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Dascanio R, de Oliveira Ribeiro RA, Coelho CSS, Souza MT, Kury M, Zanotto ED, de Souza Costa CA, Cavalli V. Effectiveness and safety of biosilicate-enhanced bleaching gels on enamel with early erosion lesion. J ESTHET RESTOR DENT 2024; 36:1412-1425. [PMID: 38853343 DOI: 10.1111/jerd.13271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 05/13/2024] [Accepted: 05/25/2024] [Indexed: 06/11/2024]
Abstract
AIM This study evaluated the efficacy and cytotoxicity of 35% hydrogen peroxide (HP) gel incorporated with 10% (w/w) biosilicate (BioS) on sound enamel and early-stage enamel erosion lesions. METHODS Discs of enamel/dentin were selected, subjected to erosive cycles (0.3% citric acid, pH 2.6), and treated with (n = 8): HP (35% HP, positive control); HP_BioS [carboxymethyl cellulose (CMC) + HP + BioS]; BioS (CMC + BioS); CMC (negative control). The discs were adapted to artificial pulp chambers with the enamel exposed for bleaching, and the dentin facing toward the culture medium (Dulbecco's modified Eagle's medium [DMEM]). Bleaching was performed in three 30-min sessions at 7-day intervals. After bleaching, the diffusion product (DMEM extract + diffused HP) was pipetted onto MDPC-23 odontoblastic cell line and inoculated. Color parameters (ΔL, Δa, Δb), color change (ΔE00), and changes in whiteness index (ΔWID) were determined before (T0) and after the last bleaching session (T3). Cell viability (MTT, %), H2O2 diffusion (μg/mL), oxidative cell stress (OxS), and cell fluorescence (live/dead assay, in confocal microscopy) were assessed (ANOVA/Tukey; α = 0.05). RESULTS No difference in ΔL, Δa, Δb, ΔE00, and ΔWID were found between HP and HP_BioS (p > 0.05). The incorporation of BioS decreased the HP diffusion into the substrates and mitigated oxidative stress in early-stage eroded enamel (p < 0.05). HP_BioS presented significantly higher cell viability compared with HP under erosion conditions. Live/dead assay indicated that BioS_HP maintained viability with larger clusters of viable cells. CONCLUSION Incorporating BioS into HP maintained bleaching effectiveness, favored cell viability, reduced the oxidative stress, and the cytotoxicity in teeth with early-stage erosion. CLINICAL SIGNIFICANCE BioS formulation showed promising results for reducing cytotoxicity in patients seeking tooth bleaching and presenting undetectable early-stage erosion.
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Affiliation(s)
- Rafael Dascanio
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Camila Siqueira Silva Coelho
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Marina Trevelin Souza
- Vitreous Materials Laboratory (LaMaV), Department of Materials Engineering, Federal University of São Carlos, São Carlos, Brazil
| | - Matheus Kury
- Dental Research Division, School of Dentistry, Paulista University (UNIP), São Paulo, Brazil
| | - Edgar Dutra Zanotto
- Vitreous Materials Laboratory (LaMaV), Department of Materials Engineering, Federal University of São Carlos, São Carlos, Brazil
| | | | - Vanessa Cavalli
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Xavier GMB, Gil GS, Paes YFO, de Meneses Costa Ferreira LM, Silva CM, Ribeiro-Costa RM, Araújo JLN. Assessment of the effect of experimental gel of pregabalin associated with 35% hydrogen peroxide bleaching on bovine dental enamel: an in vitro study. Odontology 2024:10.1007/s10266-024-00978-2. [PMID: 39060896 DOI: 10.1007/s10266-024-00978-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
To assess the effect of bleaching with gel of pregabalin associated with 35% hydrogen peroxide on the mechanical and chemical properties and ultramorphology of dental enamel. Thirty-six (36) specimens of bovine dental incisors were obtained and divided into three groups (n = 12), namely: CG = bleaching with 35% hydrogen peroxide; KFG = bleaching with 5% potassium nitrate and 2% sodium fluoride gel + 35% hydrogen peroxide; and PGG = bleaching with experimental gel of pregabalin + 35% hydrogen peroxide. The specimens were assessed with respect to Knoop microhardness, surface roughness, and colour change, before and after bleaching. They were also assessed using scanning electron microscopy and energy-dispersive spectroscopy after treatments. All groups exhibited an increase in surface roughness and a reduction in Knoop microhardness after the protocols. There was colour change in all groups, with no difference between them. In addition, there were changes in enamel morphology and non-significant loss of calcium and phosphorus. The experimental gel of pregabalin did not influence the action of 35% hydrogen peroxide, yielding results similar to those of the other groups assessed in all the parameters. Therefore, the gel of pregabalin can be an alternative for topical application on the surfaces of the teeth in association with bleaching treatments.
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Affiliation(s)
- Gabriela Monteiro Barbosa Xavier
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil
| | - Giovana Sholheid Gil
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil
| | - Yngrid Fernanda Oliveira Paes
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil
| | | | - Cecy Martins Silva
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil
| | - Roseane Maria Ribeiro-Costa
- Pharmaceutical Nanotechnology Laboratory, Faculty of Pharmacy, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil
| | - Jesuína Lamartine Nogueira Araújo
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil.
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Hortkoff D, da Silva KL, Farago PV, Gomes JC, Reis A, Gomes GM. Effect of topical application of ibuprofen/arginine on the in-office bleaching-induced tooth sensitivity: A randomized, triple-blind controlled trial. J Dent 2024; 142:104875. [PMID: 38309571 DOI: 10.1016/j.jdent.2024.104875] [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: 11/20/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVE The application of anti-inflammatories as topical desensitizers before dental bleaching is an approach to reduce bleaching-induced tooth sensitivity (TS). This randomized controlled trial compared the risk and intensity of TS and the color change resulting from in-office dental bleaching after using an experimental desensitizing gel containing ibuprofen and arginine. METHODS Sixty-two participants with upper canine shades A2 or darker were randomly assigned to either the ibuprofen-arginine desensitizing group or the placebo group. The desensitizing gel was applied for 15 min before in-office bleaching with 35 % hydrogen peroxide gel for 50 min (2 sessions). To assess the absolute risk and intensity of TS, visual (0-10) and numeric rating (0-5) scales were used, and group comparisons were made using the McNemar test, Wilcoxon test, and paired Student t-test (α = 0.05). Color change was evaluated using Vita Classical, Vita Bleachedguide (ΔSGU), and Vita EasyShade (ΔEab, ΔE00, and ΔWID) before and one month after the bleaching procedure. Group comparisons for color change were done using a paired t-test (α = 0.05). RESULTS The odds ratio for TS was 0.14 [95 % CI 0.02 to 0.6], meaning lower odds of TS for the desensitizing gel. A lower intensity of TS was also observed for the experimental group (p < 0.005) up to 48 h after bleaching. All color evaluation tools demonstrated effective and similar whitening for both groups (p > 0.05). CONCLUSIONS Using the experimental desensitizing gel containing ibuprofen and arginine effectively reduced the risk and intensity of TS without compromising the bleaching efficacy. CLINICAL RELEVANCE The topical application of ibuprofen/arginine on the in-office bleaching reduced risk and intensity of bleaching-induced tooth sensitivity.
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Affiliation(s)
- Diego Hortkoff
- Department of Dentistry, State University of Ponta Grossa - UEPG, 4748, Uvaranas - Ponta Grossa, Ponta Grossa, Paraná 84030-900, Brazil
| | - Karine Letícia da Silva
- Department of Dentistry, State University of Ponta Grossa - UEPG, 4748, Uvaranas - Ponta Grossa, Ponta Grossa, Paraná 84030-900, Brazil
| | - Paulo Vitor Farago
- Department of Pharmacy, State University of Ponta Grossa - UEPG, Ponta Grossa, Paraná, Brazil
| | - João Carlos Gomes
- Department of Dentistry, State University of Ponta Grossa - UEPG, 4748, Uvaranas - Ponta Grossa, Ponta Grossa, Paraná 84030-900, Brazil
| | - Alessandra Reis
- Department of Dentistry, State University of Ponta Grossa - UEPG, 4748, Uvaranas - Ponta Grossa, Ponta Grossa, Paraná 84030-900, Brazil
| | - Giovana Mongruel Gomes
- Department of Dentistry, State University of Ponta Grossa - UEPG, 4748, Uvaranas - Ponta Grossa, Ponta Grossa, Paraná 84030-900, Brazil.
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Gruba AS, Nunes GP, Marques MT, Danelon M, Alves RDO, de Toledo PTA, Briso ALF, Delbem ACB. Influence of bleaching gels formulated with nano-sized sodium trimetaphosphate and fluoride on the physicochemical, mechanical, and morphological properties of dental enamel. J Dent 2023; 139:104743. [PMID: 37839624 DOI: 10.1016/j.jdent.2023.104743] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/02/2023] [Accepted: 10/12/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES To evaluate in vitro the effects of sodium fluoride (F) and nano-sized sodium trimetaphosphate (TMPnano) added to a 35% hydrogen peroxide (H2O2) bleaching gel on the color alteration, enamel mechanical and morphological properties, and H2O2 transamelodentinal diffusion. MATERIALS AND METHODS Bovine enamel/dentin discs (n = 180) were divided according to the bleaching gel: 35% H2O2 (HP); 35% H2O2 + 0.1% F (HP/F); 35% H2O2 + 1% TMPnano (HP/TMPnano); 35% H2O2 + 0.1% F + 1% TMPnano (HP/F/TMPnano) and 35% H2O2 + 2% calcium gluconate (HP/Ca). The gels were applied 3 times by 40 min; once each 7-day. The Commission Internationale de l'Eclairage (CIE) L*a*b* total color alteration (ΔE), color alteration by CIEDE2000 (ΔE00), whitening index (ΔWID), surface (SH) and cross-sectional hardness (ΔKHN), surface roughness (Ra), and transamelodentinal diffusion were determined. Enamel surfaces were evaluated by Scanning Electron Microscopy (SEM) and X-ray Dispersive Energy (EDX). Data were submitted to ANOVA, followed by the Student-Newman-Keuls test (p <0.05). RESULTS ΔE, ΔE00, and ΔWID were similar among the gels that promoted a bleaching effect after treatment (p <0.001). Mineral loss (SH and ΔKHN), Ra, and H2O2 diffusion were lower for HP/F/TMPnano; the HP and HP/Ca groups presented the highest values (p <0.001). For SEM/EDX, surface changes were observed in all bleached groups, but less intense with TMPnano. CONCLUSIONS Gels containing F/TMPnano do not interfere with the bleaching effect and reduce enamel demineralization, roughness, H2O2 diffusion, and morphological changes. CLINICAL RELEVANCE Whitening gels containing F/TMPnano can be used as a new strategy to increase safety and maintain clinical performance.
