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Li K, Chen S, Wang J, Xiao X, Song Z, Liu S. Tooth whitening: current status and prospects. Odontology 2024; 112:700-710. [PMID: 38565694 DOI: 10.1007/s10266-024-00914-4] [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: 09/20/2023] [Accepted: 02/07/2024] [Indexed: 04/04/2024]
Abstract
As a safe, effective, economical, and convenient technique, tooth whitening is one of the most popular treatments for improving tooth discoloration. This review summarizes the theoretical and recent research developments in the classification and mechanisms of tooth discoloration, as well as the principles, agents, effects, and side effects of tooth whitening techniques. The aim is to provide a basis for the clinical treatment of tooth whitening techniques and to suggest possible new ideas for further research. The accepted mechanism of whitening is the redox reaction of oxides in the whitening reagent, and the whitening effect is remarkable. However, side effects such as tooth sensitivity and irritation of gum and other oral soft tissues can still occur. It is recommended that more monitoring be carried out in the clinic to monitor these side effects, and care should be taken to protect the soft tissues in the mouth during office whitening procedures. Furthermore, there is a need to develop new additives or natural whitening products to reduce the occurrence of side effects.
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Affiliation(s)
- Kaiyi Li
- Department of Oral Mucosa, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200031, People's Republic of China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, People's Republic of China
| | - Shuang Chen
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, People's Republic of China
| | - Jingjing Wang
- School of Materials Science and Engineering, University of Shanghai for Science and Technology, Shanghai, People's Republic of China
| | - Xuan Xiao
- Department of Oral Mucosa, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200031, People's Republic of China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, People's Republic of China
| | - Zhifeng Song
- Department of Oral Mucosa, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200031, People's Republic of China.
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, People's Republic of China.
| | - Shangfeng Liu
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, People's Republic of China.
- School of Materials Science and Engineering, University of Shanghai for Science and Technology, Shanghai, People's Republic of China.
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Cua J, Crespo E, Phelps S, Ramirez R, Roque-Torres G, Oyoyo U, Kwon SR. Tooth Color Change and Erosion: Hydrogen Peroxide Versus Non-peroxide Whitening Strips. Oper Dent 2022; 47:301-308. [PMID: 35584321 DOI: 10.2341/20-302-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 11/23/2022]
Abstract
AIM The study evaluated the efficacy and potential erosion of non-peroxide strips compared to hydrogen peroxide (HP) whitening strips (WSs). METHODS Color evaluation samples (N=64) were distributed into four groups and treated according to manufacturer's directions. NC: Negative control treated with water; BT: Non-peroxide Brilliant Dissolving Strips; FM: Non-peroxide Fancymay Teeth WSs; WS: Crest 3D Brilliance HP White Strips. A contact-type spectrophotometer was used to measure color at baseline (T1), 1-day posttreatment (T2), and 1-week posttreatment (T3). Teeth were cut to a rectangular block for micro-CT erosion assessment. The samples (N=30) were divided into five groups. In addition to the four groups for color assessment, a positive control (PC) treated with 0.25% citric acid was added. The samples were scanned, reconstructed, and measured for erosion depth using a micro-CT analysis program software. Kruskal-Wallis test was used to determine differences in color change and erosion depth among the groups. Tests of hypotheses were two-sided with an alpha level of 0.05. RESULTS The mean ΔE*ab at 1-day/1-week posttreatment were 2.4/2.5, 2.8/2.9, 2.8/3.2, and 8.6/11.0 for NC, BT, FM, and WS, respectively. There was a statistically significant difference for ΔE*ab at 1-day and 1-week posttreatment (p<0.001). Group WS had the highest color change, while the other three groups did not differ from each other (p>0.05). Mean erosion depths in microns were 0.52, 0.58, 0.42, 0.49, and 29.55 for NC, BT, FM, WS, and PC, respectively. There was a statistically significant difference among the groups (p=0.004). Group PC had the greatest erosion, while the other groups had negligible erosion that did not differ from each other (p>0.05). CONCLUSION Peroxide WSs had superior whitening efficacy compared to non-peroxide strips. None of the tested products compromised tooth structure integrity through enamel erosion.
