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Kunka Á, Lisztes E, Bohács J, Racskó M, Kelemen B, Kovalecz G, Tóth ED, Hegedűs C, Bágyi K, Marincsák R, Tóth BI. TRPA1 up-regulation mediates oxidative stress in a pulpitis model in vitro. Br J Pharmacol 2024; 181:3246-3262. [PMID: 38744683 DOI: 10.1111/bph.16386] [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: 03/04/2023] [Revised: 01/22/2024] [Accepted: 02/22/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND AND PURPOSE Pulpitis is associated with tooth hypersensitivity and results in pulpal damage. Thermosensitive transient receptor potential (TRP) ion channels expressed in the dental pulp may be key transducers of inflammation and nociception. We aimed at investigating the expression and role of thermo-TRPs in primary human dental pulp cells (hDPCs) in normal and inflammatory conditions. EXPERIMENTAL APPROACH Inflammatory conditions were induced in hDPC cultures by applying polyinosinic:polycytidylic acid (poly(I:C)). Gene expression and pro-inflammatory cytokine release were measured by RT-qPCR and ELISA. Functions of TRPA1 channels were investigated by monitoring changes in intracellular Ca2+ concentration. Mitochondrial superoxide production was measured using a fluorescent substrate. Cellular viability was assessed by measuring the activity of mitochondrial dehydrogenases and cytoplasmic esterases. TRPA1 activity was modified by agonists, antagonists, and gene silencing. KEY RESULTS Transcripts of TRPV1, TRPV2, TRPV4, TRPC5, and TRPA1 were highly expressed in control hDPCs, whereas TRPV3, TRPM2, and TRPM3 expressions were much lower, and TRPM8 was not detected. Poly(I:C) markedly up-regulated TRPA1 but not other thermo-TRPs. TRPA1 agonist-induced Ca2+ signals were highly potentiated in inflammatory conditions. Poly(I:C)-treated cells displayed increased Ca2+ responses to H2O2, which was abolished by TRPA1 antagonists. Inflammatory conditions induced oxidative stress, stimulated mitochondrial superoxide production, resulted in mitochondrial damage, and decreased cellular viability of hDPCs. This inflammatory cellular damage was partly prevented by the co-application of TRPA1 antagonist or TRPA1 silencing. CONCLUSION AND IMPLICATIONS Pharmacological blockade of TRPA1 channels may be a promising therapeutic approach to alleviate pulpitis and inflammation-associated pulpal damage.
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Affiliation(s)
- Árpád Kunka
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
- Doctoral School of Molecular Medicine, University of Debrecen, Debrecen, Hungary
- Department of Dentoalveolar Surgery, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Erika Lisztes
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Judit Bohács
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Molecular Medicine, University of Debrecen, Debrecen, Hungary
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Márk Racskó
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Molecular Medicine, University of Debrecen, Debrecen, Hungary
| | - Balázs Kelemen
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gabriella Kovalecz
- Department of Pediatric and Preventive Dentistry, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Etelka D Tóth
- Department of Dentoalveolar Surgery, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Csaba Hegedűs
- Department of Biomaterials and Prosthetic Dentistry, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Kinga Bágyi
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Rita Marincsák
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Balázs István Tóth
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Favoreto MW, Cordeiro DCF, Centenaro GG, Bosco LD, Arana-Gordillo LA, Reis A, Loguercio AD. Evaluating color change and hydrogen peroxide penetration in human and bovine teeth through in-office bleaching procedures. J ESTHET RESTOR DENT 2024; 36:1171-1178. [PMID: 38353378 DOI: 10.1111/jerd.13207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE Assess color alteration and hydrogen peroxide (HP) penetration in human and bovine teeth using various in-office bleaching protocols with different application times. MATERIALS AND METHODS Thirty healthy human premolars and 30 healthy bovine incisors were divided into five groups and subjected to different bleaching protocols: 2 × 15 min, 1 × 30 min, 2 × 20 min, or 1 × 40 min, with a control group for each tooth type. All teeth were treated with 35% HP gel. Color alteration was measured using digital spectrophotometry before and 1 week after bleaching. HP concentration within the pulp was determined via UV-Vis spectrophotometry. Statistical analysis included one-way ANOVA, Tukey's, and Dunnett's tests (α = 0.05). RESULTS All groups exhibited significant color alteration, with no statistically differences among them (p > 0.05). However, significant differences were observed when compared with their respective control groups (p < 0.05). HP penetration into the pulp was evident in all bleached teeth compared to the control groups (p < 0.05), with the 2 × 20 group showing the highest HP levels within the pulp cavity, irrespective of tooth type (p < 0.05). CONCLUSION A simplified 1 × 30-min protocol can be recommended as it effectively maintains color alteration and HP penetration, irrespective of whether human or bovine teeth. CLINICAL SIGNIFICANCE This study suggests that an in-office dental bleaching protocol using a 1 × 30-min session is recommended, as it ensures both effective color change and no increase in the amount of HP penetration.
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Affiliation(s)
| | | | | | - Leonardo Dal Bosco
- Department of Restorative Dentistry, State University of Ponta Grossa, Parana, Brazil
| | | | - Alessandra Reis
- Department of Restorative Dentistry, State University of Ponta Grossa, Parana, Brazil
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Donato MV, Dos Reis-Prado AH, Abreu LG, de Arantes LC, Goto J, Chaves HGDS, Cintra LTA, Briso ALF, Peixoto IFDC, Benetti F. Influence of dental bleaching on the pulp tissue: A systematic review of in vivo studies. Int Endod J 2024; 57:630-654. [PMID: 38470103 DOI: 10.1111/iej.14061] [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: 08/23/2022] [Revised: 01/08/2024] [Accepted: 02/23/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Although several studies indicate the harmful effects of bleaching on pulp tissue, the demand for this procedure using high concentrations of hydrogen peroxide (HP) is high. OBJECTIVES To investigate the influence of bleaching on the pulp tissue. METHODS Electronic searches were conducted (PubMed/MEDLINE, Scopus, Cochrane Library and grey literature) until February 2021. Only in vivo studies that evaluated the effects of HP and/or carbamide peroxide (CP) bleaching gels on the inflammatory response in the pulp tissue compared with a non-bleached group were included. Risk of bias was performed according to a modified Methodological Index for Non-Randomized Studies scale for human studies and the Systematic Review Centre for Laboratory Animal Experimentation's RoB tool for animal studies. Meta-analysis was unfeasible. RESULTS Of the 1311 studies, 30 were eligible. Of these, 18 studies evaluated the inflammatory response in animal models. All these studies reported a moderate-to-strong inflammatory response in the superficial regions of pulp, characterized by cell disorganization and necrotic areas, particularly during the initial periods following exposure to 35%-38% HP, for 30-40 min. In the evaluation of human teeth across 11 studies, seven investigated inflammatory responses, with five observing significant inflammation in the pulp of bleached teeth. In terms of tertiary dentine deposition, 11 out of 12 studies noted its occurrence after bleaching with 35%-38% HP in long-term assessments. Additionally, three studies reported significant levels of osteocalcin/osteopontin at 2 or 10 days post-treatment. Other studies indicated an increase in pro-inflammatory cytokines ranging from immediately up to 10 days after bleaching. Studies using humans' teeth had a low risk of bias, whereas animal studies had a high risk of bias. DISCUSSION Despite the heterogeneity in bleaching protocols among studies, High-concentrations of HP shows the potential to induce significant pulp damage. CONCLUSIONS High-concentrations of bleaching gel increases inflammatory response and necrosis in the pulp tissue at short periods after bleaching, mainly in rat molars and in human incisors, in addition to greater hard tissue deposition over time. However, further well-described histological studies with long-term follow-up are encouraged due to the methodological limitations of these studies. REGISTRATION PROSPERO (CRD42021230937).
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Affiliation(s)
- Mariana Viana Donato
- Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Lucas Guimarães Abreu
- Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Lara Cancella de Arantes
- Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Juliana Goto
- Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | | | | | - André Luiz Fraga Briso
- Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | | | - Francine Benetti
- Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Pinto MR, da Silva Medeiros KI, Maia LM, Coelho AA, Negreiros Nunes Alves AP, Caetano CFF, Mesquita KC, de Barros Silva PG, Sousa FB. Role of induced nitric oxide synthases in orofacial nociception/discomfort after dental tooth bleaching with hydrogen peroxide. Arch Oral Biol 2024; 161:105937. [PMID: 38442471 DOI: 10.1016/j.archoralbio.2024.105937] [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: 12/27/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To evaluate the role of induced nitric oxide synthase (iNOS) in nociception/orofacial discomfort in rats submitted to tooth whitening with hydrogen peroxide (H₂O₂). DESIGN Wistar rats were divided into three groups (n = 24/group): a sham group not submitted to whitening treatment, a saline group submitted to whitening treatment, and a test group submitted to whitening treatment and blockade of iNOS with aminoguanidine 50 mg/kg/day. After 24 and 48 h, and 7 days, the animals were euthanized to collect trigeminal ganglia and maxillae to histomorphometric analysis (size of neuronal bodies and percentage of pulp area filled by vessels) and behavior/nociception (Grimace scales, scratching and biting counting, weight loss and nociception assay). ANOVA-1- or - 2-way tests were used (p < 0.05, GraphPadPrism 5.0). RESULTS The aminoguanidine-treated group showed a reduction in nociceptive threshold in the masseteric region (p < 0.001), Grimace scale scores (p < 0.001), number of scratching (p = 0.011) and body mass loss (p = 0.007). After 24 and 48 h of tooth bleaching, the saline group showed a significant increase in the mean area of the blood vessels (p = 0.020) and iNOS immunostaining in odontoblasts (p = 0.002) and non-odontoblasts cells (p = 0.025). Aminoguanidine reversed both increases. Tooth bleaching reduced the mean area of neuronal bodies, and aminoguanidine significantly reversed it (p = 0.019), but an increase in GFAP immunostaining in neuronal bodies did not reduce after seven-days or after aminoguanidine treatment (p = 0.003). CONCLUSION iNOS blockage by aminoguanidine plays an important role in nociception and orofacial discomfort by control of inflammation in dental pulp after tooth bleaching with hydrogen peroxide (H₂O₂) 35%.
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Affiliation(s)
| | | | | | | | - Ana Paula Negreiros Nunes Alves
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil
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Alcântara SD, Benetti F, Silva LMAVD, Machado NEDS, Silva IJP, Esteves LMB, Ervolino E, Cintra LTA, Briso ALF. Bleaching gel volume influences hydrogen peroxide diffusion, inflammation, and the presence of nitric oxide in the pulp tissue: in vitro and in vivo model. J Appl Oral Sci 2023; 31:e20230265. [PMID: 38126578 PMCID: PMC10786454 DOI: 10.1590/1678-7757-2023-0265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/24/2023] [Accepted: 11/06/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To assess whether bleaching gel volume influences chromatic changes, hydrogen peroxide (HP) diffusion, inflammation, and oxidative stress in the pulp tissue. METHODOLOGY A total of 60 bovine teeth were divided into four groups, according to bleaching gel volume (n=15): without gel (WG); V30 (30 µL of 35% HP); V60 (60 µL); and V120 (120 μL). HP diffusion analysis was performed in the first session (T1). Chromatic changes (ΔE, ΔE00, and WID) were assessed after the first (T1), second (T2), third (T3) sessions, and 15 d (T4) after the end of treatment. Moreover, 20 rats were randomly divided into four groups (n=10) and their upper first molars were treated with different gel volumes: control (no treatment); V2 (2 μL of 17.5% HP); V4 (4 μL); and V8 (8 μL). After 24 h, rats were euthanized and the specimens processed for histological and immunohistochemical (nitric oxide synthase) evaluation. Data were analyzed using the Wilcoxon and Mann-Whitney tests (p<0.05). RESULTS In vitro (bovine teeth), chromatic changes were not influenced by bleaching gel volume, showing similar values in all groups and sessions, except for the control group (p<0.05). The V120 group had the highest HP diffusion values (p<0.05). In vivo (pulp tissue), the V4 and V8 groups showed the highest inflammatory infiltrate in the pulp and significant oxidative stress (p<0.05). CONCLUSION The adverse effects on the dental pulp related to HP diffusion, pulp inflammation, and oxidative stress depend on bleaching gel volume, while the bleaching effect is not proportional to the volume used.
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Affiliation(s)
- Sibele de Alcântara
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - Francine Benetti
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontologia Restauradora, Belo Horizonte, MG, Brasil
| | - Lívia Maria Alves Valentim da Silva
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - Nathália Evelyn da Silva Machado
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - Isabela Joane Prado Silva
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - Lara Maria Bueno Esteves
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - Edilson Ervolino
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Ciências Básicas, Araçatuba, SP, Brasil
| | - Luciano Tavares Angelo Cintra
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
| | - André Luiz Fraga Briso
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brasil
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Batista LAS, dos Reis-Prado AH, Chaves HGDS, de Arantes LC, Morgan LFSA, André CB, Suzuki TY, Benetti F. Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research. Restor Dent Endod 2023; 48:e39. [PMID: 38053785 PMCID: PMC10695728 DOI: 10.5395/rde.2023.48.e39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 12/07/2023] Open
Abstract
Objectives This study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells. Materials and Methods Electronic searches were performed in July 2023. In vivo and in vitro studies evaluating the effects of different topical or systemic agents on pulp inflammation or cytotoxicity after exposure to bleaching agents were included. The risk of bias was assessed. Results Out of 1,112 articles, 27 were included. Nine animal studies evaluated remineralizing/anti-inflammatories agents in rat molars subjected to bleaching with 35%-38% hydrogen peroxide (HP). Five of these studies demonstrated a significant reduction in inflammation caused by HP when combined with bioglass or MI Paste Plus (GC America), or following KF-desensitizing or Otosporin treatment (n = 3). However, orally administered drugs did not reduce pulp inflammation (n = 4). Cytotoxicity (n = 17) was primarily assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on human dental pulp cells and mouse dental papilla Cell-23 cells. Certain substances, including sodium ascorbate, butein, manganese chloride, and peroxidase, were found to reduce cytotoxicity, particularly when applied prior to bleaching. The risk of bias was high in animal studies and low in laboratory studies. Conclusions Few in vivo studies have evaluated agents to reduce the damage caused by bleaching gel to pulp tissue. Within the limitations of these studies, it was found that topical agents were effective in reducing pulp inflammation in animals and cytotoxicity. Further analyses with human pulp are required to substantiate these findings. Trial Registration PROSPERO Identifier: CRD42022337192.
