AW group in 10 min and the control group showed similar and lower HP penetration in the pulp chamber when compared to the other groups (p = 0.003). Increasing the application time to 30 minutes elevated the amount of HP inside the pulp chamber for all groups (p = 0.003), except for PL (p > 0.05). When applied for 30 min all bleaching varnishes showed higher color change (ΔWID ) when compared to 10 min (p = 0.04). CONCLUSIONS For all bleaching varnishes evaluated, PolaLuminate applied for 30 min showed lower penetration into the pulp chamber and higher bleaching effects. CLINICAL SIGNIFICANCE The use of bleaching varnishes seems promising for teeth bleaching, but it varies according to user product and protocol.
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Affiliation(s)
- Taynara S Carneiro
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
- Area of Stomatology, IDIBO research group, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Michael W Favoreto
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | | | - Michel Wendlinger
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Heloisa Forville
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Alessandra Reis
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Laura Ceballos
- Area of Stomatology, IDIBO research group, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
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Alcântara SD, Benetti F, Silva LMAVD, Machado NEDS, Silva IJP, Esteves LMB, Ervolino E, Cintra LTA, Briso ALF. Bleaching gel volume influences hydrogen peroxide diffusion, inflammation, and the presence of nitric oxide in the pulp tissue: in vitro and in vivo model. J Appl Oral Sci 2023; 31:e20230265. [PMID: 38126578 PMCID: PMC10786454 DOI: 10.1590/1678-7757-2023-0265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/24/2023] [Accepted: 11/06/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To assess whether bleaching gel volume influences chromatic changes, hydrogen peroxide (HP) diffusion, inflammation, and oxidative stress in the pulp tissue. METHODOLOGY A total of 60 bovine teeth were divided into four groups, according to bleaching gel volume (n=15): without gel (WG); V30 (30 µL of 35% HP); V60 (60 µL); and V120 (120 μL). HP diffusion analysis was performed in the first session (T1). Chromatic changes (ΔE, ΔE00, and WID) were assessed after the first (T1), second (T2), third (T3) sessions, and 15 d (T4) after the end of treatment. Moreover, 20 rats were randomly divided into four groups (n=10) and their upper first molars were treated with different gel volumes: control (no treatment); V2 (2 μL of 17.5% HP); V4 (4 μL); and V8 (8 μL). After 24 h, rats were euthanized and the specimens processed for histological and immunohistochemical (nitric oxide synthase) evaluation. Data were analyzed using the Wilcoxon and Mann-Whitney tests (p<0.05). RESULTS In vitro (bovine teeth), chromatic changes were not influenced by bleaching gel volume, showing similar values in all groups and sessions, except for the control group (p<0.05). The V120 group had the highest HP diffusion values (p<0.05). In vivo (pulp tissue), the V4 and V8 groups showed the highest inflammatory infiltrate in the pulp and significant oxidative stress (p<0.05). CONCLUSION The adverse effects on the dental pulp related to HP diffusion, pulp inflammation, and oxidative stress depend on bleaching gel volume, while the bleaching effect is not proportional to the volume used.
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Affiliation(s)
- Sibele de Alcântara
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - Francine Benetti
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontologia Restauradora, Belo Horizonte, MG, Brasil
| | - Lívia Maria Alves Valentim da Silva
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - Nathália Evelyn da Silva Machado
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - Isabela Joane Prado Silva
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - Lara Maria Bueno Esteves
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - Edilson Ervolino
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Ciências Básicas, Araçatuba, SP, Brasil
| | - Luciano Tavares Angelo Cintra
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - André Luiz Fraga Briso
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
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Reis Souza ID, Leite ML, de Oliveira Ribeiro RA, Hebling J, de Souza Costa CA. Transdentinal cytotoxicity of resin luting cements using the bovine and human dentin barrier. J Prosthet Dent 2023; 130:939.e1-939.e8. [PMID: 37867015 DOI: 10.1016/j.prosdent.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023]
Abstract
STATEMENT OF PROBLEM Based upon ethical questions and because of the difficulty of obtaining intact human teeth, researchers have used bovine teeth to assess the physical and mechanical properties of different dental materials. However, data from transdentinal cytotoxicity tests showing that the bovine dentin barrier is similar to the human dentin barrier is lacking. PURPOSE The purpose of this in vitro study was to evaluate whether the bovine dentin barrier produces similar results to those obtained when the human dentin barrier is used to assess the transdentinal cytotoxicity of resin luting cements. MATERIAL AND METHODS The number and diameter of dentinal tubules present in the human dentin barrier and bovine dentin barrier were evaluated and assessed with a t test (α=.05). After inserting the standardized dentin barriers into artificial pulp chambers, murine dental papilla-derived cells (MDPC-23) were seeded on the pulpal surface of the specimens, and the luting cements were applied to their occlusal surfaces. Then, the following groups were established for both human and bovine dentin barriers: no treatment (negative control); Single Bond Universal; RelyX Luting 2; RelyX U200; and RelyX Ultimate. After 24 hours, the viability (alamarBlue) and morphology (scanning electron microscopy) of the cells were evaluated with a 2-way analysis of variance and the Tukey honest significance test (α=.05). RESULTS Dentinal tubules with larger diameters were observed in bovine dentin (P<.05), but the number of tubules was similar (P>.05). A reduction in viability and notable changes in the morphology of MDPC-23 cells occurred in the Single Bond Universal and RelyX Luting 2 groups in comparison with the negative control (P<.05). The RelyX U200 and RelyX Ultimate groups were statistically similar to the negative control (P>.05). No difference was found in cytotoxicity when the same luting cement was applied on human or bovine dentin barriers (P>.05). CONCLUSIONS For transdentinal cytotoxicity tests of resin luting cements, the bovine dentin barrier proved similar results to the human dentin barrier.
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Affiliation(s)
- Isabela Dos Reis Souza
- Former Postgraduate student, Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Maria Luísa Leite
- Postdoctoral Researcher, Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
| | - Rafael Antonio de Oliveira Ribeiro
- PhD student, Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Josimeri Hebling
- Professor, Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Carlos Alberto de Souza Costa
- Professor, Department of Physiology and Pathology, Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil.
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Gruba AS, Nunes GP, Marques MT, Danelon M, Alves RDO, de Toledo PTA, Briso ALF, Delbem ACB. Influence of bleaching gels formulated with nano-sized sodium trimetaphosphate and fluoride on the physicochemical, mechanical, and morphological properties of dental enamel. J Dent 2023; 139:104743. [PMID: 37839624 DOI: 10.1016/j.jdent.2023.104743] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/02/2023] [Accepted: 10/12/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES To evaluate in vitro the effects of sodium fluoride (F) and nano-sized sodium trimetaphosphate (TMPnano) added to a 35% hydrogen peroxide (H2O2) bleaching gel on the color alteration, enamel mechanical and morphological properties, and H2O2 transamelodentinal diffusion. MATERIALS AND METHODS Bovine enamel/dentin discs (n = 180) were divided according to the bleaching gel: 35% H2O2 (HP); 35% H2O2 + 0.1% F (HP/F); 35% H2O2 + 1% TMPnano (HP/TMPnano); 35% H2O2 + 0.1% F + 1% TMPnano (HP/F/TMPnano) and 35% H2O2 + 2% calcium gluconate (HP/Ca). The gels were applied 3 times by 40 min; once each 7-day. The Commission Internationale de l'Eclairage (CIE) L*a*b* total color alteration (ΔE), color alteration by CIEDE2000 (ΔE00), whitening index (ΔWID), surface (SH) and cross-sectional hardness (ΔKHN), surface roughness (Ra), and transamelodentinal diffusion were determined. Enamel surfaces were evaluated by Scanning Electron Microscopy (SEM) and X-ray Dispersive Energy (EDX). Data were submitted to ANOVA, followed by the Student-Newman-Keuls test (p <0.05). RESULTS ΔE, ΔE00, and ΔWID were similar among the gels that promoted a bleaching effect after treatment (p <0.001). Mineral loss (SH and ΔKHN), Ra, and H2O2 diffusion were lower for HP/F/TMPnano; the HP and HP/Ca groups presented the highest values (p <0.001). For SEM/EDX, surface changes were observed in all bleached groups, but less intense with TMPnano. CONCLUSIONS Gels containing F/TMPnano do not interfere with the bleaching effect and reduce enamel demineralization, roughness, H2O2 diffusion, and morphological changes. CLINICAL RELEVANCE Whitening gels containing F/TMPnano can be used as a new strategy to increase safety and maintain clinical performance.
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Affiliation(s)
- Amanda Scarpin Gruba
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Mariana Takatu Marques
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Marcelle Danelon
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Renata de Oliveira Alves
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Priscila Toninatto Alves de Toledo
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - André Luiz Fraga Briso
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Alberto Carlos Botazzo Delbem
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil.