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Affiliation(s)
- Amanda Scarpin Gruba
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Mariana Takatu Marques
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Marcelle Danelon
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Renata de Oliveira Alves
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Priscila Toninatto Alves de Toledo
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - André Luiz Fraga Briso
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Alberto Carlos Botazzo Delbem
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, Sao Paulo State University (UNESP), Araçatuba, SP, Brazil.
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Motevasselian F, Kermanshah H, Dortaj D, Lippert F. Effect of pH of In-Office Bleaching Gels and Timing of Fluoride Gel Application on Microhardness and Surface Morphology of Enamel. Int J Dent 2023; 2023:1041889. [PMID: 37705827 PMCID: PMC10497361 DOI: 10.1155/2023/1041889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/16/2023] [Accepted: 08/18/2023] [Indexed: 09/15/2023] Open
Abstract
Objective To assess microhardness (VH) of enamel treated with two in-office bleaching agents with different pH and to study the effect of post- and prebleaching fluoride therapy. Materials and Methods Eighty bovine incisors were divided into eight groups: G1-Unbleached group; G2-2% NaF; G3-Pola Office (pH = 3.8); G4-Pola Office+ (pH = 7); G5-Pola Office followed by 2% NaF; G6-2% NaF followed by Pola Office; G7-Pola Office+ followed by 2% NaF; G8-2% NaF followed by Pola Office+. Bleaching was conducted 3x with 1-week intervals (T1/T7/T14). Specimens were kept in artificial saliva. VH was measured at T1, T7, and T14. Data were analyzed using repeated measure ANOVA. Surface morphology was assessed using scanning electron microscopy. Result There was no significant difference among the groups at T1. No significant difference was found between G3 and G4 at all intervals. 2% NaF (G5/G6 vs. G3) significantly prevented softening at T7 and T14. Some nonsignificant hardening was observed for 2% NaF for G7/G8 vs. G4. At T14, G3 showed the lowest VH values. G5 showed higher VH values compared to other groups apart from G6-G7. No relationship between bleaching protocols and surface morphology was observed. Conclusion Pola Office caused the most softening. 2% NaF gel application after Pola Office bleaching was effective in recovering enamel hardness. Fluoride application after Pola Office+ bleaching provided little benefit.
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Affiliation(s)
- Fariba Motevasselian
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Kermanshah
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Dorara Dortaj
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Frank Lippert
- Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN, USA
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Satti MK, Nayyer M, Alshamrani M, Kaleem M, Salawi A, Safhi AY, Alsalhi A, Sabei FY, Khan AS, Muhammad N. Synthesis, Characterization, and Investigation of Novel Ionic Liquid-Based Tooth Bleaching Gels: A Step towards Safer and Cost-Effective Cosmetic Dentistry. Molecules 2023; 28:3131. [PMID: 37049892 PMCID: PMC10096067 DOI: 10.3390/molecules28073131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/24/2023] [Accepted: 03/26/2023] [Indexed: 04/03/2023] Open
Abstract
The objective of this study was to synthesize a novel choline hydroxide ionic liquid-based tooth bleaching gel. Ionic liquid-based gels were synthesized and characterized using FTIR along with pH testing. Tooth sample preparation was carried out in line with ISO 28399:2020. The effects of synthesized gels on tooth samples were tested. Tooth samples were stained and grouped into three experimental groups: EAI (22% choline hydroxide gel), EAII (44% choline hydroxide gel), and EB (choline citrate gel) and two control groups: CA (commercial at-home 16% carbamide peroxide gel) and CB (deionized water). The tooth color analysis, which included shade matching with the Vitapan shade guide (n = 2), and digital colorimetric analysis (n = 2) were evaluated. The surface characteristics and hardness were analyzed with 3D optical profilometry, Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDX), and Microhardness testing (n = 3), respectively. The tooth color analysis (Vitapan shade guide) revealed that all the tooth samples treated with synthesized choline citrate gel (EB) showed an A1 shade as compared to the other four groups, giving a range of shades. An analysis of the ΔE values from digital colorimetry; EAI, EAII, CA, and CB showed ΔE values in a range that was clinically perceptible at a glance. However, EB showed the highest value of ΔE. The mean microhardness values for the five groups showed that the effects of three experimental gels i.e., 44% choline hydroxide, 22% choline hydroxide, and choline citrate, on the microhardness of the tooth samples were similar to that of the positive control, which comprised commercial at-home 16% carbamide peroxide gel. SEM with EDX of three tested subgroups was closely related in surface profile, elemental composition, and Ca/P ratio. The roughness average values from optical profilometry of four tested subgroups lie within approximately a similar range, showing a statistically insignificant difference (p > 0.05) between the tested subgroups. The synthesized novel experimental tooth bleaching gels displayed similar tooth bleaching actions without any deleterious effects on the surface characteristics and microhardness of the treated tooth samples when compared with the commercial at-home tooth bleaching gel.
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Affiliation(s)
- Memuna Kausar Satti
- Department of Dental Materials, National University of Medical Sciences (NUMS), Rawalpindi 46000, Pakistan
| | - Maleeha Nayyer
- Department of Dental Materials, National University of Medical Sciences (NUMS), Rawalpindi 46000, Pakistan
| | - Meshal Alshamrani
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia
| | - Muhammad Kaleem
- Department of Dental Materials, National University of Medical Sciences (NUMS), Rawalpindi 46000, Pakistan
| | - Ahmad Salawi
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia
| | - Awaji Y. Safhi
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia
| | - Abdullah Alsalhi
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia
| | - Fahad Y. Sabei
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia
| | - Abdul Samad Khan
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Nawshad Muhammad
- Department of Dental Materials, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar 25100, Pakistan
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Salam T.A. A, Mubarak Algharbi E, Ibrahim Alsane M, Ibraheem Alhaji M, Ahmed Aldohayan N, Saud Albarrak A, Chitumalla R. Assessment of Patients’ Experience and Perception Toward Dentinal Hypersensitivity for Its Diagnosis and Management: A Cross-Sectional Study. Cureus 2023; 15:e35214. [PMID: 36968862 PMCID: PMC10032551 DOI: 10.7759/cureus.35214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Background Dentinal hypersensitivity (DH) is a common clinical finding that varies greatly in prevalence. An appropriate impulse that detonates noxious stimuli in the pulp/dentin boundary causes the typical DH pain, which is sudden, short, sharp, and of rapid onset. The objective of this research was to ascertain the incidence of DH in Keralites and evaluate some contributory factors, along with other initiating stimuli. Methodology Over three months, from June 2022 to August 2022, a cluster sampling technique was employed to conduct the study in 14 districts of Kerala. Patients from five clinics from each district who reported having DH and were aged 25 to 65 years were chosen at random. Using Google Survey forms, a 20-question, closed-ended survey was mailed to patients. The data were collected, evaluated, and analyzed using SPSS Version 23.0 (IBM Corp., Armonk, NY, USA). The statistical difference in the distribution of DH and the patient's age was determined using analysis of variance (ANOVA). A chi-square test was carried out to test the association between dentinal hypersensitivity, gender, and other parameters; P < 0.05 was considered to be statistically significant. Results Among the 2,520 persons to whom questionnaires were mailed, 2,321 responded, with an unresponsive rate of 7.89%. The study revealed a sensitivity predilection among females (54%), although statistically insignificant. Respondents aged 25 to 35 years (41.01%) were commonly reported to have DH, the age distribution of which was found to be highly significant statistically (P < 0.01). Teeth whitening resulted in 82.98% of the sensitivity, whereas 47.99% accepted poor oral hygiene as an additional contributory factor. DH was reported in 52.01% of the patients with gastritis and 63.03% of the patients with gingival recession. Further, blame for poor dental treatment (88.88%) and climate change (82.92%) were also found relevant. The quality of life was claimed to be afflicted in 90.99% of the patients. Desensitizing agents were used by 68.97% of the patients, with which 68.03% reported satisfaction. Of the subjects who underwent professional treatment, 87.03% reported being satisfied. Oral prophylaxis-induced sensitivity was reported in 57.99%, indicating enhanced oral health awareness among Kerala residents. There was a statistically highly significant difference in the patient distribution based on the exposure to DH, and their perception of the causes and factors affecting DH (P < 0.01). Conclusions DH is a frequently and widely prevalent dental malady. Respondents demonstrated that they were conversant with DH. The quality of life and enjoyment of daily activities are both impacted by dentin hypersensitivity, and many patients are unaware that it is a treatable illness. Various desensitizing substances are also available and can be applied quickly to sensitive areas. Patients prefer this procedure as it is simpler to apply these agents and the effects are pleasant and beneficial.
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Dias MF, Martins BV, de Oliveira Ribeiro RA, Hebling J, de Souza Costa CA. Improved esthetic efficacy and reduced cytotoxicity are achieved with a violet LED irradiation of manganese oxide-enriched bleaching gels. Lasers Med Sci 2022; 38:2. [PMID: 36534293 DOI: 10.1007/s10103-022-03688-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/22/2022] [Indexed: 12/23/2022]
Abstract
Gels with high concentrations of hydrogen peroxide (H2O2) have been associated with cytotoxicity and consequent post-bleaching tooth sensitivity. This study assessed the bleaching efficacy (BE) and cytotoxicity (CT) of bleaching gels with low concentrations of H2O2 containing manganese oxide (MnO2) and photocatalyzed with violet LED (LEDv). The following groups were established: G1: no treatment (negative control, NC); G2: 35% H2O2 (positive control, PC); G3: LEDv; G4: 10% H2O2; G5: 6% H2O2; G6: 10% H2O2 + MnO2 + LEDv; G7: 6% H2O2 + MnO2 + LEDv. To analyze BE, standardized enamel/dentin discs (E/DDs) were subjected to the bleaching procedures for 45 min (1 session). The color change was determined before and after performing the bleaching protocols (ΔE00; ΔWI). To analyze CT, the E/DDs were adapted to artificial pulp chambers, and the extracts (culture medium + diffused gel components) were applied to cultured odontoblast-like MDPC-23 cells. Then, the cells were assessed concerning their viability (VB), oxidative stress (OxS), and Live/Dead. The amount of H2O2 diffused was also determined (ANOVA/Tukey; p < 0.05). Cell viability decreased in all bleached groups compared to G1 (NC; p < 0.05). The cells in G6 and G7 presented higher viability than in G2, G4, and G5 (p < 0.05). The BE in G7 was similar to G2 (PC; p < 0.05). The lowest OxS and H2O2 diffusion values were found in G6 and G7, compared to the other bleached groups (G2, G4, and G5; p < 0.05). The 6% H2O2 bleaching gel (G7) submitted to both methods of catalysis (MnO2 + LEDv) caused only a mild cytotoxicity and maintained the excellent esthetic outcome promoted by in-office conventional tooth bleaching.