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Affiliation(s)
- Letícia Aparecida Silva Batista
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | | | | | - Lara Cancella de Arantes
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | | | - Carolina Bosso André
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - Thaís Yumi Suzuki
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
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da Silva KL, Favoreto MW, Centenaro GG, Bernardi LG, Borges CPF, Reis A, Loguercio AD. Can all highly concentrated in-office bleaching gels be used as a single-application? Clin Oral Investig 2023; 27:3663-3671. [PMID: 37017758 DOI: 10.1007/s00784-023-04980-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/24/2023] [Indexed: 04/06/2023]
Abstract
OBJECTIVE This in vitro study aims to evaluate of hydrogen peroxide (HP) diffusion into the pulp chamber, bleaching efficacy (BE), and pH stability (pH) of single-application high concentrated in-office bleaching gels. MATERIALS AND METHODS Eighty-eight healthy premolars were randomly into eleven groups (n = 8) according to the in-office dental bleaching: DSP White Clinic 35% calcium (DW), Nano White 35% (NW), Opalescence XTra Boost 40% (OB), Pola Office + 37.5% (PO), Potenza Bianco Pro SS 38% (PB), Total Blanc 35% (TB), Total Blanc One-Step 35% (TO), Whiteness Automixx 35% (WA), Whiteness Automixx Plus 35% (WP), and Whiteness HP Blue 35% (WB). A group not exposed to bleaching agents was the control group (CG). All bleaching agents were applied in one session with a single application. After the bleaching procedure, the concentration of HP diffusion (μg/mL) into the pulp chamber was assessed using UV-Vis spectrophotometry. The BE (ΔEab and ΔE00) was evaluated before and 1 week after the bleaching procedure using a digital spectrophotometer. The pH of each bleaching gel was evaluated by digital pHmeter. The one-way ANOVA and Tukey's was used for a statistical analysis (α = 0.05). RESULTS The concentration of HP diffusion into the pulp chamber was higher in all in-office bleaching gels when compared to CG (p < 0.0000001). However, there are a significant difference between them (p = 0.0001). A significant BE was observed in all in-office bleaching gels (p < 0.0001 for ΔEab and ΔE00), with a significant difference between them (p < 0.0001). PO, OB, TB, WP, and WB showed a higher BE when compared to DW, PB, and WA (p < 0.0001). Most bleaching gels were slightly acidic or alkaline during the total application time, while DW, PB, TB, and WA showed a high acidic behavior after 30 min of application. CONCLUSIONS A single application was able to produce a bleaching efficacy. However, usually, gels with slightly acidic or alkaline pH during the application time reduces the HP diffusion into the pulp chamber. CLINICAL RELEVANCE The single-application of bleaching gels with slightly acidic or alkaline and stable pH decreased the penetration of hydrogen peroxide into the pulp chamber in in-office bleaching and maintained the bleaching efficacy.
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Affiliation(s)
- Karine Letícia da Silva
- Department of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M - Uvaranas, Ponta Grossa, Paraná, Brazil
| | - Michael Willian Favoreto
- Department of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M - Uvaranas, Ponta Grossa, Paraná, Brazil
| | - Gabrielle Gomes Centenaro
- Department of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M - Uvaranas, Ponta Grossa, Paraná, Brazil
| | - Laís Giacomini Bernardi
- Department of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M - Uvaranas, Ponta Grossa, Paraná, Brazil
| | | | - Alessandra Reis
- Department of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M - Uvaranas, Ponta Grossa, Paraná, Brazil
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M - Uvaranas, Ponta Grossa, Paraná, Brazil.
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Caneschi CDS, Benetti F, de Oliveira LCA, Belchior JC, Ferreira RC, Moreira AN, Dos Santos Alves Morgan LF. Bleaching effectiveness and cytotoxicity of new experimental formulation of niobium-based bleaching gel. Clin Oral Investig 2023; 27:1613-1621. [PMID: 36607491 DOI: 10.1007/s00784-022-04785-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/08/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The development of new bleaching agents with minimum concentration of hydrogen peroxide (HP), without adverse effects, and with bleaching effectiveness, has great clinical relevance. The aim of this study was to evaluate the bleaching efficacy and cytotoxicity of a new niobium-based bleaching gel, compared to already available HP-based gels. MATERIALS AND METHODS For the bleaching efficacy analysis, 40 bovine incisors were randomly divided into 4 groups according to the established bleaching protocol: control, untreated; 35HP, 35% HP bleaching gel; 6HP, 6% HP bleaching gel; NbHP, niobium gel associated with 3% HP gel. The color variation was measured in a spectrophotometer and the values of ΔL, Δa, Δb, and ΔE obtained. For the cell viability assay by MTT, MC3T3 cells were exposed to bleaching gel extracts (1:500, 1:250, 1:125 dilutions; immediately and 24 h). Statistical tests were performed (P < 0.05). RESULTS The color alteration for all bleaching gels was significant compared to control (P < 0.05), but the NbHP gel showed a significant ΔE than other gels, with expressive color alteration at 14 days (P < 0.05). The 35HP showed high cytotoxicity regarding control and the most groups in all periods and extracts analyzed (P < 0.05), while the NbHP showed greater cell viability than control in the immediate period, dilution of the 1:500 and superior to 6HP in the most extracts at 24 h. CONCLUSION The new experimental niobium-based gel has bleaching efficacy similar to that of gels with a high concentration of HP, and it has high cytocompatibility. CLINICAL RELEVANCE The use of this new generation of niobium-based whitening gel associated with a low concentration of hydrogen peroxide represents the possibility of a tooth whitening with lower dentin sensitivity.
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Affiliation(s)
- Camila de Sousa Caneschi
- Department of Restorative Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627 - Bairro Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627 - Bairro Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Luiz Carlos Alves de Oliveira
- Department of Chemistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627 - Bairro Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Jadson Cláudio Belchior
- Department of Chemistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627 - Bairro Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Raquel Conceição Ferreira
- Department of Social and Preventive Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627 - Bairro Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Allyson Nogueira Moreira
- Department of Restorative Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627 - Bairro Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
| | - Luís Fernando Dos Santos Alves Morgan
- Department of Restorative Dentistry, Federal University of Minas Gerais, Avenida Antônio Carlos, 6627 - Bairro Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
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Carneiro TS, Favoreto MW, Bernardi LG, Bandeca MC, Borges C, Reis A, Loguercio AD. Application Tip and Concentration of a Self-mixing Bleach: Hydrogen Peroxide Inside the Pulp Chamber, Color Change, and Amount of Bleaching Gel Used. Oper Dent 2023; 48:146-154. [PMID: 36786759 DOI: 10.2341/21-053-l] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 02/15/2023]
Abstract
PURPOSE The objective of this study was to evaluate if the application method (tip with brush or tip without brush) and hydrogen peroxide (HP) concentration (6% or 35% self-mixing) of in-office bleaching gel influences the penetration of HP into the pulp chamber, color change, and the amount of bleaching gel used. METHODS Forty healthy premolars were randomly divided into the following five groups (n=8): no treatment; HP6% using a tip with a brush, HP6% using a tip without a brush, HP35% using a tip with a brush, and HP35% using a tip without a brush. After treatments, the HP concentration (μg/mL) within the pulp chamber was determined using UV-Vis spectrophotometry. The color change (ΔEab, ΔE00, and ΔWID) was evaluated using a digital spectrophotometer. The amount of gel used (g) in each group was measured using a precision analytical balance. Data from each test were submitted to parametric tests (α=0.05). RESULTS The tip with a brush resulted in a lower amount of HP inside the pulp chamber and less gel used when compared with the tip without a brush, regardless of HP concentration (p<0.05). However, regarding the tip used, although no significant difference was observed when HP35% was used (p>0.05), a higher whitening effect was observed when the 6% HP was applied without a brush as opposed to with a tip brush (p<0.05). CONCLUSIONS The use of a tip with a brush, regardless of the in-office bleaching gel concentration (6% or 35% self-mixing), presented a lower penetration and lower volume of spent gel when compared to a tip without brush. However, the whitening effect depended on the concentration of HP used.
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Affiliation(s)
- T S Carneiro
- Taynara S Carneiro, DDDS, MSc, PhD student, Department of Stomatology, IDIBO research group, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - M W Favoreto
- Michael W Favoreto, DDS, MSc, PhD student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, PR, Brazil
| | - L G Bernardi
- Lais G Bernardi, DDS, MSc, PhD student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, PR, Brazil
| | - M C Bandeca
- Matheus C Bandeca, DDS, MS, PhD, Department of Restorative Dentistry, School of Dentistry, CEUMA University, São Luís, MA, Brazil
| | - Cpf Borges
- Christiane PF Borges, BSc, PhD, Department of Chemistry, State University of Ponta Grossa, PR, Brazil
| | - A Reis
- Alessandra Reis, DDS, PhD, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, PR, Brazil
| | - A D Loguercio
- *Alessandro D Loguercio, DDS, MSc, PhD, Department of Restorative Dentistry, School of Dentistry State University of Ponta Grossa, PR, Brazil
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Ribeiro RADO, Peruchi V, Fernandes LDO, Anselmi C, Soares IPM, Hebling J, Costa CADS. The influence of violet LED application time on the esthetic efficacy and cytotoxicity of a 35% H 2O 2 bleaching gel. Photodiagnosis Photodyn Ther 2022; 40:103069. [PMID: 35987461 DOI: 10.1016/j.pdpdt.2022.103069] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/03/2022] [Accepted: 08/16/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess the potential influence of violet LED (V-LED) application time on the esthetic efficacy and cytotoxicity of a 35% H2O2 bleaching gel. METHODOLOGY Stained and standardized enamel/dentin discs were subjected to one in-office tooth bleaching session (45 min), and the gel was either irradiated or not with V-LED. Thus, the following groups were established (n = 8): G1: No treatment (negative control, NC); G2: 35% H2O2 (positive control, PC); G3: 35%H2O2 + V-LED/15 min; G4: 35%H2O2 + V-LED/30 min; G5: 35%H2O2 + V-LED/45 min. First, esthetic efficacy was assessed (ΔE00 and ΔWI). Discs assembled in artificial pulp chambers were subjected to the same bleaching treatments. Then, the extracts (culture medium + diffused bleaching gel components) were collected and applied to MDPC-23 pulp cells, which were analyzed for viability (Live/Dead, MTT) and oxidative stress (OxS). The amount of H2O2 in the extracts was also determined (leuco crystal-violet/peroxidase). The data were subjected to ANOVA/Tukey at a 5% significance level. RESULTS Although esthetic efficacy did not differ among the irradiated groups (G3, G4, and G5) (p > 0.05), their results were higher than in G2 (PC; p < 0.05). In the irradiated groups, the cell viability and OxS as well as the amount of H2O2 in the extracts were statistically similar to G2 (PC), regardless of irradiation time (p > 0.05). CONCLUSION Although V-LED improves the esthetic outcome of in-office tooth bleaching, increasing irradiation time does not effect the color changes and cytotoxicity of this professional therapy.
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Affiliation(s)
| | - Victória Peruchi
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Lídia de Oliveira Fernandes
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Caroline Anselmi
- Department of Morphology and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Igor Paulino Mendes Soares
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Josimeri Hebling
- Department of Morphology 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), Araraquara, Rua Humaitá, 1680, Araraquara, São Paulo 14801-903, Brazil.
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Effect of an experimental desensitizing gel on bleaching-induced tooth sensitivity after in-office bleaching—a double-blind, randomized controlled trial. Clin Oral Investig 2022; 27:1567-1576. [PMID: 36418502 PMCID: PMC9685084 DOI: 10.1007/s00784-022-04778-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/06/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the risk and intensity of tooth sensitivity (TS), and the efficacy of in-office bleaching after applying an experimental desensitizing gel composed of 10% calcium gluconate, 0.1% dexamethasone acetate, 10% potassium nitrate, and 5% glutaraldehyde. MATERIAL AND METHODS In a split-mouth, double-blind, placebo-controlled study, 50 participants had their upper hemiarches randomized into experimental and placebo groups. Desensitizing and placebo gels were applied for 10 min before in-office bleaching (35% hydrogen peroxide, 1 × 50 min; two bleaching sessions; 1-week interval). TS was recorded immediately after bleaching, 1, 24, and 48 h after each session, with a 0-10 visual analogue scale (VAS) and a five-point numerical rating scale (NRS). The color was recorded in all groups at baseline, 1 week after each session, and 1 month after the end of bleaching using shade guide units (ΔSGUs) and a spectrophotometer (ΔEab, ΔE00, and ΔWID). RESULTS Most participants (96%) felt some discomfort during treatment regardless of the study group. The odds ratio for pain was 0.65 (95% CI 0.1 to 4.1; p = 1.0). The intensity of TS did not differ between groups (p > 0.31), and it was only 0.34 VAS units lower in the experimental group. A significant color change occurred in both groups regardless of the group. CONCLUSIONS The desensitizing experimental gel applied before in-office bleaching did not reduce the risk and the intensity of TS and did not affect color change. CLINICAL RELEVANCE Although the experimental desensitizing agent with varying mechanisms of action did not jeopardize the color change, it did not reduce the risk or intensity of in-office bleaching. CLINICAL TRIAL REGISTRATION NUMBER RBR-7T7D4D.