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Affiliation(s)
- J Cua
- John Cua, RDH, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - E Crespo
- Elisabeth Crespo, RDH, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - S Phelps
- Sarah Phelps, RDH, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - R Ramirez
- Rachel Ramirez, RDH, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - G Roque-Torres
- Gina Roque-Torres, DDS, MS, PhD, assistant professor, Center for Dental Research, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - U Oyoyo
- Udochukwu Oyoyo, MPH, assistant professor, Dental Education Services, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - S R Kwon
- *So Ran Kwon, DDS, MS, PhD, MS, professor & director of Student Research Program, Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA, USA
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Tran C, Choi E, Watu B, Oyoyo U, Perry C, Kwon SR. Laboratory model to evaluate efficacy of an experimental titanium oxide nanofibers bleaching agent. Restor Dent Endod 2021; 46:e47. [PMID: 34909411 PMCID: PMC8636076 DOI: 10.5395/rde.2021.46.e47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/22/2021] [Accepted: 05/09/2021] [Indexed: 11/11/2022] Open
Abstract
Objectives This study aimed to use a laboratory model to evaluate the efficacy of an experimental bleaching agent. Materials and Methods The model used human extracted molars that were treated and measured for bleaching efficacy. Teeth (n = 50) were distributed into 5 groups: Negative control (NC): immersion in water for 8 hours; Nanofibers (NFs): Experimental titanium dioxide nanofibers with stirring and light activation for 8 hours; Whitestrips (WS): Crest 3D White Glamorous White Whitestrips, 2 applications daily for 30 minutes, 14 days; 1% hydrogen peroxide (HP) standard: 1% hydrogen peroxide for 8 hours; and 30% HP standard: 30% hydrogen peroxide for 8 hours. Instrumental measurements were performed using a spectrophotometer. Results were recorded at baseline, 1-day post-bleaching, and 1-week post-bleaching. Kruskal-Wallis procedure was used to determine differences in color change. Pearson correlation was used to evaluate the relationship between visual and instrumental measurements. Tests of hypotheses were 2-sided with alpha = 0.05. Results There was no significant difference in color parameters (L1, a1, b1, and shade guide units [SGU]) at baseline (p > 0.05). There was a significant difference among the groups for overall color change (ΔE*ab) and change in shade guide units (ΔSGU) at 1-day and 1-week post-bleaching (p < 0.05). The higher the HP concentration, the higher the color change as expressed in ΔSGU and ΔE*ab. The negative control exceeded the perceptibility threshold of ΔE* = 1.2 regardless of time point. NFs showed a decrease in chroma, but were not statistically different compared to the negative control. Conclusions The laboratory model was successful in screening an experimental bleaching agent.
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Affiliation(s)
- Clayton Tran
- Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, California, USA
| | - Ellin Choi
- Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, California, USA
| | - Brittany Watu
- Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, California, USA
| | - Udochukwu Oyoyo
- Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, California, USA
| | - Christopher Perry
- Department of Biochemistry, Loma Linda University School of Medicine, Loma Linda, California, USA
| | - So Ran Kwon
- Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, California, USA
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Blatz M, Chiche G, Bahat O, Roblee R, Coachman C, Heymann H. Evolution of Aesthetic Dentistry. J Dent Res 2019; 98:1294-1304. [DOI: 10.1177/0022034519875450] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
One of the main goals of dental treatment is to mimic teeth and design smiles in a most natural and aesthetic manner, based on the individual and specific needs of the patient. Possibilities to reach that goal have significantly improved over the last decade through new and specific treatment modalities, steadily enhanced and more aesthetic dental materials, and novel techniques and technologies. This article gives an overview of the evolution of aesthetic dentistry over the past 100 y from a historical point of view and highlights advances in the development of dental research and clinical interventions that have contributed the science and art of aesthetic dentistry. Among the most noteworthy advancements over the past decade are the establishment of universal aesthetic rules and guidelines based on the assessment of natural aesthetic parameters, anatomy, and physiognomy; the development of tooth whitening and advanced restorative as well as prosthetic materials and techniques, supported by the pioneering discovery of dental adhesion; the significant progress in orthodontics and periodontal as well as oral and maxillofacial surgery; and, most recently, the implementation of digital technologies in the 3-dimensional planning and realization of truly natural, individual, and aesthetic smiles. In the future, artificial intelligence and machine learning will likely lead to automation of aesthetic evaluation, smile design, and treatment-planning processes.