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Affiliation(s)
- Marlon Ferreira Dias
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Beatriz Voss Martins
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | | | - Josimeri Hebling
- Department of Morphology, Genetics, Orthodontics, and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, Araraquara, 1680, Brazil.
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Júnior NAN, Nunes GP, Gruba AS, Danelon M, da Silva LMAV, de Farias Batista G, Briso ALF, Delbem ACB. Evaluation of bleaching efficacy, microhardness, and trans-amelodentinal diffusion of a novel bleaching agent for an in-office technique containing hexametaphosphate and fluoride. Clin Oral Investig 2022; 26:5071-5078. [PMID: 35403911 DOI: 10.1007/s00784-022-04480-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/05/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study evaluated in vitro the effects of calcium gluconate (CaGlu), sodium fluoride (NaF), sodium hexametaphosphate (HMP), and NaF/TMP added to a 35% hydrogen peroxide (H2O2) bleaching gel on the color change, enamel hardness, and trans-amelodentinal diffusion. MATERIALS AND METHODS Enamel discs/bovine dentin (n = 150) were divided according to the bleaching gel: 35% H2O2 (H2O2); 35% H2O2 + 0.1% NaF (H2O2/NaF); 35% H2O2 + 1% HMP (H2O2/HMP); 35% H2O2 + 0.1% NaF + 1% HMP (H2O2/NaF/HMP), and 35% H2O2 + 2% CaGlu (H2O2/Caglu). The bleaching gels were applied three times (40 min/session) at 7-day intervals between each application. Then, color alteration (ΔE), whitening index (ΔWID), percentage of surface hardness loss (% SH), cross-sectional hardness (ΔKHN), and trans-amelodentinal diffusion were determined. Data were submitted for analysis of variance (ANOVA), followed by the Student-Newman-Keuls test (p < 0.05). RESULTS All bleaching gels showed significant color changes after treatment (p < 0.001). ΔE and ΔWID were similar among the evaluated gels. Mineral loss (% SH and ΔKHN) and trans-amelodentinal diffusion of hydrogen peroxide were lower for H2O2/NaF/HMP; the H2O2/CaGlu group presented the highest values about the other groups (p < 0.001). CONCLUSION It is possible to conclude that the addition of NaF/HMP to the in-office bleaching agent did not interfere with the bleaching efficacy and reduced enamel demineralization and H2O2 diffusion. CLINICAL SIGNIFICANCE The association of NaF/HMP to the bleaching gel can be used as a novel approach for minimizing the adverse effects of H2O2 by-products and with similar clinical efficacy.
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Affiliation(s)
- Nilson Antônio Nunes Júnior
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Amanda Scarpin Gruba
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Marcelle Danelon
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Lívia Maria Alves Valentim da Silva
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gabriella de Farias Batista
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - André Luiz Fraga Briso
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Alberto Carlos Botazzo Delbem
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil.
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A Titanium Tetrafluoride Experimental Gel Combined with Highly Concentrated Hydrogen Peroxide as an Alternative Bleaching Agent: An In Vitro Study. Gels 2022; 8:gels8030178. [PMID: 35323291 PMCID: PMC8951146 DOI: 10.3390/gels8030178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023] Open
Abstract
This in vitro study evaluated color change, mineral content, and morphology of enamel, pH and cytotoxicity of experimental bleaching agents containing 35% hydrogen peroxide (HP), titanium tetrafluoride (TiF4), Natrosol, and Chemygel. Sixty enamel/dentin blocks were randomly treated with (n = 10) HP; HP+Natrosol+Chemygel with different TiF4 concentrations: 0.05 g HPT0.5, 0.1 g HPT1, 0.2 g HPT2, 0.3 g HPT3, 0.4 g HPT4. Bleaching was performed in three sessions (3 × 15 min application). Color change (CIELab-ΔEab, CIEDE2000-ΔE00, ΔWID) and Knoop microhardness (KHN) were evaluated. Enamel morphology and composition were observed under scanning electron microscopy and energy-dispersive spectrometry (EDS), respectively. Cell viability of keratinocyte cells was evaluated using MTT assay. Data were analyzed by one-way ANOVA and LSD and Tukey tests, and two-way repeated measures ANOVA and Bonferroni (α = 5%). The pH and EDS were analyzed descriptively. Lightness-L* increased, and a* and b* parameters decreased, except for HPT3 and HPT4 (b*). HPT0.5, HPT1, and HPT2 exhibited ΔEab and ΔWID similar to HP. ΔE00 did not present statistical difference. HP, HPT0.5, and HPT1 promoted higher KHN. HPT0.5 exhibited no changes on enamel surface. Keratinocyte cells were viable when treated with T0.5, and weak viable for T1. Experimental agents exhibited acidic pH and Ti elements. HPT0.5 exhibited bleaching efficacy, maintained KHN without enamel alterations, and did not increase cytotoxicity.
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de Barros Silva PG, Filho ELC, Nigri FMN, Dantas TS, de Miranda Candeiro GT, Neri JR. Photobiomodulation Reduces Pain-Related Symptoms Without Interfering in the Efficacy of In-Office Tooth Bleaching: A Systematic Review and Meta-Analysis of Placebo-Controlled Clinical Trials. Photobiomodul Photomed Laser Surg 2022; 40:163-177. [DOI: 10.1089/photob.2021.0105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Paulo Goberlânio de Barros Silva
- Department of Dentistry, University Center Christus, Fortaleza, Brazil
- Graduate School of Dentistry, University Center Christus, Fortaleza, Brazil
| | - Edson Luiz Cetira Filho
- Department of Dentistry, University Center Christus, Fortaleza, Brazil
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | | | | | - George Táccio de Miranda Candeiro
- Department of Dentistry, University Center Christus, Fortaleza, Brazil
- Graduate School of Dentistry, University Center Christus, Fortaleza, Brazil
| | - Jiovanne Rabelo Neri
- Department of Dentistry, University Center Christus, Fortaleza, Brazil
- Graduate School of Dentistry, University Center Christus, Fortaleza, Brazil
- Graduate School of Dentistry, University of Fortaleza, Fortaleza, Brazil
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12
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Ortecho-Zuta U, de Oliveira Duque CC, de Oliveira Ribeiro RA, Leite ML, Soares DG, Hebling J, Briso ALF, de Souza Costa CA. Strategy for reducing cytotoxicity and obtaining esthetic efficacy with 15 min of in-office dental bleaching. Clin Oral Investig 2022; 26:4099-4108. [PMID: 35199193 DOI: 10.1007/s00784-022-04379-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/13/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Evaluate in vitro the esthetic efficacy and cytotoxicity of a bleaching gel containing 35% hydrogen peroxide (BG-35%H2O2), applied for different time intervals, on enamel coated or not with polymeric biomaterials. MATERIALS AND METHODS Nanofiber scaffolds (NSc) and a primer catalyst (PrCa) were used to coat the bovine enamel/dentin discs before the application of BG-35%H2O2, according to the following groups: G1-negative control (NC, without treatment); G2, G3, and G4-BG-35%H2O2 applied for 3 × 15, 2 × 15, and 15 min; G5, G6, and G7-BG-35%H2O2 applied on enamel coated with NSc and PrCa for 3 × 15; 2 × 15, and 15 min, respectively. The culture medium with components of gel diffused through the discs was applied on MDPC-23 cells, which were evaluated regarding to viability (VB), integrity of the membrane (IM), and oxidative stress (OxS). The quantity of H2O2 diffused and esthetic efficacy (ΔE/ΔWI) of the dental tissues were also analyzed (ANOVA/Tukey; p < 0.05). RESULTS Only G7 was similar to G1 regarding VB (p > 0.05). The lowest value of H2O2 diffusion occurred in G4 and G7, where the cells exhibited the lowest OxS than G2 (p < 0.05). Despite G5 showing the greatest ΔE regarding other groups (p < 0.05), the esthetic efficacy observed in G7 was similar to G2 (p > 0.05). ΔWI indicated a greater bleaching effect for groups G5, G6, and G7 (p < 0.05). CONCLUSION Coating the dental enamel with polymeric biomaterials reduced the time and the cytotoxicity of BG-35%H2O2. CLINICAL SIGNIFICANCE Coating the dental enamel with polymeric biomaterials allows safer and faster BG-35%H2O2 application.
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Affiliation(s)
- Uxua Ortecho-Zuta
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Carla Caroline de Oliveira Duque
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Rafael Antonio de Oliveira Ribeiro
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Maria Luísa Leite
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Diana Gabriela Soares
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Rua Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, SP, 17012-901, Brazil
| | - Josimeri Hebling
- Departament of Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, University São Paulo State (Unesp), Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - André Luiz Fraga Briso
- Department of Restorative Dentistry, Araçatuba, School of Dentistry University São Paulo State University (Unesp), Rua José Bonifácio 1193, Vila Mendonça, 16015-050, Brazil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, Araraquara School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, Araraquara, SP, 168014801-903, Brazil.
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Tavares NRNO, Galvão ADM, Dietrich L, Carvalho RF, Silva RS, Silva ALFE, Silva GRD. Can ozone or violet light improve the color change or physicochemical properties of hydrogen peroxide-bleached tooth? Braz Dent J 2021; 32:19-30. [PMID: 34787248 DOI: 10.1590/0103-6440202104002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 09/29/2021] [Indexed: 11/22/2022] Open
Abstract
This study investigated the bleaching effectiveness and the physicochemical effects on enamel of violet light and ozone, associate or not to hydrogen peroxide, compared to 35%-hydrogen peroxide. Enamel-dentin blocks from human molars were randomly allocated to receive one of the following bleaching protocols (n=15): (HP) 35%-hydrogen peroxide, (VL) violet light, (OZ) ozone, the association between hydrogen peroxide with ozone (OZ+HP) or violet light (VL+HP). All protocols were performed in two sessions with a 48h interval. Color (spectrophotometer) and mineral composition (Raman spectroscopy) were measured before and after the bleaching. Color changes were calculated by ΔEab, ΔE00, and whitening index (WI). The surface roughness was measured with an atomic force microscope. Data were analyzed by One-way or Two-way repeated measure ANOVA followed by the Tukey's test (α = 0.05). The lowest color change values (either measured by WI, ΔEab, or ΔE00) were observed for VL and OZ used with no HP. Violet light associate with HP was unable to improve the color changes observed for the peroxide alone, in combination with OZ and HP, the highest color changes were verified. Regardless of bleaching protocol, the bleached enamel presented higher contents of PO4 and CO3 -2 than those observed at baseline. All bleaching protocols resulted in similar enamel surface roughness. Both the VL and the OZ caused reduced effects on the enamel color change when used alone. The ozone therapy improved the bleaching effect in the group that received the association of HP.