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12
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de Oliveira Ribeiro RA, Zuta UO, Soares IPM, Anselmi C, Soares DG, Briso ALF, Hebling J, de Souza Costa CA. Manganese oxide increases bleaching efficacy and reduces the cytotoxicity of a 10% hydrogen peroxide bleaching gel. Clin Oral Investig 2022; 26:7277-7286. [PMID: 35974255 DOI: 10.1007/s00784-022-04688-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The study aims to assess the effects of a 10% H2O2 bleaching gel with different MnO2 concentrations on the bleaching efficacy (BE), degradation kinetics (DK) of H2O2, and trans-amelodentinal cytotoxicity (TC). MATERIALS AND METHODS Standardized bovine enamel/dentin disks (n = 96) were placed in artificial pulp chambers, and the bleaching gels were applied for 45 min. Thus, the following groups were established: (G1) no treatment (negative control/NC); (G2) 35% H2O2 (positive control/PC); (G3) 10% H2O2; (G4) 10% H2O2 + 2 mg/mL MnO2; (G5) 10% H2O2 + 6 mg/mL MnO2; and (G6) 10% H2O2 + 10 mg/mL MnO2. After analyzing bleaching efficacy (ΔE00 and ΔWI), the degradation kinetics of H2O2 and trans-amelodentinal cytotoxicity were determined (n = 8, ANOVA/Tukey; p < 0.05). RESULTS G6 presented BE (ΔE00 and ΔWI) statistically similar to G2, which represented conventional in-office bleaching (p = 0.6795; p > 0.9999). A significant reduction in the diffusion of H2O2 occurred in G3, G4, G5, and G6 compared to G2 (p < 0.0001). The highest DK of H2O2 occurred in G6 (p < 0.0001), which had the lowest TC in comparison with all other bleached groups (p ≤ 0.0186). CONCLUSION The addition of 10 mg/mL of MnO2 in a 10% H2O2 bleaching gel potentiates the degradation of this reactive molecule, which increases the BE of the product and decreases TC. CLINICAL SIGNIFICANCE Replacing a 35% H2O2 gel commonly used for conventional in-office dental bleaching by a 10% H2O2 gel containing 10 mg/mL of MnO2 reduces the cytotoxicity of this professional therapy, maintaining its excellent esthetic efficacy.
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Affiliation(s)
| | - Uxua Ortecho Zuta
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Igor Paulino Mendes Soares
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Caroline Anselmi
- Department of Morphology and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Diana Gabriela Soares
- Department of Dentistry, Endodontics and Dental Materials, School of Dentistry, São Paulo University (USP), Bauru, Brazil
| | - André Luiz Fraga Briso
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Aracatuba, Brazil
| | - Josimeri Hebling
- Department of Morphology 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), Araraquara, Brazil.
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Ribeiro R, de Oliveira Duque CC, Ortecho-Zuta U, Leite ML, Hebling J, Soares DG, de Souza Costa CA. Influence of Manganese Oxide on the Esthetic Efficacy and Toxicity Caused by Conventional In-office Tooth Bleaching Therapy. Oper Dent 2022; 47:425-436. [PMID: 35917237 DOI: 10.2341/20-257-l] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study aimed to evaluate the esthetic efficacy, cytotoxicity, and kinetics of decomposition of hydrogen peroxide (H2O2) present in a commercial bleaching gel with 35% H2O2 (BG35%) chemically activated with manganese oxide (MnO2). METHODS AND MATERIALS After incorporating 2 mg/mL, 6 mg/mL, and 10 mg/mL of MnO2 into BG35%, the stability of pH and temperature of the products were analyzed. To assess the esthetic efficacy (ΔE and ΔWI), the BG35%s with MnO2 were applied for 45 minutes on enamel/dentin discs (DiE/D). BG35% or no treatment were used as positive (PC) and negative (NC) controls, respectively. To analyze the cell viability (CV) and oxidative stress (OXS), the same bleaching protocols were performed on DiE/D adapted to artificial pulp chambers. The extracts (culture medium + gel components that diffused through the discs) were applied to pulp cells and submitted to H2O2 quantification. BG35% with MnO2 that showed the best results was evaluated relative to kinetic decomposition of H2O2, with consequent generation of free radicals (FR) and hydroxyl radicals (OH•). The data were submitted to the one-way analysis of variance complemented by Tukey post-test (α=0.05). Data on kinetics of H2O2 decomposition were submitted to the Student's-t test (α=0.05). RESULTS All the BG35%s with MnO2 showed stability of pH and temperature, and the gel with 10 mg/mL of this activator had an esthetic efficacy 31% higher than that of the PC (p<0.05). Reduction in OXS and trans-amelodentinal diffusion of H2O2 occurred when all the BG35%s with MnO2 were used. The addition of 6 and 10 mg/mL of MnO2 to BG35% increased the CV in comparison with PC, confirmed by the cell morphology analysis. An increase in FR and OH• formation was observed when 10 mg/mL of MnO2 was added to BG35%. CONCLUSION Catalysis of BG35% with MnO2 minimized the trans-amelodentinal diffusion of H2O2 and toxicity of the product to pulp cells. BG35% containing 10 mg/mL of MnO2 potentiated the decomposition of H2O2, enhancing the generation of FR and OH•, as well as the efficacy of the in-office tooth therapy.
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Affiliation(s)
- Rao Ribeiro
- Rafael Antonio de Oliveira Ribeiro, PhD student, Department of Dental Materials and Prosthodontics, Univ Estadual Paulista - UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil. ORCID: 0000-0001-8100-3294
| | - C C de Oliveira Duque
- Carla Caroline de Oliveira Duque, PhD, Department of Dental Materials and Prosthodontics, Univ Estadual Paulista -UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil. ORCID 0000-0002-5898-4132
| | - U Ortecho-Zuta
- Uxua Ortecho Zuta, PhD student, Department of Dental Materials and Prosthodontics, Univ Estadual Paulista -UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil. ORCID 0000-0002-2922-3609
| | - M L Leite
- Maria Luísa Leite, PhD student, Department of Dental Materials and Prosthodontics, Univ Estadual Paulista -UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil. ORCID 0000-0001-6650-3637
| | - J Hebling
- Josimeri Hebling, professor, Department of Orthodontics and Pediatric Dentistry, Univ Estadual Paulista - UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil. ORCID 0000-0002-2846-2325
| | - D G Soares
- Diana Gabriela Soares, professor, Department of Dentistry, Endodontics and Dental Materials, Univ de São Paulo - USP, Bauru, Bauru School of Dentistry, Bauru, SP, Brazil. ORCID 0000-0002-1485-6104
| | - C A de Souza Costa
- *Carlos Alberto de Souza Costa, professor, Department of Physiology and Pathology, Univ Estadual Paulista - UNESP, Araraquara School of Dentistry, Araraquara, SP, Brazil. ORCID 0000-0002-7455-6867
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da Silva LMAV, Cintra LTA, de Alcântara S, Machado NEDS, Benetti F, Ervolino E, Briso ALF. Influence of violet LED associated or not with peroxide gel on inflammation, mineralization, and collagen fiber maturation in dentin and pulp tissue. Photodiagnosis Photodyn Ther 2022; 39:102959. [PMID: 35691564 DOI: 10.1016/j.pdpdt.2022.102959] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To evaluate the influence of violet LED, associated or not with a 17.5% hydrogen peroxide (HP) bleaching gel, on inflammation, mineralization in pulp tissue, and collagen fiber maturation in dentin and pulp tissue. MATERIALS AND METHODS The maxillary molars of eighty Wistar rats were distributed into four groups (n = 10): CONT - without treatment; HP - 30-minute application of 17.5% HP; LED - 20-minute application of violet LED; and HP+LED - application of PH and violet LED. Rats were euthanized and jaws were processed for histologic and immunohistochemical evaluation (IL-17, IL-23, and osteocalcin) and picrosirius red immediately after (T0), and at 7 (T1), 15 (T2), and 30 days (T3) post-treatment, with Wilcoxon, Mann-Whitney, paired T-test, and T-test (α = 0.05). RESULTS HP and HP+LED presented necrosis and severe inflammatory infiltrate. When compared to CONT group, LED presented severe osteocalcin (OCN) immunostaining in T2 and less immature fibers in T2 and T3. CONCLUSION The violet LED caused no severe damage to the pulp tissue, increased IL-17 and IL-23 expression in T0 when associated with HP, and had no influence on pulp tissue mineralization, besides accelerating the maturation of collagen fibers of dentin. CLINICAL RELEVANCE Violet LED therapy induced no inflammation in the pulp tissue of rats and played no role in pulp tissue fibrosis, besides accelerating the maturation of dentin collagen fibers.
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Affiliation(s)
- Livia Maria Alves Valentim da Silva
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, Vila Mendonça, Araçatuba, São Paulo 1193, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, Vila Mendonça, Araçatuba, São Paulo 1193, Brazil
| | - Sibele de Alcântara
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, Vila Mendonça, Araçatuba, São Paulo 1193, Brazil
| | - Nathália Evelyn da Silva Machado
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, Vila Mendonça, Araçatuba, São Paulo 1193, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - André Luiz Fraga Briso
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry Araçatuba, José Bonifácio, Vila Mendonça, Araçatuba, São Paulo 1193, Brazil.
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Carneiro AMP, Barros APO, de Oliveira RP, de Paula BLF, Silva AM, de Melo Alencar C, Silva CM. The effect of photobiomodulation using low-level laser therapy on tooth sensitivity after dental bleaching: a systematic review. Lasers Med Sci 2022; 37:2791-2804. [PMID: 35597839 DOI: 10.1007/s10103-022-03578-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
The authors aimed to conduct a systematic review to assess data from the current literature on the effectiveness of low-level laser therapy (LLLT) in preventing tooth sensitivity (TS) after tooth whitening (DB). PRISMA guidelines for systematic reviews were followed. Clinical trials evaluating the treatment of LLLT in patients with sensitivity after tooth whitening were selected. A full bibliographic search was performed on May 4, 2021, in the following databases: Embase, MEDLINE via PubMed, SciELO, VHL Regional Portal, Web of Science, Gray Literature, Scopus, ClinicalTrials.gov and Cochrane Library. This study followed Cochrane's recommendations for analyzing risk of bias. A total of 1054 studies were found (255 studies were excluded because they were duplicates and 785 because of titles and abstracts). Only 14 articles were selected for analysis, of which eight were excluded because they had one or more exclusion criteria, resulting in six articles included in this systematic review, the vast majority being classified as low risk of bias. The studies reviewed indicated that LLLT showed promise in preventing TS after TB. However, evidence is limited and more clinical trials with low risk of bias are needed to reach a definitive conclusion on the action of LLLT in pain control after TB.
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Affiliation(s)
| | | | | | | | - Aryvelto Miranda Silva
- Department of Restorative Dentistry, Araraquara Dental School, Sao Paulo State University, Araraquara, SP, Brazil
| | - Cristiane de Melo Alencar
- Department of Restorative Dentistry, Araraquara Dental School, Sao Paulo State University, Araraquara, SP, Brazil
| | - Cecy Martins Silva
- School of Dentistry, Federal University of Pará, Augusto Correa Av, No 1, Guamá, Belém, Pará, 66075-110, Brazil. .,Dental Materials Laboratory of the Postgraduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil.
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Evaluation of the Pulp Oxygen Saturation Reading after Tooth Bleaching: A Randomized Clinical Trial. Int J Dent 2022; 2022:1598145. [PMID: 35531572 PMCID: PMC9072050 DOI: 10.1155/2022/1598145] [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: 12/15/2021] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives The purpose of this clinical trial was to evaluate the influence of in-office dental bleaching on the pulp oxygen saturation (SpO2p) reading. Material and Methods. SpO2p was measured using a pulse oximeter in 112 upper and lower anterior teeth (canines and incisors) of patients submitted to bleaching. Whitegold Office 35% (WGO) (upper and lower left hemiarch) and Whiteness HP Auto Mixx 35% (WHP) (upper and lower right hemiarch) bleaching agents were used. SpO2 measurements (teeth and index finger) were taken before and after each of the three application sessions of the agents. In the 4th session, in which no bleaching gel was used, only SpO2 was measured. Before and after the bleaching sessions, a colorimetric device performed the teeth color reading. The waiting time between sessions was 7 days. Data were analyzed by the Friedman, Kruskal–Wallis, and Mann–Whitney U tests (α = 0.05). Color change (ΔE) data were correlated (Spearman's Rho test) with the SpO2p levels. Results Neither of the two bleaching agents showed significant differences between the readings when evaluated individually (WGO, P=0.780, and WHP, P=0.494). When taken together, the results showed significant difference between the readings performed, with higher median values after bleaching sessions: before (97.3) and after (98.6) 1st session; before (98.3) and after (98.3) 2nd session; before (98.3) and after (99.0) 3rd session; and after 1 week (98.3). The dental groups formed by maxillary lateral incisors (P=0.012) and mandibular incisors (P < 0.001) showed a significant difference. Spearman's Rho test showed a nonsignificant and weak correlation between ΔE and SpO2p in most comparisons. Conclusions The in-office dental bleaching influenced the SpO2p reading, regardless of the dental group evaluated or the bleaching agent used. Clinical Relevance. This study provides information about the influence of in-office tooth whitening on the pulp SpO2p levels. The observation of pulp vitality during and after the use of bleaching agents is important for the follow-up of patients undergoing tooth whitening. The use of a pulse oximeter may be a viable and painless alternative to perform this monitoring. The clinical trial was registered with the Brazilian Registry of Clinical Trials (ReBEC; registration number: https://clinicaltrials.gov/ct2/show/RBR-68xbth).
