Effect of an antioxidizing agent on the shear bond strength of brackets bonded to bleached human enamel

Reduction of surface treatment time by combination of citric acid and ascorbic acid while restoring shear bond strength of metal brackets bonded to bleached enamel: a pilot study

BACKGROUND

To investigate the effect of a 50% ascorbic acid with 50% citric acid solution on the immediate shear bond strength (SBS) of metallic brackets after tooth bleaching. The enamel etching pattern and the required quantity of these combined acids as antioxidants following 35% hydrogen peroxide (HP) bleaching were also determined.

METHODS

The stability of the solution at room temperature was assessed at various time intervals. Fifty teeth were randomly divided into five groups: non-bleached (G1), bleached then acid etched (G2), bleached followed by a 10-minute treatment with 10% sodium ascorbate and acid etched (G3), 5-minute treatment with 50% ascorbic acid (G4), and 5-minute treatment with a combination of 50% ascorbic acid and 50% citric acid (G5). Groups G2, G3, G4 and G5 were bleached by 35% HP gel for a total of 32 min. Acid etching in groups G1, G2, and G3 was performed using 37% phosphoric acid (Ormco®, Orange, CA, USA) for 15 s. In all groups, metal brackets were immediately bonded using Transbond™ XT primer and Transbond™ PLUS adhesive, with light curing for 40 s. The SBS was tested with a universal testing machine, and statistical analysis was conducted using one-way ANOVA followed by Tukey's HSD test. The level of significance was set at p < 0.05 for all statistical tests.

RESULTS

Stability tests demonstrated that the combined acids remained effective for up to 21 days. Group G5 significantly increased the SBS of bleached teeth to the level of G1 (p < 0.05), while G3 did not achieve the same increase in SBS (p > 0.05). SEM analysis revealed enamel etching patterns similar to those of both control groups (G1 and G2). Kinetic studies at 6 min indicated that the antioxidation in G5 reacted 0.2 mmole lower than in G3 and G4.

CONCLUSION

5-minute application of the combined acids enhanced the SBS of bleached teeth comparable to unbleached teeth. The combined acids remain stable over two weeks, presenting a time-efficient, single-step solution for antioxidant application and enamel etching in orthodontic bracket bonding.

Comparative Evaluation of the Effect of Different Types of Bleaching Dentifrices on Shear Bond Strength of Orthodontic Metal Brackets Bonded by Conventional Composite to Human Teeth: An In Vitro Study

AIM

This study aims to evaluate and compare the effect of different types of bleaching dentifrices on the shear bond strength of orthodontic metal brackets bonded by light-cured composite adhesive to human teeth.

MATERIALS AND METHODS

Forty-five human premolar teeth were randomly divided into three groups, receiving the following treatments: Group 1 (control group; teeth in this group were not bleached), Group 2 (teeth in this group were treated with active oxygen bleaching dentifrice), and Group 3 (teeth in this group were treated with peroxide bleaching dentifrice). Orthodontic brackets were bonded using a light-cured composite adhesive. A universal measuring device was used to assess the shear bond strength with a crosshead speed of 0.5 mm/min. One-way ANOVA, post hoc Tukey tests, and an independent t-test were used to analyse the data.

RESULTS

There was a highly significant difference (p≤0.001) in the mean shear bond strength of orthodontic brackets bonded to untreated teeth as compared to teeth treated with bleaching dentifrice. There was no significant difference in the mean shear bond strength of orthodontic brackets bonded to teeth treated with peroxide bleaching dentifrice or active oxygen bleaching dentifrice.

CONCLUSION

There was a significant reduction in the mean shear bond strength of orthodontic metal brackets when bonded to human teeth treated with bleaching dentifrices.

Effect of antioxidants on adhesive bond strength to bleached enamel

OBJECTIVE

To evaluate the influence of antioxidants (ATX) resveratrol, winter's bark, green tea and yerba mate on the bond strength between bleached enamel and the nanohybrid composite resin.

METHODOLOGY

Bovine incisor crowns (n = 132) were randomly divided into 22 groups (n = 6) according to the application times (5, 10, 15, 30, and 60 min) of each antioxidant. Teeth restored without previous bleaching or ATX constituted the non-bleached control group (NB Ctrl) (n = 6), and teeth restored after bleaching and without ATX represented the bleached control group (B Ctrl) (n = 6). The 35 % hydrogen peroxide was applied for 45 min (3 application of 15 min) to the buccal enamel surface. ATX was used after bleaching for the specified time of each group and removed with air-water spray. The enamel was etched with 37 % phosphoric acid (30 s) and rinsed with air-water spray. The adhesive resin was applied to the enamel dry surface. Teeth were restored using 1 mm composite resin increments (10 × 10 × 3 mm) and sectioned in test specimens of 6 mm in length and 1 mm2 in cross-sectional area submitted to microtensile bond strength test (0.5 mm/min). The load (N) at failure was recorded, and the bond strength (σt) was calculated (MPa). The fracture area was analyzed under optical microscopy, and failures were classified as cohesive, mixed, or adhesive. Data was evaluated by Kruskal-Wallis and Dunn tests (p ≤ 0.05).

RESULTS

B Ctrl group presented lower σt than NB Ctrl (p < 0.001). Applying resveratrol for 5 or 10 min, winter's bark for 10 or 15 min, green tea for less than 15 min, and yerba mate for 15 min provided similar σt between bleached enamel and nanohybrid composite to the control group.

CONCLUSION

Restorative procedures performed immediately after tooth bleaching compromises adhesion. Experimental antioxidants applied to bleached enamel can increase the immediate bond strength of restorations performed directly after bleaching, with similar values to those observed in unbleached enamel.

CLINICAL SIGNIFICANCE

This study presents promising results to support the use of antioxidants on the recently bleached enamel to allow adhesive tooth restorations. The immediate bonding obtained using antioxidants was similar to the one achieved in non-bleached enamel in brief application times. Green tea extract and resveratrol were able to restore the bond strength to bleached enamel in a short application time of 5 min. The reduction in the required application time holds the potential to decrease the overall duration of the clinical section, offering clinical advantages and improving the feasibility of using antioxidants on the bleached enamel prior to adhesive procedures.

Effect of bleaching treatments on the adhesion of orthodontic brackets: a systematic review

BACKGROUND

Nowadays bleaching procedures have gained popularity in orthodontic patients. Peroxide and Carbamide acids are the common agents which are used in in-office and at home bleaching techniques. Consequently, the Bonding adhesion to the enamel can be influenced by the orthodontic phase and the residual peroxide might interfere with the polymerization and the adhesion of the brackets. Frequent debonding of the brackets from teeth after the bleaching procedure could cause the lengthening of the therapy and promote irregularities on enamel surface derived from an additional bonding phase of the brackets. The aim of this systematic review is to appraise the influence regarding the effect of the bleaching procedure on the bond strength of orthodontic brackets.

METHODS

An electronic database search was performed. Search terms included: bleaching, brackets, adhesion; data were extracted and summarized. Risk of bias was assessed using the Chocrane risk of bias tool, adapted for in vitro studies.

RESULTS

A total of 8689 articles were screened and 11 studies met the inclusion criteria of this systematic review. 1000 teeth of human and bovine origin were analyzed for the shear bond strength (SBS) of stainless and ceramic brackets after the bleaching treatments. All the authors divided the groups in different subgroups with different bleaching agents and in different concentration. The SBS value allowed to demonstrate the necessity to delay the bonding of the brackets for two weeks after a bleaching treatment and its improvement when tooth mousse or antioxidants agents are used.

CONCLUSIONS

The SBS values and the delay of the bonding procedure must be considered in dental practice and clinical strategies are necessary in order to avoid drawbacks which could cause the debonding of the brackets after bleaching due to the alterations of the dental substrate, thus interfering with the orthodontic treatments.

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

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

Can antioxidant treatment replace delay in bracket bonding? An in vitro study

BACKGROUND

Deterioration in shear bond strength has been reported after immediate bracket bonding following hydrogen peroxide bleaching. This study compared the effectiveness of three antioxidant agents, namely, alpha-tocopherol, green tea extract, and sodium ascorbate, in reversing the bleaching effect and as possible alternatives to delayed bonding.