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In-vitro evaluation of the effectiveness of polyphenols based strawberry extracts for dental bleaching. Sci Rep 2023; 13:4181. [PMID: 36914760 PMCID: PMC10011378 DOI: 10.1038/s41598-023-31125-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
To formulate a dental bleaching agent with strawberry extract that has potent bleaching properties and antimicrobial efficacy. Enamel specimens (3 × 3 × 2 mm3) were prepared. Quaternary Ammonium Silane (CaC2 enriched) was homogenized with fresh strawberries: Group 1: supernatant strawberry (10 g) extract < Group 2: supernatant strawberry (10 g) extract + 15%HA (Hydroxyapatite) < Group 3: supernatant strawberry (10 g) extract + 15% (HA-2%k21) < Group 4: supernatant strawberry (20 g) extract only (20 g strawberries) < Group 5: supernatant strawberry (20 g) extract + 15% HA < Group 6: supernatant strawberry (20 g) extract + 15% (HA-2%K21) < Group 7: In-office Opalescence Boost 35%. Single-colony lactobacillus was examined using confocal microscopy identifying bacterial growth and inhibition in presence of bleaching agents using 300 µL aliquot of each bacterial culture. Images were analysed by illuminating with a 488 nm argon/helium laser beam. Colour difference (∆E00) was calculated using an Excel spreadsheet implementation of the CIEDE2000 colour difference formula and colour change measured between after staining and after bleaching. Scanning electron microscope was used to image specimens. Raman spectra were collected, and enamel slices were used for STEM/TEM analysis. HPLC was used for strawberry extract analysis. Nano-indentation was performed and X-ray photoelectron spectroscopy. Antioxidant activity was determined along with molecular simulation. hDPSCs were expanded for Alamar Blue Analysis and SEM. Mean colour change was significantly reduced in group 1 compared to other groups (p < 0.05). CLSM showed detrimental effects of different strawberry extracts on bioflms, especially with antimicrobial (p < 0.05). Groups 1, 2 and 3 showed flatter/irregular surfaces with condensation of anti-microbial in group 3. In strawberry specimens, bands predominate at 960 cm-1. HPLC determined the strawberry extracts content. Molecular simulation verified interaction between calcium and polyphenol components. XPS peak-fitted high-resolution corresponding results of Ca2p3/2 and Ca2p1/2 for all k21 groups. Combination of 10 g strawberry extract supernatant and 15% (hydroxyapatite 2%k21) improved the whiteness and provided additional antimicrobial potential. The novel strawberry extract and antimicrobial based dental formulation had immediate bleaching effect without promoting significant changes in enamel morphology.
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Nagarkar S, Loguercio AD, Perdigão J. Evidence-based fact checking for selective procedures in restorative dentistry. Clin Oral Investig 2023; 27:475-488. [PMID: 36607490 DOI: 10.1007/s00784-022-04832-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/18/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Similar to other dental specialties, there are many clinical procedures in restorative dentistry that may or may not be supported by good evidence. Thus, the effectiveness of these procedures is uncertain. The aim of this paper is to reduce this knowledge gap by critically inspecting selective procedures in restorative dentistry and exploring if these well-established or widely advocated treatment modalities are necessary for improving treatment outcomes based on the best available evidence. MATERIALS AND METHODS A MEDLINE search was conducted to identify research on selective procedures while focusing on clinical trials and systematic reviews. Due to their practical relevance in the decision-making process, cost-effectiveness analyses were also included. RESULTS Mixed results were identified regarding the included interventions. Some procedures had adequate evidence supporting them while others were mostly based on beliefs. CONCLUSIONS A critical review of the available literature indicates that some common restorative procedures lack adequate support from high-quality research evidence. CLINICAL RELEVANCE This paper attempts to highlight the need to critically examine the scientific validity of traditional knowledge and techniques through the context of current research evidence. This will not only help generate consensus between educators, clinicians, and researchers regarding restorative procedures but will also lead to improved patient care and outcomes.
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Affiliation(s)
- Sanket Nagarkar
- Park Dental Group, Minneapolis, MN, USA.,Department of Restorative Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Alessandro D Loguercio
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Jorge Perdigão
- Division of Operative Dentistry, Department of Restorative Sciences, University of Minnesota, 515 SE Delaware St, 8-450 Moos Tower, Minneapolis, MN, 55455, USA.
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Clemente CF, de Alcântara S, da Silva LMAV, Esteves LMB, Catelan A, Aidar KMS, Fagundes TC, Briso ALF. Direct dentin bleaching: Would it be possible? Photodiagnosis Photodyn Ther 2022; 40:103121. [PMID: 36126830 DOI: 10.1016/j.pdpdt.2022.103121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 12/14/2022]
Abstract
This study aims to evaluate in vitro the effect of violet LED when applied directly to dentin tissue pigmented by different substances. We analyzed the chromatic alteration, the bleaching effect and the temperature variation. Hence, 60 bovine dentin tissue discs were divided into five groups: NNatural Pigmentation; T-Black Tea; C-Soluble Coffee; W-Red Wine; B-Equine Blood. Individualized pigmentation protocols were performed and all groups reached the same chromatic change value. Subsequently, we simultaneously performed a bleaching session and measured temperature variation using a K-type thermocouple device. Data on chromatic change (∆E, ∆E00, ∆a, ∆b and ∆L), whitening effect (WID) and temperature variation were subjected to one-way Anova and Tukey's post-test at a 5% significance level. The C group showed the most relevant chromatic change values, similar to the N group, responding positively to the treatment. However, the B group differed from the control group, which showed difficulty to respond to the treatment. Regarding the whitening index, only the W group showed lower results than the others. The B group showed the greatest temperature changes. We conclude that the violet LED offered chromatic change, which generated a bleaching effect. Pigmentations with red wine and blood showed the greatest difficulty to respond to treatment, also promoting a higher temperature rise in teeth pigmented with blood.
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Affiliation(s)
- Camila Ferro Clemente
- Undergraduate Student in Dentistry at the Faculty of Araçatuba, UNESP Faculty of Dentistry, José Bonifácio, 1193, Araçatuba, SP 16015-050, Brazil
| | - Sibele de Alcântara
- Department of Restorative Dentistry, São Paulo State University, (UNESP), School of Dentistry, José Bonifácio, 1193, Araçatuba, SP 16015-050, Brazil
| | - Lívia Maria Alves Valentim da Silva
- Department of Restorative Dentistry, São Paulo State University, (UNESP), School of Dentistry, José Bonifácio, 1193, Araçatuba, SP 16015-050, Brazil
| | - Lara Maria Bueno Esteves
- Department of Restorative Dentistry, São Paulo State University, (UNESP), School of Dentistry, José Bonifácio, 1193, Araçatuba, SP 16015-050, Brazil
| | - Anderson Catelan
- Department of Dentistry, Faculty of Health Sciences, University of Western São Paulo, José Bongiovani, 700, Presidente Prudente, SP, Brazil
| | - Karen Milaré Seiscento Aidar
- Department of Restorative Dentistry, São Paulo State University, (UNESP), School of Dentistry, José Bonifácio, 1193, Araçatuba, SP 16015-050, Brazil
| | - Ticiane Cestari Fagundes
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP CEP-16015-050, Brazil
| | - André Luiz Fraga Briso
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP CEP-16015-050, Brazil.
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da Silva LMAV, Cintra LTA, de Alcântara S, Machado NEDS, Benetti F, Ervolino E, Briso ALF. Influence of violet LED associated or not with peroxide gel on inflammation, mineralization, and collagen fiber maturation in dentin and pulp tissue. Photodiagnosis Photodyn Ther 2022; 39:102959. [PMID: 35691564 DOI: 10.1016/j.pdpdt.2022.102959] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- Livia Maria Alves Valentim da Silva
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, Vila Mendonça, Araçatuba, São Paulo 1193, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, Vila Mendonça, Araçatuba, São Paulo 1193, Brazil
| | - Sibele de Alcântara
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, Vila Mendonça, Araçatuba, São Paulo 1193, Brazil
| | - Nathália Evelyn da Silva Machado
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, Vila Mendonça, Araçatuba, São Paulo 1193, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - André Luiz Fraga Briso
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, Vila Mendonça, Araçatuba, São Paulo 1193, Brazil.
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A Titanium Tetrafluoride Experimental Gel Combined with Highly Concentrated Hydrogen Peroxide as an Alternative Bleaching Agent: An In Vitro Study. Gels 2022; 8:gels8030178. [PMID: 35323291 PMCID: PMC8951146 DOI: 10.3390/gels8030178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023] Open
Abstract
This in vitro study evaluated color change, mineral content, and morphology of enamel, pH and cytotoxicity of experimental bleaching agents containing 35% hydrogen peroxide (HP), titanium tetrafluoride (TiF4), Natrosol, and Chemygel. Sixty enamel/dentin blocks were randomly treated with (n = 10) HP; HP+Natrosol+Chemygel with different TiF4 concentrations: 0.05 g HPT0.5, 0.1 g HPT1, 0.2 g HPT2, 0.3 g HPT3, 0.4 g HPT4. Bleaching was performed in three sessions (3 × 15 min application). Color change (CIELab-ΔEab, CIEDE2000-ΔE00, ΔWID) and Knoop microhardness (KHN) were evaluated. Enamel morphology and composition were observed under scanning electron microscopy and energy-dispersive spectrometry (EDS), respectively. Cell viability of keratinocyte cells was evaluated using MTT assay. Data were analyzed by one-way ANOVA and LSD and Tukey tests, and two-way repeated measures ANOVA and Bonferroni (α = 5%). The pH and EDS were analyzed descriptively. Lightness-L* increased, and a* and b* parameters decreased, except for HPT3 and HPT4 (b*). HPT0.5, HPT1, and HPT2 exhibited ΔEab and ΔWID similar to HP. ΔE00 did not present statistical difference. HP, HPT0.5, and HPT1 promoted higher KHN. HPT0.5 exhibited no changes on enamel surface. Keratinocyte cells were viable when treated with T0.5, and weak viable for T1. Experimental agents exhibited acidic pH and Ti elements. HPT0.5 exhibited bleaching efficacy, maintained KHN without enamel alterations, and did not increase cytotoxicity.