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Silva IJP, Cintra LTA, Ervolino E, Chaves HGDS, Sivieri-AraúJo G, Briso ALF, Cosme-Silva L, Benetti F. Photobiomodulation reduces inflammation but does not influence the hypoxia-inducible factor-1α in pulp tissue of rats after bleaching. J Appl Oral Sci 2022; 30:e20210559. [PMID: 35416830 PMCID: PMC9004371 DOI: 10.1590/1678-7757-2021-0559] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/28/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives: To evaluate the influence of photobiomodulation with infrared laser (IRL) in the rat pulp tissue after bleaching, considering the immunolabeling of interleukin (IL)-23 and hypoxia-inducible factor (HIF)-1α. Methodology: The right and left molars of forty rats were divided into groups: Control – with placebo gel and Bleached – with 35% hydrogen peroxide (H2O2). Half of the rats received one IRL application on both sides, establishing a split-mouth design, which resulted in 4 groups with 20 hemi-maxillae each: Control, Bleach, IRL, and Bleached-IRL. Rats (n=10) from each group were euthanized, at 2- and 30-days mark, and the pulp tissue was evaluated using inflammation and immunolabeling scores. Wilcoxon and Mann-Whitney statistical tests were performed (p<0.05). Results: At the 2-days mark, the Bleached group had severe inflammation and necrosis in the occlusal thirds of the pulp, and moderate to severe inflammation in cervical third, whereas the Bleached-IRL had mild to moderate inflammation (p<0.05). At the 30-days mark, there was no inflammation, but tertiary dentine formation in the bleached groups. Regarding IL-23, severe immunolabeling was observed in the Bleached group (p<0.05) at the 2-days mark; at the 30-days mark, there was a reduction in immunolabeling, in which the Bleached group had moderate and the Bleached-IRL group had mild immunolabeling (p>0.05). HIF-1α was more evident at the 2-days mark in the Bleached group, without significant difference with the Bleached-IRL (p>0.05). The difference was observed between the bleached and control groups, without immunolabeling (p<0.05); at the 30-days mark, the Bleached group had reduction in HIF-1α immunolabeling, while the Bleached-IRL had an increase; the difference remained between the bleached and the controls groups (p<0.05) Conclusion: Photobiomodulation using IRL minimized the inflammation and IL-23 immunolabeling in the pulp tissue of rats after dental bleaching, but did not influence significantly the HIF-1α immunolabeling.
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Affiliation(s)
- Isabela Joane Prado Silva
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Endodontia, Araçatuba, SP, Brasil
| | | | - Edilson Ervolino
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Ciências Básicas, Araçatuba, SP, Brasil
| | - Hebertt Gonzaga Dos Santos Chaves
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Odontologia, Departamento de Odontologia Restauradora, Belo Horizonte, MG, Brasil
| | - Gustavo Sivieri-AraúJo
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Endodontia, Araçatuba, SP, Brasil
| | - André Luiz Fraga Briso
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Odontologia Restauradora, Araçatuba, SP, Brasil
| | - Leopoldo Cosme-Silva
- Universidade Federal de Alagoas (UFAL), Faculdade de Odontologia, Maceió, AL, Brasil
| | - Francine Benetti
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Odontologia, Departamento de Odontologia Restauradora, Belo Horizonte, MG, Brasil
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Moura SK, dos Santos ML, do Nascimento LA, da Silva MF, de França GM, da Costa LM, Medeiros AC, Araújo-Júnior RF, de Araújo AA, Oliveira CN, Dorini AL, de Carvalho RA, Borges BC, da Silva-Júnior AA, Galvão HC. Design of a thermosensitive ibuprofen-loaded nanogel as smart material applied as anti-inflammatory in tooth bleaching: An in vivo study. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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19
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Topical application of Otosporin® before in-office bleaching: a split mouth, triple-blind, multicenter randomized clinical trial. Clin Oral Investig 2021; 26:2555-2564. [PMID: 34668065 DOI: 10.1007/s00784-021-04224-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/10/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate if the topical application of Otosporin® before in-office bleaching with a 35% hydrogen peroxide (HP) gel reduces the risk and intensity of tooth sensitivity (TS), as well as the bleaching effectiveness. MATERIALS AND METHODS Twenty participants were selected for this split mouth, triple-blind, multicenter randomized clinical trial. Before each bleaching session, the placebo was applied in the patient's hemi-arch and the other half received the Otosporin®, according to the randomization procedure. Both products were applied topically for 10 min. The 35% HP was applied in two sessions with a 1-week interval. The risk and intensity of TS were assessed using the Numerical Scale (NRS) and the Visual Analog Scale (VAS). The bleaching effectiveness were evaluated with the visual scales and with a digital spectrophotometer. The absolute risk of TS was compared by McNemar's test. To compare the intensity of TS, the Wilcoxon signed-rank test was used to evaluate the NRS, while the paired t test was used to evaluate VAS. Bleaching effectiveness (ΔSGUs and ΔEab, ΔE00, and ΔWID) was compared between groups using the paired t-test (α = 0.05). RESULTS No significant difference at risk (p = 1.0) and intensity of TS (p > 0.59; VAS and p = 1.00 for NRS) was detected between groups. For both groups, a significant bleaching was observed after 30 days of evaluation (p < 0.39). CONCLUSIONS The previous application of Otosporin® in the in-office bleaching did not reduce the risk and intensity of TS and did not affect the effectiveness of the bleaching. CLINICAL RELEVANCE The application of Otosporin® before in-office bleaching with 35% HP was not able to reduce the risk and intensity of TS.
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Chen C, Huang X, Zhu W, Ding C, Huang P, Li R. H2O2 gel bleaching induces cytotoxicity and pain conduction in dental pulp stem cells via intracellular reactive oxygen species on enamel/dentin disc. PLoS One 2021; 16:e0257221. [PMID: 34506603 PMCID: PMC8432789 DOI: 10.1371/journal.pone.0257221] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/25/2021] [Indexed: 01/26/2023] Open
Abstract
Background Bleaching is widely accepted for improving the appearance of discolored teeth; however, patient compliance is affected by bleaching-related complications, especially bleaching sensitivity. This study aimed to investigate the role of reactive oxygen species (ROS) in cytotoxicity and pain conduction activated by experimental tooth bleaching. Methods Dental pulp stem cells with or without N-acetyl-L-cysteine (NAC), an ROS scavenger, were cultured on the dentin side of the enamel/dentin disc. Subsequently, 15% (90 min) and 40% (30 min) bleaching gels were painted on the enamel surface. Cell viability, intracellular ROS, Ca2+, adenosine triphosphate (ATP), and extracellular ATP levels were evaluated using the Cell Counting Kit-8 assay, 2’,7’-dichlorodihydrofluorescein diacetate, CellROX, fura-3AM fluorescence assay, and ATP measurement kit. The rat incisor model was used to evaluate in vivo effects after 0, 1, 3, 7, and 30 days of bleaching. Changes in gene and protein expression of interleukin 6 (IL-6), tumor necrosis factor-alpha (TNFα), transient receptor potential ankyrin 1 (TRPA1), and Pannexin1 (PANX1) in dental pulp stem cells and pulp tissue were detected through RT-PCR, western blotting, and immunofluorescence. Results The bleaching gel suppressed dental pulp stem cell viability and extracellular ATP levels and increased intracellular ROS, Ca2+, and intracellular ATP levels. The mRNA and protein expression of IL-6, TNFα, TRPA1, and PANX1 were up-regulated in vitro and in vivo. Furthermore, the 40% gel had a stronger effect than the 15% gel, and NAC ameliorated the gel effects. Conclusions Our findings suggest that bleaching gels induce cytotoxicity and pain conduction in dental pulp stem cells via intracellular ROS, which may provide a potential therapeutic target for alleviating tooth bleaching nociception.
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Affiliation(s)
- Chang Chen
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiansheng Huang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wenqiang Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chen Ding
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Piaopiao Huang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Rong Li
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- * E-mail:
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21
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Reis-Prado AHD, Grossi IR, Chaves HGDS, André CB, Morgan LFDSA, Briso ALF, Cintra LTA, Benetti F. Influence of Hydrogen Peroxide on Mineralization in Dental Pulp Cells: A Systematic Review. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.689537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Dental bleaching agents show the ability to permeate through dental hard tissues, which may lead to pulp tissue changes. This systematic review (PROSPERO register: CRD42020213767) is aimed at understanding the effects of bleaching agents on the process of mineralization of the pulp tissue.Methods: Only in vitro studies evaluating the influence of hydrogen peroxide (HP) on mineralization in dental pulp cells were included. Studies without a non-bleached control group or cells after co-treatment with a bleaching agent other than HP and/or carbamide peroxide were excluded. The primary outcomes evaluated were alkaline phosphatase (ALP) activity and mineralized nodule deposition. The mineralization markers analysis in dental pulp cells and the cell viability were considered secondary outcomes. Two independent authors conducted a systematic search (PubMed/MEDLINE, Scopus, Embase, Cochrane Library, and OpenGrey until January 2021) with no language restrictions and performed data extraction. The quality assessment was appraised according to a modified Joanna Briggs Institute critical appraisal checklist.Results: The search resulted in 473 studies, and 11 were considered eligible. Overall, a reduction in the process of mineralization was observed among pulp cells after bleaching. A reduction in the ALP activity was reported in the mostly bleached groups using different protocols and analysis periods of nine studies. Regarding mineralized nodule deposition, 6 studies reported a significant reduction from 7 to 21 days among bleached groups. Of those three studies that investigated other mineralization markers, two found a reduction in the expression of dentin matrix acidic phosphoprotein (DMP)-1, dentin sialophosphoprotein (DSPP), and matrix extracellular phosphoglycoprotein (MEPE) among some bleaching gel concentrations. In contrast, one study showed a greater expression of osteopontin (OPN) and osteocalcin (OCN) in 100 μmol/L HP after 5 or 10 min of exposure, and another study showed significant induction of DSPP in concentrations of up to 0.5 mmol/L HP.Conclusion: Especially, high concentrations of bleaching gel reduce the potential of mineralization in pulp cells in in vitro studies; however, different HP concentrations, bleaching protocols, and analysis periods can influence this outcome.
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Cintra LTA, Gomes MS, da Silva CC, Faria FD, Benetti F, Cosme-Silva L, Samuel RO, Pinheiro TN, Estrela C, González AC, Segura-Egea JJ. Evolution of endodontic medicine: a critical narrative review of the interrelationship between endodontics and systemic pathological conditions. Odontology 2021; 109:741-769. [PMID: 34240297 DOI: 10.1007/s10266-021-00636-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022]
Abstract
Endodontics has gained emphasis in the scientific community in recent years due to the increase in clinical and in animal models studies focused on endodontic medicine, which aims to evaluate the interrelationship between systemic and periapical tissues pathological conditions. These studies have shown that systemic changes can boost the pathogenesis of endodontic infection, favoring its development and progression. A contrary relationship is reported in numerous studies that affirm the potential of endodontic infection to trigger systemic damage and may lead to the worsening of pre-existing pathologies. Recently, the potential of filling materials to develop systemic changes such as neurological alterations had been evaluated, also showing that systemic diseases can negatively influence tissue responses to filling materials after endodontic treatment. Despite advances in endodontic medicine studies, there are still gaps in knowledge on the mechanisms of interactions between apical periodontitis (AP) and systemic diseases and much research to be done. In this sense, this critical narrative literature review aimed to show the evolution of studies in endodontic medicine to help the endodontist to know the role of systemic diseases in the pathogenesis of AP and the possible interference in the repair of periapical tissues after endodontic treatment, as well as to evidence the systemic complications that can be triggered or aggravated in the presence of endodontic infection.