METHODS

A total of 105 extracted human premolars were arbitrarily assigned to 7 groups (n = 15 each), including group 1 as the unbleached control group and six experimental groups, which were bleached with 40% hydrogen peroxide in three sessions of 15 min each. In experimental group 2, bonding was performed immediately after bleaching, whereas in groups 3 and 4, bonding was delayed for 1 and 2 weeks, respectively; meanwhile, the specimens were immersed in artificial saliva at 37 °C. Groups 5, 6, and 7 were treated immediately after bleaching with 10% of alpha-tocopherol, green tea extract, and sodium ascorbate solutions, respectively, for 15 min. Specimens were processed using 500 thermal cycles between 5 and 55 °C, with a dwell time of 30 s after 24 h of bracket bonding, and then tested for shear bond strength. The adhesive remnant index was examined to evaluate fracture mode. One-way analysis of variance, Kruskal-Wallis H, and post hoc Tukey's honestly significant difference tests were used to compare the data. Significant results were subjected to pairwise comparisons with Bonferroni's correction-adjusted of p values ≤ 0.050.

RESULTS

Shear bond strength was significantly lower (p < 0.001) in the immediate bonding and 1-week delay groups than in the control group. However, no significant difference was detected among the 2-week delay, antioxidant-treated, and control groups (p > 0.05).

CONCLUSIONS

Application of 10% alpha-tocopherol, green tea extract, or sodium ascorbate for 15 min could restore shear bond strength after 40% hydrogen peroxide bleaching as an alternative to delay in bracket bonding.

Comparative Evaluation of Effect of Different Antioxidants on Shear Bond Strength of Composites on Bleached Enamel: An In Vitro Study

Aim

To evaluate the effect of antioxidants on the shear bond strength of composite resin to bleached enamel.

Materials and methods

A total of 120 extracted permanent anterior teeth were split into four major groups, one among them being a control group. Group I (bleaching + without antioxidant), group II (bleaching + 10% sodium ascorbate), group III (bleaching + 5% grape seed extract), and group IV (bleaching + 5% pine bark extract). All of the groups were bleached using a gel containing 35% carbamide peroxide, and then they were divided into two subgroups depending on when the bonding operation was to be completed-subgroup A was done in 24 hours, while subgroup B took 3 weeks. The universal testing machine was used to measure the shear bond strength.

Results

Subgroup IA showed poor shear bond strength than other groups, there was no statistically significant difference between subgroup IB, IIA, and IVA. Subgroup IIIA showed the highest shear bond strength than the remaining groups. Between subgroups IIA and IIB, IIIA and IIIB, and IVA and IVB there was no statistically significant difference. This shows that delaying the bonding procedure for 3 weeks shows similar shear bond strength when compared to groups that were immediately bonded after antioxidant applying groups.

Conclusion

All the antioxidants' immediate application could reverse compromised bond strength. Among them, 5% grape seed extract shows the highest increase in shear bond strength.

How to cite this article

Maddula DC, Vasepalli M, Martha S, et al. Comparative Evaluation of Effect of Different Antioxidants on Shear Bond Strength of Composites on Bleached Enamel: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(1):87-92.

Applications of Antioxidants in Dental Procedures

As people are paying more and more attention to dental health, various dental treatment procedures have emerged, such as tooth bleaching, dental implants, and dental restorations. However, a large number of free radicals are typically produced during the dental procedures. When the imbalance in distribution of reactive oxygen species (ROS) is induced, oxidative stress coupled with oxidative damage occurs. Oral inflammations such as those in periodontitis and pulpitis are also unavoidable. Therefore, the applications of exogenous antioxidants in oral environment have been proposed. In this article, the origin of ROS during dental procedures, the types of antioxidants, and their working mechanisms are reviewed. Additionally, antioxidants delivery in the complicated dental procedures and their feasibility for clinical applications are also covered. Finally, the importance of safety assessment of these materials and future work to take the challenge in antioxidants development are proposed for perspective.

Effect of different bleaching treatment protocols on shear bond strength of bonded orthodontic brackets with no-primer adhesive resin

BACKGROUNDS:

Bleaching procedure can be companied before, during, or after orthodontic treatments. However, the risk of compromised bond strength of brackets to bleached enamels is in debate. This study tried to evaluate the shear bond strength (SBS) of bonded metal brackets to the previously bleached enamels.

MATERIALS AND METHODS:

In this in vitro study, 60 extracted, sound, human premolars were mounted vertically in cylindrical molds. The samples were randomly divided into four groups (n = 15): Control (C); at-home bleached by 20% carbamide peroxide (HB); in-office bleached by 45% carbamide peroxide (OB); and in-office bleached by 40% hydrogen peroxide activated with diode laser (L-OB). Sixty stainless steel brackets were bonded by no-primer adhesive resin (OrthoCem). Then SBS of bonded brackets was measured after 5000 thermal cycles at 5°C and 55°C. Finally, the collected data were analyzed by one-way ANOVA, and Tukey HSD tests by using SPPS software at a significant level of 0.05 (α = 0.05).

RESULTS:

Group C showed significantly higher SBS values (all P < 0.001); however, there were no significant differences in SBS compared to other tests' groups with each other (all P > 0.05).

CONCLUSION:

The SBS of bonded orthodontic brackets were compromised after bleaching with 20% and 40% of carbamide peroxide. Diode laser activation may not eliminate the negative effect of bleaching agents on SBS of bonded orthodontic brackets, neither.

Effect of over-the-counter whitening strips and toothpaste on shear bond strength of orthodontic brackets

Background

To investigate: 1) the effects of over-the-counter white strip enamel bleaching and 2-Step whitening toothpaste application on the shear bond strength of orthodontic brackets at 24-hours and 7-days post-bleaching latent period; and 2) the correlation between amount of bleaching and shear bond strength.

Material and Methods

Sixty human premolar teeth were randomly assigned into two bleaching groups, white strip group treated with Crest® 3D WHITE™ LUXE Professional Effects Whitestrips (Proctor & Gamble, Greensboro, NC), and whitening toothpaste group, treated with Crest® 3D WHITE™ BRILLIANCE 2-Step Toothpaste (Proctor & Gamble, Greensboro, NC). The groups were further divided into 4 subgroups A, B, C, D (n=15 per group). Subgroups A and C were bonded 7 days after bleaching while subgoups B and D were bonded 24 hours after bleaching. Differences in shear bond strength between the subgroups and an unbleached control group (n=15) were compared using the Kruskal-Wallis test. Spectrophotometric color changes were recorded pre- and post-bleaching.

Results

The mean shear bond strength for the white strip groups were 10.35±3.6 MPa and 11.69±4.33 MPa for the 7-day and 24-hour delayed bonding periods, respectively. Means for the whitening toothpaste groups were 11.01±4.31 MPa and 10.83±3.79 MPa for the 7-day and 24-hour delayed bonding periods. The mean for the control group was 9.59±3.32 MPa. There were no significant differences in shear bond strength between the groups at 7-days and 24-hour (P=0.650). There was a significant difference between teeth bleached with white strips as compared to those bleached with toothpaste and controls. The correlations between color change and shear bond strength were not significant (P=0.448).

Conclusions

There is a significant difference in the amount of whitening achieved by over-the-counter white strips compared to toothpaste; however, no significant effects on shear bond strength occurred after bleaching with white strips and toothpaste at 24-hours and 7-days.

Key words:Bleaching, shear bond strength, orthodontics, over-the-counter.

Use of antioxidants to restore bond strength after tooth bleaching with peroxides

This review compiles the literature on the antioxidants used after tooth bleaching with either low or high-concentrated carbamide and hydrogen peroxide to recover the bond strength. Antioxidants used in bleached teeth are mainly natural and non-enzymatic, except for catalase. Commonly, antioxidants are applied to remove any reactive oxygen species (ROS) residues left from bleaching gels, which adversely affect adhesive procedures, such as restorations or orthodontic brackets bonding. Even though sodium ascorbate, the most thoroughly investigated antioxidant, showed the most efficient bond strength recovery at 10% concentration, its performance depends on the type of solution and the application time. Natural extracts, such as proanthocyanidins and green tea, showed satisfactory results in the reversal of bond strength at 5% and 10% concentrations, respectively. Sodium ascorbyl phosphate, α-tocopherol, and catalase exhibited promising results, but further research is required. The adhesive system type plays an important role in the outcome of enamel bond strength after the antioxidant application. The postponement of either restorations or orthodontic brackets cementation following bleaching procedures seems to be efficiently replaced by antioxidant application prior to bonding procedures. However, the efficacy of using an antioxidant to recover bond strength depends on its type and application time.