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Affiliation(s)
| | - Alexia da Mata Galvão
- Department of Operative Dentistry and Dental Materials, Dental School, Federal University of Uberlândia(UFU), Uberlândia, Minas Gerais, Brazil
| | - Lia Dietrich
- Department of Operative Dentistry and Dental Materials, Dental School, Federal University of Uberlândia(UFU), Uberlândia, Minas Gerais, Brazil
| | | | - Robinson Sabino Silva
- Department of Physiology, Institute of Biomedical Sciences, Federal University of Uberlândia(UFU), Uberlândia, Minas Gerais, Brazil
| | - André Luis Faria E Silva
- Department of Dentistry, Dental School, Federal University of Sergipe(UFS), Aracaju, Sergipe, Brazil
| | - Gisele Rodrigues da Silva
- Department of Operative Dentistry and Dental Materials, Dental School, Federal University of Uberlândia(UFU), Uberlândia, Minas Gerais, Brazil
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Oliveira PHC, Oliveira LHC, Oliveira MRC, Moriyama C, de Paula E, de Vito Moraes AG, De Melo Deanna A, Zanin FAA, Gomes AO, Brugnera Junior A, Bussadori SK. In Vitro Evaluation of the Effectiveness of Dental Bleaching with Carbamide Peroxide and Violet Light. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:535-543. [PMID: 34342514 DOI: 10.1089/photob.2020.4824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The aim of the current study was to use the CIELab system to evaluate the performance of the whitening treatment involving violet light-emitting diode (LED) combined with a home 10% and 22% carbamide peroxide dental bleaching technique on dental enamel. Methods: Fifty blocks of bovine dental enamel were divided into five groups: control group (control), receiving only LED irradiation; Whitening 10%, receiving 10% carbamide peroxide treatment; Whitening 10%+VL, receiving 10% carbamide peroxide treatment combined with LED irradiation; Whitening 22%, receiving 22% carbamide peroxide treatment; and Whitening 22%+VL, receiving 22% carbamide peroxide treatment combined with violet LED irradiation. Color tests were performed before the protocols, after 1 week and after 2 weeks of treatment by using a spectrophotometer and the CIELab parameters: L*, (a*) and (b*). The Whitening 10%, Whitening 10%+VL, Whitening 22% and Whitening 22%+VL groups were submitted to 10% and 22% carbamide peroxide 8 h per day for 14 days, whereas the Control was only stored in artificial saliva. For irradiation in the Control, Whitening 10%+VL, and Whitening 22%+VL groups, we used violet LED at a wavelength of 405-410 nm activated for 60 permanent seconds and 30 sec of pause once per week. As all data exhibited normal distribution, the comparisons were performed by using two-way repeated-measures analysis of variance. A post hoc t-test was employed, followed by the Ryan-Holm stepdown Bonferroni procedure. Results: After 1 week, the Whitening 22%+VL group differed significantly from all other groups in relation to hue, while no difference was found between the remaining groups (p < 0.05). Analyzing lightness, the Whitening 22%+VL and Whiteness10%+VL groups differed from the other groups (p > 0.05). In the 2nd week, the Whitening 22%+VL groups differed significantly from all other groups (p < 0.05) in hue, chroma, and lightness. The comparative analysis of bleaching times within the same group revealed significant differences in the Whitening 22%+VL group between baseline and week 1, baseline and week 2, as well as weeks 1 and 2 in terms of hue (p > 0.05). In the Whitening 22%+VL group, significant differences (p < 0.05) were found between baseline and week 2 as well as between weeks 1 and 2 in chroma (p > 0.05). In the Whitening 22%+VL group, statistically significant differences (p < 0.05) were found between baseline and week 1, baseline and week 2, as well as between weeks 1 and 2 in lightness. In the Whitening 10%+VL group, statistically significant differences (p < 0.05) were found between baseline and week 1, between baseline and week 2, as well as between weeks 1 and 2 in lightness. Conclusions: Tooth whitening treatment involving 10% and 22% carbamide peroxide combined with violet light promoted changes in the three axes of color (ΔH, ΔC, and ΔL) of the specimens evaluated. The use of the gel bleach alone was more efficient when the higher concentration was used. When violet light was combined with the gel, the lower concentration was more efficient.
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Affiliation(s)
| | | | | | - Caroline Moriyama
- Department of Pediatric Dentistry and Graduate Program in Dentistry, Metropolitan University of Santos, Santos, Brazil
| | - Eloisa de Paula
- Department of Pediatric Dentistry and Graduate Program in Dentistry, Metropolitan University of Santos, Santos, Brazil
| | - André Guaraci de Vito Moraes
- Department of Pediatric Dentistry and Graduate Program in Dentistry, Metropolitan University of Santos, Santos, Brazil.,Department of Biomaterials and Oral Biology at University of São Paulo, São Paulo, Brazil
| | - Alessandro De Melo Deanna
- Graduate Program in Biophotonics Applied to Health Sciences, University of Nove de Julho, São Paulo, Brazil
| | | | - Andréa Oliver Gomes
- Graduate Program in Rehabilitation Sciences, University of Nove de Julho, São Paulo, Brazil
| | - Aldo Brugnera Junior
- Institute of Physics of São Carlos, University of the São Paulo, São Paulo, Brazil
| | - Sandra Kalil Bussadori
- Graduate Program in Biophotonics Applied to Health Sciences, University of Nove de Julho, São Paulo, Brazil.,Graduate Program in Rehabilitation Sciences, University of Nove de Julho, São Paulo, Brazil
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15
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Vilela AP, Rezende M, Terra RMO, da Silva KL, Sutil E, Calixto AL, Reis A, D Loguercio A, Farago PV. Effect of topical application of nanoencapsulated eugenol on dental sensitivity reduction after in-office dental bleaching: a randomized, triple-blind clinical trial. J ESTHET RESTOR DENT 2021; 33:660-667. [PMID: 33694253 DOI: 10.1111/jerd.12728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/12/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE This randomized, split-mouth, triple-blind clinical study evaluated the effect of application of nanoencapsulated eugenol (NE) on the absolute risk and intensity of tooth sensitivity (TS) resulting from in-office bleaching. METHODS Fifty-six patients received a NE in one hemiarch and a placebo gel in the other hemiarch, determined by random sequence, before in-office bleaching. A visual analogue scale (VAS) (0-10) and a numeric rating scale (NRS) (0-4) were used to record TS during bleaching and 1 and 48 h after bleaching. The tooth color was performed from baseline to 2 weeks after bleaching with shade guides (ΔSGU) and a spectrophotometer (∆Eab , ∆E00, and WID ). The TS was assessed through the McNemar test (α = 0.05) and by the Wilcoxon signed-rank test (NRS) and paired t-test (VAS). The paired test-t was employed to compare the color changes (ΔSGU and ΔEab , ∆E00, and WID ). The significance level was 5%. RESULTS No statistically significant difference was found in the absolute risk or intensity of TS between both groups (p > 0.05). A significant color change was observed in both groups (p > 0.05). CONCLUSION Administration of the gel containing NE before the in-office dental bleaching did not reduce the TS and did not interfere in the bleaching effect. CLINICAL RELEVANCE STATEMENT The use of desensitizing gel containing NE did not reduce in-office bleaching-induced tooth sensitivity.
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Affiliation(s)
- Ana Paula Vilela
- Postgraduate Program in Pharmaceutical Sciences, Department of Pharmaceutical Sciences, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Márcia Rezende
- School of Dentistry, School Paulo Picanço, Fortaleza, Ceará, Brazil
| | - Renata Maria Oleniki Terra
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil
| | - Karine Letícia da Silva
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil
| | - Elisama Sutil
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil
| | - Abraham L Calixto
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil
| | - Alessandra Reis
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil
| | - Alessandro D Loguercio
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil
| | - Paulo Vitor Farago
- Postgraduate Program in Pharmaceutical Sciences, Department of Pharmaceutical Sciences, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
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Alkahtani R, Stone S, German M, Waterhouse P. A review on dental whitening. J Dent 2020; 100:103423. [PMID: 32615235 DOI: 10.1016/j.jdent.2020.103423] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 04/20/2020] [Accepted: 06/27/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To provide a narrative review on vital dental whitening chemistry, toxicity and safety, vital dental whitening techniques, whitening systems, potential side effects of whitening and cyclic whitening using products with a range of concentrations and pH values. In addition, new developments and recommendations in the field of vital dental whitening will be presented to help clinicians understand the whitening process, its advantages, limitations, and the impact of whitening concentration and pH on enamel providing guidance in tailoring whitening treatments. DATA Data were gathered using the following keywords: dental whitening, roughness, hardness, sensitivity, hydrogen peroxide, whitening pH, whitening concentration, whitening chemistry, colour, and toxicity. SOURCES An electronic search was performed using PubMed and Scopus databases. Bibliographic material from papers reviewed was then used to find other relevant publications. CONCLUSIONS The effectiveness of vital dental whitening depends on many factors, such as the concentration/pH of the whitening agent, application duration, chemical additives, and re-mineralising agents used. Developing new whitening products and technologies such as nano-additives and alternative carrier systems is showing promising results, and might prove efficient in maximising whitening benefits by accelerating the whitening reaction and/or minimising expected reversible/irreversible enamel structural damage.
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Affiliation(s)
- Rawan Alkahtani
- College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; School of Dental Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, Tyne and Wear, NE2 4BW, United Kingdom.
| | - Simon Stone
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, Tyne and Wear, NE2 4BW, United Kingdom
| | - Matthew German
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, Tyne and Wear, NE2 4BW, United Kingdom
| | - Paula Waterhouse
- School of Dental Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, Tyne and Wear, NE2 4BW, United Kingdom
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Kury M, Wada EE, Silva DPD, Tabchoury CPM, Giannini M, Cavalli V. Effect of violet LED light on in-office bleaching protocols: a randomized controlled clinical trial. J Appl Oral Sci 2020; 28:e20190720. [PMID: 32428059 PMCID: PMC7213781 DOI: 10.1590/1678-7757-2019-0720] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/24/2020] [Indexed: 11/30/2022] Open
Abstract
Objective This study evaluated the clinical effect of violet LED light on in-office bleaching used alone or combined with 37% carbamide peroxide (CP) or 35% hydrogen peroxide (HP). Methodology A total of 100 patients were divided into five groups (n=20): LED, LED/CP, CP, LED/HP and HP. Colorimetric evaluation was performed using a spectrophotometer (ΔE, ΔL, Δa, Δb) and a visual shade guide (ΔSGU). Calcium (Ca)/phosphorous (P) ratio was quantified in the enamel microbiopsies. Measurements were performed at baseline (T 0 ), after bleaching (T B ) and in the 14-day follow-up (T 14 ). At each bleaching session, a visual scale determined the absolute risk (AR) and intensity of tooth sensitivity (TS). Data were evaluated by one-way (ΔE, Δa, ΔL, Δb), two-way repeated measures ANOVA (Ca/P ratio), and Tukey post-hoc tests. ΔSGU and TS were evaluated by Kruskal-Wallis and Mann-Whitney, and AR by Chi-Squared tests (a=5%). Results LED produced the lowest ΔE (p<0.05), but LED/HP promoted greater ΔE, ΔSGU and Δb (T 14 ) than HP (p<0.05). No differences were observed in ΔE and ΔSGU for LED/CP and HP groups (p>0.05). ΔL and Δa were not influenced by LED activation. After bleaching, LED/CP exhibited greater Δb than CP (p>0.05), but no differences were found between these groups at T 14 (p>0.05). LED treatment promoted the lowest risk of TS (16%), while HP promoted the highest (94.4%) (p<0.05). No statistical differences of risk of TS were found for CP (44%), LED/CP (61%) and LED/HP (88%) groups (p>0.05). No differences were found in enamel Ca/P ratio among treatments, regardless of evaluation times. Conclusions Violet LED alone produced the lowest bleaching effect, but enhanced HP bleaching results. Patients treated with LED/CP reached the same efficacy of HP, with reduced risk and intensity of tooth sensitivity and none of the bleaching protocols adversely affected enamel mineral content.