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Affiliation(s)
- Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil. .,Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil.
| | - Maximiliano Schünke Gomes
- Departament of Odontology, School of Dentistry and Medical and Dental Center, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristiane Cantiga da Silva
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leopoldo Cosme-Silva
- Department of Clinics and Surgery, School of Dentistry, Federal University of Alfenas (Unifal), Alfenas, MG, Brazil
| | - Renata Oliveira Samuel
- Department of Clinical Dentistry, Dental School, Universidade de Uberaba, Uberaba, MG, Brazil
| | - Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Dental School of Amazonas State University, Manaus, AM, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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Meireles SS, Santos ME, Lustosa ÍMC, Leite ELL. Effects of a reduced in-office bleaching protocol with 37.5% hydrogen peroxide on effectiveness and tooth sensitivity: A double-blind randomized clinical trial. J ESTHET RESTOR DENT 2021; 33:824-831. [PMID: 34180574 DOI: 10.1111/jerd.12744] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/31/2021] [Accepted: 04/30/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This randomized clinical trial evaluated the effectiveness and tooth sensitivity (TS) of 37.5% hydrogen peroxide (37.5HP) in-office bleaching with reduced protocol. MATERIALS AND METHODS Forty participants with shade mean C2 or darker for the six maxillary anterior teeth were randomly allocated into two treatment groups (n = 20): two (37.5HP2) or three (37.5HP3) 8 min applications/clinical session. Three clinical sessions were performed with a 1 week interval. Color evaluations were done with a spectrophotometer at baseline and 1 week post-bleaching. TS was measured during and up to 48 h after bleaching using a five-point numeric rating scale. Color change was evaluated by Student's t-test for independent samples. The absolute risk and intensity of TS were analyzed by Fisher's and Mann-Whitney/Friedman tests (p < 0.05). RESULT Both treatment groups resulted in a significant tooth whitening 1 week post-bleaching (p < 0.001). There were no significant differences between 37.5HP2 and 37.5HP3 for ΔE*ab , ΔE00 and ∆WID . Also, there were not differences between groups regarding high absolute risk (p = 1.0) and low intensity of TS at all time assessments (p > 0.7). CONCLUSIONS The in-office bleaching with two 37.5% HP applications produced the same whitening degree, risk and intensity of TS to that performed with three gel applications. CLINICAL SIGNIFICANCE Clinicians should opt to use a neutral 37.5% HP in-office bleaching gel for two 8 min applications/clinical session because produces the same whitening effectiveness, risk and low intensity of TS as the protocol proposed by manufacturer (three 8 min applications).
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Affiliation(s)
- Sônia Saeger Meireles
- Department of Operative Dentistry, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
| | | | | | - Eva Lis Lopes Leite
- Department of Operative Dentistry, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
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Silva DP, Resende BA, Kury M, André CB, Tabchoury C, Giannini M, Cavalli V. Intrapulpal Concentration of Hydrogen Peroxide of Teeth Restored With Bulk Fill and Conventional Bioactive Composites. Oper Dent 2021; 46:E158-E170. [PMID: 34662908 DOI: 10.2341/20-091-l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2020] [Indexed: 11/23/2022]
Abstract
This study evaluated intrapulpal concentration and hydrogen peroxide (HP) penetration at the interface of teeth restored with bioactive composites, using conventional or bulk-fill composites. Cylindrical cavities were prepared on the buccal surface of bovine incisor crowns (n=20) and restored with: resin modified glass-ionomer (RMGI, Riva Light Cure, SDI), non-bioactive bulk-fill composite (FB, Filtek Bulk, 3M Oral Care), non-bioactive conventional composite (FZ, Filtek Z350, 3M Oral Care), bioactive bulk-fill composite (AC, Activa BioActive, Pulpedent), and bioactive conventional composite (BII, Beautifil II, Shofu). After 5,000 thermal cycles, restorations (n=10) were exposed to high (35% HP [4 applications of 8 min/session-4 sessions]) or low (9.5% HP [30 min/day-14 days]) concentration bleaching protocols. After the last bleaching application, the HP intrapulpal concentration was determined. Additional teeth were restored, pigmented with rhodamine B solution, and HP penetration around the interface was observed under laser scanning confocal fluorescence microscopy (LSCFM, n=3). The presence of gaps at the interface was observed on replicas of the cross-sectioned samples under scanning electron microscopy (SEM, n=5). Data were submitted to one-way (gap analysis) and twoway analysis of variance (ANOVA; HP intrapulpal concentration) and Tukey test (α=0.05). The LSCFM images were qualitatively analyzed. The restored teeth submitted to 35% HP presented higher HP intrapulpal concentration than teeth submitted to 9.5% HP (p<0.05). No differences in HP intrapulpal concentration was observed among groups (p>0.05) when exposed to 9.5% HP. Lower HP intrapulpal concentration was observed for teeth restored with RMGI exposed to HP 35%, when compared with teeth restored with nonbioactive conventional (FZ; p=0.004) and bulk-fill composites (FB; p=0.01). No gap formation was observed at the outer enamel adhesive interface for all restorative materials. LSCFM images showed that 35% HP promoted greater degradation of rhodamine B at the enamel, except for RMGI. In this context, RMGI promoted lower HP intrapulpal concentration than non-bioactive conventional and bulk-fill composites.
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Besegato JF, Silva AM, de Almeida ENM, Rastelli ANDS, Takahashi R, Dezan-Garbelini CC, Hoeppner MG. Microstructural effect of a laser-activated bleaching agent containing titanium dioxide on human enamel. J Conserv Dent 2021; 23:558-562. [PMID: 34083909 PMCID: PMC8095693 DOI: 10.4103/jcd.jcd_312_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 04/04/2020] [Accepted: 08/12/2020] [Indexed: 11/17/2022] Open
Abstract
Aim: This study aimed to evaluate the effect of a laser-activated bleaching agent containing titanium dioxide (TiO2) nanoparticles on enamel roughness and hardness. Materials and Methods: Twenty human premolars were randomized into two groups according to the bleaching treatments performed: HP – 35% hydrogen peroxide and HP + TiO2 – 30% hydrogen peroxide containing TiO2 light-activated by diode laser (980 nm). It was performed two bleaching sessions with an interval of 7 days. Microhardness and roughness of the enamel were assessed at three times: T0 – Before 1st appointment, T1 – after 2nd appointment, and T2–7 days after 2nd appointment. Results: The HP + TiO2 did not cause changes on enamel roughness and hardness and presented the same effects of the HP. Conclusions: Both bleaching agents showed no difference between them. Then, it is possible to conclude that both are viable for clinical use during in-office dental bleaching technique regarding the microstructural changes that they might cause.
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Affiliation(s)
- João Felipe Besegato
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Aryvelto Miranda Silva
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Eran Nair Mesquita de Almeida
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | | | - Ricardo Takahashi
- Department of Oral Medicine and Paediatric Dentistry, State University of Londrina - UEL, Londrina, PR, Brazil
| | | | - Márcio Grama Hoeppner
- Department of Restorative Dentistry, State University of Londrina - UEL, Londrina, PR, Brazil
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Carminatti M, Benetti F, Siqueira RL, Zanotto ED, Briso ALF, Chaves-Neto AH, Cintra LTA. Experimental gel containing bioactive glass-ceramic to minimize the pulp damage caused by dental bleaching in rats. J Appl Oral Sci 2020; 28:e20190384. [PMID: 32520077 PMCID: PMC7299561 DOI: 10.1590/1678-7757-2019-0384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/17/2020] [Indexed: 12/26/2022] Open
Abstract
Objectives This study evaluated if the use of a bioactive glass-ceramic-based gel, named Biosilicate (BS), before, after or mixed with bleaching gel, could influence the inflammation of the dental pulp tissue of rats’ molars undergoing dental bleaching with hydrogen peroxide (H2O2). Methodology The upper molars of Wistar rats (Rattus norvegicus, albinus) were divided into Ble: bleached (35% H2O2, 30-min); Ble-BS: bleached and followed by BS-based gel application (20 min); BS-Ble: BS-based gel application and then bleaching; BS/7d-Ble: BS-based gel applications for 7 days and then bleaching; Ble+BS: blend of H2O2 with BS-based gel (1:1, 30-min); and control: placebo gel. After 2 and 30 days (n=10), the rats were euthanized for histological evaluation. The Kruskal-Wallis and Dunn statistical tests were performed (P<0.05). Results At 2 days, the Ble and Ble-BS groups had significant alterations in the pulp tissue, with an area of necrosis. The groups with the application of BS-based gel before H2O2 had moderate inflammation and partial disorganization in the occlusal third of the coronary pulp and were significantly different from the Ble in the middle and cervical thirds (P<0.05). The most favorable results were observed in the Ble+BS, which was similar to the control in all thirds of the coronary pulp (P>0.05). At 30 days, the pulp tissue was organized and the bleached groups presented tertiary dentin deposition. The Ble group had the highest deposition of tertiary dentin, followed by the Ble-BS, and both were different from control (P<0.05). Conclusion A single BS-based gel application beforehand or BS-based gel blended with a bleaching gel minimize the pulp damage induced by dental bleaching.
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Affiliation(s)
- Marina Carminatti
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brazil
| | - Francine Benetti
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brazil.,Universidade Federal de Minas Gerais (UFMG), Faculdade de Odontologia, Departamento de Odontologia Restauradora, Belo Horizonte, MG, Brazil
| | - Renato Luiz Siqueira
- Universidade Federal de São Carlos (UFSCar), Departamento de Engenharia de Materiais, Laboratório de Materiais Vitreos, São Carlos, SP, Brazil
| | - Edgar Dutra Zanotto
- Universidade Federal de São Carlos (UFSCar), Departamento de Engenharia de Materiais, Laboratório de Materiais Vitreos, São Carlos, SP, Brazil
| | - André Luiz Fraga Briso
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brazil
| | - Antônio Hernandes Chaves-Neto
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Ciências Básicas, Araçatuba, SP, Brazil
| | - Luciano Tavares Angelo Cintra
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Preventiva e Restauradora, Araçatuba, SP, Brazil
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da Silva LMAV, Cintra LTA, Gallinari MDO, Benetti F, Rahal V, Ervolino E, de Alcântara S, Briso ALF. Influence of pain-relieving therapies on inflammation and the expression of proinflammatory neuropeptides after dental bleaching treatment. Restor Dent Endod 2020; 45:e20. [PMID: 32483537 PMCID: PMC7239683 DOI: 10.5395/rde.2020.45.e20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/11/2022] Open
Abstract
Objectives To minimize the tooth sensitivity caused by in-office bleaching, many dentists use non-steroidal anti-inflammatory drugs and topical desensitizing gels containing potassium nitrate and sodium fluoride. This study aimed to evaluate the influence of these substances on inflammation and the expression of substance P and calcitonin gene-related peptide in pulp nerve fibers. Materials and Methods Seventy-two rats were divided into 6 groups as follows: GI, control; GII, only dental bleaching; GIII, only ibuprofen; GIV, ibuprofen administered 30 minutes before and after the bleaching treatment and every 12 hours until the analysis; GV, only topical application of a desensitizing agent; and GVI, topical application of a desensitizing agent before dental bleaching. Placebo gel was applied to the upper left jaw and the bleaching agent was applied to the upper right jaw in all groups. Subsequently, the groups were divided into 3 subgroups based on the time of analysis: 0, 24, and 48 hours after bleaching (n = 8). The rats were euthanized and the maxillae were processed and evaluated by histopathological and immunohistochemical analyses. The data were analyzed using the Kruskal-Wallis test, followed by the Dunn test (p < 0.05). Results In the bleaching groups, the inflammatory process and expression of neuropeptides decreased over time. The animals in which a desensitizing agent was applied showed better results within 24 hours. Conclusions The use of a desensitizing agent had positive effects on inflammation and pain-related neuropeptide expression, minimizing the painful effects of dental bleaching treatment.
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Affiliation(s)
| | | | | | - Francine Benetti
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Vanessa Rahal
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Sibele de Alcântara
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - André Luiz Fraga Briso
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
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Terayama AM, Benetti F, de Araújo Lopes JM, Barbosa JG, Silva IJP, Sivieri-Araújo G, Briso ALF, Cintra LTA. Influence of low-level laser therapy on inflammation, collagen fiber maturation, and tertiary dentin deposition in the pulp of bleached teeth. Clin Oral Investig 2020; 24:3911-3921. [PMID: 32198660 DOI: 10.1007/s00784-020-03258-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/06/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We evaluated the effects of low-level laser therapy (LLLT) using an infrared laser (IRL) and a red laser (RL) on the pulp of molar teeth in rats after dental bleaching to assess inflammation, collagen fiber maturation, and tertiary dentin formation. MATERIALS AND METHODS Eighty Wistar rats (Rattus norvegicus, albinus) were randomly divided into eight groups with 10 hemimaxillae in each of the following: control; bleached (Ble, 35% hydrogen peroxide [H2O2]); Ble-1IRL and Ble-1RL (one IRL [808 nm, 30 s, 3 J] or RL [660 nm, 15 s, 1.5 J] application immediately after H2O2); Ble-3IRL and Ble-3RL (three [immediately, 24 h, and 48 h] IRL or RL applications after H2O2); and 3IRL and 3RL (three IRL or RL applications without bleaching). The rats were euthanized after 2 and 30 days for histological evaluation of inflammation (hematoxylin-eosin) and maturation of collagen fibers (picrosirius red). Additionally, the dentin deposition in the specimens obtained at 30 days was quantified via microtomography of the pulp chamber volume. Statistical analyses were performed (P < 0.05). RESULTS Initially, severe damages to the pulp were observed in the Ble and Ble-1RL groups. Ble-1IRL and Ble-3RL groups showed lower inflammation. The bleached groups had a greater amount of mature collagen fibers than the control group. The Ble-3IRL group had a greater number of immature fibers than the Ble group. At 30 days, there was an absence of inflammation and equal proportion of mature and immature collagen fibers. All bleached groups showed a reduction in the volume of the pulp chamber. CONCLUSION Three consecutive applications of RL and one IRL application can minimize damage to the pulp of bleached teeth, whereas three IRL applications can minimize pulp fibrosis. However, LLLT did not prevent deposition of tertiary dentin. CLINICAL RELEVANCE This study describes LLLT protocols capable of minimizing inflammation and maturation of collagen fibers in pulp tissue after dental bleaching. However, the protocols proved insufficient for reducing the formation of tertiary dentin in bleached teeth.