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Trevisan TC, Bortolatto JF, Rizzi G, Meloto BT, Dantas AAR, de Oliveira Junior OB. Clinical performance of 6% hydrogen peroxide containing TiO 2N nanoparticles activated by LED in varying wavelengths-a randomized clinical trial. Lasers Med Sci 2021; 37:2017-2024. [PMID: 34778937 DOI: 10.1007/s10103-021-03464-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 11/05/2021] [Indexed: 11/22/2022]
Abstract
This randomized, controlled, and double-blinded clinical trial evaluated the clinical performance of dental bleaching performed with 6% hydrogen peroxide containing TiO2-N nanoparticles exposed to blue and violet activation lights. Forty volunteers, selected according to the inclusion and exclusion criteria, were randomly distributed into four experimental groups (n = 10): 35% hydrogen peroxide (PH35)-control; 6% hydrogen peroxide (PH6) containing TiO2-N nanoparticles without light activation; PH6 activated with a blue LED (PH6A); and PH6 activated with a violet LED (PH6V). The three bleaching sessions consisted of 3 consecutive 16-min applications of the bleaching agent described for each group. The groups receiving LED activation were exposed to light intermittently every 1 min, with a total exposure time of 8 min in each application. Efficacy was determined by the color variation in the upper central incisors and canines, using reflectance spectroscopy analysis performed by a calibrated evaluator (ICC = 0.83). Tooth sensitivity was characterized according to the presence and intensity (SI) self-recorded in specific forms. The group treated with PH6V was as effective as the control group (PH35), whereas the groups PH6A and PH6 showed lower efficacy. Regardless of the activation, all groups treated with 6% hydrogen peroxide were less likely to cause sensitivity compared to the control group (PH35). The use pf PH6 activated by LED violet resulted in an effective and safe clinical protocol for in-office dental bleaching.Trial registration number: RBR-8pbydg; registration date: 08/29/2017.
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Affiliation(s)
- Tamara Carolina Trevisan
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - Univ, Estadual Paulista, Araraquara, 14801-903, Brazil.
| | - Janaina Freitas Bortolatto
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - Univ, Estadual Paulista, Araraquara, 14801-903, Brazil
| | - Giovana Rizzi
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - Univ, Estadual Paulista, Araraquara, 14801-903, Brazil
| | - Bruna Tavoni Meloto
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - Univ, Estadual Paulista, Araraquara, 14801-903, Brazil
| | - Andrea Abi Rached Dantas
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - Univ, Estadual Paulista, Araraquara, 14801-903, Brazil
| | - Osmir Batista de Oliveira Junior
- Department of Restorative Dentistry, Araraquara School of Dentistry, UNESP - Univ, Estadual Paulista, Araraquara, 14801-903, Brazil
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Kiyuna RC, Martins LM, Hanzen TA, Reis A, Loguercio AD, Silva LM. Comparison of the Effect of Agitation on Whitening and Tooth Sensitivity of In-Office Bleaching: A Randomized Clinical Trial. Oper Dent 2021; 46:143-150. [PMID: 34143220 DOI: 10.2341/19-223-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This single-blind, split-mouth, randomized trial was aimed at evaluating the bleaching efficacy (BE) and tooth sensitivity (TS) of a 20% hydrogen peroxide (HP) bleaching agent used under active or passive application. METHODS AND MATERIALS Twenty-two patients with canines darker than C2 were selected. Teeth were bleached in two sessions, with a one-week interval between treatments. The bleaching agent was applied using active (HPactive) or passive (HPpassive) application. Each tooth in the HPactive-allocated hemiarch received bleaching gel with sonic activation after 10 and 30 minutes from the start of treatment, with rounded movements all over the buccal surface. The color changes were evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (VITA Easyshade Spectrophotometer) methods at baseline and 30 days after the second session. TS was recorded up to 48 hours after treatment using a 0-10 visual analog scale. Color change in shade guide units (SGUs) and ΔE was analyzed using a Wilcoxon test (α=0.05). The absolute risk and intensity of TS were evaluated using McNemar test and a Wilcoxon test, respectively (α=0.05). RESULTS Significant whitening was observed in both groups after 30 days of clinical evaluation. The activation did not significantly influence BE (ΔSGU HPpassive=5.6 and HPActive=5.8; p=0.98; and ΔE HPpassive=10.6 and HPactive=10.3; p=0.83). Absolute risk of TS (HPactive=36.4% and HPpassive=31.8%; p=0.94) was similar for both groups (Fisher exact test). TS intensity (visual analogue scale) was higher during the bleaching sessions and up to 24 hours thereafter for both groups, with no differences between groups (twoway analysis of variance and Tukey). CONCLUSION The active application of a 20% HP gel did not improve BE and TS.
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Hatırlı H, Karaarslan EŞ, Yaşa B, Kılıç E, Yaylacı A. Clinical effects of dehydration on tooth color: How much and how long? J ESTHET RESTOR DENT 2020; 33:364-370. [PMID: 32573090 DOI: 10.1111/jerd.12612] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/25/2020] [Accepted: 05/31/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate effects of dehydration on tooth color determine whether color returns to baseline after 30 min or 24 h. MATERIALS AND METHODS Thirty participants with intact maxillary central and lateral incisors were recruited for the study. Color measurements were performed with a spectrophotometer (SpectroShade Micro) at baseline and at 10, 20, and 30 min of dehydration, as well as 30 min and 24 h of rehydration. CIEDE2000 color parameters were used to calculate color difference. The data were analyzed for color changes over time by repeated-measures analysis of variance (ANOVA), and the Bonferroni-Tukey test was used for post-ANOVA comparisons (P < .05). RESULTS After 30 min of dehydration, all the tested teeth were above the perceptibility threshold (ΔE00 = 0.8), and 85% of the teeth were above the acceptability threshold (ΔE00 = 1.8). After 30 min of rehydration, 78.3% of the tested teeth were above the perceptibility threshold, and 31.6% of the teeth were above the acceptability threshold. After 24 h of rehydration, 99.2% of the teeth were below the acceptability threshold, and 90% of the values were below the perceptibility threshold. CONCLUSIONS Thirty-minute tooth dehydration can result in a clinically significant color change. After a 24-h rehydration period, reliable color assessment can be performed. CLINICAL SIGNIFICANCE Tooth dehydration causes significant color change, thus assessment of final color or clinical success should be considered after tooth rehydration for esthetic restorations and tooth bleaching.
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Affiliation(s)
- Hüseyin Hatırlı
- Faculty of Dentistry, Department of Restorative Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Emine Şirin Karaarslan
- Faculty of Dentistry, Department of Restorative Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Bilal Yaşa
- Faculty of Dentistry, Department of Restorative Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - Enes Kılıç
- Faculty of Dentistry, Department of Restorative Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Ayla Yaylacı
- Faculty of Dentistry, Department of Restorative Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey
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da Silva LMAV, Cintra LTA, Gallinari MDO, Benetti F, Rahal V, Ervolino E, de Alcântara S, Briso ALF. Influence of pain-relieving therapies on inflammation and the expression of proinflammatory neuropeptides after dental bleaching treatment. Restor Dent Endod 2020; 45:e20. [PMID: 32483537 PMCID: PMC7239683 DOI: 10.5395/rde.2020.45.e20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/11/2022] Open
Abstract
Objectives To minimize the tooth sensitivity caused by in-office bleaching, many dentists use non-steroidal anti-inflammatory drugs and topical desensitizing gels containing potassium nitrate and sodium fluoride. This study aimed to evaluate the influence of these substances on inflammation and the expression of substance P and calcitonin gene-related peptide in pulp nerve fibers. Materials and Methods Seventy-two rats were divided into 6 groups as follows: GI, control; GII, only dental bleaching; GIII, only ibuprofen; GIV, ibuprofen administered 30 minutes before and after the bleaching treatment and every 12 hours until the analysis; GV, only topical application of a desensitizing agent; and GVI, topical application of a desensitizing agent before dental bleaching. Placebo gel was applied to the upper left jaw and the bleaching agent was applied to the upper right jaw in all groups. Subsequently, the groups were divided into 3 subgroups based on the time of analysis: 0, 24, and 48 hours after bleaching (n = 8). The rats were euthanized and the maxillae were processed and evaluated by histopathological and immunohistochemical analyses. The data were analyzed using the Kruskal-Wallis test, followed by the Dunn test (p < 0.05). Results In the bleaching groups, the inflammatory process and expression of neuropeptides decreased over time. The animals in which a desensitizing agent was applied showed better results within 24 hours. Conclusions The use of a desensitizing agent had positive effects on inflammation and pain-related neuropeptide expression, minimizing the painful effects of dental bleaching treatment.
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Affiliation(s)
| | | | | | - Francine Benetti
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Vanessa Rahal
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Sibele de Alcântara
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - André Luiz Fraga Briso
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
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Evaluation of the color change and tooth sensitivity in treatments that associate violet LED with carbamide peroxide 10 %: A randomized clinical trial of a split-mouth design. Photodiagnosis Photodyn Ther 2020; 30:101679. [DOI: 10.1016/j.pdpdt.2020.101679] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/14/2020] [Accepted: 01/27/2020] [Indexed: 12/22/2022]
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Pontes M, Gomes J, Lemos C, Leão RS, Moraes S, Vasconcelos B, Pellizzer EP. Effect of Bleaching Gel Concentration on Tooth Color and Sensitivity: A Systematic Review and Meta-analysis. Oper Dent 2020; 45:265-275. [PMID: 32396502 DOI: 10.2341/17-376-l] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis was to evaluate a high concentration of hydrogen peroxide (35%) regarding tooth sensitivity and color change in tooth bleaching in comparison to low concentrations (6% to 20%). METHODS AND MATERIALS This review was conducted using the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and is registered on the Prospective Register of Systematic Reviews (CRD42017064493). The PICO question was "Does a concentration of hydrogen peroxide ≥35% using in-office bleaching procedure contribute to greater tooth sensitivity?" A search was made in PubMed/MEDLINE, Scopus, and the Cochrane Library. RESULTS Fourteen studies were selected for the qualitative analysis and seven for quantitative analysis. A total of 649 patients were evaluated (mean age: 36.32 years; range: 13.9 to 31 years), and the follow-up period ranged from one week to 12 months. The meta-analysis demonstrated that tooth sensitivity was higher in the patients submitted to treatment involving a high concentration of hydrogen peroxide (0.67; 95% confidence interval [CI]: 0.44 to 1.03; p=0.04; I 2 : 56%), and a significant difference was found regarding objective color ΔE (1.53; 95% CI: 2.99 to 0.08; p<0.0001; I 2 : 82%) but no significant difference was found regarding subjective color ΔSGU (0.24; CI: 0.75 to 1.23; p<0.00001; I 2 : 89%). CONCLUSIONS This study indicated that a lower concentration of hydrogen peroxide causes less tooth sensitivity and better effectiveness in objective color change (ΔE); however, there is no difference between them related to subjective color (ΔSGU).