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Affiliation(s)
- Matheus Kury
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
| | - Erica Eiko Wada
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
| | - Daylana Pacheco da Silva
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
| | - Cínthia Pereira Machado Tabchoury
- Departamento de Ciências Fisiológicas, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
| | - Marcelo Giannini
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
| | - Vanessa Cavalli
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
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Pontes M, Gomes J, Lemos C, Leão RS, Moraes S, Vasconcelos B, Pellizzer EP. Effect of Bleaching Gel Concentration on Tooth Color and Sensitivity: A Systematic Review and Meta-analysis. Oper Dent 2020; 45:265-275. [PMID: 32396502 DOI: 10.2341/17-376-l] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis was to evaluate a high concentration of hydrogen peroxide (35%) regarding tooth sensitivity and color change in tooth bleaching in comparison to low concentrations (6% to 20%). METHODS AND MATERIALS This review was conducted using the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and is registered on the Prospective Register of Systematic Reviews (CRD42017064493). The PICO question was "Does a concentration of hydrogen peroxide ≥35% using in-office bleaching procedure contribute to greater tooth sensitivity?" A search was made in PubMed/MEDLINE, Scopus, and the Cochrane Library. RESULTS Fourteen studies were selected for the qualitative analysis and seven for quantitative analysis. A total of 649 patients were evaluated (mean age: 36.32 years; range: 13.9 to 31 years), and the follow-up period ranged from one week to 12 months. The meta-analysis demonstrated that tooth sensitivity was higher in the patients submitted to treatment involving a high concentration of hydrogen peroxide (0.67; 95% confidence interval [CI]: 0.44 to 1.03; p=0.04; I 2 : 56%), and a significant difference was found regarding objective color ΔE (1.53; 95% CI: 2.99 to 0.08; p<0.0001; I 2 : 82%) but no significant difference was found regarding subjective color ΔSGU (0.24; CI: 0.75 to 1.23; p<0.00001; I 2 : 89%). CONCLUSIONS This study indicated that a lower concentration of hydrogen peroxide causes less tooth sensitivity and better effectiveness in objective color change (ΔE); however, there is no difference between them related to subjective color (ΔSGU).
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De Almeida ACP, Barros KS, Ribeiro MES, Baia JCP, Silva e Sousa Júnior MH, Loretto SC. Influence of Different Time Intervals among the in-Office Bleaching Sessions on the Tooth Enamel Mass Variation. JOURNAL OF HEALTH SCIENCES 2019. [DOI: 10.17921/2447-8938.2019v21n4p342-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AbstractThis study evaluated the effect of different time intervals between tooth bleaching sessions on the variation of tooth enamel mass, using a 35% hydrogen peroxide (HP35) gel. Twenty bovine incisor teeth were collected and cross-sectioned twice, leaving only the middle coronal portion. The dentin layer was removed, leaving only the buccal dental enamel. The samples were randomly divided into 2 groups (n = 10): G1 (with a 7-day time interval between each bleaching session), and G2 (with a 2-day time interval between each bleaching session). Three bleaching sessions were performed for each group. Each specimen’s mass was measured using an electronic analytical scale, first at the beginning of the experiments (T0), and then immediately after each bleaching intervention (T1, T2 and T3, respectively). All samples were stored in artificial saliva and kept in a biological chamber during the time of the study. The data analysis was performed using ANOVA for the related samples (p = 0.05). The results showed a reduction in the enamel mass values in G2 after the 3rd session when comparing to enamel mass values presented at the beginning of the study. On the other hand, G1 presented an increase in the mass values at the end of the third session, and these intragroup differences were statistically significant (p <0.001). It was concluded that bleaching treatment with 7-day intervals between sessions leads to no tooth enamel mass loss, whereas the reduced 2–day time interval between sessions caused a significant tooth enamel mass loss. Keywords: Tooth. Tooth Bleaching. Tooth Enamel. Resumo Este estudo avaliou a influência de diferentes intervalos de tempo entre as sessões de clareamento com peróxido de hidrogênio a 35% (PH35) sobre a variação de massa do esmalte dental. Foram utilizados 20 dentes incisivos bovinos hígidos, seccionados em duas porções transversais, com a camada de dentina vestibular toda removida, restando apenas o esmalte dental vestibular. As amostras foram distribuídas em 2 grupos (n=10): G1 - intervalo de tempo de 7 dias entre as sessões de clareamento, e G2 - Intervalo de 2 dias entre as sessões de clareamento. Foram realizadas 3 aplicações de gel clareador em cada grupo. A pesagem dos espécimes foi realizada antes do início do tratamento clareador e ao final de cada intervenção clareadora, em uma balança analítica eletrônica. Os espécimes foram armazenados em saliva artificial, e mantidos em estufa biológica. Os dados foram submetidos à ANOVA para amostras relacionadas (p=0.05). O G2 apresentou uma redução nos valores de massa do esmalte quando comparados os tempos antes do clareamento (T0 - 0.1650g) e após a 3° sessão (T3 - 0.1643g). Entretanto, o G1 apresentou um aumento nos valores de massa ao término da terceira sessão (T0 - 0.1615g e T3 - 0.1624g), sendo essas diferenças intragrupos estatisticamente significantes (p<0.001). Foi possível concluir que no clareamento com intervalo de 7 dias entre as sessões não houve perda de massa do esmalte dental, ao passo que quando reduzido o intervalo entre as sessões para 2 dias, uma perda significativa de massa foi observada. Palavras-chave: Dente. Clareamento Dental. Esmalte Dentário.
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Ortecho-Zuta U, de Oliveira Duque CC, Leite ML, Bordini EAF, Basso FG, Hebling J, de Souza Costa CA, Soares DG. Effects of Enzymatic Activation of Bleaching Gels on Hydrogen Peroxide Degradation Rates, Bleaching Effectiveness, and Cytotoxicity. Oper Dent 2019; 44:414-423. [DOI: 10.2341/17-276-l] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
The aim of this study was to evaluate the effect of horseradish peroxidase (HRP) on the release of free radicals, bleaching effectiveness, and indirect cytotoxicity of a 35% hydrogen peroxide (HP) bleaching gel.
Methods and Materials:
First, HP degradation rates and free radical release were evaluated for 35% HP in contact or not with HRP (10 mg/mL). The bleaching gel associated or not with HRP was then applied (3 × 15 minutes) to enamel/dentin discs adapted to artificial pulp chambers, and the culture medium in contact with dentin surfaces (extract) was collected and exposed to cultured odontoblast-like cells. Membrane damage and viability of cells as well as oxidative stress were evaluated. Residual HP/free radical diffusion was quantified, and bleaching effectiveness (ΔE) was assessed. Unbleached discs served as negative controls.
Results:
The addition of HRP to the 35% HP bleaching gel enhanced the release of free radicals in comparison with plain HP gel. The 35% HP-mediated cytotoxicity significantly decreased with HRP in the bleaching gel and was associated with reduced HP/free radical diffusion through the enamel/dentin discs. ΔE values increased every bleaching session for HRP-containing gel relative to positive control, accelerating the whitening outcome.
Conclusion:
The enzymatic activation of a 35% HP bleaching gel with HRP accelerated HP degradation mediated by intensification of free radical release. This effect optimized whitening outcome as well as minimized residual HP and free radical diffusion through enamel and dentin, decreasing the harmful effects on odontoblast-like cells.
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Affiliation(s)
| | - CC de Oliveira Duque
- Carla Caroline de Oliveira Duque, DDS, MS, PhD student, Department of Dental Materials and Prosthodontics, Univ Estadual Paulista–UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil
| | - ML Leite
- Maria Luísa de Alencar e Silva Leite, DDS, MS, PhD student, Department of Dental Materials and Prosthodontics, Univ Estadual Paulista–UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil
| | - EAF Bordini
- Ester Alves Ferreira Bordini, DDS, MS, PhD student, Department of Dental Materials and Prosthodontics, Univ Estadual Paulista–UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil
| | - FG Basso
- Fernanda Gonçalves Basso, DDS, MS, PhD, researcher, Department of Physiology and Pathology, Univ Estadual Paulista–UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil
| | - J Hebling
- Josimeri Hebling, DDS, MS, PhD, professor, Department of Orthodontics and Pediatric Dentistry, Univ Estadual Paulista–UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil
| | - CA de Souza Costa
- Carlos Alberto de Souza Costa, DDS, MS, PhD, professor, Department of Physiology and Pathology, Univ Estadual Paulista–UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil
| | - DG Soares
- Diana Gabriela Soares, DDS, MS, PhD, professor, Department Operative Dentistry, Endodontics and Dental Materials, Sao Paulo University–USP, Bauru School of Dentistry, Bauru, SP, Brazil
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Carlos NR, Pinto A, do Amaral F, França F, Turssi CP, Basting RT. Influence of Staining Solutions on Color Change and Enamel Surface Properties During At-home and In-office Dental Bleaching: An In Situ Study. Oper Dent 2019; 44:595-608. [PMID: 31034349 DOI: 10.2341/18-236-c] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this in situ study was to evaluate the influence of staining solutions (coffee and cola) on the color change, microhardness, roughness, and micromorphology of the enamel surface during at-home and in-office dental bleaching. One hundred and thirty-five enamel bovine blocks were prepared to perform the evaluations. Fifteen volunteers used an intraoral appliance with nine enamel blocks for 15 days. The enamel blocks were randomly assigned among the different groups according to the three treatments: in-office bleaching with high hydrogen peroxide concentration (Opalescence Boost PF 40%, Ultradent) for 40 minutes in three sessions (first, eighth, and 15th days of treatment), at-home bleaching with low carbamide peroxide concentration (Opalescence PF 10%, Ultradent) for 60 minutes daily for 15 days, and a control group (no bleaching agent applied). The enamel blocks were immersed daily in different staining solutions (coffee or cola) for 30 minutes for 15 days or were not submitted to staining (control) to obtain a factorial scheme (3×3) of the dental bleaching treatment and staining solution (n=15). The microhardness analyses (Knoop), roughness evaluations (Ra), surface micromorphological observations, and color measurements (using the CIELAB system and the VITA Classical scale) were made before and after the bleaching treatments to assess immersion in staining solutions. Mixed model tests showed that there was a decrease in enamel microhardness after exposure to cola compared with coffee and the control group (p<0.0001) for both bleaching techniques. Roughness was higher for the cola groups (p<0.0001), and there was no significant difference between the coffee and the control groups. Generalized linear models showed that when no staining solution was applied, lighter color scores were found for the VITA Classical scale (p<0.0001). Without the staining solutions, there was an increase in luminosity (ΔL) (p=0.0444) for in-office bleaching. Lower values of Δa (p=0.0010) were observed when the staining solutions were not used. The Δb (p=0.3929) did not vary significantly between the bleaching agents, but when cola was applied, the values were significantly higher than for the control (p=0.0293). Higher values of ΔE (p=0.0089) were observed for in-office bleaching without staining solutions, while lower values of ΔE were observed for the in-office associated with coffee immersion. Regardless of whether being submitted to bleaching, the enamel stained with cola showed a decrease in microhardness, an increase in roughness, and changes in the micromorphology. The efficacy of the bleaching agents was greater when no staining solution (cola or coffee) was used, and in-office bleaching showed greater color change than the at-home bleaching technique.