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Affiliation(s)
- Amanda Miyuki Terayama
- Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Francine Benetti
- Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil.,Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | | | | | - Gustavo Sivieri-Araújo
- Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - André Luiz Fraga Briso
- Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
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Benetti F, Briso ALF, de Araújo Lopes JM, Carminatti M, Conti LC, Gallinari MO, Ervolino E, Cintra LTA. In vivo analysis of the presence of heme oxygenase-1, transcription factor Jun-D and CD90+/CD73+/CD105+/CD45- cells in the pulp of bleached teeth. Int Endod J 2019; 52:1723-1737. [PMID: 31322737 DOI: 10.1111/iej.13190] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 07/16/2019] [Indexed: 12/27/2022]
Abstract
AIM To investigate hydrogen peroxide (H2 O2 )-induced responsiveness in pulp cells using heme oxygenase-1 (HO-1) immunolabelling, Jun-D immunolabelling to study the effects of H2 O2 on odontoblastic differentiation and CD90+/CD73+/CD105+/CD45- cell counting for in vivo identification of mesenchymal stem cells in the pulp. METHODOLOGY The maxillary molars of 50 rats were treated with a bleaching gel (35% H2 O2 , 1 × 30 min) or placebo gel (control groups). At 2, 3, 7, 15 and 30 days after the treatment (n = 10), inflammation in pulp tissue was analysed by haematoxylin-eosin staining, HO-1- and Jun-D-immunolabelled cells were counted in each third of the pulp chamber, and the number of CD90+/CD73+/CD105+/CD45- cells was quantified by immunofluorescence. The results were assessed using the Paired t-test or Wilcoxon signed-rank test (P < 0.05). RESULTS Significant H2 O2 -induced inflammation was noted at 2 and 3 days (P < 0.05), with tertiary dentine formation occurring from 7 days. The bleached specimens had greater HO-1 immunolabelling in the middle and cervical thirds of the coronal pulp at 2 and 3 days, in all thirds at 7 days, and in the occlusal third at 15 days (P < 0.05), and significant nuclear Jun-D immunolabelling in the cervical third at 2 and 3 days and in the occlusal and middle thirds at 7 days (P < 0.05). Bleached and control groups had low numbers of CD90+/CD73+/CD105+/CD45- cells in the pulp at all periods (P > 0.05). CONCLUSIONS Pulp cells responded to oxidative stress by expressing HO-1 during the post-bleaching inflammation phase until the beginning of the repair phase. Jun-D expression occurred during the reduction of inflammation and the beginning of tertiary dentine production. The presence of oxidative stress did not influence the number of CD90+/CD73+/CD105+/CD45- cells identified in vivo in the dental pulp.
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Affiliation(s)
- F Benetti
- Department of Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil.,Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - A L F Briso
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - J M de Araújo Lopes
- Department of Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - M Carminatti
- Department of Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - L C Conti
- Department of Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - M O Gallinari
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - E Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - L T A Cintra
- Department of Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
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Soares DG, Marcomini N, Duque CCDO, Bordini EAF, Zuta UO, Basso FG, Hebling J, Costa CADS. Increased whitening efficacy and reduced cytotoxicity are achieved by the chemical activation of a highly concentrated hydrogen peroxide bleaching gel. J Appl Oral Sci 2019; 27:e20180453. [PMID: 31411261 DOI: 10.1590/1678-7757-2018-0453] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 11/28/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study was designed for the chemical activation of a 35% hydrogen peroxide (H2O2) bleaching gel to increase its whitening effectiveness and reduce its toxicity. METHODOLOGY First, the bleaching gel - associated or not with ferrous sulfate (FS), manganese chloride (MC), peroxidase (PR), or catalase (CT) - was applied (3x 15 min) to enamel/dentin discs adapted to artificial pulp chambers. Then, odontoblast-like MDPC-23 cells were exposed for 1 h to the extracts (culture medium + components released from the product), for the assessment of viability (MTT assay) and oxidative stress (H2DCFDA). Residual H2O2 and bleaching effectiveness (DE) were also evaluated. Data were analyzed with one-way ANOVA complemented with Tukey's test (n=8. p<0.05). RESULTS All chemically activated groups minimized MDPC-23 oxidative stress generation; however, significantly higher cell viability was detected for MC, PR, and CT than for plain 35% H2O2 gel. Nevertheless, FS, MC, PR, and CT reduced the amount of residual H2O2 and increased bleaching effectiveness. CONCLUSION Chemical activation of 35% H2O2 gel with MC, PR, and CT minimized residual H2O2 and pulp cell toxicity; but PR duplicated the whitening potential of the bleaching gel after a single 45-minute session.
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Affiliation(s)
- Diana Gabriela Soares
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, São Paulo, Brasil
| | - Natália Marcomini
- Universidade Estadual Paulista - UNESP, Faculdade de Odontologia de Araraquara, Departamento de Dentística Restauradora, Araraquara, São Paulo, Brasil
| | - Carla Caroline de Oliveira Duque
- Universidade Estadual Paulista - UNESP, Faculdade de Odontologia de Araraquara, Departamento de Materiais Dentários e Prótese, Araraquara, São Paulo, Brasil
| | - Ester Alves Ferreira Bordini
- Universidade Estadual Paulista - UNESP, Faculdade de Odontologia de Araraquara, Departamento de Materiais Dentários e Prótese, Araraquara, São Paulo, Brasil
| | - Uxua Ortecho Zuta
- Universidade Estadual Paulista - UNESP, Faculdade de Odontologia de Araraquara, Departamento de Materiais Dentários e Prótese, Araraquara, São Paulo, Brasil
| | - Fernanda Gonçalves Basso
- Universidade Estadual Paulista - UNESP, Faculdade de Odontologia de Araraquara, Departamento de Fisiologia e Patologia, Araraquara, São Paulo, Brasil
| | - Josimeri Hebling
- Universidade Estadual Paulista - UNESP, Faculdade de Odontologia de Araraquara, Departamento de Clínica Infantil, Araraquara, São Paulo, Brasil
| | - Carlos Alberto de Souza Costa
- Universidade Estadual Paulista - UNESP, Faculdade de Odontologia de Araraquara, Departamento de Fisiologia e Patologia, Araraquara, São Paulo, Brasil
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31
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Sabel N, Karlsson A, Sjölin L. XRMA analysis and X-ray diffraction analysis of dental enamel from human permanent teeth exposed to hydrogen peroxide of varying pH. J Clin Exp Dent 2019; 11:e512-e520. [PMID: 31346370 PMCID: PMC6645263 DOI: 10.4317/jced.55618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 04/25/2019] [Indexed: 11/26/2022] Open
Abstract
Background This in vitroinvestigation shows how 3.3% H2O2, at different pH-values affects the enamel. Material and Methods A number of fifteen human premolars were used. The enamel of the coronal half in six of the teeth, were exposed by H2O2. Nine teeth were prepared to enamel powder. The enamel was exposed to 3.3% H2O2, at six different pH-values (pH range 4.5 - 7.0). Analyses of the topography of enamel performed by scanning electron microscope (SEM) and the chemical composition of enamel by X-ray microanalysis (XRMA). X-ray powder diffraction (XRD) analysed the crystallinity in enamel powder. Results The exposure to H2O2 at pH<5.5 resulted in a rougher topography of the enamel, according to the SEM studies. The XRMA analysis revealed a increase in the ratio of Ca:C. Exposure to H2O2 at pH>5.5 resulted in a decrease of O in the exposed enamel, and changes in C:P, Ca:C, Ca:P and Ca:O were observed. The H2O22 did not affect the unit cell parameters, but the signal-to-noise level was increased for slightly acidic or neutral solutions. The unit cell parameters decreased in the acidic solutions. Conclusions The exposure to H2O2 at varying pH values affect the enamel with two different mechanisms. One effect is the oxidation of the organic or bioorganic matter in the hydroxyapatite matrix, due to the use of 3.3% H2O2. The other effect is due to the current pH of the H2O2, since the structure of the hydroxyapatite starts to erode when the pH<5.5. Key words:Dental Enamel, Tooth Bleaching Agents, Hydrogen Peroxide, Scanning Electron Microscopy, X-ray diffraction.
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Affiliation(s)
- Nina Sabel
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andreas Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lennart Sjölin
- Department of Chemical and Biological Engineering, Chalmers University of Technology, Göteborg, Sweden
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Barbosa JG, Benetti F, de Oliveira Gallinari M, Carminatti M, da Silva ABD, Lopes INI, Briso ALF, Cintra LTA. Bleaching gel mixed with MI Paste Plus reduces penetration of H 2O 2 and damage to pulp tissue and maintains bleaching effectiveness. Clin Oral Investig 2019; 24:1299-1309. [PMID: 31302769 DOI: 10.1007/s00784-019-03009-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 07/03/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES MI Paste Plus remineralizer (Rem) strengthens dental structures after bleaching. We investigated the effect of Rem on the penetration of hydrogen peroxide (H2O2), bleaching effectiveness, and pulp inflammation after bleaching. MATERIALS AND METHODS Bovine disks were grouped as follows (n = 10): control (untreated), bleached (Ble; 35% H2O2, 30 min), Ble-Rem (H2O2 followed by Rem, 30 min), Rem-Ble (Rem followed by H2O2), Rem-Ble-Rem (Rem before and after H2O2), and Ble+Rem (mixture of Rem with H2O2, 1:1, 30 min). The penetration of H2O2 was quantified and bleaching efficacy was analyzed. Upper rat molars (n = 10) received the same treatments at random. The rats were euthanized after two days and 30 days, and their jaws were removed for histological analysis. Statistical tests were performed (P < 0.05). RESULTS The bleached groups, except Ble+Rem (P > 0.05), showed significant H2O2 penetration compared with control (P < 0.05). Color alteration analysis showed that ΔL and ΔE were significantly higher in the bleached groups than those in control (P < 0.05); the Δb of the bleached groups differed from that of control at 24 h (P < 0.05). At two days, necrosis or inflammation was observed in the bleached groups compared with control (P < 0.05), except Ble+Rem, which was similar to control (P > 0.05). At 30 days, tertiary dentin formation was significant in the bleached groups (P < 0.05), except Ble+Rem (P > 0.05). CONCLUSION The mixture of MI Paste Plus and bleaching gel reduces H2O2 penetration and pulp damage and maintains bleaching effectiveness. CLINICAL RELEVANCE Because bleaching can damage dental tissues, we studied a new bleaching protocol that reduces damage to the pulp tissue while maintaining bleaching efficiency: a single application of 30 min of MI Paste Plus mixed with 35% H2O2 bleaching gel (1:1).
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Affiliation(s)
- Jéssica Galbiati Barbosa
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
| | - Francine Benetti
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
- Restorative Dentistry, School of Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Marina Carminatti
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
| | - Anna Beatriz Dias da Silva
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
| | | | - André Luiz Fraga Briso
- Department of Restorative Dentistry, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
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33
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Llena C, Collado-González M, García-Bernal D, Oñate-Sánchez RE, Martínez CM, Moraleda JM, Rodríguez-Lozano FJ, Forner L. Comparison of diffusion, cytotoxicity and tissue inflammatory reactions of four commercial bleaching products against human dental pulp stem cells. Sci Rep 2019; 9:7743. [PMID: 31123303 PMCID: PMC6533274 DOI: 10.1038/s41598-019-44223-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/08/2019] [Indexed: 12/23/2022] Open
Abstract
Multiple side effects related to bleaching were found to occur in the dental pulp tissue, including decreased cell metabolism and viability. In this work we evaluated the in vitro diffusion capacity, cytotoxicity and biocompatibility of four commercial bleaching products on stem cells from human dental pulp (hDPSCs). Two commercial bleaching gels hydrogen peroxide-based (HP), Norblanc Office 37.5% (Nor-HP) and Opalescence Boost 40% (Opal-HP) were applied for 30 min to enamel/dentine discs. Another two gels from the same manufacturers, 16% carbamide peroxide-based (CP), Norblanc Home (Nor-CP) and Opalescence CP 16% (Opal-CP), were applied for 90 min. The diffusion of HP was analysed by fluorometry. Cytotoxicity was determined using the MTT assays, the determination of apoptosis, immunofluorescence assays and intracellular reactive oxygen species (ROS) level. Tissue inflammatory reactions were evaluated histopathologically in rats. Statistical differences were performed by one-way ANOVA and Bonferroni post-test (α < 0.05). Normon products showed lower cytotoxicity and diffusion capacity than the Ultradent products. A high intracellular ROS level was measured in hDPSCs after exposure to Opal-HP. Finally, a severe necrosis of both coronal and radicular pulp was observed with Opal-HP. Similar concentrations of hydrogen peroxide and carbamide peroxide in a variety of bleaching products exhibited different responses in cells and dental pulp tissue, suggesting that bleaching products contain unknown agents that could influence their toxicity.