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Abbasi M, Pordel E, Chiniforush N, Firuzjaee SG, Omrani LR. Hydrogen peroxide penetration into the pulp chamber during conventional in-office bleaching and diode laser-assisted bleaching with three different wavelengths. Laser Ther 2019; 28:285-290. [PMID: 32255920 PMCID: PMC7087340 DOI: 10.5978/islsm.19-or-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 11/11/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIMS Penetration of hydrogen peroxide into the pulp chamber and subsequent tooth hypersensitivity is a common concern in dental bleaching. The aim of this study was to assess the penetration of hydrogen peroxide (H2O2) into the pulp chamber in diode-laser activated bleaching with different laser wavelengths. MATERIALS AND METHODS Fifty extracted human maxillary anterior teeth were collected and divided into five groups(n = 10). Group 1: conventional in-office bleaching using Opalescence Boost gel. Group 2: Bleaching with Biolase Laser White 20 gel activated by 980 nm diode laser. Group 3: Bleaching with Biolase Laser White 20 gel activated by 810 nm diode laser. Group 4: Bleaching with Biolase Laser White 20 gel activated by 940 nm diode laser. Group 5: No bleaching control group.After bleaching, the solution into the pulp chamber was collected and analyzed using a spectrophotometer. The recorded data were compared with a standard sample and the results were analyzed and compared using one-way ANOVA and Tukey's HSD tests. RESULTS In all bleached groups, H2O2 had infiltrated into the pulp chamber. The highest level of penetration was noted in group 2 (2.32 ± 0.25 µg), while the lowest level was noted in group 3 (1.85 ± 0.33 µg). The difference in this regard was significant between groups 2 and 3 (P = 0.024), but the differences between other groups were not statistically significant (P ≥ 0.42). CONCLUSION Considering the results of this study, it can be stated that hydroge peroxide penetration in to pulp chamber in diode laser activation of bleaching agent according to manufactures instruction is not higher than in-office bleaching. The wavelength of diode laser had significant effect on penetration of hydrogen peroxide into pulp chamber.
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Affiliation(s)
- Mahdi Abbasi
- DDS, MSc's, assistant professor, Restorative Dentistry Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Edris Pordel
- Department of Pediatric Dentistry, Borujerd Branch, Islamic Azad University Boroujerd, Iran
| | - Nasim Chiniforush
- Dentist, PhD of laser dentistry, Laser Research Canter of Dentistry, Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sattar Gorgani Firuzjaee
- DDS. Department of Medical Laboratory Sciences, School of Allied Health Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Ladan Ranjbar Omrani
- DDS, MSc's, associate professor, Restorative Dentistry Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Kury M, Perches C, Silva DP, André CB, Tabchoury CPM, Giannini M, Cavalli V. Color change, diffusion of hydrogen peroxide, and enamel morphology after in‐office bleaching with violet light or nonthermal atmospheric plasma: An in vitro study. J ESTHET RESTOR DENT 2019; 32:102-112. [DOI: 10.1111/jerd.12556] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/22/2019] [Accepted: 12/02/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Matheus Kury
- Department of Restorative DentistryPiracicaba Dental School, University of Campinas Piracicaba São Paulo Brazil
| | - Carolina Perches
- Department of Restorative DentistryPiracicaba Dental School, University of Campinas Piracicaba São Paulo Brazil
| | - Daylana P. Silva
- Department of Restorative DentistryPiracicaba Dental School, University of Campinas Piracicaba São Paulo Brazil
| | - Carolina B. André
- Department of Restorative DentistryPiracicaba Dental School, University of Campinas Piracicaba São Paulo Brazil
- Department of Restorative DentistryFederal University of Minas Gerais Belo Horizonte Minas Gerais Brazil
| | - Cínthia P. M. Tabchoury
- Department of Physiological SciencesPiracicaba Dental School, University of Campinas Piracicaba São Paulo Brazil
| | - Marcelo Giannini
- Department of Restorative DentistryPiracicaba Dental School, University of Campinas Piracicaba São Paulo Brazil
| | - Vanessa Cavalli
- Department of Restorative DentistryPiracicaba Dental School, University of Campinas Piracicaba São Paulo Brazil
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Clinical analysis of color change and tooth sensitivity to violet LED during bleaching treatment: A case series with split-mouth design. Photodiagnosis Photodyn Ther 2019; 27:59-65. [DOI: 10.1016/j.pdpdt.2019.05.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/13/2019] [Accepted: 05/17/2019] [Indexed: 12/21/2022]
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Gallinari MO, Fagundes TC, da Silva LM, de Almeida Souza MB, Barboza ACS, Briso ALF. A New Approach for Dental Bleaching Using Violet Light With or Without the Use of Whitening Gel: Study of Bleaching Effectiveness. Oper Dent 2019; 44:521-529. [DOI: 10.2341/17-257-l] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
The objective of this study was to evaluate the effectiveness of violet light-emitting diodes (LEDs) in dental bleaching treatment when used in conjunction with bleaching gels containing different concentrations of hydrogen peroxide (HP). Here, 90 bovine teeth (n=15) were randomly assigned to the following groups: GI, placebo without light; GII, 35% HP without light; GIII, 17.5% HP without light; GIV, placebo with violet LED; GV, 35% HP with violet LED; and GVI, 17.5% HP with violet LEDs. Three bleaching sessions of 45 minutes were conducted; 21 cycles involving one minute of irradiation by violet LEDs with 30-second intervals were performed during each session of bleaching (GIV, GV, and GVI). Color changes (ΔE, ΔL, Δa, and Δb) were analyzed using a visible ultraviolet light spectrophotometer 7 days after each bleaching session. The mean ΔE, ΔL, Δa, and Δb values were compared between groups by analysis of variance and Tukey tests, with a significance level of 5%. The groups treated with 35% HP had higher ΔE and ΔL and lower Δb values, regardless of whether violet light was used. The group that received only violet LED differed from the control group in terms of ΔE, and the group treated with 17.5% HP and violet LED presented higher ΔE values than the group treated with 17.5% HP only. Thus, violet light did not influence bleaching efficacy when using 35% HP, but when used in conjunction with 17.5% HP, it increased the bleaching efficacy. Moreover, use of the violet LED only also prompted a bleaching effect, although it was less marked.
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Affiliation(s)
- MO Gallinari
- Marjorie de Oliveira Gallinari, DDS, MS, PhD student, Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - TC Fagundes
- Ticiane Cestari Fagundes, associate professor, Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - LM da Silva
- Livia Maria Alves Valentim da Silva, DDS student, Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - MB de Almeida Souza
- Morganna Machado Borges de Almeida Souza, DDS, MS student, Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - ACS Barboza
- Ana Carolina de Souza Barboza, DDS, MS student, Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - ALF Briso
- André Luiz Fraga Briso, associate professor, Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
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Are combined bleaching techniques better than their sole application? A systematic review and meta-analysis. Clin Oral Investig 2019; 23:3673-3689. [PMID: 31468261 DOI: 10.1007/s00784-019-03042-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 08/05/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES A systematic review and meta-analysis were performed to answer this research question: "Does combined in-office (IO) and at-home (AH) bleaching produce improved color change and lower tooth sensitivity (TS) better than solely AH or IO bleaching in adults?" MATERIAL AND METHODS Randomized controlled trials in adults that compared combined versus sole application bleaching were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. Meta-analyses were conducted for color change in shade guide units (∆SGU) and with a spectrophotometer (∆E*), risk, and intensity of TS, using the random effects model. Heterogeneity was assessed with Cochran's Q test and I2 statistics. GRADE assessed the quality of the evidence. PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, SIGLE, IADR abstracts, unpublished, ongoing trial registries, dissertations, and theses were searched on August 28, 2017 (updated on January 29, 2019). RESULTS Twelve studies remained. Two were considered to have low RoB. For combined vs. IO bleaching, no significant difference for ∆E*, ∆SGU, and risk of TS were observed; data were not available to analyze the intensity of TS. For combined vs. AH bleaching, no significant difference for ∆E*, ∆SGU, but lower TS to risk (RR 1.40, 95% 1.10 to 1.80) and intensity (MD 1.40, 95% CI 0.18 to 2.63) were detected for AH bleaching. Quality of evidence was graded as low or very low in all meta-analyses. CONCLUSION Lower risk and intensity of TS was observed for the solely AH group without jeopardizing color change. However, more studies are still encouraged due to the low quality of evidence for most of the outcomes. CLINICAL RELEVANCE If clinicians are to choose between combined or sole AH bleaching, the solely AH may be preferable; combined bleaching may potentiate the risk of TS without benefits in color change. For combined or sole IO bleaching, no important clinical difference in color change and risk of TS were detected; however, intensity of TS could not be compared due to lack of data. Further studies should be conducted due to the low/very low quality of the evidence.