Comparative Analysis of Shear Bond Strength of Composites to the Sodium Ascorbate Hydrogel-treated Bleached Enamel Surfaces: An In Vitro Analysis

Aim

To compare the shear bond strength of composites to the sodium ascorbate hydrogel-treated bleached enamel surfaces.

Materials and methods

Sixty-six extracted human maxillary first premolars were sectioned mesiodistally to obtain two nonocclusal surfaces (n = 132). The specimen in the experimental group (n = 80) were divided into four treatment groups depending upon bleaching protocols used: group I (10% FGM home bleach), group II (22% Pola Night home bleach), group III (37% light-activated in-office bleach Pola Office+), and group IV (35% Pola office in-office bleach without light activation). Specimens were subjected to the 1-minute application twice with sodium ascorbate hydrogel and were further divided into two subgroups “a” (acetone-based) and “b”(ethanol-based) depending upon the bonding agents used. The specimens of the control group (n = 52) were further divided into two treatment groups, that is, positive control and negative control. The specimens were tested using universal testing machine.

Results

The result of the present study revealed that the specimens bleached with 10% FGM home bleach showed the greatest shear bond strength and specimens bleached with 35% in-office bleach Pola Office showed the lowest shear bond strength.

Conclusion

A twice 1-minute application of sodium ascorbate hydrogel was effective to reverse the deleterious results of bleaching on enamel shear bond strength. Bonding agent containing acetone as a solvent (Prime and Bond NT) in this present study showed greater shear bond strength values than the bonding agent containing ethanol as a solvent (Adper Single Bond).

Statement of clinical relevance

The shear bond strength of composite restorative materials could be improved by applying sodium ascorbate gel to the bleached enamel surfaces.

How to cite this article

Pathak K, Kumar P, Choudhary A, et al. Comparative Analysis of Shear Bond Strength of Composites to the Sodium Ascorbate Hydrogel-treated Bleached Enamel Surfaces: An In vitro Analysis. Int J Clin Pediatr Dent 2021;14(6):741–747.

Remineralization Potential and Shear Bond Strength of Surface Treated Hypomineralized Enamel in Bonding of Orthodontic Brackets: An In Vitro Study

Aim:

To investigate the effect of different conditioning methods on remineralization potential of hypomineralized enamel and its shear bond strength (SBS) to orthodontic brackets.

Materials and Methods:

An in vitro study was conducted at Mansoura University, Egypt. Eighty premolars were collected and randomly classified into four groups ( n = 20 each) as follows: Group 1. Control (sound teeth), Group 2. Demineralized, Group 3. Demineralized and treated with nanohydroxyapatite (nano-HA) varnish, Group 4. Demineralized and treated with casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) paste. To detect the rate of remineralization on the surface of treated specimens, energy dispersive X-ray (EDX) analysis was used in conjunction with the scanning electron microscope (SEM). The SBS was measured with a universal testing machine. One-way ANOVA test was carried out to analyze differences between the tested groups.

Result:

SE micrographs of Group 3 and Group 4 specimens showed smoother and less porous enamel surface than that of the Group 2 specimens. EDX analysis showed highest calcium (Ca) (25.47%) and phosphorous (P) (12.76%) values for Group 4 while Group 2 showed the lowest Ca and P values (16.96%) and (10.20%), respectively ( P < .001). Demineralized enamel showed lowest (3.70 MPa) SBS mean value compared to sound (10.69 MPa) and remineralized enamel (Group 3—9.90 MPa, Group 4—10.32 MPa) ( P < .001).

Conclusion:

Nano-HA and CPP–ACP have equal remineralizing effect on hypomineralized enamel lesions and positive influence on SBS.

Improving shear bond strength of metallic brackets after whitening

Objective:

To evaluate a protocol for bonding metallic brackets after bleaching with hydrogen peroxide (HP).

Methods:

60 extracted maxillary premolar were randomly divided into an unbleached control group and two groups bleached with a solution of 35% hydrogen peroxide prior to bonding. The teeth in one of the treated groups were bonded immediately after bleaching; while the other group was treated with 10% sodium ascorbate immediately after bleaching and before bonding. The teeth in all groups were stored in an artificial saliva solution for 7 days after bonding. The shear bond strength data was measured in megapascals (MPa) and the fail attempts were verified. The significance level was established at p< 0.05.

Results:

The unbleached group, in which brackets were bonded to untreated enamel, had the highest bond strength values (11.0 ± 5.7MPa) in comparison to the bleached group (7.14 ± 40MPa), in which brackets were bonded to recently bleached enamel. Slightly improved bond strength was observed in the antioxidant group (8.13 ± 5.4MPa), in which the teeth were bleached and then the antioxidant was applied to the teeth before bonding. Unbleached and bleached groups showed statistically significant difference for shear bond strength (p=0.03) and load strength (p=0.03); no significant differences were noted between unbleached and antioxidant groups (p=0.52).

Conclusion:

The antioxidant treatment applied immediately after bleaching was effective in reversing the reduction in shear bond strength of brackets after tooth bleaching.

Effect of bleaching with carbamide peroxide on shear bond strength of orthodontic brackets: A meta-analysis of in vitro studies

INTRODUCTION

This study aimed to evaluate the effect of bleaching with carbamide peroxide (CP) according to different doses and intervals between bleaching and bonding on shear bond strength (SBS) of orthodontic brackets.

METHODS

Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, PubMed, and Scopus were searched for articles published up to June 2018. After removing the duplicates, two of the authors screened the titles and abstracts independently. Assessing the eligibility of the selected full texts was also conducted by two of the authors independently. Disagreements were resolved by discussion. Modified version of Cochrane's risk of bias tool was used to assess the quality of studies. Fifteen studies were selected.

RESULTS

Overall, bleaching with CP decreased the SBS by around 2MPa (P<0.0001). Using 10% CP decreased the SBS of the immediately bonded brackets by 5.13MPa (P<0.005). This value was 1.67MPa when the bonding procedure was postponed by one day (P<0.0001). Postponing the bonding procedure for longer periods did not cause a statistically significant change in SBS. Using 11-16% CP, the reduction in SBS of the immediately bonded brackets was 8.51MPa (P<0.01). The SBS decreased by 4.12MPa when the bonding procedure was postponed for 20days (P<0.05). According to one study, use of CP with>16% concentration seemed not to affect the SBS.

CONCLUSIONS

Bleaching with CP decreases the SBS, especially if the bracket bonding is performed shortly after bleaching. However, given the small number of articles interpretation should be made with caution.

Reversal of Compromised Bond Strength of Bleached Enamel Using Cranberry Extract as an Antioxidant: an In Vitro Study

Background and Objectives: Bleaching reduces the bond strength of enamel, if adhesive restorations are carried out immediately. Reversal of compromised bond strength of bleached enamel by application of antioxidant agents has been reported in the literature. The aim of the study is to assess the neutralizing effect of 6% cranberry (CB) solution on the bond strength of bleached enamel compared with that of 10% sodium ascorbate (SA) solution.

Materials and Methods: Enamel surfaces of 64 extracted human premolar teeth were randomly divided into four groups based on the antioxidant used. Further subgrouping was done in Groups II, III, and IV dividing each group into subgroup A and subgroup B of eight teeth each based on whether the bonding was performed immediately or after a delay of 14 days postbleaching respectively. Shear bond strength (SBS) of the specimens was measured using a Universal testing machine. The data were then tabulated and statistically analyzed using one-way ANOVA (analysis of variance) and Tukey’s post-hoc parametric tests. A p-value of <0.05 was considered statistically significant.

Results: The SBS measurements were compared among the four groups including the subgroups. The SBS was highest in the SA delayed bonding group and lowest in the bleached immediate bonding group.