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Affiliation(s)
- C Llena
- Department of Stomatology, Universitat de València, Valencia, Spain
| | - M Collado-González
- Department of Stomatology, Universitat de València, Valencia, Spain.,Unit of Special Care in Dentistry and Cell Therapy and Hematopoietic Transplant Unit, Internal Medicine Department, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - D García-Bernal
- Unit of Special Care in Dentistry and Cell Therapy and Hematopoietic Transplant Unit, Internal Medicine Department, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - R E Oñate-Sánchez
- Unit of Special Care in Dentistry and Cell Therapy and Hematopoietic Transplant Unit, Internal Medicine Department, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - C M Martínez
- Experimental Pathology Unit, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - J M Moraleda
- Unit of Special Care in Dentistry and Cell Therapy and Hematopoietic Transplant Unit, Internal Medicine Department, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - F J Rodríguez-Lozano
- Unit of Special Care in Dentistry and Cell Therapy and Hematopoietic Transplant Unit, Internal Medicine Department, IMIB-Arrixaca, University of Murcia, Murcia, Spain.
| | - L Forner
- Department of Stomatology, Universitat de València, Valencia, Spain
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34
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Benetti F, Briso ALF, Ferreira LL, Carminatti M, Álamo L, Ervolino E, Dezan-Júnior E, Cintra LTA. In Vivo Study of the Action of a Topical Anti-Inflammatory Drug In Rat Teeth Submitted To Dental Bleaching. Braz Dent J 2019; 29:555-561. [PMID: 30517478 DOI: 10.1590/0103-6440201802177] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/13/2018] [Indexed: 12/11/2022] Open
Abstract
Bleaching gel containing hydrogen peroxide (H2O2) cause damages in pulp tissue. This study investigated the action of a topical anti-inflammatory, the Otosporin®, in rats' bleached teeth with the null hypothesis of which the Otosporin® is no able to minimize the pulp inflammation that bleaching gel generates. The rat's molars were divided into groups: BLE: bleached (35% H2O2 concentration /single application of 30 min); BLE-O: bleached followed by Otosporin® (10 min); and control: placebo gel. In the second day after dental bleaching, the rats were killed, and the jaws were processed for hematoxylin-eosin and immunohistochemistry analysis for tumor necrosis factor alpha (TNF-α), interleukin (IL)-6 and IL-17. The data collected were subjected to Kruskal-Wallis and Dunn statistical tests with at a 5% level of significance (p<0.05). The BLE group had moderate to strong inflammation in the occlusal third of the coronary pulp, with necrotic areas; and BLE-O, mild inflammation (p<0.05). There was a significant difference in the occlusal and middle thirds of the coronary pulp between the BLE with BLE-O and control groups (p<0.05). There was no difference in the cervical third (p>0.05). The BLE group had a high immunoexpression of TNF-α than BLE-O and control groups (p<0.05), with moderate and mild immunoexpression, respectively. Regarding IL-6 and IL-17, the BLE group had higher immunoexpression than control (p<0.05); the BLE-O was similar to the control (p>0.05). The topical anti-inflammatory Otosporin® can reduce pulp inflammation after dental bleaching in the rat teeth.
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Affiliation(s)
- Francine Benetti
- Endodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - André Luiz Fraga Briso
- Restorative Dentistry, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Luciana Louzada Ferreira
- Endodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Marina Carminatti
- Endodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Larissa Álamo
- Endodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Edilson Ervolino
- Basic Science, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Eloi Dezan-Júnior
- Endodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
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35
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Lorena Ferreira L, Ana Helena Gonçalves de A, Decurcio DDA, Silva JA, Favarão IN, Loureiro MAZ, Barletta FB, Estrela C. Effect of dental bleaching on pulp oxygen saturation in maxillary central incisors - a randomized clinical trial. J Appl Oral Sci 2019; 27:e20180442. [PMID: 30994776 PMCID: PMC6459226 DOI: 10.1590/1678-7757-2018-0442] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/07/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess pulp oxygen saturation levels (SaO2) in maxillary central incisors after dental bleaching. MATERIALS AND METHODS 80 participants (160 teeth) were randomly allocated to four groups: G1 In-office bleaching with two applications of 35% hydrogen peroxide (HP) (20 minutes), followed by at-home bleaching with 10% carbamide peroxide (CP) (2 hours/day for 16 days); G2 - Same protocol as G1, plus desensitizing toothpaste; G3 - In-office bleaching with 35% HP and one application of placebo gel (20 minutes), followed by at-home bleaching with 10% CP (2 hours/day for 16 days); and G4 - Same protocol as G3, plus desensitizing toothpaste. Pulp SaO2 levels were measured before (T0) and immediately after (T1) in-office bleaching; on the 5th (T2), 8th (T3), 12th (T4), and 16th days of at-home bleaching (T5); and on the 7th (T6) and 30th (T7) days. Mean (SD) pulp SaO2 levels were compared within groups by generalized estimating equations (GEE) and Student's t-test (P<0.05). RESULTS Mean pulp SaO2 at T0 was 84.29% in G1, 84.38% in G2, 84.79% in G3, and 85.83% in G4. At T1, these values decreased to 81.96%, 82.06%, 82.19%, and 81.15% in G1, G2, G3, and G4 respectively, with significant difference in G4 (P<0.05). During home bleaching, pulp SaO2 levels varied in all groups, with 86.55%, 86.60%, 85.71%, and 87.15% means at T7 for G1, G2, G3, and G4, respectively; G2 presented significant difference (P<0.05). CONCLUSIONS Pulp SaO2 level in maxillary central incisors was similar at baseline, reducing immediately after in-office bleaching, regardless of using desensitizing toothpaste and increasing at 30 days after dental bleaching.
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Affiliation(s)
- Lima Lorena Ferreira
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, Goiás, Brazil
| | | | - Daniel de Almeida Decurcio
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, Goiás, Brazil
| | - Julio Almeida Silva
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, Goiás, Brazil
| | - Isabella Negro Favarão
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, Goiás, Brazil
| | - Marco Antônio Zaiden Loureiro
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, Goiás, Brazil
| | - Fernando Branco Barletta
- Universidade Luterana do Brasil, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Canoas, Rio Grande do Sul, Brazil
| | - Carlos Estrela
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, Goiás, Brazil
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Huang S, Zheng B, Jin X, Yu Q, Zhang X, Sun X, Chen Y, Ren X, Wismeijer D, Ma J, Zhang C, Wu G, Pan Y. Blockade of Cyclophilin D Attenuates Oxidative Stress-Induced Cell Death in Human Dental Pulp Cells. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:1729013. [PMID: 31089403 PMCID: PMC6476071 DOI: 10.1155/2019/1729013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 01/03/2019] [Accepted: 02/16/2019] [Indexed: 12/13/2022]
Abstract
Pathological stimuli, such as bacterial activity, dental bleaching, and nonpolymerized resin monomers, can cause death of dental pulp cells (DPCs) through oxidative stress- (OS-) induced mitochondrial dysfunction. However, the crucial molecular mechanisms that mediate such a phenomenon remain largely unknown. OS is characterized by the overproduction of reactive oxygen species (ROS), e.g., H2O2, O2 -, and ·OH. Mitochondria are a major source of ROS and the principal attack target of ROS. Cyclophilin D (CypD), as the only crucial protein for mitochondrial permeability transition pore (mPTP) induction, facilitates the opening of mPTP and causes mitochondrial dysfunction, leading to cell death. In the present study, we hypothesized that CypD-mediated mitochondrial molecular pathways were closely involved in the process of OS-induced death of human DPCs (HDPCs). We tested the phenotypic and molecular changes of HDPCs in a well-established OS model-H2O2 treatment. We showed that H2O2 dramatically reduced the viability and increased the death of HDPCs in a time- and dose-dependent manner by performing MTT, flow cytometry, and TUNEL assays and quantifying the expression changes of Bax and Bcl-2 proteins. H2O2 also induced mitochondrial dysfunction, as reflected by the increased mitochondrial ROS, reduced ATP production, and activation of mPTP (decreased mitochondrial membrane potential and enhanced intracellular Ca2+ level). An antioxidant (N-acetyl-L-cysteine) effectively preserved mitochondrial function and significantly attenuated H2O2-induced cytotoxicity and death. Moreover, H2O2 treatment markedly upregulated the CypD protein level in HDPCs. Notably, genetic or pharmacological blockade of CypD significantly attenuated H2O2-induced mitochondrial dysfunction and cell death. These findings provided novel insights into the role of a CypD-dependent mitochondrial pathway in the H2O2-induced death in HDPCs, indicating that CypD may be a potential therapeutic target to prevent OS-mediated injury in dental pulp.
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Affiliation(s)
- Shengbin Huang
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, Netherlands
| | - Bingbing Zheng
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
- Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xing Jin
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
- Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Qihao Yu
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
- Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xiaorong Zhang
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
- Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xiaoyu Sun
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Yuting Chen
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xuerui Ren
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
- Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Daniel Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, Netherlands
| | - Jianfeng Ma
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Chengfei Zhang
- Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Gang Wu
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, Netherlands
| | - Yihuai Pan
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
- Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
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Louzada LM, Briso ALF, Benetti F, Vieira LB, de Castilho Jacinto R, Dezan-Júnior E, Cintra LTA. Anti-inflammatory potential of a carvedilol gel in the pulpal tissue of rats after dental bleaching: A histopathological evaluation. JOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY 2019; 10:e12401. [PMID: 30693672 DOI: 10.1111/jicd.12401] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/02/2018] [Accepted: 12/07/2018] [Indexed: 12/01/2022]
Abstract
AIM Carvedilol is an antioxidant that decreases inflammation in periodontitis. The hydrogen peroxide (H2 O2 ) of bleaching gel causes inflammation and necrosis of the dental pulp. In the present study, we evaluated the anti-inflammatory potential of carvedilol in the pulp of rats after bleaching. METHODS The right upper molars of rats received 35% H2 O2 (1× 30 minutes), and the left upper molars were used as the control. Half of the rats received carvedilol gel (1× 10 minutes), forming the following groups: bleached, bleached followed by carvedilol (bleached+carvedilol), and control. After 2 and 30 days (N = 7 hemi-maxillae/group), the rats were killed for histological evaluation, and statistical tests were performed (P < 0.05). RESULTS After 2 days, the bleached group showed necrosis in the occlusal third of the coronal pulp, and in the bleached+carvedilol group, severe inflammation (P > 0.05), both different from the control (P < 0.05). In the middle third, the bleached group showed severe inflammation, and the bleached+carvedilol group showed moderate inflammation (P > 0.05), with the only difference between the bleached and control groups (P < 0.05). In the cervical third, the bleached group showed moderate inflammation, and the bleached+carvedilol group showed mild inflammation (P > 0.05). The difference again was only between the bleached and control groups (P < 0.05). At 30 days, there was no inflammation and a marked amount of tertiary dentin in bleached teeth (P > 0.05). CONCLUSION Carvedilol gel has the potential of minimizing H2 O2 damage, especially in deep regions of the dental pulp of rats after bleaching.
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Affiliation(s)
- Lidiane M Louzada
- School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - André L F Briso
- School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Francine Benetti
- School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Letícia B Vieira
- School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | | | - Elói Dezan-Júnior
- School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Luciano T A Cintra
- School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
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Gallinari MDO, Cintra LTÂ, Benetti F, Rahal V, Ervolino E, Briso ALF. Pulp response of rats submitted to bleaching and the use of different anti-inflammatory drugs. PLoS One 2019; 14:e0210338. [PMID: 30620760 PMCID: PMC6324791 DOI: 10.1371/journal.pone.0210338] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 12/20/2018] [Indexed: 11/19/2022] Open
Abstract
This study aimed to evaluate neuropeptide expression after bleaching treatment using histopathological and immunohistochemical analyses and the effects of hydrocortisone and acetaminophen on pulp inflammation, sine dental bleaching and inflammation first occur, and only then, the treatmentt. Sixty-three rats were divided into three groups (n = 21) according to the pain-relieving therapy used: I-control; II-topical application of Otosporin for 10 min after the bleaching treatment; III-oral administration of paracetamol 30 min before whitening and then every 12h. In all the study groups, placebo gel was applied to the left upper jaw (control) and a 35% H2O2-based whitening gel was applied to the right upper jaw for 45 min. Seven animals from each group were euthanized at different time points: 0h after treatment, 24h, and 48h. After euthanasia, the first molar on each side was analyzed by histology and immunohistochemistry to assess the degree of inflammation and verify the presence of the neuropeptides, substance P (SP) and calcitonin gene-related peptide (CGRP). The data were analyzed using the statistical nonparametric Kruskal-Wallis test followed by Dunn's test for individual comparisons. Extensive areas of necrosis were observed in the groups that received bleaching treatment only, whereas reduced damage were obtained in the group treated with Otosporin. The immunohistochemical analysis showed positive immunolabeling in all groups, including the control, but this was stronger in the groups that received bleaching treatment. The best results were obtained in the group that received treatment with Otosporin. The use of Otosporin after dental bleaching minimized the side effects of this treatment.