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Lilaj B, Dauti R, Agis H, Schmid-Schwap M, Franz A, Kanz F, Moritz A, Schedle A, Cvikl B. Comparison of Bleaching Products With Up to 6% and With More Than 6% Hydrogen Peroxide: Whitening Efficacy Using BI and WI D and Side Effects - An in vitro Study. Front Physiol 2019; 10:919. [PMID: 31543822 PMCID: PMC6728628 DOI: 10.3389/fphys.2019.00919] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/05/2019] [Indexed: 12/30/2022] Open
Abstract
The aim of this study was to evaluate the effect of bleaching agents containing different concentrations of hydrogen peroxide (HP) on color-change and on enamel-surface in bovine teeth. Furthermore the influence on cell viability and proliferation was investigated. Two hundred and forty teeth were randomly assigned into four groups (home bleaching ≤6%, in-office bleaching ≤6%, in-office bleaching > 6% HP, and control group). Bleaching was performed after artificial staining and the bleached index (BI) as well as the whiteness index (WID) was measured at several time points. Chemical analysis for HP concentrations and the pH of the bleaching products was done. Furthermore, enamel surfaces of randomly selected specimens were analyzed using scanning electron microscopy (SEM) and cytotoxicity of the tested bleaching products was evaluated in vitro using dental pulp cells (DPCs) and L929 cells. A statistically significant whitening effect was observed in almost all products. As expected all investigated products resulted in decreased cell viability, however, with different values of LC50 (median lethal concentration). SEM analysis showed an analog of enamel alterations with decreasing pH, increasing exposure time, and increasing HP concentration. Bleaching agents containing a low HP concentration are considered to be effective and to have less damaging effects on enamel and tested cells.
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Affiliation(s)
- Bledar Lilaj
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Rinet Dauti
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Hermann Agis
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Martina Schmid-Schwap
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Alexander Franz
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Fabian Kanz
- Center for Forensic Medicine, Medical University of Vienna, Vienna, Austria
| | - Andreas Moritz
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Andreas Schedle
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Barbara Cvikl
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Department of Conservative Dentistry, Sigmund Freud University, Vienna, Austria
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Barbosa JG, Benetti F, de Oliveira Gallinari M, Carminatti M, da Silva ABD, Lopes INI, Briso ALF, Cintra LTA. Bleaching gel mixed with MI Paste Plus reduces penetration of H 2O 2 and damage to pulp tissue and maintains bleaching effectiveness. Clin Oral Investig 2019; 24:1299-1309. [PMID: 31302769 DOI: 10.1007/s00784-019-03009-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 07/03/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES MI Paste Plus remineralizer (Rem) strengthens dental structures after bleaching. We investigated the effect of Rem on the penetration of hydrogen peroxide (H2O2), bleaching effectiveness, and pulp inflammation after bleaching. MATERIALS AND METHODS Bovine disks were grouped as follows (n = 10): control (untreated), bleached (Ble; 35% H2O2, 30 min), Ble-Rem (H2O2 followed by Rem, 30 min), Rem-Ble (Rem followed by H2O2), Rem-Ble-Rem (Rem before and after H2O2), and Ble+Rem (mixture of Rem with H2O2, 1:1, 30 min). The penetration of H2O2 was quantified and bleaching efficacy was analyzed. Upper rat molars (n = 10) received the same treatments at random. The rats were euthanized after two days and 30 days, and their jaws were removed for histological analysis. Statistical tests were performed (P < 0.05). RESULTS The bleached groups, except Ble+Rem (P > 0.05), showed significant H2O2 penetration compared with control (P < 0.05). Color alteration analysis showed that ΔL and ΔE were significantly higher in the bleached groups than those in control (P < 0.05); the Δb of the bleached groups differed from that of control at 24 h (P < 0.05). At two days, necrosis or inflammation was observed in the bleached groups compared with control (P < 0.05), except Ble+Rem, which was similar to control (P > 0.05). At 30 days, tertiary dentin formation was significant in the bleached groups (P < 0.05), except Ble+Rem (P > 0.05). CONCLUSION The mixture of MI Paste Plus and bleaching gel reduces H2O2 penetration and pulp damage and maintains bleaching effectiveness. CLINICAL RELEVANCE Because bleaching can damage dental tissues, we studied a new bleaching protocol that reduces damage to the pulp tissue while maintaining bleaching efficiency: a single application of 30 min of MI Paste Plus mixed with 35% H2O2 bleaching gel (1:1).
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Affiliation(s)
- Jéssica Galbiati Barbosa
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
| | - Francine Benetti
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
- Restorative Dentistry, School of Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Marina Carminatti
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
| | - Anna Beatriz Dias da Silva
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
| | | | - André Luiz Fraga Briso
- Department of Restorative Dentistry, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
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Llena C, Collado-González M, García-Bernal D, Oñate-Sánchez RE, Martínez CM, Moraleda JM, Rodríguez-Lozano FJ, Forner L. Comparison of diffusion, cytotoxicity and tissue inflammatory reactions of four commercial bleaching products against human dental pulp stem cells. Sci Rep 2019; 9:7743. [PMID: 31123303 PMCID: PMC6533274 DOI: 10.1038/s41598-019-44223-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/08/2019] [Indexed: 12/23/2022] Open
Abstract
Multiple side effects related to bleaching were found to occur in the dental pulp tissue, including decreased cell metabolism and viability. In this work we evaluated the in vitro diffusion capacity, cytotoxicity and biocompatibility of four commercial bleaching products on stem cells from human dental pulp (hDPSCs). Two commercial bleaching gels hydrogen peroxide-based (HP), Norblanc Office 37.5% (Nor-HP) and Opalescence Boost 40% (Opal-HP) were applied for 30 min to enamel/dentine discs. Another two gels from the same manufacturers, 16% carbamide peroxide-based (CP), Norblanc Home (Nor-CP) and Opalescence CP 16% (Opal-CP), were applied for 90 min. The diffusion of HP was analysed by fluorometry. Cytotoxicity was determined using the MTT assays, the determination of apoptosis, immunofluorescence assays and intracellular reactive oxygen species (ROS) level. Tissue inflammatory reactions were evaluated histopathologically in rats. Statistical differences were performed by one-way ANOVA and Bonferroni post-test (α < 0.05). Normon products showed lower cytotoxicity and diffusion capacity than the Ultradent products. A high intracellular ROS level was measured in hDPSCs after exposure to Opal-HP. Finally, a severe necrosis of both coronal and radicular pulp was observed with Opal-HP. Similar concentrations of hydrogen peroxide and carbamide peroxide in a variety of bleaching products exhibited different responses in cells and dental pulp tissue, suggesting that bleaching products contain unknown agents that could influence their toxicity.
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Affiliation(s)
- C Llena
- Department of Stomatology, Universitat de València, Valencia, Spain
| | - M Collado-González
- Department of Stomatology, Universitat de València, Valencia, Spain.,Unit of Special Care in Dentistry and Cell Therapy and Hematopoietic Transplant Unit, Internal Medicine Department, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - D García-Bernal
- Unit of Special Care in Dentistry and Cell Therapy and Hematopoietic Transplant Unit, Internal Medicine Department, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - R E Oñate-Sánchez
- Unit of Special Care in Dentistry and Cell Therapy and Hematopoietic Transplant Unit, Internal Medicine Department, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - C M Martínez
- Experimental Pathology Unit, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - J M Moraleda
- Unit of Special Care in Dentistry and Cell Therapy and Hematopoietic Transplant Unit, Internal Medicine Department, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - F J Rodríguez-Lozano
- Unit of Special Care in Dentistry and Cell Therapy and Hematopoietic Transplant Unit, Internal Medicine Department, IMIB-Arrixaca, University of Murcia, Murcia, Spain.
| | - L Forner
- Department of Stomatology, Universitat de València, Valencia, Spain
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Hydrogen peroxide-based products alter inflammatory and tissue damage-related proteins in the gingival crevicular fluid of healthy volunteers: a randomized trial. Sci Rep 2019; 9:3457. [PMID: 30837573 PMCID: PMC6400941 DOI: 10.1038/s41598-019-40006-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/04/2019] [Indexed: 02/06/2023] Open
Abstract
Hydrogen peroxide (H2O2)-based products are effective in tooth whitening; however, their safety is controversial as they may harm patient tissues/cells. These effects are suggested to be concentration-dependent; nonetheless, to date, there are no reports on H2O2-mediated oxidative damage in the gingival tissue, and neither whether this can be detected in gingival crevicular fluid (GCF) samples. We hypothesize that H2O2 whitening products may cause collateral oxidative tissue damage following in office application. Therefore, H2O2 and nitric oxide (NO) levels were investigated in GCF samples obtained from patients undergoing dental bleaching with H2O2 at different concentrations, in a randomized, double-blind, split-mouth clinical trial. A proteomic analysis of these samples was also performed. H2O2-based whitening products promoted inflammation which was detected in GCF samples and lasted for longer following 35% H2O2 bleaching. This included time-dependent changes in NO levels and in the abundance of proteins associated with NO synthesis, oxidative stress, neutrophil regulation, nucleic acid damage, cell survival and/or tissue regeneration. Overall, H2O2-based products used in office promote inflammation irrespective of their concentration. As the inflammation caused by 35% H2O2 is longer, patients may benefit better from using lower concentrations of this bleaching product, as they may result in less tissue damage.