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Vaez SC, Correia A, Santana TR, Santana M, Peixoto AC, Leal PC, Faria-E-Silva AL. Is a Single Preliminary Session of In-office Bleaching Beneficial for the Effectiveness of At-home Tooth Bleaching? A Randomized Controlled Clinical Trial. Oper Dent 2019; 44:E180-E189. [PMID: 30849011 DOI: 10.2341/18-196-c] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To evaluate the effect of combining in-office with at-home bleaching procedures in terms of the time required to obtain satisfactory tooth color, final color changes, and tooth sensitivity (TS) reported by patients. METHODS AND MATERIALS Twenty-six patients enrolled in this study used 10% carbamide peroxide in a bleaching tray for 1 h/d until satisfactory tooth color was obtained. One-half of the participants underwent a preliminary session of in-office tooth bleaching with 35% hydrogen peroxide for 45 minutes. The time in days for the patients to obtain satisfactory tooth color by at-home bleaching procedures was recorded. The color change of the maxillary canines was assessed using the Vita Bleachedguide 3D Master scale and a spectrophotometer at 1 week and after the end of bleaching procedures. Participants' satisfaction with their smile was recorded using a visual analog scale, and TS was determined throughout the entire treatment. Data were analyzed by t-test, Mann-Whitney test, or Fisher exact test (α=0.05). RESULTS The combined protocol reduced (by an average of 3.7 days) the time required to obtain satisfactory tooth color but increased the risk and level of TS. No difference in the final tooth color change (around 5.0 shade guide units; ΔE=11.6-14.9), or the level of patients' satisfaction with their smile, was observed. CONCLUSIONS A preliminary session of in-office bleaching reduced the time necessary to obtain satisfactory tooth color with at-home bleaching but increased the risk and level of TS.
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Bersezio C, Estay J, Jorquera G, Peña M, Araya C, Angel P, Fernández E. Effectiveness of Dental Bleaching With 37.5% and 6% Hydrogen Peroxide and Its Effect on Quality of Life. Oper Dent 2019; 44:146-155. [DOI: 10.2341/17-229-c] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective:
This study investigated whether it is possible to achieve equally satisfactory results between 37.5% hydrogen peroxide (HP) gel and 6% HP gel. We also assessed the psychosocial impact and self-perception of esthetics generated by extracoronal tooth whitening.
Methods and Materials:
A prospective, double-blind, randomized clinical trial was carried out. A total of 33 patients were selected from the clinic of the Faculty of Dentistry at the University of Chile. The patients included men and women over 18 years old without prior tooth whitening treatments, tooth decay, or restorations of the maxillary anterior teeth. The patients had tooth colors of A3 or less according to the Vita Classical scale, which was determined with a Vita Easy Shade spectrophotometer. The study was carried out with a “split-mouth” design. One side of each mouth was randomly treated with 37.5% HP, and the other side was bleached with 6% HP. Each group received 3 to 12 minutes of treatment with the respective gel applications. Two sessions of bleaching were carried out each week. A spectrophotometer was used to measure the total variation of color (ΔE), and a subjective evaluation was made with Vita Classical scale (ΔSGU) between the baseline (session 1) and different measurement times. We compared ΔE and ΔSGU for both agents using the Mann-Whitney test (α=0.05).
Results:
In both groups, there was variation among the initial color and the color in the different measurement times. In the month after the treatment was completed, ΔE was 9.06 in the 37.5% HP group and 5.69 in the 6% HP group. The difference between the two groups was statistically significant starting in the second session (p=0.000).
Conclusion:
There was a significant difference between the effectiveness of the bleaching gel concentrations of 37.5% and 6% HP according to spectrophotometer measurements and subjective evaluations. There was also a positive effect on psychosocial impact and esthetic self-perception among patients.
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Affiliation(s)
- C Bersezio
- Cristian Bersezio, Department of Restorative Dentistry, Operative Dentistry, University of Chile, Santiago, Chile and Universidad Andres Bello, Santiago, Chile
| | - J Estay
- Juan Estay, Department of Restorative Dentistry, Operative Dentistry, University of Chile, Santiago, Chile
| | - G Jorquera
- Gilbert Jorquera, Department of Prosthodontics, College of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - M Peña
- Manuel Peña, Departament of Restorative Dentistry, University of Chile Dental School, Santiago, Chile
| | - C Araya
- Carolina Araya, Departament of Restorative Dentistry, University of Chile Dental School, Santiago, Chile Pablo Angel, Departament of Restorative Dentistry, University of Chile Dental School, Santiago, Chile
| | - P Angel
- Carolina Araya, Departament of Restorative Dentistry, University of Chile Dental School, Santiago, Chile Pablo Angel, Departament of Restorative Dentistry, University of Chile Dental School, Santiago, Chile
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Acuña ED, Parreiras SO, Favoreto MW, Cruz GP, Gomes A, Borges CPF, Loguercio AD, Reis A. In-office bleaching with a commercial 40% hydrogen peroxide gel modified to have different pHs: Color change, surface morphology, and penetration of hydrogen peroxide into the pulp chamber. J ESTHET RESTOR DENT 2019; 34:322-327. [PMID: 30790402 DOI: 10.1111/jerd.12453] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 11/25/2018] [Accepted: 12/05/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE In-office bleaching gels are usually marketed in different pHs. This study is aimed at evaluating the efficacy, enamel surface morphology and concentration of hydrogen peroxide (HP) in the pulp chamber of teeth bleached with 40% HP with different pHs. MATERIALS AND METHODS Forty premolars were randomly divided according to bleaching gel pH: 5.1, 6.3, 7.0, and control (no bleaching). Teeth were prepared, an acetate buffer was placed in the pulp chamber and teeth were bleached with two 20-minutes applications. The amount of HP was determined on a UV-VIS spectrophotometer. Color change was assessed by using a digital spectrophotometer before and 1 week after bleaching treatment. Five additional premolars were divided into four parts, assigned to the same groups above for analysis under scanning electron microscope. Data were subjected to anova and Tukey's tests (alpha = 0.05). RESULTS The group pH 5.1 showed the highest HP diffusion in the pulp chamber (P < .001). No significant difference was detected in color change (P = .51). All groups presented the same pattern of enamel demineralization. CONCLUSIONS The bleaching agent with pH 5.1 presented the highest HP amounts in the pulp chamber, but color change and enamel morphology were similar among groups. CLINICAL SIGNIFICANCE Regardless of the pH, the bleaching effect can be observed in teeth submitted to high concentrations of HP, but a higher permeability of HP was found in the pulp chamber of teeth bleached with more acidic bleaching agents. Based on that, we suggest the use of alkaline gels for in-office bleaching to minimize damage to the pulpal tissue.
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Affiliation(s)
- Eric D Acuña
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Uvaranas, Ponta Grossa, Paraná - Brazil
| | - Sibelli O Parreiras
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Uvaranas, Ponta Grossa, Paraná - Brazil
| | - Michael W Favoreto
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Uvaranas, Ponta Grossa, Paraná - Brazil
| | - Gustavo P Cruz
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Uvaranas, Ponta Grossa, Paraná - Brazil
| | - Anderson Gomes
- Department of Applied Chemistry, School of Chemistry State University of Ponta Grossa, Uvaranas, Ponta Grossa, Paraná - Brazil
| | - Christiane P F Borges
- Department of Chemistry, State University of Ponta Grossa, Uvaranas, Ponta Grossa, Paraná - Brazil
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Uvaranas, Ponta Grossa, Paraná - Brazil
| | - Alessandra Reis
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Uvaranas, Ponta Grossa, Paraná - Brazil
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Rodrigues JL, Rocha PS, Pardim SLDS, Machado ACV, Faria-E-Silva AL, Seraidarian PI. Association Between In-Office And At-Home Tooth Bleaching: A Single Blind Randomized Clinical Trial. Braz Dent J 2018; 29:133-139. [PMID: 29898058 DOI: 10.1590/0103-6440201801726] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 12/12/2017] [Indexed: 11/22/2022] Open
Abstract
This controlled randomized clinical trial evaluated the effect of associating at-home and in-office bleaching procedures on tooth sensitivity (TS) and bleaching effectiveness. Forty patients subjected to on session of in-office bleaching with 38% peroxide hydrogen. Subsequently, the patients were randomly allocated to receive a second session of in-office bleaching or to use a tray containing 10% carbamide peroxide delivered during 7 consecutive days. The worst TS score reported during or after each bleaching procedure was recorded using a verbal rating scale and TS risk (score different from 0) was calculated. Color changes were measured 7 days after each in-office session (for patients receiving in-office procedures only) or after the end of at-home bleaching (for the combined protocol), and 6 months after the last procedure for both bleaching protocols. Color was assessed by a spectrophotometer and by color match with the Vita Classical and Bleach guide scales. Statistical analyses were carried out to assess possible differences between the protocols regarding the outcomes and to analyze the effect of time of assessment on color changes. The bleaching protocol did not affect the risk for and the maximum level of TS reported, irrespective of the time of assessment. In the color evaluation, the bleaching protocol also did not affect the ultimate tooth color. In conclusion, after one in-office bleaching session, there was no difference in bleaching effectiveness and TS between performing a second in-office session and associating it with 1-week at-home bleaching.