Conclusion: A 10% SA solution has proven superior to 6% CB solution in the reversal of compromised bond strength following bleaching.

Effect of bromelain enzyme on the microleakage of composite resin restorations after external tooth bleaching: An in vitro study

Aims:

The aim of this study is to evaluate in vitro the effect of application of bromelain enzyme on the microleakage of composite resin restorations after external tooth bleaching using spectrophotometric evaluation.

Subjects and Methods:

Buccal Class V cavities were prepared on the surface of fifty intact premolars, which were randomly divided into five groups. All cavities were filled with composite resin.

Group I: Teeth were not bleached but restored (n = 10). External bleaching with 35% hydrogen peroxide was carried out for the rest of the specimens

Group II: Cavities were restored immediately after bleaching (n = 10)

Group III: Cavities were restored after a delay of 3 weeks (n = 10)

Group IV: Cavities were treated with sodium ascorbate after bleaching and then restored (n = 10)

Group V: Cavities were treated with bromelain enzyme solution after bleaching and then restored (n = 10). Microleakage was assessed by the dye extraction method using a spectrophotometer.

Statistical Analysis Used:

The data were analyzed statistically by comparison of mean microleakage and post hoc test using SPSS 2.0 software.

Results:

Group I displayed the least amount of microleakage, whereas Group II showed the greatest amount of microleakage (P < 0.05). Groups III, IV, and V showed a significantly lower amount of microleakage compared to Group II (P < 0.05). There was no statistically significant difference between Groups IV and V.

Conclusions:

Microleakage increased significantly after external bleaching with 35% hydrogen peroxide, and decreased when the bleached teeth were treated with antioxidants. Ten percent bromelain enzyme was effective in decreasing microleakage; however, its efficacy was similar to 10% sodium ascorbate.

Effect of mangosteen peel extract as an antioxidant agent on the shear bond strength of orthodontic brackets bonded to bleached teeth

Introduction:

The number of patients who seek orthodontic treatment that may have a history of tooth bleaching is increasing over the time. Bleaching may influence the decrease of the bond strength of orthodontic brackets.

Objective:

To determine and prove the effect of mangosteen peel (MP) extract to reverse the reduced shear bond strength (SBS) of orthodontic brackets after bleaching.

Methods:

A total of 150 maxillary first premolar teeth were randomly divided into 6 experimental groups as follow (n=25): negative-control (N: no bleaching), positive-control (P: bleaching + no treatment), and the treatment groups (bleaching + 10% sodium ascorbate (SA), 10% (MP-10), 20% (MP-20) and 40% (MP-40) MP extract gel). After treatment, the brackets were bonded with the resin-modified glass ionomer cement, SBS testing was performed using universal testing machine, and the adhesive remnant index (ARI) was examined using stereoscopic microscope after debonding. The SBS data were analyzed by analysis of variance (Anova) and the Tukey test. For the ARI, the Kruskal-Wallis test was performed.

Result:

There was significant SBS difference (p< 0.001) between various groups. The group without bleaching showed significantly higher SBS (8.19 ± 2.26 MPa) compared to others, while SBS in the group treated with 40% MP gel was significantly higher (7.93 ± 1.92 MPa) than other groups treated with antioxidants. The failure of orthodontic brackets bonded after bleaching and treatment using MP extract occurred at the enamel-adhesive interface.

Conclusion:

The application of MP extract as an antioxidant after bleaching was effective in reversing the reduced shear bond strength of orthodontic brackets after bleaching.

The Effect of Different Bleaching Treatments and Thermal-Mechanical Cycling on the Shear Bond Strength of Orthodontic Brackets

Objective

The aim of the present study was to compare the shear bond strength (SBS) of orthodontic brackets bonded to the enamel after at-home and in-office bleaching treatments.

Methods

Sixty bovine incisors were subjected to initial color readings and then classified into three groups: CP (16% carbamide peroxide), HP (35% hydrogen peroxide), and C (control). After treatments, new color readout was obtained, and orthodontic brackets were bonded to the bleached area. Half of the samples of each group (n=10) were subjected to thermal-mechanical cycling (TMC) testing (1,200,000 cycles; 44.2 N; 2 Hz/s), whereas the other half were stored in distilled water at 37 °C for 24 h. Samples were subjected to the SBS test at a speed of 0.5 mm/min. The mean SBS was analyzed (two-way ANOVA, Bonferroni test, p<0.05), and the fracture patterns were classified as adhesive, cohesive, and mixed types.

Results

There was no difference (p>0.05) in SBS values between the samples subjected to TMC and the cycled samples in any group. Samples subjected to carbamide peroxide presented lower SBS (p<0.05) than the non-cycled ones. Enamel adhesive fractures were higher in the bleached groups than in the control group, which presented mixed fractures prevalence, regardless of whether it was subjected to TMC or not.

Conclusion

Thermal-mechanical cycling was not significant for SBS of orthodontic brackets, but tooth bleaching was a factor.

Effect of Non-Vital Bleaching on the Durability of Resin⁻Dentin Bond with an Ethanol-Based Etch-And-Rinse Adhesive

To evaluate the bleaching procedure and application of sodium ascorbate on dentin bond durability, the enamel surface of intact human third molars (n = 18) were removed, and the teeth were randomly divided into two groups for immediate and six-month bond strength evaluation. The specimens were further assigned into three subgroups according to treatment procedure, as follows: subgroup A, no bleaching (positive control) was performed prior to the etch-and-rinse bonding with single bond and subsequent build-up with Z250 composite; subgroup B, the samples were bleached with 20% carbamide peroxide 6 h/day for five consecutive days prior to bonding; and subgroup C, bleaching was performed as in subgroup B, after which 10% sodium ascorbate was applied on dentin surface for 10 min before the bonding procedures. A microtensile bond strength test was performed and the failure modes were evaluated under a stereomicroscope. The data were analyzed using two-way analysis of variance (ANOVA) and Tukey’s post-hoc tests with a level of significance of 0.05. Bleaching significantly decreased the immediate and six-month bond strength. The application of sodium ascorbate had no significant effect on the immediate and six-month bond strength of bleached specimens. We conclude that the bleaching procedure may decrease the durability of the resin–dentin bond of the tested etch-and-rinse adhesive.

Protocols for sodium ascorbate application on intracoronary dentin bleached with high-concentrated agent

Purpose:

Composite resin restorations are normally replaced after the internal bleaching of endodontically treated-teeth because the bleaching agent does not alter the color of the restorative material. This study evaluated the effect of 10% sodium ascorbate (SA) applied at different protocols on bleached dentin.

Materials and Methods:

One-hundred slabs of intracoronary bovine dentin were divided into 5 groups: 2 controls-GI without bleaching (positive), GII bleached with 35% hydrogen peroxide (HP) (negative); and 3 experimentals – GIII. 35% HP + SA at protocol 1 (dripping, washing and drying the solution), GIV. 35% HP + SA at protocol 2 (dripping and aspirating the solution) and GV. 35% HP + SA at protocol 3 (dripping, rubbing and aspirating the solution). Sixty fragments were restored and subjected to shear bond strength test (n = 12). Forty fragments (n = 8) were prepared for chemical analysis (energy dispersive X-ray spectrometry) and surface morphology (scanning electron microscopy). Data were analyzed by ANOVA and Tukey test (P < 0.05).

Results:

GI (3.169 ± 1.510a) had the highest means values, similar to GIV (2.752 ± 0.961a) and GV (2.981 ± 1.185a) (P < 0.05). Inferior values were obtained in GII (1.472 ± 0.342b) and GIII (2.037 ± 0.742ab) had intermediate values (P > 0.05). Oxygen concentration was reduced in groups treated with SA, and the surface exhibited residual granules of the solution.

Conclusion:

The 10% SA solution reestablishes the bond strength of restorative material to bleached dentin, especially if active protocols of application and aspiration were used.

Effect of Two-minute Application of 35% Sodium Ascorbate on Composite Bond Strength following Bleaching

AIM

The aim of this study is to assess the effect of 35% sodium ascorbate on microtensile bond strength of dentin immediately after bleaching with 35% hydrogen peroxide.