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Gallinari MDO, Cintra LTÂ, Benetti F, Rahal V, Ervolino E, Briso ALF. Pulp response of rats submitted to bleaching and the use of different anti-inflammatory drugs. PLoS One 2019; 14:e0210338. [PMID: 30620760 PMCID: PMC6324791 DOI: 10.1371/journal.pone.0210338] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 12/20/2018] [Indexed: 11/19/2022] Open
Abstract
This study aimed to evaluate neuropeptide expression after bleaching treatment using histopathological and immunohistochemical analyses and the effects of hydrocortisone and acetaminophen on pulp inflammation, sine dental bleaching and inflammation first occur, and only then, the treatmentt. Sixty-three rats were divided into three groups (n = 21) according to the pain-relieving therapy used: I-control; II-topical application of Otosporin for 10 min after the bleaching treatment; III-oral administration of paracetamol 30 min before whitening and then every 12h. In all the study groups, placebo gel was applied to the left upper jaw (control) and a 35% H2O2-based whitening gel was applied to the right upper jaw for 45 min. Seven animals from each group were euthanized at different time points: 0h after treatment, 24h, and 48h. After euthanasia, the first molar on each side was analyzed by histology and immunohistochemistry to assess the degree of inflammation and verify the presence of the neuropeptides, substance P (SP) and calcitonin gene-related peptide (CGRP). The data were analyzed using the statistical nonparametric Kruskal-Wallis test followed by Dunn's test for individual comparisons. Extensive areas of necrosis were observed in the groups that received bleaching treatment only, whereas reduced damage were obtained in the group treated with Otosporin. The immunohistochemical analysis showed positive immunolabeling in all groups, including the control, but this was stronger in the groups that received bleaching treatment. The best results were obtained in the group that received treatment with Otosporin. The use of Otosporin after dental bleaching minimized the side effects of this treatment.
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Affiliation(s)
- Marjorie de Oliveira Gallinari
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Luciano Tavares Ângelo Cintra
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Vanessa Rahal
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - André Luiz Fraga Briso
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
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Rodrigues JL, Rocha PS, Pardim SLDS, Machado ACV, Faria-E-Silva AL, Seraidarian PI. Association Between In-Office And At-Home Tooth Bleaching: A Single Blind Randomized Clinical Trial. Braz Dent J 2018; 29:133-139. [PMID: 29898058 DOI: 10.1590/0103-6440201801726] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 12/12/2017] [Indexed: 11/22/2022] Open
Abstract
This controlled randomized clinical trial evaluated the effect of associating at-home and in-office bleaching procedures on tooth sensitivity (TS) and bleaching effectiveness. Forty patients subjected to on session of in-office bleaching with 38% peroxide hydrogen. Subsequently, the patients were randomly allocated to receive a second session of in-office bleaching or to use a tray containing 10% carbamide peroxide delivered during 7 consecutive days. The worst TS score reported during or after each bleaching procedure was recorded using a verbal rating scale and TS risk (score different from 0) was calculated. Color changes were measured 7 days after each in-office session (for patients receiving in-office procedures only) or after the end of at-home bleaching (for the combined protocol), and 6 months after the last procedure for both bleaching protocols. Color was assessed by a spectrophotometer and by color match with the Vita Classical and Bleach guide scales. Statistical analyses were carried out to assess possible differences between the protocols regarding the outcomes and to analyze the effect of time of assessment on color changes. The bleaching protocol did not affect the risk for and the maximum level of TS reported, irrespective of the time of assessment. In the color evaluation, the bleaching protocol also did not affect the ultimate tooth color. In conclusion, after one in-office bleaching session, there was no difference in bleaching effectiveness and TS between performing a second in-office session and associating it with 1-week at-home bleaching.
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Affiliation(s)
- João Lima Rodrigues
- PUC Minas - Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | | | | | - Paulo Isaías Seraidarian
- Department of Prosthodontics, PUC Minas - Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil
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Hydrogen Peroxide Diffusion through Enamel and Dentin. MATERIALS 2018; 11:ma11091694. [PMID: 30213083 PMCID: PMC6165410 DOI: 10.3390/ma11091694] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 09/05/2018] [Accepted: 09/09/2018] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to evaluate the in vitro diffusion of commercial bleaching products (hydrogen peroxide (HP) or carbamide peroxide (CP) based) with different application protocols. Human enamel-dentin discs were obtained and divided into 20 groups. Four commercial products based on HP (Pola Office+(PO), Perfect Bleach (PB), Norblanc Office-automix (NO), and Boost (BT)), and one based on CP (PolaDay CP (PD)), were evaluated with different application protocols (3 applications × 10 min or 1 application × 30 min, with or without light activation). Artificial pulp chambers with 100 µL of a buffer solution were prepared. After each application, the buffer was removed and diffused HP was quantified by fluorimetry. Data were analyzed with two-way analysis of variance (ANOVA) and Tukey’s test. In groups where 3 × 10 min applications were done, after the first 10 min, PB, NO, and PD showed similar diffusion (p < 0.05). After the second and third applications, diffusion proved similar for PO and PD, while PB exhibited the greatest diffusion. In the 30 min application groups, PO and BT showed no significant differences (p > 0.05), with similar results for NO and PD. Comparing products with or without light activation, PO, BT, and PB showed significantly greater diffusion with light activation (p < 0.05). Reapplication, and light activation, increased HP diffusion independently of the concentration of the product.
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Human Dental Pulp Stem Cells Exhibit Different Biological Behaviours in Response to Commercial Bleaching Products. MATERIALS 2018; 11:ma11071098. [PMID: 29954139 PMCID: PMC6073762 DOI: 10.3390/ma11071098] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 06/13/2018] [Accepted: 06/22/2018] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to evaluate the diffusion capacity and the biological effects of different bleaching products on human dental pulp stem cells (hDPSCs). The bleaching gel was applied for 90, 30 or 15 min to enamel/dentine discs that adapted in an artificial chamber. The diffusion of hydrogen peroxide (HP) was analysed by fluorometry and the diffusion products were applied to hDPSCs. Cell viability, cell migration and cell morphology assays were performed using the eluates of diffusion products. Finally, cell apoptosis and the expression of mesenchymal stem cell markers were analysed by flow cytometry. Statistical analysis was performed using analysis of variance and Kruskal⁻Wallis or Mann⁻Whitney tests (α < 0.05). Significant reductions of approximately 95% in cell viability were observed for the 3 × 15 min groups (p < 0.001), while 1 × 30 min of PerfectBleach and 1 × 90 min of PolaNight resulted in reductions of 50% and 60% in cell viability, respectively (p < 0.001). Similar results were obtained in the migration assay. Moreover, the 3 × 15 min group was associated with cell morphology alterations and reductions of >70% in cell live. Finally, hDPSCs maintained their mesenchymal phenotype in all conditions. Similar concentrations of carbamide peroxide (CP) and HP in different commercial products exhibited different biological effects on hDPSCs.
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Peixoto AC, Vaez SC, Pereira NADR, Santana CNDS, Soares KDA, Romão ACTR, Ferreira LF, Martins-Filho PRS, Faria-E-Silva AL. High-concentration carbamide peroxide can reduce the sensitivity caused by in-office tooth bleaching: a single-blinded randomized controlled trial. J Appl Oral Sci 2018; 26:e20170573. [PMID: 30084472 PMCID: PMC6007969 DOI: 10.1590/1678-7757-2017-0573] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 12/28/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives A single-blinded, randomized, parallel clinical trial evaluated the use of 37% carbamide peroxide (CP) on bleaching effectiveness and tooth sensitivity reported by patients undergoing in-office tooth bleaching, in comparison with the results of using 35% hydrogen peroxide. Material and Methods Forty patients were allocated to receive two sessions of in-office tooth bleaching using either 35% hydrogen peroxide (HP) or 37% CP. Each patient’s sensitivity level was evaluated during and up to 24 h after bleaching. The effectiveness of the bleaching procedures was evaluated with a spectrophotometer one week after each session and 30 days after the last session. The impact of tooth bleaching on the patients’ perceptions regarding smile changes, in addition to the bleaching procedures and their results, were also recorded. Absolute and relative sensitivity risks were calculated. Data on sensitivity level were analyzed using the Mann-Whitney or T-test, and data from the color evaluation were subjected to 2-way repeated measures ANOVA. Results The use of CP reduced the risk and level of tooth sensitivity to values close to zero, whereas the difference between the bleaching agents disappeared after 24 h. An increased bleaching effect was observed for HP, mainly due to an improved reduction of redness and yellowness. Participants perceived improved tooth bleaching for HP and reduced sensitivity for CP, but no differences regarding the comfort of the techniques were noted. Conclusions In our study, 37% CP resulted in reduced tooth sensitivity but decreased the tooth bleaching effectiveness. However, both bleaching agents resulted in high levels of patient satisfaction.
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Menezes RPD, Silva PD, Leal PC, Faria-e-Silva AL. Impact of 35% Hydrogen Peroxide on Color and Translucency Changes in Enamel and Dentin. Braz Dent J 2018; 29:88-92. [DOI: 10.1590/0103-6440201801553] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 11/07/2017] [Indexed: 11/22/2022] Open
Abstract
Abstract This study evaluated the effects of tooth bleaching with high-concentration of hydrogen peroxide on alterations of translucency parameter (TP) and color of dentin and enamel. The crown of five human molars was sectioned into four slices parallel to buccal surface. The dentin of external slices containing buccal/ lingual enamel was fully removed with diamond bur; while these slices were used to assess alterations on enamel. Alterations on dentin were assessed into the center of internal slices. The color of specimens was measured over white and black backgrounds using a spectrophotometer (CieL*a*b) at baseline, allowing to calculate the TP by difference between the color measured over each background. Specimens were submitted to three 15-min applications of 35% hydrogen peroxide followed by their storage in water for one-week. Afterwards, the color measurements were repeated at both backgrounds. Color (∆L, ∆a, ∆b and ∆E) and translucency (∆TP) changes were calculated and data individually analyzed by T-test (α = 0.05). Influence of hard tissue and assessment time on each color parameter was also analyzed by 2-way repeated measure ANOVA (α = 0.05). Tooth bleaching resulted in increased lightness for the enamel, whereas no alteration on this parameter occurred for dentin. No difference between the tooth hard tissues was observed regards the other color parameters and ∆E. A slightly reduction on TP was observed only for the enamel. In conclusion, 35% hydrogen peroxide caused similar color and translucency changes on dentin and enamel.