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Affiliation(s)
- João Lima Rodrigues
- PUC Minas - Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | | | | | - Paulo Isaías Seraidarian
- Department of Prosthodontics, PUC Minas - Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil
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The effects of hybrid light activation and enamel acid etching on the effectiveness, stability and sensitivity after a single session in-office bleaching: A 12-month clinical trial. Photodiagnosis Photodyn Ther 2018; 24:22-26. [DOI: 10.1016/j.pdpdt.2018.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/07/2018] [Accepted: 08/13/2018] [Indexed: 02/07/2023]
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Jiang N, Zhang C, Agingu C, Attin T, Cheng H, Yu H. Comparison of Whitening Dentifrices on the Effectiveness of In-office Tooth Bleaching: A Double-blind Randomized Controlled Clinical Trial. Oper Dent 2018; 44:138-145. [PMID: 30106335 DOI: 10.2341/17-333-c] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES: To investigate the effect of whitening dentifrices on the effectiveness of in-office tooth bleaching. METHODS AND MATERIALS: A double-blind randomized controlled clinical trial was performed. The participants were randomly allocated into three groups according to the different dentifrices used during this clinical trial: regular dentifrice (group C), conventional whitening dentifrice (group CW), and whitening dentifrice containing blue covarine (group CU). All participants received in-office tooth bleaching for the maxillary anterior teeth (two sessions conducted at a one-week interval). Tooth color was measured with a spectrophotometer at baseline (T1), after the first bleaching session (T2), after the second bleaching session (T3); one week after the completion of in-office bleaching (T4); and three weeks after the completion of in-office bleaching (T5). The data were statistically analyzed through repeated analysis of variance and the Tukey test (α=0.05). RESULTS: Sixty participants completed the study (n=20 per group). At T3, group CU exhibited the lowest ΔE values ( p=0.008). The ΔE values increased from T4 to T5 in the CW and CU groups, whereas a decrease in ΔE values was observed for group C. CONCLUSIONS: The use of a whitening dentifrice containing blue covarine during in-office bleaching reduced color changes. After tooth bleaching, brighter tooth colors were observed in the participants who brushed with whitening dentifrices compared to those who brushed with a regular dentifrice.
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Alencar CDM, De Paula BLF, Araújo JLN, Alves EB, De Albuquerque Jassé FF, Silva CM. Effect of low-level laser therapy combined with 5000 parts per million fluoride dentifrice on postbleaching sensitivity: A clinical, randomized, and double-blind study. J ESTHET RESTOR DENT 2018; 30:352-359. [PMID: 30079637 DOI: 10.1111/jerd.12386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The aim of this double-blind, randomized, controlled clinical study was to assess the efficacy of low-level laser therapy (LLLT) combined with 5000 ppm fluoride dentifrice on postbleaching sensitivity in teeth exposed to 35% hydrogen peroxide for four weeks. MATERIALS AND METHODS Twenty-five volunteers were evaluated using the split-mouth model in which the right and left maxillary/mandibular quadrants were randomized and allocated to one of two groups: GPLACEBO, in which the laser tip was positioned without the emission of light (placebo effect) + 5000 ppm sodium fluoride, or GLASER, which comprised LLLT + 5000 ppm sodium fluoride. For both groups, LLLT and placebo were used before bleaching, whereas fluoride was applied after bleaching. LLLT was applied at two points: on the central cervical and medial regions of the incisors, canines, and premolars in the corresponding hemi-arch. At each point, 60 J/cm2 was applied for 16 seconds with an irradiance of 3.75 W/cm2 using the therapeutic infrared device. To assess tooth sensitivity, a modified visual analogue scale was used after an evaporative stimulus, and a daily pain questionnaire was also applied. RESULTS The Wilcoxon and Friedman tests demonstrated a significant difference in the incidence of sensitivity pain between GPLACEBO and GLASER (P ≤ .05), with different evaluation times. CONCLUSION Teeth treated with laser therapy in combination with the topical use of sodium fluoride at each bleaching session demonstrated less sensitivity compared with the application of sodium fluoride only. CLINICAL SIGNIFICANCE The use of a low-level laser therapy in combination with topical use of sodium fluoride improves symptoms of dentin sensitivity at each bleaching session.
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Affiliation(s)
- Cristiane De Melo Alencar
- Department of restorative dentistry, School of Dentistry, Federal University of Pará, Belém, Pará, Brazil
| | | | | | - Eliane Bemerguy Alves
- Department of restorative dentistry, School of Dentistry, Federal University of Pará, Belém, Pará, Brazil
| | | | - Cecy Martins Silva
- Department of restorative dentistry, School of Dentistry, Federal University of Pará, Belém, Pará, Brazil
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Pimentel de Oliveira R, Baia JCP, Ribeiro MES, Junior MHDSES, Loretto SC. Influence of Time Intervals between Bleaching Procedures on Enamel Microhardness and Surface Roughness. Open Dent J 2018; 12:555-559. [PMID: 30197694 PMCID: PMC6110064 DOI: 10.2174/1874210601812010555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 06/20/2018] [Accepted: 07/10/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Dental bleaching has been increasingly sought out to improve dental aesthetics, but it may cause changes in dental enamel. OBJECTIVE To assess the influence of different time intervals on bleaching gel applications with regard to the Microhardness (MH) and Surface Roughness (SR) on dental enamel. MATERIAL AND METHODS Forty bovine incisors were randomly divided into two groups (G1 and G2) and both were bleached with 35% Hydrogen Peroxide (HP35) (n=20; G1: seven-day interval and G2: two-day interval). The MH and SR tests were performed before bleaching (T0) and after the first (T1), second (T2), and third (T3) bleaching gel applications. The specimens were stored in artificial saliva between each application (37°C). The data were analyzed using the student's t-test (p ≤ 0.05) for dependent samples. RESULTS The reduced time interval (two days) led to a significant reduction in MH, while MH was not affected during the seven-day interval. The SR results increased regardless of the bleaching gel application time interval. CONCLUSION The decreased time interval of two days between bleaching gel applications caused changes in MH but did not influence the SR of dental enamel.
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Bersezio C, Martín J, Angel P, Bottner J, Godoy I, Avalos F, Fernández E. Teeth whitening with 6% hydrogen peroxide and its impact on quality of life: 2 years of follow-up. Odontology 2018; 107:118-125. [DOI: 10.1007/s10266-018-0372-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/19/2018] [Indexed: 12/21/2022]
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Pre-operative use of dexamethasone does not reduce incidence or intensity of bleaching-induced tooth sensitivity. A triple-blind, parallel-design, randomized clinical trial. Clin Oral Investig 2018; 23:435-444. [DOI: 10.1007/s00784-018-2452-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 04/16/2018] [Indexed: 11/25/2022]
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Mehta D, Jyothi S, Moogi P, Finger WJ, Sasaki K. Novel treatment of in-office tooth bleaching sensitivity: A randomized, placebo-controlled clinical study. J ESTHET RESTOR DENT 2018. [PMID: 29520944 DOI: 10.1111/jerd.12374] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Aim of this clinical trial was to investigate the effect of a calcium phosphate based desensitizer paste applied prior to in-office tooth whitening on bleaching sensitivity (BS). METHODS This crossover study was designed as randomized double-blinded, placebo-controlled trial. The desensitizer paste Teethmate AP (TAP) contains tetracalcium phosphate and dicalcium phosphate anhydrous in glycerol and polyethylene glycol, whereas placebo (PLA) is a calcium phosphate free analog. Fifty patients with sound maxillary incisors and canines were enrolled. Tooth shades were determined with a Vitapan Classic Shade guide. Randomly, TAP and PLA were applied to the left or to the right anterior teeth. After rinsing and air-drying the bleaching gel (Opalescence Boost PF 40%) was applied and left on the labial surfaces for 15 minutes. Sensitivity was recorded using a 10 cm visual analog scale (VAS) before, at 5, 10, and 15 minutes during, and at 1 hour, 1, 2, and 7 days after bleaching. Tooth whitening was determined with the shade guide after 1 day and 1 week. RESULTS Prebleaching desensitization with TAP reduced BS significantly when compared with PLA. Between 1 and 7 days the average sensitivity scores were close to zero, whereas the average scores for PLA were significantly higher during this time interval. Independent from the desensitizing treatment after 1 and 7 days the medians of the shades were between 5 and 3.5 units brighter. CONCLUSIONS Prebleaching desensitization with TAP was effective in reducing BS during and after tooth whitening treatment and had no adverse effect on the bleaching result. CLINICAL SIGNIFICANCE Prebleaching topical application of a calcium phosphate containing compound reduced significantly bleaching sensitivity during a single 15 minutes treatment and up to one week with a 40% hydrogen peroxide containing gel without compromising tooth whitening.
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Affiliation(s)
- Deepak Mehta
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College and Hospital, Bangalore, India
| | | | - Prashant Moogi
- Department of Conservative Dentistry and Endodontics, K.L.E. Society's Institute of Dental Sciences, Bangalore, India
| | - Werner J Finger
- Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Keiichi Sasaki
- Department of Oral Function and Morphology, Division of Advance Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Alencar CDM, Pedrinha VF, Araújo JLN, Esteves RA, Silva da Silveira AD, Silva CM. Effect of 10% Strontium Chloride and 5% Potassium Nitrate with Fluoride on Bleached Bovine Enamel. Open Dent J 2017; 11:476-484. [PMID: 28979576 PMCID: PMC5611777 DOI: 10.2174/1874210601711010476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/19/2017] [Accepted: 07/17/2017] [Indexed: 11/22/2022] Open
Abstract
Background: Dental whitening has been increasingly sought out to improve dental aesthetics, but may cause chemical and morphological changes in dental enamel surfaces. Objective: This study evaluated in vitro the effect of 10% strontium chloride and 5% potassium nitrate with fluoride on bovine enamel, through tristimulus colorimetry, Knoop microhardness (KHN), and roughness after bleaching with 35% hydrogen peroxide (HP). Methods: The specimens were divided into three groups (n=15): GControl received bleaching treatment with 35% HP; GNitrate received bleaching with 35% HP followed by the application of 5% potassium nitrate with 2% sodium fluoride; and GStrontium received bleaching with 35% HP followed by the application of 10% strontium chloride on the enamel. Next, five specimens of each experimental group were subjected to KHN and tristimulus colorimetry tests, and 10 specimens were subjected to surface roughness (SR) tests. The values obtained for the different groups were compared through analysis of variance (ANOVA) followed by a post-hoc Tukey-Kramer test in addition to Student’s T-test for paired data. Results: In the intergroup comparison, KHN final differed statistically (p<0.05). The mean SR final of the experimental groups differed statistically from the GControl group (p<0.05). In addition, the groups did not differ in color variation (p>0.05). Conclusion: 10% strontium chloride and 5% potassium nitrate combined with 2% fluoride downplayed morphological changes to the enamel, without interfering with the effectiveness of the bleaching process.