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Affiliation(s)
- M.B. Blatz
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - G. Chiche
- Department of Restorative Sciences, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - O. Bahat
- Private Practice, Beverly Hills, CA, USA
| | - R. Roblee
- Private Practice Limited to Orthodontics, Fayetteville, AR, USA
| | - C. Coachman
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Private Practice, Sao Paulo, Brazil
| | - H.O. Heymann
- Division of Operative Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
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Lin KY, Chung CH, Ciou JS, Su PF, Wang PW, Shieh DB, Wang TC. Molecular damage and responses of oral keratinocyte to hydrogen peroxide. BMC Oral Health 2019; 19:10. [PMID: 30634966 PMCID: PMC6329095 DOI: 10.1186/s12903-018-0694-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 12/17/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hydrogen peroxide (H2O2)-based tooth bleaching reagents have recently increased in popularity and controversy. H2O2 gel (3%) is used in a Nightguard for vital bleaching; transient tooth sensitivity and oral mucosa irritation have been reported. Genotoxicity and carcinogenicity have also been significant concerns. METHODS We used primary cultured normal human oral keratinocytes (NHOKs) as an in vitro model to investigate the pathological effects to mitochondria functions on human oral keratinocytes exposed to different doses of H2O2 for different durations. RESULTS An MTT assay showed compromised cell viability at a dose over 5 mM. The treatments induced nuclear DNA damage, measured using a single-cell gel electrophoresis assay. A real-time quantitative polymerase chain reaction showed H2O2 induced significant increase in mitochondrial 4977-bp deletion. Mitochondrial membrane potential and apoptosis assays suggested that oxidative damage defense mechanisms were activated after prolonged exposure to H2O2. Reduced intracellular glutathione was an effective defense against oxidative damage from 5 mM of H2O2. CONCLUSION Our study suggests the importance for keratinocyte damage of the dose and the duration of the exposure to H2O2 in at-home-bleaching. A treatment dose ≥100 mM directly causes severe cytotoxicity with as little as 15 min of exposure.
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Affiliation(s)
- Kuan-Yu Lin
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, State College, Harrisburg, PA, 16803, USA
| | - Ching-Hung Chung
- Department of Stomatology, National Cheng-Kung University Hospital, Tainan, 70101, Taiwan
| | - Jheng-Sian Ciou
- Graduate Institute of Pharmaceutical Science, Chia-Nan University of Pharmacy and Science, Tainan, 71710, Taiwan
| | - Pei-Fang Su
- Department of Statistics, National Cheng Kung University, Tainan, 70101, Taiwan
| | - Pei-Wen Wang
- Institute of Oral Medicine and Department of Stomatology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 70101, Taiwan
| | - Dar-Bin Shieh
- Department of Stomatology, National Cheng-Kung University Hospital, Tainan, 70101, Taiwan. .,Institute of Oral Medicine and Department of Stomatology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 70101, Taiwan. .,Center of Applied Nanomedicine, Center for Micro/Nano Science and Technology, Advanced Optronic Technology Center, Innovation Center for Advanced Medical Device Technology, National Cheng Kung University, Tainan, 70101, Taiwan.
| | - Tzu-Chueh Wang
- Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, 71710, Taiwan.