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Fernandes AMM, Vilela PGF, Valera MC, Bolay C, Hiller KA, Schweikl H, Schmalz G. Effect of bleaching agent extracts on murine macrophages. Clin Oral Investig 2017; 22:1771-1781. [PMID: 29196947 DOI: 10.1007/s00784-017-2273-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 11/07/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the cytotoxicity and the influence of bleaching agents on immunologically cell surface antigens of murine macrophages in vitro. MATERIALS AND METHODS RAW 264.7 cells were exposed to bleaching gel extracts (40% hydrogen peroxide or 20% carbamide peroxide) and different H2O2 concentrations after 1 and 24-h exposure periods and 1-h exposure and 23-h recovery. Tests were performed with and without N-acetyl cysteine (NAC) and buthionine sulfoximine (BSO). Cell viability was determined by MTT assay. The expression of surface markers CD14, CD40, and CD54 with and without LPS stimulation was detected by flow cytometry, while the production of TNF-α was measured by ELISA. Statistical analysis was performed using the Mann-Whitney U test (α = 0.05). RESULTS Extracts of bleaching agents were cytotoxic for cells after a 1-h exposure; cells could not recover after 24 h. This effect can be mitigated by the antioxidant NAC and increased by BSO, an inhibitor of glutathione (GSH) synthesis. LPS stimulated expression of all surface markers and TNF-α production. Exposure to bleaching agent extracts and H2O2 leads to a reduction of TNF-α, CD14, and CD40 expression, while the expression of CD54 was upregulated at non-cytotoxic concentrations. Whereas NAC reduced this effect, it was increased in the presence of BSO. CONCLUSIONS Extracts of bleaching agents were irreversibly cytotoxic to macrophages after a 1-h exposure. Only the expression of CD54 was upregulated. The reactions are mediated by the non-enzymatic antioxidant GSH. CLINICAL RELEVANCE The addition of an antioxidant can downregulate unfavorable effects of dental bleaching.
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Affiliation(s)
- Aletéia M M Fernandes
- Department of Health Sciences, Endodontics Division, Nove de Julho University (UNINOVE), São Paulo, Brazil.,Department of Health Sciences, Anatomy and Pathology Division, Anhanguera University, Vergueiro, 235/249-Liberdade, São Paulo, SP, 01504-000, Brazil
| | - Polyana G F Vilela
- Department of Bioscience and Oral Diagnosis, Microbiology Division, São José dos Campos Dental School, State University of São Paulo, UNESP, Av. Eng. Francisco José Longo, 777-Jardim Sao Dimas, São José dos Campos, SP, 12245-000, Brazil
| | - Marcia C Valera
- Department of Restorative Dentistry, Endodontic Division, São José dos Campos Dental School, State University of São Paulo UNESP, Av. Eng. Francisco José Longo, 777-Jardim Sao Dimas, São José dos Campos, SP, 12245-000, Brazil
| | - Carola Bolay
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Karl Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Helmut Schweikl
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany. .,Department of Periodontology, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
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Lima SNL, Ribeiro IS, Grisotto MA, Fernandes ES, Hass V, de Jesus Tavarez RR, Pinto SCS, Lima DM, Loguercio AD, Bandeca MC. Evaluation of several clinical parameters after bleaching with hydrogen peroxide at different concentrations: A randomized clinical trial. J Dent 2017; 68:91-97. [PMID: 29169968 DOI: 10.1016/j.jdent.2017.11.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/09/2017] [Accepted: 11/19/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE This randomized double-blind clinical trial compared tooth sensitivity (TS), bleaching efficacy, and cytokine levels after applying in-office bleaching treatments containing 15% and 35% hydrogen peroxide (HP15% and HP35%, respectively). METHODS Twenty-five volunteers were randomly assigned to receive HP15% or HP35% treatment. The bleaching agent was applied in three 15-min applications per session. Two bleaching sessions were separated by a 1-week interval. The participants scored TS using a visual analog scale and numerical rating scale. Bleaching efficacy was determined by subjective and objective methods. Gingival crevicular fluid was collected from three jaws sites per patient for the analysis of fluid volume. Flow cytometry was used to analyze gingival crevicular fluid levels of interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-10, tumor necrosis factor, and interferon-gamma. All measurements were obtained before and after bleaching. All data were statistically analyzed (α=0.05). RESULTS The absolute risk and intensity of TS was higher for HP35% than for HP15% (p>0.002). One month post-bleaching, HP35% produced more bleaching than HP15% (p=0.02). However patient perception (p=0.06) and patient satisfaction (p=0.53) with regard to bleaching were not significantly different. No significant differences existed in the gingival fluid volume (p>0.38) or in any cytokine level (p>0.05) for either HP concentration. CONCLUSION Treatment: with HP35% is more effective than HP15%, but generates a greater risk and intensity of TS. No inflammatory changes occurred despite the difference in the HP concentrations. CLINICAL SIGNIFICANCE Hydrogen peroxide at a lower concentration (e.g., 15%) should be considered a good treatment alternative for in-office bleaching because the higher concentration for in-office bleaching generates a greater risk and intensity of TS for patients.
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Affiliation(s)
| | | | | | | | - Viviane Hass
- Universidade Ceuma, Rua Josue Montello s/n, São Luís, Maranhão 65075-120, Brazil
| | | | - Shelon Cristina Souza Pinto
- Universidade Estadual Ponta Grossa, Avenida General Carlos Cavalcanti, 4748, Uvaranas, Ponta Grossa, Paraná 84030-900, Brazil
| | - Darlon Martins Lima
- Universidade Federal do Maranhão-UFMA, Avenida Dos Portugueses, 1966, Bacanga, São Luís 65080-805, Brazil
| | - Alessandro D Loguercio
- Universidade Estadual Ponta Grossa, Avenida General Carlos Cavalcanti, 4748, Uvaranas, Ponta Grossa, Paraná 84030-900, Brazil.
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36
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Fernandes MT, Vaez SC, Lima CM, Nahsan FP, Loguércio AD, Faria-e-Silva AL. Preemptive Use of Naproxen on Tooth Sensitivity Caused by In-Office Bleaching: A Triple-Blind, Crossover, Randomized Clinical Trial. Oper Dent 2017; 42:486-496. [DOI: 10.2341/16-100-c] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
A triple-blind, randomized, crossover clinical trial evaluated prior use of nonsteroidal anti-inflammatory naproxen on sensitivity reported by patients undergoing in-office tooth bleaching.
Methods and Materials:
Fifty patients were subjected to two sessions of in-office tooth bleaching with 35% hydrogen peroxide in a single application of 40 minutes for two sessions, with an interval of seven days between applications. One hour prior to the procedure, each patient randomly received a single dose of naproxen (500 mg) or placebo. The patient's sensitivity level was evaluated during and immediately after the bleaching using two scales (verbal and visual analog); the verbal scale only was repeated after 24 hours. The effectiveness of the bleaching procedures was evaluated with the Bleachedguide scale. Relative risk to sensitivity was calculated and adjusted by session, while comparison of overall risk was performed by the McNemar test. Data on the sensitivity level for both scales and shade were subjected to the Friedman, Wilcoxon, and Mann-Whitney tests (α=0.05).
Results:
The use of naproxen only decreased the absolute risk and intensity of tooth sensitivity reported immediately after the second session. On the other hand, no measurable effect was observed during or 24 hours after either session. The sequence of drug administration did not affect the bleaching effectiveness.
Conclusions:
Preemptive use of naproxen only reduced tooth sensitivity reported by patients immediately after the second session of bleaching.
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Affiliation(s)
- MT Fernandes
- Micaelle T Fernandes, MSc, graduate student, Graduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - SC Vaez
- Savil C Vaez, MSc, graduate student, Graduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - CM Lima
- Cláudio M Lima, professor, Department of Pharmacy, Federal University of Sergipe, Lagarto, Brazil
| | - FP Nahsan
- Flavia P Nahsan, DDS, PhD, professor, Department of Dentistry, Federal University of Sergipe, Lagarto, Brazil
| | | | - AL Faria-e-Silva
- Andre L Faria-e-Silva, DDS, MSc, PhD, Department of Dentistry, Federal University of Sergipe, Aracaju, Brazil
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Cintra LTA, Benetti F, Ferreira LL, Gomes-Filho JE, Ervolino E, Gallinari MDO, Rahal V, Briso ALF. Penetration Capacity, Color Alteration and Biological Response of Two In-office Bleaching Protocols. Braz Dent J 2017; 27:169-75. [PMID: 27058379 DOI: 10.1590/0103-6440201600329] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 01/22/2016] [Indexed: 11/21/2022] Open
Abstract
Hydrogen peroxide (H2O2) penetrates into the dental hard tissues causing color alteration but also alterations in pulpal tissues. Hard-tissue penetration, color alteration and the pulp response alterations were evaluated for two in-office bleaching protocols with H2O2. For trans-enamel/dentin penetration and color alteration, discs of bovine teeth were attached to an artificial pulp chamber and bleached according to the groups: BLU (20% H2O2 - 1x50 min, Whiteness HP Blue); MAX (35% H2O2 - 3x15 min, Whiteness HP Maxx); Control (1x50 min, placebo). Trans-enamel/dentin penetration was quantified based on the reaction of H2O2 with leucocrystal violet and the color analyzed by CIELab System. Twenty Wistar rats were divided into two groups (BLU and MAX) and their maxillary right molars were treated according to the same protocols of the in vitro study; the maxillary left molars were used as controls. After 2 days, the animals were killed and their maxillae were examined by light microscopy. The inflammation of pulp tissue was scored according to the inflammatory infiltrate (1, absent; 2, mild; 3, moderate; 4, severe/necrosis). Data were analyzed by statistical tests (α=0.05). MAX showed higher trans-enamel/dentinal penetration of H2O2 (p<0.05). The color alteration was similar for both groups (p>0.05), and different when compared to Control group (p<0.05). MAX showed severe inflammation in the upper thirds of the coronal pulp, and BLU showed moderate inflammation (p<0.05). In-office bleaching protocols using lower concentrations of hydrogen peroxide should be preferred due to their reduced trans-enamel/dentinal penetration since they cause less pulp damage and provide same bleaching efficiency.