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Fernandes MT, Vaez SC, Lima CM, Nahsan FP, Loguércio AD, Faria-e-Silva AL. Preemptive Use of Naproxen on Tooth Sensitivity Caused by In-Office Bleaching: A Triple-Blind, Crossover, Randomized Clinical Trial. Oper Dent 2017; 42:486-496. [DOI: 10.2341/16-100-c] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
A triple-blind, randomized, crossover clinical trial evaluated prior use of nonsteroidal anti-inflammatory naproxen on sensitivity reported by patients undergoing in-office tooth bleaching.
Methods and Materials:
Fifty patients were subjected to two sessions of in-office tooth bleaching with 35% hydrogen peroxide in a single application of 40 minutes for two sessions, with an interval of seven days between applications. One hour prior to the procedure, each patient randomly received a single dose of naproxen (500 mg) or placebo. The patient's sensitivity level was evaluated during and immediately after the bleaching using two scales (verbal and visual analog); the verbal scale only was repeated after 24 hours. The effectiveness of the bleaching procedures was evaluated with the Bleachedguide scale. Relative risk to sensitivity was calculated and adjusted by session, while comparison of overall risk was performed by the McNemar test. Data on the sensitivity level for both scales and shade were subjected to the Friedman, Wilcoxon, and Mann-Whitney tests (α=0.05).
Results:
The use of naproxen only decreased the absolute risk and intensity of tooth sensitivity reported immediately after the second session. On the other hand, no measurable effect was observed during or 24 hours after either session. The sequence of drug administration did not affect the bleaching effectiveness.
Conclusions:
Preemptive use of naproxen only reduced tooth sensitivity reported by patients immediately after the second session of bleaching.
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Affiliation(s)
- MT Fernandes
- Micaelle T Fernandes, MSc, graduate student, Graduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - SC Vaez
- Savil C Vaez, MSc, graduate student, Graduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - CM Lima
- Cláudio M Lima, professor, Department of Pharmacy, Federal University of Sergipe, Lagarto, Brazil
| | - FP Nahsan
- Flavia P Nahsan, DDS, PhD, professor, Department of Dentistry, Federal University of Sergipe, Lagarto, Brazil
| | | | - AL Faria-e-Silva
- Andre L Faria-e-Silva, DDS, MSc, PhD, Department of Dentistry, Federal University of Sergipe, Aracaju, Brazil
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Loguercio AD, Maran BM, Hanzen TA, Paula AMD, Perdigão J, Reis A. Randomized clinical trials of dental bleaching - Compliance with the CONSORT Statement: a systematic review. Braz Oral Res 2017; 31:e60. [PMID: 28902240 DOI: 10.1590/1807-3107bor-2017.vol31.0060] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 05/22/2017] [Indexed: 12/17/2022] Open
Abstract
We reviewed the literature to evaluate: a) The compliance of randomized clinical trials (RCTs) on bleaching with the CONSORT; and b) the risk of bias of these studies using the Cochrane Collaboration risk of bias tool (CCRT). We searched the Cochrane Library, PubMed and other electronic databases, to find RCTs focused on bleaching (or whitening). The articles were evaluated in compliance with CONSORT in a scale: 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the number of studies by journal, follow-up period, country and quality assessments were performed with CCRT for assessing risk of bias in RCTs. 185 RCTs were included for assessment. More than 30% of the studies received score 0 or 1. Protocol, flow chart, allocation concealment and sample size were more critical items, as 80% of the studies scored 0. The overall CONSORT score for the included studies was 16.7 ± 5.4 points, which represents 52.2% of the maximum CONSORT score. A significant difference among journal, country and period of time was observed (p < 0.02). Only 7.6% of the studies were judged at "low" risk; 62.1% were classified as "unclear"; and 30.3% as "high" risk of bias. The adherence of RCTs evaluating bleaching materials and techniques to the CONSORT is still low with unclear/high risk of bias.
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Affiliation(s)
- Alessandro Dourado Loguercio
- Universidade Estadual de Ponta Grossa - UEPG, School of Dentistry, Department of Restorative Dentistry, Ponta Grossa, Paraná, Brazil
| | - Bianca Medeiros Maran
- Universidade Estadual de Ponta Grossa - UEPG, School of Dentistry, Department of Restorative Dentistry, Ponta Grossa, Paraná, Brazil
| | - Taíse Alessandra Hanzen
- Universidade Estadual de Ponta Grossa - UEPG, School of Dentistry, Department of Restorative Dentistry, Ponta Grossa, Paraná, Brazil
| | - Alexandra Mara de Paula
- Universidade Estadual de Ponta Grossa - UEPG, School of Dentistry, Department of Restorative Dentistry, Ponta Grossa, Paraná, Brazil
| | - Jorge Perdigão
- University of Minnesota, Department of Restorative Sciences, Minneapolis, MN, United States of America
| | - Alessandra Reis
- Universidade Estadual de Ponta Grossa - UEPG, School of Dentistry, Department of Restorative Dentistry, Ponta Grossa, Paraná, Brazil
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Vildósola P, Vera F, Ramírez J, Rencoret J, Pretel H, Oliveira OB, Tonetto M, Martín J, Fernández E. Comparison of Effectiveness and Sensitivity Using Two In-Office Bleaching Protocols for a 6% Hydrogen Peroxide Gel in a Randomized Clinical Trial. Oper Dent 2017; 42:244-252. [DOI: 10.2341/16-043-c] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective:
The aim of this blinded and randomized clinical trial was to compare two application protocols (one 36-minute application vs three 12-minute applications). We then assessed the effectiveness of the bleaching and any increase in sensitivity that was induced by bleaching via a split-mouth design.
Methods and Materials:
Thirty patients were treated. One group had a half arch of teeth treated with a traditional application protocol (group A: 3 × 12 minutes for two sessions). The other received an abbreviated protocol (group B: 1 × 36 minutes over two sessions). Two sessions were appointed with a two-day interval between them. The tooth color was registered at each session, as well as one week and one month after completing the treatment via a spectrophotometer. This measured L*, a*, and b*. This was also evaluated subjectively using the VITA classical A1-D4 guide and VITA Bleachedguide 3D-MASTER. Tooth sensitivity was registered according to the visual analogue scale (VAS) scale. Tooth color variation and sensitivity were compared between groups.
Results:
Both treatments changed tooth color vs baseline. The ΔE* = 5.71 ± 2.62 in group A, and ΔE* = 4.93 ± 2.09 in group B one month after completing the bleaching (p=0.20). No statistical differences were seen via subjective evaluations. There were no differences in tooth sensitivity between the groups. The absolute risk of sensitivity reported for both groups was 6.25% (p=0.298). The intensity by VAS was mild (p=1.00).
Conclusions:
We used hydrogen peroxide (6%) that was light activated with a hybrid LED/laser and two different protocols (one 36-minute application vs three 12-minute applications each for two sessions). These approaches were equally effective. There were no differences in absolute risk of sensitivity; both groups reported mild sensitivity.
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Affiliation(s)
| | - F Vera
- Fabiola Vera, DDS, Restorative Dentistry, University of Chile, Santiago, Chile
| | - J Ramírez
- Javiera Ramírez, DDS Restorative Dentistry, University of Chile, Santiago, Chile
| | - J Rencoret
- Javiera Rencoret, DDS, Restorative Dentistry, University of Chile, Santiago, Chile
| | - H Pretel
- Hermes Pretel, DDS, MS, PhD, NUPEN Research Group, Restorative Dentistry, Araraquara School of Dentistry, Univ Estadual Paulista (UNESP), Araraquara, Brazil
| | - OB Oliveira
- Osmir Batista Oliveira Jr, DDS, DMD, PhD, Restorative Dentistry, Araraquara School of Dentistry, Univ Estadual Paulista (UNESP), Araraquara, Brazil
| | - M Tonetto
- Mateus Rodrigues Tonetto, DDS, MS, PhD, Department of Postgraduate Program in Dentistry, University of Cuiabá, Cuiaba, Brazil
| | - J Martín
- Javier Martín, DDS, DS, PhD, Restorative Dentistry, University of Chile, Santiago, Chile
| | - E Fernández
- Eduardo Fernández, DDS, DS, PhD, Restorative Dentistry, University of Chile and Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Chile
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de Geus JL, Wambier LM, Kossatz S, Loguercio AD, Reis A. At-home vs In-office Bleaching: A Systematic Review and Meta-analysis. Oper Dent 2016; 41:341-56. [PMID: 27045285 DOI: 10.2341/15-287-lit] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE A systematic review and meta-analysis were performed to evaluate the risk and intensity of tooth sensitivity during in-office and at-home bleaching in adult patients. The efficacy of dental bleaching was also evaluated. METHODS A comprehensive search was performed in the MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library, and System for Information on Grey Literature in Europe without restrictions. The annual conference of the International Association for Dental Research abstracts (1990-2014) and unpublished and ongoing trials registry were also searched. Dissertations and theses were searched using the ProQuest Dissertations and Periódicos Capes Theses databases. Only randomized clinical trials that compared the prevalence or intensity of tooth sensitivity during in-office and at-home bleaching in adult patients were included and studies that evaluated the efficacy of these dental bleaching techniques, in terms of shade guide units (ΔSGU) and in terms of color difference measured with a spectrophotometer (ΔE*). RESULTS After the removal of duplicates, 1139 articles were identified. After title and abstract screening, 29 studies remained. Fifteen studies were further excluded, whereas 12 studies remained for qualitative analyses and 8 for the meta-analysis of the primary and secondary outcomes. No significant difference in the risk/intensity of tooth sensitivity or in bleaching efficacy was observed in the present study. CONCLUSION In an overall comparison of at-home and in-office bleaching, no differences were detected, either regarding risk/intensity of tooth sensitivity or the effectiveness of the bleaching treatment. This comparison, however, does not take into consideration variations in the protocols (daily usage time, number of bleaching sessions, and product concentration) of the bleaching techniques in the studies included.
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Münchow EA, Hamann HJ, Carvajal MT, Pinal R, Bottino MC. Stain removal effect of novel papain- and bromelain-containing gels applied to enamel. Clin Oral Investig 2016; 20:2315-2320. [DOI: 10.1007/s00784-016-1840-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/24/2016] [Indexed: 02/01/2023]
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A clinical, randomized, controlled study on the use of desensitizing agents during tooth bleaching. J Dent 2015; 43:1099-1105. [DOI: 10.1016/j.jdent.2015.07.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 06/30/2015] [Accepted: 07/01/2015] [Indexed: 11/18/2022] Open
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40
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Martín J, Vildósola P, Bersezio C, Herrera A, Bortolatto J, Saad J, Oliveira O, Fernández E. Effectiveness of 6% hydrogen peroxide concentration for tooth bleaching—A double-blind, randomized clinical trial. J Dent 2015; 43:965-72. [DOI: 10.1016/j.jdent.2015.05.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/17/2015] [Accepted: 05/31/2015] [Indexed: 10/23/2022] Open
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