MATERIALS AND METHODS

A total of 25 sound human 3^rd molars were collected. Teeth were randomly divided into five groups for different treatments: Group I [bleaching + immediate bonding (i.e., restoration)], group II (bleaching + delayed bonding), group III (bleaching + sodium ascorbate + immediate bonding), group IV (bleaching + sodium ascorbate + delayed bonding), and group V (bonding only). After bleaching, but before bonding, groups II and IV were stored for 1 week in deionized water at 37°C. All samples were bonded using OptiBoned FL (Kerr) and Filtek Supreme (3M/ESPE). Teeth were sectioned into 1 × 1 mm 2 bars, and microtensile bond strength was tested with a universal testing machine (Instron 8841) at a cross-head speed of 0.5 mm/minute.

RESULTS

Microtensile bond strength differed significantly across the five groups, with a significant reduction in microtensile bond strength observed for samples in group I relative to samples in any of the other treatment groups (p < 0.05).

CONCLUSION

The application of a high concentration of sodium ascorbate for a shorter time reversed the negative effect of 35% hydrogen peroxide bleaching on composite bonding strength to dentin.

CLINICAL SIGNIFICANCE

The negative effects of bleaching on composite bonding can be neutralized by the application of the reversing agent sodium ascorbate thus, increasing the efficiency of clinic chair time. This is clinically relevant for those patients requiring restorative treatment immediately after in-office bleaching.

Effect of different intracoronal bleaching methods on shear bond strength of ceramic brackets bonded to bleached enamel: An in-vitro study

OBJECTIVE

To investigate the effect of different intracoronal bleaching methods on the shear bond strength and site of failure of ceramic brackets.

MATERIALS AND METHODS

Sixty freshly extracted human maxillary incisors were randomly divided into four groups (n = 15). Endodontic access cavity was prepared and root canals were filled, root fillings were removed 2mm apical to the cementoenamel junction, and a 2-mmthick layer of glass ionomer cement base was applied. Group 1 served as the control. Intracoronal bleaching was performed with 35% carbamide peroxide in group 2, sodium perborate in group 3, and 37.5% hydrogen peroxide in group 4. The teeth were immersed in artificial saliva for 4 weeks before bracket bonding. Ceramic brackets were bonded with composite resin and cured with LED light. After bonding, the shear bond strength of the brackets was tested with a universal testing machine. The site of bond failure was determined by modified ARI (Adhesive Remnant Index).

RESULTS

The highest value of shear bond strength was measured in control group (18.67 ± 1.59 MPa), which was statistically significant from groups 2,3, and 4. There was no significant difference between groups 2 and 4. The lowest shear bond strength was measured in group 3. ARI scores were not significant from each other.

CONCLUSIONS

Intracoronal bleaching significantly affected the shear bond strength of ceramic brackets even after 4 weeks of bleaching. Bleaching with sodium perborate affects shear bond strength more adversely than does bleaching with other agents like hydrogen peroxide and carbamide peroxide.

The effect of the teeth bleaching with 35% hydrogen peroxide on the tensile bond strength of metal brackets

The objective of this study was to determine the effects of teeth bleaching on the tensile bond strength of metal brackets bonded with light-curing adhesive system to the human enamel. 40 recently extracted human permanent molars were used for the study. The mesial buccal surface of each tooth was used as a control group and the distal buccal surface was used as an experimental group. Control group surfaces were not submitted to bleaching, while experimental group surfaces were bleached with in-office bleaching material containing 35% hydrogen peroxide. 30 days after the bleaching, identical premolar metal brackets were bonded to each surface using light-curing adhesive. Both groups were submitted to a tension test, using a universal machine. The tensile bond strength of brackets bonded to the bleached enamel was 15% lower than that of brackets bonded to the unbleached enamel. After debonding, more adhesive was left on the bracket base in experimental group than in the control group. The conclusion of this study was that bleaching with an in-office bleaching material containing 35% hydrogen peroxide reduced the tensile bond strength of orthodontic bracket adhesive to the enamel surface.

Evaluating the effect of antioxidant agents on shear bond strength of tooth-colored restorative materials after bleaching: A systematic review

PURPOSE

The main objective of the present study was to make a systematic review of how antioxidant agents affect shear bond strength of tooth-colored restorative materials after bleaching.

DATA SOURCES

Electronic search was used to extract the related articles on the targeted key words such as "antioxidant", "dental bleaching" and "shear bond strength" (SBS) from MeSH, PubMed, Medline, and Cochrane electronic data bases. These articles were all published before 2016.

STUDY SELECTION

Inclusion criteria were restricted to English journal articles concerning humans, clinical trials, cohorts and case-control studies. Therefore, systematic reviews, case reports, letters to editors, editorials and congress abstracts were excluded from the analysis.

CONCLUSIONS

Most studies conducted on the issue have produced experimental data which are rather controversial, and there is no general agreement about the reported outcomes. As an illustration, most studies have not considered the relationship between the type of antioxidant materials and the shear bond strength. In point of fact, some researchers (e.g Kimyai et al.) have concluded that antioxidants like gel and solution leave similar effects on SBS. Alternatively, certain studies (e.g., Kunt et al.) have produced inconclusive data regarding the impact of one week postponement of the restorative process on SBS after the bleaching process. The results of the studies evaluating the role of various adhesive systems used after bleaching have demonstrated that regardless of the type of adhesive system used, applying antioxidants before restorative procedures can adversely affect the bleaching agents utilized for SBS. It has also been suggested that the type of the adhesive system used might be correlated with the magnitude of SBS. The results obtained from the systematic review of the articles under investigation reflected that the use of antioxidant agents, regardless of their type, form, concentration and duration of application, can improve SBS after bleaching.

Pattern of Hydroxyapatite Crystal Growth on Bleached Enamel Following the Application of Two Antioxidants: An Atomic Force Microscope Study

OBJECTIVES

This study observed the topographical pattern of hydroxyapatite deposition and growth (D&G) on bleached enamel following application of two antioxidants (sodium ascorbate and catalase) using atomic force microscope.

STUDY DESIGN

Twenty enamel specimens (4×3×2mm), prepared from extracted impacted third molars, were mounted in self-cure acrylic and randomly grouped as: Group I-untreated; Group II- 35%H₂O₂; Group III- 35%H₂O₂ + artificial saliva; Group IV- 35%H₂O₂ + catalase+ artificial saliva; Group V- 35%H₂O₂ + sodium ascorbate+ artificial saliva. Groups I and II were observed immediately after treatment. Groups III-V were observed after 72 hrs. Roughness average was also calculated and analyzed with non-parametric Kruskall-Wallis ANOVA and Mann-Whitney tests.

RESULTS

H₂O₂ dissolved matrix, exposed hydroxyapatite crystals (HACs), causing dissolution on the sides of and within HACs and opening up of nano-spaces. Artificial saliva showed growth of dissoluted crystals. Antioxidants+saliva showed potentiated remineralization by D&G on dissoluted HACs of bleached enamel. Catalase potentiated blockshaped, while sodium ascorbate the needle-shaped crystals with stair-pattern of crystallization. Evidence of oxygen bubbles was a new finding with catalase. Maximum roughness average was in group V followed by group II > group IV > group III > group I.

CONCLUSION

Post-bleaching application of catalase and sodium ascorbate potentiated remineralization by saliva, but in different patterns. None of the tested antioxidant could return the original topography of enamel.

Efficacy of quercetin flavonoid in recovering the postbleaching bond strength of orthodontic brackets: A preliminary study

Objectives:

To evaluate comparatively the effect of quercetin on postbleaching shear bond strength (SBS) and adhesive remnant index (ARI).

Materials and Methods:

Intact maxillary premolars were divided randomly into 12 groups of 10 each: (1) bonding the bracket immediately after bleaching, (2) bonding 1 week after bleaching, (3–8) application of three experimental concentrations of quercetin (0.1%, 0.5%, and 1%) at two time durations (5 and 10 min), (9–10) application of the solvent of quercetin at two time periods (5 and 10 min), (11) application of 10% sodium ascorbate for 10 min, and (12) bonding the brackets on nonbleached teeth. Bleaching was performed using 15% carbamide peroxide gel for 5 days (6 h daily). After incubation and thermocycling, the SBS of brackets was measured. The ARI too was recorded at ×20. The data were analyzed statistically (α =0.05).