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Ferraz NKL, Nogueira LC, Neiva IM, Ferreira RC, Moreira AN, Magalhães CS. Longevity, effectiveness, safety, and impact on quality of life of low-concentration hydrogen peroxides in-office bleaching: a randomized clinical trial. Clin Oral Investig 2018; 23:2061-2070. [DOI: 10.1007/s00784-018-2607-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/23/2018] [Indexed: 11/24/2022]
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de Castro DT, Valente MLDC, Aires CP, Alves OL, Dos Reis AC. Elemental ion release and cytotoxicity of antimicrobial acrylic resins incorporated with nanomaterial. Gerodontology 2017; 34:320-325. [PMID: 28436056 DOI: 10.1111/ger.12267] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study evaluated the release of ions and the cytotoxicity of acrylic resins incorporated with silver vanadate decorated with silver nanoparticles (AgVO3 ). BACKGROUND The inhibition of the accumulation of microorganisms on the resins is critical in preventing diseases. However, the hypothesis is that the release of ions from the incorporation of AgVO3 may be important in biocompatibility. MATERIALS AND METHODS Specimens of autopolymerising (AP) and heat-polymerising resin (HP) with AgVO3 were prepared and immersed in culture medium. The release of silver ions (Ag) and vanadium (V) was evaluated by mass spectrometry with inductively coupled plasma (ICP-MS) (n=9) and the cell viability of fibroblasts L929 by MTT (3-[4,5-dimethylthiazol- 2yl]-2,5-diphenyltetrazolium bromide) (n=12). The results were evaluated with analysis of variance (ANOVA), Tukey and Pearson correlation test (α=.05). RESULTS The groups containing AgVO3 presented a difference in relation to the control (0%) regarding the release of Ag and V (P<.0001). All groups showed a reduction in L929 viability when compared with the cellular control (100%) (P<.0001). In comparison with the control resins for HP, a reduction in the metabolism of cells occurred starting at 2.5% and for AP at 5% (P<.0001). A positive correlation was found between the concentration of AgVO3 and the ion release, and a negative between the ion release and the cell viability. CONCLUSIONS Significant numbers of Ag and V ions were released from resins with higher concentrations of AgVO3 , presenting cytotoxicity for cells, suggesting that the use of low concentrations is indicated to avoid risks to patients.
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Affiliation(s)
- Denise Tornavoi de Castro
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mariana Lima da Costa Valente
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carolina Patricia Aires
- Department of Physics and Chemistry, Ribeirão Preto Pharmaceutical Sciences School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Oswaldo Luiz Alves
- Laboratory of Solid State Chemistry, State University of Campinas-UNICAMP, Campinas, São Paul, Brazil
| | - Andréa Cândido Dos Reis
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Paula AB, Dias MI, Ferreira MM, Carrilho T, Marto CM, Casalta J, Cabrita AS, Carrilho E. Effects on gastric mucosa induced by dental bleaching--an experimental study with 6% hydrogen peroxide in rats. J Appl Oral Sci 2016; 23:497-507. [PMID: 26537721 PMCID: PMC4621943 DOI: 10.1590/1678-775720150235] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 08/26/2015] [Indexed: 11/22/2022] Open
Abstract
The value of aesthetic dentistry has precipitated several developments in the investigation of dental materials related to this field. The free marketing of these products is a problem and it is subject to various interpretations regarding its legality. There are several techniques for tooth whitening, the most used one being the external bleaching. It is the later version of such technique that poses the greatest danger of ingesting the product. The present study analysed the systemic effect of these products when they are swallowed.
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Affiliation(s)
| | - Maria Isabel Dias
- Escola de Ciências Agrárias e Veterinárias, Universidade de Trás-Os-Montes e Alto Douro, Vila Real, Portugal
| | | | - Teresa Carrilho
- Escola de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | | | - João Casalta
- Escola de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | | | - Eunice Carrilho
- Escola de Medicina, Universidade de Coimbra, Coimbra, Portugal
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Sbiancamento domiciliare e professionale a confronto. Seconda parte: procedure professionali. DENTAL CADMOS 2012. [DOI: 10.1016/j.cadmos.2012.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Vidal IG, Dias ILT, Neto GDO, Lanza MRDV, Sotomayor MDPT. Carbamide Peroxide Determination in Tooth Whitening Using a Reagentless HRP-Biosensor. ANAL LETT 2009. [DOI: 10.1080/00032710802507927] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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The whitening effect of enzymatic bleaching on tetracycline. J Dent 2008; 36:795-800. [PMID: 18635305 DOI: 10.1016/j.jdent.2008.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 05/20/2008] [Accepted: 05/30/2008] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Carbamide peroxide and hydrogen peroxide have been used as tooth whitening agents. The aim of this paper was to determine the efficiency of several enzyme-containing whitening systems. A method to determine the rate of 'in vitro' tetracycline whitening was also developed. METHODS We determined the tetracycline whitening ability of carbamide peroxide and hydrogen peroxide, and the influence of peroxidase and lactoperoxidase on this tetracycline whitening rate. RESULTS High peroxidase and lactoperoxidase concentrations increased the rate of tetracycline decoloration obtained with carbamide peroxide or hydrogen peroxide. The decoloration rate observed was lower when the glucose/glucose oxidase system was used to generate hydrogen peroxide 'in situ'. The presence of peroxidase increased the decoloration rate of extracted teeth obtained with carbamide. CONCLUSIONS Enzymes such as peroxidase could be used as whitening catalysts to increase the rate of tetracycline decoloration.