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Affiliation(s)
| | - Francine Benetti
- Endodontics, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | | | | | - Edilson Ervolino
- Basic Science, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | | | - Vanessa Rahal
- Restorative Dentistry, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - André Luiz Fraga Briso
- Restorative Dentistry, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
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de Almeida LCAG, Soares DG, Azevedo FA, Gallinari MDO, Costa CADS, dos Santos PH, Briso ALF. At-Home Bleaching: Color Alteration, Hydrogen Peroxide Diffusion and Cytotoxicity. Braz Dent J 2017; 26:378-83. [PMID: 26312976 DOI: 10.1590/0103-6440201300380] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 04/07/2015] [Indexed: 11/21/2022] Open
Abstract
This study evaluated the color change, cytotoxicity and hydrogen peroxide (HP) diffusion caused by different home bleaching protocols: 10% carbamide peroxide (CP) for 3 or 1.5 h, 6% hydrogen peroxide for 1.5 h or 45 min. To quantify the peroxide penetration, disks of bovine teeth were placed in artificial pulp chambers (APCs) containing acetate buffer, which was collected for evaluation in a spectrophotometer. For analysis of cytotoxicity, specimens were adapted in APCs containing culture medium, which subsequently was applied on MDPC-23 odontoblast-like cells for 1 h. Cellular metabolism was evaluated by methyl tetrazolium (MTT) assay and the color change of the specimens was analyzed using the CIE L * a * b * system. The data were submitted to ANOVA and Fisher test (α=5%). The treatment with 10% CP for 3 h was the most effective, and 6% HP for 45 min produced the lowest color change. The groups 10% CP for 1.5 h and 6% HP for 45 min had the lowest trans-enamel dentinal HP penetration, and the 6% HP for 1.5 h had the highest. None of the protocols affected cellular metabolism and morphology. In conclusion, reduced peroxide exposure time reduced the bleaching result; higher HP diffusion did not mean higher effectiveness.
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Affiliation(s)
| | - Diana Gabriela Soares
- Department of Physiology and Pathology, Araraquara School of Dentistry, Univ Estadual Paulista, Araraquara, SP, BR
| | - Fernanda Almeida Azevedo
- Department of Restorative Dentistry, Araçatuba School of Dentistry, Univ Estadual Paulista, Araçatuba, SP, BR
| | | | | | - Paulo Henrique dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, Univ Estadual Paulista, Araçatuba, SP, BR
| | - André Luiz Fraga Briso
- Department of Restorative Dentistry, Araçatuba School of Dentistry, Univ Estadual Paulista, Araçatuba, SP, BR
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Roderjan DA, Stanislawczuk R, Hebling J, Costa CADS, Reis A, Loguercio AD. Response of human pulps to different in-office bleaching techniques: preliminary findings. Braz Dent J 2017. [PMID: 26200147 DOI: 10.1590/0103-6440201302282] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This study evaluated a whitening effect and the likely side effect (tooth sensitivity and pulp response) of human teeth subjected to different in-office bleaching (IOB) techniques and materials, mainly the presence of calcium in the IOB materials. A calcium-free (CF) and a calcium-containing (CC) 35% hydrogen peroxide (HP) gels were evaluated. The CF was refreshed every 15 minutes, three times (CF 3-15) or in a single 45-min application (CF 1-45) at one bleaching appointment. The CC was used only in a single 45-min application (CC 1-45). Each technique was applied in 5 mandibular incisors scheduled for extraction for different patients. In control group, no tooth bleaching was performed. The tooth colour (TC) and tooth sensitivity (TS) were recorded at baseline and after IOB. The teeth were extracted 2 days after the application of IOB and subjected to histological analysis. The data was submitted to appropriate statistical analysis (α=0.05). The changes of TC were similar between groups and statistically different from the control (p<0.05). However, TS of groups bleached with CF was statistically higher than that recorded for CC and the control (p<0.05). In CF 3-15 and CF 1-45 groups, the coronal pulp tissue exhibited partial necrosis associated with tertiary dentin deposition. In CC 1-45 group smaller area of necrosis occurred only in three bleached teeth in which tertiary dentin deposition was observed. The calcium-containing 35%HP gel could be preferable for in-office bleaching because it caused less tooth sensibility and pulp damage.
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Affiliation(s)
- Douglas Augusto Roderjan
- Department of Restorative Dentistry, School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brasil
| | - Rodrigo Stanislawczuk
- Department of Restorative Dentistry, School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brasil
| | - Josimeri Hebling
- Department of Orthodontics and Pediatric Dentistry, Araraquara Dental School, Universidade Estadual Paulista, Araraquara, SP, Brasil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, Araraquara Dental School, Universidade Estadual Paulista, Araraquara, SP, Brasil
| | - Alessandra Reis
- Department of Restorative Dentistry, School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brasil
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brasil
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40
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Loiola ABA, Souza-Gabriel AE, Scatolin RS, Corona SAM. Impact of hydrogen peroxide activated by lighting-emitting diode/laser system on enamel color and microhardness: An in situ design. Contemp Clin Dent 2016; 7:312-6. [PMID: 27630493 PMCID: PMC5004542 DOI: 10.4103/0976-237x.188544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Hydrogen peroxide (HP) at lower concentration can provide less alteration on enamel surface and when combined with laser therapy, could decrease tooth sensitivity. This in situ study evaluated the influence of 15% and 35% HP gel activated by lighting-emitting diode (LED)/laser light for in-office tooth bleaching. Materials and Methods: Forty-four bovine enamel slabs were polished and subjected to surface microhardness (load of 25 g for 5 s). The specimens were placed in intraoral palatal devices of 11 volunteers (n = 11). Sample was randomly distributed into four groups according to the bleaching protocol: 15% HP, 15% HP activated by LED/laser, 35% HP, and 35% HP activated by LED/laser. The experimental phase comprised 15 days and bleaching protocols were performed on the 2nd and 9th days. Surface microhardness (KHN) and color changes were measured and data were analyzed by ANOVA (α = 0.05). Results: There were no significant differences in microhardness values neither in color alteration of enamel treated with 15% HP and 35% HP activated or not by LED/laser system (P > 0.05). Conclusions: Both concentrations of HP (15 or 35%), regardless of activated by an LED/laser light, did not affect the surface microhardness and had the same effectiveness in enamel bleaching.
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Affiliation(s)
- Ana Bárbara Araújo Loiola
- Department of Restorative Dentistry, Ribeirao Preto School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Renata Siqueira Scatolin
- Department of Restorative Dentistry, Ribeirao Preto School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
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41
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Rezende M, Ferri L, Kossatz S, Loguercio AD, Reis A. Combined Bleaching Technique Using Low and High Hydrogen Peroxide In-Office Bleaching Gel. Oper Dent 2016; 41:388-96. [DOI: 10.2341/15-266-c] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives: The aim of this study was to evaluate the efficacy, color stability, risk, and intensity of tooth sensitivity (TS) of combined bleaching techniques performed with 20% or 35% hydrogen peroxide for an in-office protocol.
Methods: Thirty patients were randomly divided into two groups and submitted to a single 45-minute in-office bleaching session with 35% hydrogen peroxide or 20% hydrogen peroxide. At-home bleaching was performed with 10% carbamide peroxide for two hours daily over the course of two weeks. The color was evaluated with the value-oriented shade guide Vita Classical at different periods up to 12 months after bleaching. Patients recorded the intensity of TS using a five-point verbal scale. Color change data were submitted to a two-way repeated-measures analysis of variance and Tukey test (α=0.05). The absolute risk and intensity of TS were compared with the Fisher exact test and Mann-Whitney test, respectively (α=0.05).
Results: On average, an effective and similar whitening of three units in shade guide was observed for both groups, which remained stable for 12 months. When both protocols were compared, the one with hydrogen peroxide 35% showed a higher risk (p=0.02) and intensity of TS (p=0.04). In regard to the TS intensity, no significant difference was observed up to 48 hours after in-office bleaching (p=0.09) and during the at-home bleaching phase of the study (p=0.71).
Conclusion: The combined bleaching technique using at-home bleaching associated with in-office bleaching was effective and stable over the course of 12 months, regardless of the concentration of the hydrogen peroxide used for in-office bleaching. However, the protocol with 20% hydrogen peroxide produced lower risk and intensity of TS.
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Affiliation(s)
- M Rezende
- Márcia Rezende, DDS, MS, postdoctoral student, Department of Restorative Dentistry, University Estadual de Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - L Ferri
- Letícia Ferri, DDS, MS, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - S Kossatz
- Stella Kossatz, DDS, MS, PhD, professor, School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Pataná, Brazil
| | - AD Loguercio
- Alessandro Dourado Loguercio, DDS, MS, PhD, professor, School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Pataná, Brazil
| | - A Reis
- Alessandra Reis, DDS, PhD, professor, School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Pataná, Brazil
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