Results:

Bleaching reduced the SBS below 10 Megapascal (MPa) level (P < 0.05) while all the postbleaching treatments (except the application of the solvent of quercetin) recovered the SBS back to values greater than 10 MPa (P < 0.05) and also back to nonbleached SBS levels (P > 0.01). All eight postbleaching treatments had rather similar efficacies (P = 0.1396). The concentration of quercetin (beta = 0.259, P = 0.042) but not its duration (beta = 0.213, P = 0.093) significantly improved its efficacy.

Conclusion:

Bleaching can weaken the bond strength of orthodontic brackets below acceptable levels. The application of quercetin or Vitamin C or delaying the bracket bonding improved the postbleaching SBS.

Correlation between antioxidant activity and bonding strength on bleached enamel

Objective: This study used the 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) method to evaluate the percentage of antioxidant activity (%AA) of green tea (GT) and sodium ascorbate (SA) gel in three concentrations (10%, 20% and 30%), and the influence of these concentrations on the microshear bond strength (μ-SBT) values of bleached enamel, using 10% carbamide peroxide (CP).

Materials and methods: Eighty intact third molars were selected to perform the μ-SBT test, and were randomly divided into eight experimental groups: G1: positive control – no treatment; G2: negative control – bleached with CP; G3: PC +10% GT; G4: PC +20% GT; G5: PC +30% GT; G6: PC +10% SA; G7: PC +20% SA and G8: PC +30% SA. After applying the treatments, adhesive procedures were performed using Single Bond 2 and Filtek Z350XT. After 24 h, the samples were tested in a universal testing machine until fracture. The %AA was assessed in triplicate by DDPH method using a UV–VIS spectrophotometer.

Results: In the μ-SBT, ANOVA revealed no significant difference between the antioxidants evaluated (p = .625), but did reveal significant effects of the concentrations studied (p = .007). A negative correlation was observed between μ-SBT and solution concentrations. The values of %AA were from 90.58 to 96.75.

Conclusions: The reverse results occurred in μ-SBT values, only when the antioxidants were used in a 10% concentration and, %AA did not influence μ-SBT.

Comparing orthodontic bond failures of light-cured composite resin with chemical-cured composite resin: A 12-month clinical trial

INTRODUCTION

In this clinical trial, we evaluated and compared bond failure rates of light-cured composite resin vs chemical-cured composite resin for 12 months.

METHODS

Twenty-two subjects (356 stainless steel brackets) were included in this study, and a split-mouth design was used to randomly allocate diagonally opposite quadrants to either chemical-cured (178 brackets) or light-cured (178 brackets) composite resin; the brackets came from the same manufacturer. The survival and failure rates of the brackets were evaluated by the mode of polymerization. The overall bracket survival rates were estimated using the Kaplan-Meier product limit estimate.

RESULTS

There were no significant differences in the bond failure rates between the chemical-cured and the light-cured composites (P = 0.52). Bond failures were greater in posterior teeth (6.7%) than in anterior teeth (1.2%). The highest failure rate was observed in the second premolars (7.7%).

CONCLUSIONS

The overall failure rate of brackets with the 2 bonding systems was 2.8%, which is acceptable for clinical use. The polymerization mode did not influence the bracket survival rate significantly.

Comparative evaluation of superoxide dismutase, alpha-tocopherol, and 10% sodium ascorbate on reversal of shear bond strength of bleached enamel: An in vitro study

OBJECTIVE

The aim of this study was to investigate the neutralizer effect of antioxidant agents on the bond strength of bleached enamel.

MATERIALS AND METHODS

Sixty enamel slabs were prepared from 60 freshly extracted maxillary central incisors and were divided into six groups. The negative control group received no bleaching treatment and the other groups were bleached with 35% carbamide peroxide (Opalescence Quick; Ultradent, South Jordan, USA). In Group II, composite was built immediately after bleaching and cured without any antioxidants. In Group III, bleached specimens received composite build ups delayed by 1 week. In Groups IV, V, and VI bleached specimens received applications of superoxide dismutase (SOD), sodium ascorbate (SA), and tocopherol solutions, respectively, for 10 min. Following composite bonding, the micro shear bond strength (μSBS) was measured at a speed of 1 mm/min in universal testing machine.

STATISTICAL ANALYSIS USED

The μSBS values of all the groups were analyzed using the analysis of variance followed by Tukey honestly significant difference post-hoc test.

RESULTS

Bonding of composites to unbleached group (Group I) exhibited the highest mean SBS values and among the antioxidant-treated groups, the highest SBS values were seen with SOD (Group IV) treated samples (23.0040 ± 4.30565 MPa).

CONCLUSIONS

Application of SA, alpha-tocopherol, and SOD can effectively reverse the bond strength with bleached enamel. SOD gave a comparatively more promising reversal of bond strength than SA and alpha-tocopherol, and deserves further studies.

Effect of 10% Sodium Ascorbate on Shear Bond Strength of Bleached Teeth - An in-vitro Study

BACKGROUND

Patient often requires some additional interventions such as replacement of old restorations, laminates and veneers after bleaching, for aesthetic purposes. The residual oxygen inhibits polymerization of resin based materials which results in reduced bond strength of the restorations. Some techniques are available to solve the clinical problems related to the post bleach compromised bond strength.

OBJECTIVES

The purpose of this study is to evaluate, the role of 10% sodium ascorbate on reversing the compromised bond strength and compare enamel shear bond strength of 5th and 6th generation dentine bonding agents on bleached and unbleached teeth.

MATERIALS AND METHODS

Eighty freshly extracted human anterior teeth were assigned in to Group A and Group B of 40 teeth each. Samples in both groups were subdivided in to 4 subgroups of 10 teeth each. In Group A composite resins was bonded using 5th generation dentine bonding agent (3M Single Bond) and Group B was bonded using 6th generation (3M ESPE Adper SE Plus). Subgroups were subjected to the procedure as, A1;B1 etching and bonding (control), A2; B2 bleaching, etching and immediate bonding, A3; B3 bleaching,10% ascorbic acid treatment for 10 minutes after that etching and bonding immediately, A4; B4 bleaching, storage in artificial saliva for 4 days and then etching and bonding. Pola office, in office bleach (SDI (082216) was used for bleaching. The specimens were subjected to shear load in a Universal testing machine to evaluate bond strength.

RESULTS

A decrease in bond strength was seen with 6th generation adhesive system compared to 5th generation bonding system, which is statistically significant, p<0.001.

CONCLUSION

Treating the bleached enamel surfaces when treated with 10% sodium ascorbate, which reverses the compromised bond strength and is a good alternative to delayed bonding.

Antioxidants in Endodontics: A Strategic Review

Over the past few decades, the free radicals and antioxidants have attracted tremendous importance in the field of dentistry. Depending on the level of free radicals in the body, they can either be harmful or helpful. Antioxidants are the substances that interact with and stabilize free radicals thereby protecting cells from the damage caused by free radicals. The indigenous antioxidants may be useful in preventing the harmful effects of oxidative stress. The present article presents a review on the free radicals formation, their role in disease pathogenesis, antioxidants and their potential role in endodontics.

Effect of low-concentration bleaching products on enamel bond strength at different elapsed times after bleaching treatment

This study evaluated the effects of several low-concentration bleaching products on microtensile bond strength (µTBS) to enamel at different elapsed times after the bleaching treatment. One hundred and fifty bovine incisors were divided into five groups: No treatment, 10% carbamide peroxide (Opalescence), 10% hydrogen peroxide (Opalescence Treswhite Supreme), 3% carbamide peroxide plus lactoperoxidase (WhiteKin), or 3% carbamide peroxide plus 2.7% carbamide peroxide (Clysiden Kit Express). All treatments lasted 4 weeks. After bleaching treatment or non-treatment, teeth were restored immediately, at 1, 3, 7, or 14 days after bleaching and submitted to µTBS test. Data were analyzed by ANOVA and Tukey's test (p<0.05). For WhiteKin and Clysiden, µTBS to enamel was significantly reduced immediately, at 1, 3 and 7 days after bleaching. At 14 days after bleaching, similar µTBS values were obtained regardless of bleaching product. Therefore, while over-the-counter (OTC) products might affect bond strength to enamel, this effect was no longer observed after 14 days.