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Application of mode-of-action considerations in human cancer risk assessment. Toxicol Lett 2008; 180:75-80. [PMID: 18588958 DOI: 10.1016/j.toxlet.2008.05.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Revised: 05/28/2008] [Accepted: 05/28/2008] [Indexed: 10/22/2022]
Abstract
The distinction between carcinogens with DNA-reactive and epigenetic modes of action and the application of mode-of-action considerations to risk assessment is reviewed. A bioindicator-based risk assessment strategy is described. This approach involves the use of mechanistic data to establish a "toxicologically insignificant daily intake".
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Abstract
PURPOSE OF REVIEW Patients seeking the expertise of facial plastic surgeons for facial aesthetic improvement may also desire or benefit from dental aesthetic procedures. This paper reviews current treatment options available in cosmetic dentistry. RECENT FINDINGS Many techniques exist to improve dental aesthetics in color, position, shape, size, alignment and overall smile appearance. Although orthodontic therapy is still an important modality for smile aesthetics, some simpler procedures can provide acceptable aesthetic results. Comparison of external dental bleaching techniques reveals similar long-term results for in-office and at-home bleaching; in-office treatments, however, may provide the benefit of faster results. Internal dental bleaching is an effective method for correcting nonvital teeth coloration. Enamel shaping via either direct tooth contouring or the application of resins or veneers to tooth surfaces can correct defects, asymmetries and shape or rotation problems. Veneers or crowns are also options to correct intrinsic dental stains not amenable to bleaching techniques. Treatments to refine gingival margins and borders are another proven beneficial cosmetic procedure. SUMMARY A myriad of techniques exist to correct a patient's particular concerns. Correction of discoloration is usually feasible as is the improvement of a patient's smile and overall dental aesthetics.
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Bibliography. Current world literature. Head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg 2006; 14:289-91. [PMID: 16832188 DOI: 10.1097/01.moo.0000233602.37541.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Munro IC, Williams GM, Heymann HO, Kroes R. Use of Hydrogen Peroxide-Based Tooth Whitening Products and its Relationship to Oral Cancer. J ESTHET RESTOR DENT 2006; 18:119-25. [PMID: 16831183 DOI: 10.1111/j.1708-8240.2006.00006.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED Tooth whitening products containing hydrogen peroxide or carbamide peroxide were evaluated in this review for potential oral cancer risk from their use. Hydrogen peroxide is genotoxic in vitro, but not in vivo. Hydrogen peroxide was not considered to pose a genotoxic risk to humans. The animal toxicology data relevant to the assessment of the carcinogenicity of hydrogen peroxide do not indicate that it has significant carcinogenic activity at any site, including the oral cavity. Hydrogen peroxide was found to enhance the carcinogenic effects of potent DNA reactive carcinogens in experimental animals. However, these experimental conditions are artificial as they are related to high exposures and are of no relevance to potential human exposures to low quantities of hydrogen peroxide from the use of tooth whitening products. Clinical data on hydrogen peroxide-containing tooth whitening products show no evidence for the development of preneoplastic or neoplastic oral lesions. Exposures to hydrogen peroxide received by the oral cavity are exceedingly low, of short duration (30-60 minutes), and could not plausibly enhance any carcinogenic risk associated with exposure of the oral cavity to chemicals in cigarette smoke or to alcohol, both known risk factors for the development of oral cancer. CLINICAL SIGNIFICANCE Based on a comprehensive review of the available literature and research, the use of tooth whitening products containing hydrogen peroxide or carbamide peroxide does not appear to pose an increased risk of oral cancer in the general population, including those persons who are alcohol abusers and/or heavy cigarette smokers.
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Affiliation(s)
- Ian C Munro
- Cantox Health Sciences International, Suite 308, 2233 Argentia Road Mississauga, Ontario, Canada.
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