Effects of antioxidants on the microleakage of composite resin restorations after external tooth bleaching

OBJECTIVE

To compare the effects of three antioxidants (sodium ascorbate, sodium ascorbate combined with a surfactant, and catalase) on the microleakage of composite resin restorations after external tooth bleaching with 10% carbamide peroxide.

MATERIALS AND METHODS

Buccal cavities were prepared on the surface of 60 intact premolars, which were randomly divided into six groups. All cavities were filled with composite resin. In group 1, teeth were not bleached; in group 2, cavities were filled immediately after bleaching; in group 3, cavities were delay-filled for 3 weeks; in group 4, cavities were treated with sodium ascorbate after bleaching and then filled; in group 5, cavities were treated with sodium ascorbate combined with surfactant after bleaching and then filled; and in group 6, cavities were treated with catalase after bleaching and then filled. Microleakage of the restorations was measured from sections using a stereomicroscope.

RESULTS

Group 1 displayed the least amount of microleakage, while group 2 showed the greatest amount of microleakage (P < 0.05). Groups 3 and 4 were similar to group 2 (P > 0.05). However, groups 5 and 6 showed a significantly lower amount of microleakage compared to group 2 (P < 0.05).

CONCLUSION

Microleakage increased significantly after external bleaching with 10% carbamide peroxide, and decreased when the bleached teeth were treated with sodium ascorbate combined with Tween(®) 80, or with catalase. Catalase was more effective in decreasing microleakage, while delayed filling or treatment with sodium ascorbate alone did not effectively decrease the microleakage.

Evaluation of shear bond strength of orthodontic brackets bonded on the tooth surface after internal bleaching

Introduction: There is great demand for esthetic treatment by patients who have discolored teeth, because currently aesthetic standards have become stricter and many patients have tooth bleaching procedures performed before or during orthodontic treatment. Objective: To evaluate the bonding of orthodontic brackets to human molars after internal tooth bleaching. Material and method: Forty molars were divided into four groups according to the bleaching agent used: PS) sodium perborate + water; PC) carbamide peroxide; PC + PS) carbamide peroxide + sodium perborate; Cont) water (control group). Bleaching agents placed inside the pulp chambers were replaced every 7 days for 2 weeks, and the brackets were bonded 30 days after the end of bleaching. The shear strength test was performed in a universal testing machine (Emic). Result: ANOVA with a significance level of 5% (p > 0.05), showed no statistically significant difference between groups (p = 0.1214). Conclusion: It was concluded that the different bleaching agents studied did not interfere with the bond strength of brackets to enamel and bonding the brackets 30 days after internal bleaching is a safe procedure.

Tooth-bleaching procedures and their controversial effects: A literature review

AIM

This review article will help clinicians improve their understanding of the history of bleaching procedures, bleaching types, components, mechanisms, and their effects on soft tissue, tooth structures, resin composite, and bonding.

METHODS

The controversial issues about bleaching procedures and their effects are reviewed. Additionally, the consequences of pre- and post-bleaching on the bonding potential of composite resin restorations to tooth structure are discussed.

CONCLUSION

The overall goal of the paper is to help reduce risks for patients.

Effect of Sodium Ascorbate on Dentin Bonding After Two Bleaching Techniques

The purpose of this study was to analyze the influence of 10% sodium ascorbate (SA) on the hybrid layer, resin tag length, and bond strength to dentin after bleaching. Six groups were tested: G C, control; G SA, sodium ascorbate (SA) + restoration; G CP, bleaching with carbamide peroxide (CP) + restoration; G CP+SA, bleaching with CP + SA+ restoration; G HP, bleaching with 35% hydrogen peroxide (HP) + restoration; and G HP+SA, HP + SA + restoration. After dental bleaching, the dentin was exposed and the antioxidant solution was applied to groups G SA, G CP+SA, and G HP+SA, before bonding procedures. The teeth were sectioned in the mesiodistal direction. One section was decalcified, and the specimens were embedded in paraffin and sectioned in the longitudinal direction with a thickness of 6 μm. Fifteen slices of each specimen were selected according to a systematic sample of slices with an interval proportional to the total number of slices obtained for each tooth. The specimens were stained using the Brown & Brenn method, and an optic microscope was used to analyze the hybrid layer thickness and resin tag length. The remaining tooth segment was sectioned into stick-shaped specimens and used for microtensile bond strength testing (0.5 mm/min). Statistical analysis was performed using two-way analysis of variance and Fisher test. The results for hybrid layer + tag formation (in micrometers) were G C, 13.27 Aa; G SA, 11.85 Ba; G CP, 6.84 Bb; G CP+SA, 9.02 Ab; G HP, 7.28 Bb; and G HP+SA, 9.22 Ab; bond strength results (in MPa) were G C, 49.5 Aa; G SA, 51.7 Aa; G CP, 37.16 Bb; G CP+SA, 47.69 Aa; G HP, 32.39 Ab; and G HP+SA, 39.67 Ab. Tooth bleaching with CP or HP impairs the formation of the hybrid layer and resin tags and reduces the microtensile bond strength. Statistically, the use of SA significantly increases the hybrid layer thickness and resin tag length. The microtensile bond strength values for carbamide peroxide increased, but the microtensile bond strength for hydrogen peroxide was not affected.

Effect of Epigallocatechin Gallate on shear bond strength of composite resin to bleached enamel: an in vitro study

Objectives

The aim of this study was to determine the effect of epigallocatechin gallate (EGCG) on the shear bond strength of composite resin to bleached enamel.

Materials and Methods

Ninety enamel surfaces of maxillary incisors were randomly divided into 9 groups as follows: G1: control (no bleaching); G2: bleaching; G3: bleaching and storage for seven days; G4 - 6: bleaching and application of 600, 800 and 1,000 µmol of EGCG-containing solution for 10 minutes, respectively; G7 - 9: bleaching and application of 600, 800 and 1,000 µmol of EGCG-containing solution for 20 minutes, respectively. The specimens were bleached with 30% hydrogen peroxide gel and a composite resin cylinder was bonded on each specimen using a bonding agent. Shear bond strength of the samples were measured in MPa. Data was analyzed using the two-way ANOVA and Tukey HSD tests (α = 0.05).

Results

The maximum and minimum mean shear bond strength values were observed in G1 and G2, respectively. Time and concentration of EGCG showed no significant effects on bond strength of the groups (p > 0.05). Multiple comparison of groups did not reveal any significant differences between the groups except for G2 and all the other groups (p < 0.05).

Conclusions

There is a significant decrease in bond strength of composite resin to enamel immediately after bleaching. A delay of one week before bonding and the use of EGCG increased bond strength of composite resin to bleached enamel.

Antioxidant agents and their effects on shear bond strength of bleached enamel

AIM

The goal of this study was to fnd a method to eliminate bond strength reduction after vital bleaching.

MATERIALS AND METHODS

Sixty fat surfaces of enamel central human incisors were prepared by diamond disks. In the frst group, the samples immediately bonded to the tooth after bleaching. For the second group, the bleached samples were treated by sodium ascorbate for 1 hours. In the third and fourth groups the treatment was down using a new antioxidant agent for 1 hour and 15 minutes respectively. For the ffth group no bleaching was done. Cylindrical composite resin (Z 100) with a Single Bond adhesive system was bonded to the enamel with a special metal mold. After thermocycling, the samples were loaded at a crosshead speed of 0.5 mm/min. The mode of failures was inspected by the Dino Lite microscope and the microstructure of the debonding surfaces was observed by SEM. Considering normal data, statistical analysis was conducted by ANOVA and Tukey tests (p = 0.05).

RESULTS

The fourth group had maximum (21.82), while the frst group had the least (9.0971) shear bond strength. The ANOVA test showed a signifcant difference among the fve groups (p = 0.0002). There was not any signifcant statistical difference between the three types of debonding (p = 0.165).

CONCLUSION

The usage of sodium ascorbate or sodium ascorbate with detergent after vital bleaching are effective methods for reducing the damaging effects of bleaching agents on the shear bond strength of composite resin restoration to enamel. CLINICAL SIGNIFCANCE: Using antioxidants is necessary post bleaching and before resin bonding.

The effect of bleaching of teeth on the bond strength of brackets: An in vitro study

AIM

To determine the reversal effect of 10% sodium ascorbate, on the bond strength of previously bleached teeth with hydrogen peroxide.

MATERIALS AND METHODS

Sixty extracted maxillary premolars were selected and they were divided randomly into three groups. Group A teeth were etched and bonded; Group B bleached, etched and immediately bonded; Group C was subjected to bleaching, followed by treatment with 10% sodium ascorbate solution, then etched and bonded; Then all the three groups were subjected to testing procedure for bond strength.

RESULTS

The bond strength analysis was carried out by using instron, universal testing machine. In this study Group A had the maximum bond strength of 12.24 Mpa followed by Group C 11.62 Mpa and Group B 10.96 Mpa.

CONCLUSION

Group C the experimental group which was treated with 10% sodium ascorbate following bleaching with 35% hydrogen peroxide provided higher bond strength compared to Group B which was bonded immediately after bleaching even though it was not statistically significant.

Post-bleaching application of an antioxidant on dentin bond strength of three dental adhesives

Background:

Antioxidizing agents have recently been suggested to compensate decreased bond strength of resin materials to bleached tooth tissues. This study compared the shear bond strength (SBS) of three different adhesives on bleached dentin immediately after bleaching, bleached/delayed for 1 week, and bleached/applied antioxidizing agent.

Materials and Methods:

The dentinal surfaces of 132 intact extracted molars were prepared and divided into 12 groups. The following adhesives were investigated: Optibond FL (OFL) (three-step etch-and-rinse), Optibond Solo Plus (two-step etch-and-rinse), and Optibond all-in-one (OA) (one-step self-etch) (Kerr, Orange, USA). Unbleached dentin groups (groups 1-3) were prepared as negative controls (NC). The remainder surfaces (groups 4-12) were bleached with 20% Opalescent PF (Ultradent, USA). Specimens were bonded immediately after bleaching (groups 4-6), after 1 week (groups 7-9), or after using 10% sodium ascorbate (SA) gel (groups 10-12). Subsequent to bonding of composite resin, the samples were tested for SBS and analyzed using Kruskal-Wallis and Mann-Whitney tests (α=0.05).

Results:

Regarding control groups, OA showed the highest SBS among the studied adhesives (P<0.05). The SBS decreased for the adhesives after bleaching except for OFL. No statistically significant difference in SBS were noted when the SA and delayed bonding groups were compared with their similar NC groups (P>0.05) except the of delay bonding with OA.

Conclusions:

The findings suggest that bond strength of resin to bleached dentin may be affected with the adhesive system. Reduced SBS to bleached dentin can be amended by the use of SA as an antioxidizing agent. However, the amount of reversed bond strength subsequent to applying antioxidant might be related to the kind of dental adhesive.

Effect of Ascorbic Acid on Shear Bond Strength of Orthodontic Brackets Bonded with Resin-modified Glass-ionomer Cement to Bleached Teeth

BACKGROUND AND AIMS

Bleaching can considerably reduce shear bond strength (SBS) of orthodontic brackets bonded with composite adhesives. Application of antioxidants is a method to reverse the negative effect of bleaching on composite-to-enamel bond. However, the efficacy of antioxidants in increasing the SBS of brackets bonded using resin-modified glass-ionomer cement (RMGIC) has not been studied, which was the aim of this study.

MATERIALS AND METHODS

Fifty freshly extracted human maxillary first premolars were bleached with 35% hydrogen peroxide (Pola Office Bleaching, SDI). Sodium ascorbate 10% was applied to the experimental specimens (n=25). All the specimens were etched with 37% phosphoric acid (Ivoclar/Vivadent) and bonded using RMGIC (Fuji Ortho LC, GC). The specimens were subjected to incubation (37°C, 24h) and thermocycling (1000 cycles, 5-55°C, dwell time = 1 min). The SBS was measured at 0.5 mm/min debonding crosshead speed. The adhesive remnant index (ARI) was scored under ×10 magni-fication. Data were analyzed using Mann-Whitney U test, one- and independent-samples t-test, and Fisher'sexact test (α=0.05).

RESULTS

The mean SBS of experimental and control groups were 11.97 ± 4.49 and 7.7 ± 3.19 MPa, respectively. The dif-ference was statistically significant (P=0.000 by t-test). SBS of both control (P=0.014) and experimental (P=0.000) groups were significantly higher than the minimum acceptable SBS of 6 MPa, according to one-sample t-test.

CONCLUSION

Application of ascorbic acid can guarantee a strong bond when RMGIC is to be used. However, RMGIC might tolerate the negative effect of bleaching with minimum SA treatments (or perhaps without treatments), which de-serves further studies.

Effect of 10% sodium ascorbate hydrogel and delayed bonding on shear bond strength of composite resin and resin-modified glass ionomer to bleached enamel

OBJECTIVE

The aim of this study was to comparatively investigate the neutralizing effect of antioxidant treatment and delayed bonding after bleaching with hydrogen peroxide on the shear bond strength of a composite resin (CR) and resin-modified glass ionomer (RmGI) to enamel.

MATERIALS AND METHODS

Ninety-six freshly extracted human 3rd molars with flat enamel surfaces were divided into six experimental groups (n=12/group) and two control groups (n=12/group). After initial preparation, specimens in Groups 1 and 5 (control groups) were not bleached and the buccal enamel surface of specimens were bonded immediately with CR and RmGI. The samples of the remaining groups were all bleached six hours a day for seven days consecutively. Immediately after bleaching, groups two and six specimens were bonded with CR and RmGI. Groups 3 and 7 specimens were immersed in distilled water at 37°C for 7 days and the specimens in Groups 4 and 8 were treated with 10% sodium ascorbate as an antioxidant agent after bleaching. Specimens in Groups 3 and 4 were bonded with CR and Groups 7 and 8 specimens were bonded with RmGI immediately. After specimens were bonded, the shear bond strength (SBS) was measured. The SBS data analyses were subjected to one-way analysis of variance (ANOVA) followed by Tukey test for comparison of specific mean values.

RESULTS

The mean SBS value in Group 2 (immediately bonded with CR after bleaching) was significantly lower than other CR groups (P=0.045). RmGI did not bond to buccal enamel surface of specimens in group 6. There was no significant difference between other groups bonded with RmGI (P>0.05).

CONCLUSIONS

Applying 10% sodium ascorbate hydrogel and one week delay before bonding resulted in reversal of reduced bond strength of CR and RmGI to bleached enamel.

Effect of antioxidant treatment on the shear bond strength of composite resin to bleached enamel

INTRODUCTION

This study examined the antioxidant treatment on the shear bond strength of composite resin to enamel after bleaching with two different bleaching systems.

MATERIALS AND METHODS

Seventy flat enamel surfaces were prepared from freshly extracted human molars using a low speed diamond saw. Then the specimens were divided into seven random groups (n = 10) to apply different procedures; namely, bleaching with White Smile and bonding with composite resin (G1), bleaching with White Smile, treatment with ascorbic acid and bonding with composite resin (G2), bleaching with White Smile, immersing in artificial saliva for 2 weeks and bonding with composite resin (G3), bleaching with Opalesence and bonding with composite resin (G4), bleaching with Opalesence, treatment with ascorbic acid and bonding with composite resin (G5) and bleaching with Opalesence, immersing in artificial saliva for 2 weeks and bonding with composite resin (G6). Another group was used as a control group. Shear bond test was performed on all specimens and data were analyzed using one way ANOVA and Bonferroni's test (p < 0.05).

RESULTS

Bond strengths of bleached specimens were significantly lower than those of non-bleached specimens. No statistical difference was found in bond strength between the bleached and non-bleached groups when the antioxidant treatment was carried out.

CONCLUSION

Ten per cent ascorbic acid treatment was found to be an effective method to reverse the compromised bond strength.