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Affiliation(s)
- Marjorie de Oliveira Gallinari
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Luciano Tavares Ângelo Cintra
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Vanessa Rahal
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - André Luiz Fraga Briso
- Department of Restorative Dentistry, Araçatuba Dental School, UNESP—Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
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Benetti F, Briso ALF, Carminatti M, de Araújo Lopes JM, Barbosa JG, Ervolino E, Gomes-Filho JE, Cintra LTA. The presence of osteocalcin, osteopontin and reactive oxygen species-positive cells in pulp tissue after dental bleaching. Int Endod J 2018; 52:665-675. [PMID: 30488465 DOI: 10.1111/iej.13049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 11/23/2018] [Indexed: 01/24/2023]
Abstract
AIM To analyse the influence of H2 O2 on pulp repair through osteocalcin and osteopontin immunolabelling and in cellular defence by using the antireactive oxygen species (ROS) antibody. METHODOLOGY The maxillary molars of 50 rats were treated with 35% H2 O2 (Ble groups) or placebo gel (control groups). At 0 h and 2, 7, 15 and 30 days (n = 10 hemimaxillae), the rats were killed and pulp tissue was evaluated using inflammation and immunolabelling scores (osteocalcin/osteopontin); ROS-positive cells were counted. Paired t-test and Wilcoxon signed-rank test were used (P < 0.05). RESULTS The Ble group had necrosis in the coronal pulp at 0 h and in the occlusal third of the coronal pulp at 2 days; at 7, 15 and 30 days, no inflammation was noted similar to the controls (P > 0.05). Osteocalcin was absent in the Ble at 0 h, moderate at 2 days and increased thereafter, differing from the controls at all two periods (P < 0.05). Osteopontin was higher principally at 7 and 15 days in Ble groups, but differing with control groups from 2 days after bleaching (P < 0.05). The Ble group had more ROS-positive cells in the pulp at 7 and 15 days (P < 0.05). Tertiary dentine was observed at 7 days, increasing thereafter (P < 0.05). CONCLUSIONS Post-bleaching pulp repair was associated with increased osteocalcin over time. Osteopontin also participated in this process, and anti-ROS was involved in cellular defence against H2 O2 .
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Affiliation(s)
- F Benetti
- Department of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - A L F Briso
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - M Carminatti
- Department of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - J M de Araújo Lopes
- Department of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - J G Barbosa
- Department of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - E Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - J E Gomes-Filho
- Department of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - L T A Cintra
- Department of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
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de Paula B, Alencar C, Ortiz M, Couto R, Araújo J, Silva C. Effect of photobiomodulation with low-level laser therapy combined with potassium nitrate on controlling post-bleaching tooth sensitivity: clinical, randomized, controlled, double-blind, and split-mouth study. Clin Oral Investig 2018; 23:2723-2732. [PMID: 30361793 DOI: 10.1007/s00784-018-2715-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/17/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the effect of photobiomodulation with low-level laser therapy (PBM-LLLT) combined with 5% potassium nitrate (KNO3) on controlling tooth sensitivity (TS) after in-office tooth bleaching. MATERIALS AND METHODS Fifty volunteers were selected based on the inclusion and exclusion criteria and were randomly allocated into four groups: G1 (control): placebo gel application, 35% hydrogen peroxide bleaching (HP35) and mock PBM-LLLT without light emission; G2: placebo gel application, bleaching with HP35 and PBM-LLLT; G3: application of KNO3, bleaching with HP35 and mock PBM-LLLT; and G4: application of KNO3, bleaching with HP35 and PBM-LLLT. A pain assessment questionnaire was used to evaluate TS during the 21 days of treatment. The Friedman test was used for intragroup analysis, and the Wilcoxon and Mann-Whitney tests were used for intergroup comparisons. RESULTS The intragroup evaluation showed significant differences among the evaluation times in all groups (p ≤ 0.05). The highest pain sensitivity levels were recorded on the 1st, 8th, and 15th days. In G1, TS manifested for up to 3 days after each bleaching session, while G2, G3, and G4 presented TS only on the days of the bleaching sessions. Intergroup analysis showed that TS manifestation differed significantly between G1 and the other groups (p ≤ 0.05) but did not differ significantly among G2, G3, and G4 (p ≥ 0.05). CONCLUSION PBM-LLLT and KNO3 are effective at reducing pain sensitivity after tooth bleaching, but no synergistic effect between these treatments was observed for the different evaluation periods. CLINICAL RELEVANCE The effect of PBM-LLLT combined with KNO3 on post-bleaching tooth sensitivity is similar to their individual use alone.
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Affiliation(s)
- Brennda de Paula
- Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil
| | - Cristiane Alencar
- Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil
| | - Mariángela Ortiz
- Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil
| | - Roberta Couto
- Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil
| | - Jesuína Araújo
- School of Dentistry, Federal University of Pará, Belém, PA, Brazil
| | - Cecy Silva
- Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil. .,Faculdade de Odontologia, Universidade Federal do Pará, Avenida Augusto Correa, no 1, Guamá, Belém, PA, 66075-110, Brazil.
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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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Silva-Costa RSGD, Ribeiro AEDL, Assunção IVD, Araújo Júnior RFD, Araújo AAD, Guerra GCB, Borges BCD. In-office tooth bleaching with 38% hydrogen peroxide promotes moderate/severe pulp inflammation and production of ll-1β, TNF-β, GPX, FGF-2 and osteocalcin in rats. J Appl Oral Sci 2018; 26:e20170367. [PMID: 29898175 PMCID: PMC5963911 DOI: 10.1590/1678-7757-2017-0367] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 02/05/2018] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVES To study the intensity of inflammatory infiltrate and production of interleukin-1β (ll-1β), tumor necrosis factor-β (TNF-β), fibroblast growth factor-2 (FGF-2), glutathione peroxidase (GPX), and osteocalcin in response to in-office tooth bleaching in rats. MATERIAL AND METHODS Twenty male Wistar rats were randomized into four groups (n=5) according to the received treatment (tooth bleaching or no treatment - control) and the period of euthanasia after treatment (24 h or 10 days). We performed tooth bleaching using a 38% hydrogen peroxide gel on maxillary and mandibular incisors. After euthanasia, incisors (20 per group) were processed for histological analysis, immunohistochemistry staining of ll-1β, TNF-β, FGF-2 and GPX and osteocalcin by immunofluorescence. We analyzed data using the Mann-Whitney and Kruskal-Wallis/Dunn tests (p<0.05). RESULTS The bleached groups presented statistically significant differences regarding the pulp inflammation stage compared with the control groups. Bleached teeth showed moderate/severe inflammatory infiltrate and control groups presented absent inflammatory cells or a negligible number of mononuclear cells (p<0.001) at two times (24 h and 10 days). There was strong staining for ll-1β, TNF-β, and GPX in bleached groups at 24 h and strong staining for ll-1β, TNF-β, GPX and FGF-2 at 10 days. After 10 days of tooth bleaching, the bleached group showed a statistically superior amount of osteocalcin than the other groups (p<0.01). CONCLUSIONS Tooth bleaching with 38% hydrogen peroxide causes severe pulp inflammation, but characteristics of tissue repair after 10 days.
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Affiliation(s)
- Renata Suellen Galvão da Silva-Costa
- Universidade Federal do Rio Grande do Norte, Departamento de Odontologia, Programa de Pós-Graduação em Saúde Pública, Natal, Rio Grande do Norte, Brasil
| | - Andressa Eveline de Lima Ribeiro
- Universidade Federal do Rio Grande do Norte, Departamento de Odontologia, Programa de Pós-Graduação em Saúde Pública, Natal, Rio Grande do Norte, Brasil
| | - Isauremi Vieira de Assunção
- Universidade Federal do Rio Grande do Norte, Departamento de Odontologia, Programa de Pós-Graduação em Saúde Pública, Natal, Rio Grande do Norte, Brasil
| | - Raimundo Fernandes de Araújo Júnior
- Universidade Federal do Rio Grande do Norte, Departamento de Morfologia, Programa de Pós-Graduação em Ciências da Saúde, Programa de Pós-Graduação em Biologia Funcional e Estrutural, Natal, Rio Grande do Norte, Brasil
| | - Aurigena Antunes de Araújo
- Universidade Federal do Rio Grande do Norte, Departamento de Biofísica e Farmacologia, Programa de Pós-Graduação em Ciências Farmacêuticas, Programa de Pós-Graduação em Saúde Pública, Natal, Rio Grande do Norte, Brasil
| | - Gerlane Coelho Bernardo Guerra
- Universidade Federal do Rio Grande do Norte, Departamento de Biofísica e Farmacologia, Programa de Pós-Graduação em Ciências Biológicas, Programa de Pós-Graduação em Ciências Farmacêuticas, Natal, Rio Grande do Norte, Brasil
| | - Boniek Castillo Dutra Borges
- Universidade Federal do Rio Grande do Norte, Departamento de Odontologia, Programa de Pós-Graduação em Saúde Pública, Natal, Rio Grande do Norte, Brasil
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Benetti F, Gomes-Filho JE, Ferreira LL, Sivieri-Araújo G, Ervolino E, Briso ALF, Cintra LTA. Concentration-dependent effect of bleaching agents on the immunolabelling of interleukin-6, interleukin-17 and CD5-positive cells in the dental pulp. Int Endod J 2018; 51:789-799. [PMID: 29352770 DOI: 10.1111/iej.12891] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 01/12/2018] [Indexed: 01/02/2023]
Abstract
AIM To evaluate lymphocyte-like cell activation (CD5-positive cells) and the expression of interleukin (IL)-6 and IL-17 in the pulp after tooth bleaching with two concentrations of hydrogen peroxide (H2 O2 ). METHODOLOGY The right and left maxillary molars from 40 rats were treated randomly with bleaching gel with 20% H2 O2 (BLUE group, 1 application of 50 min), 35% H2 O2 (MAXX group, three applications of 15 min), or placebo gel (control). After 2 and 30 days, the rats were killed (n = 10), and the jaws were processed for histological and immunohistochemistry analysis of the pulp tissue. The scores of inflammation and immunolabelling (IL-6/IL-17) were submitted to Mann-Whitney and Kruskal-Wallis followed Dunn tests, respectively; anova tests were used for comparisons of number of CD5-positive cells and pulp chamber area values (P < 0.05). RESULTS At 2 days, 60% of specimens of the BLUE group were associated with moderate inflammation in pulp horns, and in the MAXX group with necrosis (P < 0.05). At 30 days, the pulp was organized, and tertiary dentine was formed. The MAXX group had superior immunolabelling of IL-17 at 2 days differing significantly from other groups (P < 0.05). At 2 days, 90% of the specimens of the BLUE group had moderate immunolabelling of IL-6, and 50% of the MAXX group had severe immunolabelling, both significantly different from the control (P < 0.05). There was no significant difference between the groups at 30 days (P > 0.05). CD5-positive cells were present at 2 and 30 days, particularly in the bleached groups (P < 0.05), without significant difference between time periods (P > 0.05). CONCLUSIONS IL-6 and IL-17 participated in inflammation in the pulp tissue of rats after tooth bleaching, particularly at 2 days. The immunolabelling was greater with increasing H2 O2 concentration. This process was accompanied by the prolonged activation of CD5-positive cells.
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Affiliation(s)
- F Benetti
- Department of Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - J E Gomes-Filho
- Department of Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - L L Ferreira
- Department of Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - G Sivieri-Araújo
- Department of Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - E Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - A L F Briso
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - L T A Cintra
- Department of Endodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
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Influence of different types of light on the response of the pulp tissue in dental bleaching: a systematic review. Clin Oral Investig 2017; 22:1825-1837. [PMID: 29230545 DOI: 10.1007/s00784-017-2278-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/19/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES This systematic review (PROSPERO register: CRD42016053140) investigated the influence of different types of light on the pulp tissue during dental bleaching. MATERIALS AND METHODS Two independent authors conducted a systematic search and risk of bias evaluations. An electronic search was undertaken (PubMed/Medline, Embase, The Cochrane Library, and other databases) until May 2017. The population, intervention, comparison, outcomes (PICO) question was: "Does the light in dental bleaching change the response of the pulp to the bleaching procedure?" The intervention involved pulp tissue/cells after bleaching with light, while the comparison involved pulp tissue/cells after bleaching without light. The primary outcome was the inflammation/cytotoxicity observed in pulp after bleaching. RESULTS Out of 2210 articles found, 12 articles were included in the review; four were in vivo studies (one study in dogs/others in human), and eight were in vitro studies (cell culture/with artificial pulp chamber or not). The light source used was halogen, light-emitting diode (LED), and laser. Only one in vivo study that used heat to simulate light effects showed significant pulp inflammation. Only two in vitro studies demonstrated that light influenced cell metabolism; one using halogen light indicated negative effects, and the other using laser therapy indicated positive effects. Given that animal and in vitro studies have been identified, there remain some limitations for extrapolation to the human situation. Furthermore, different light parameters were used. CONCLUSIONS The effects of dental bleaching on the pulp are not influenced by different types of light, but different light parameters can influence these properties. CLINICAL RELEVANCE There is insufficient evidence about the influence of different types of light on inflammation/cytotoxicity of the pulp.
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Ferreira LL, Gomes-Filho JE, Benetti F, Carminatti M, Ervolino E, Briso ALF, Cintra LTA. The effect of dental bleaching on pulpal tissue response in a diabetic animal model: a study of immunoregulatory cytokines. Int Endod J 2017; 51:347-356. [PMID: 28857196 DOI: 10.1111/iej.12852] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 08/25/2017] [Indexed: 12/20/2022]
Abstract
AIM To evaluate the influence of tooth bleaching on immunoregulatory cytokines production (IL-6, Tumour necrosis factor (TNF)-α and IL-17) in the pulp tissue of normoglycaemic and diabetic rats. METHODOLOGY Twenty-eight rats were divided into normoglycaemic and diabetic rats (n = 14). Diabetes mellitus (DM) was induced with a single dose of alloxan diluted in citrate buffer via intramuscular injection. After DM confirmation, all rats were sedated and tooth bleaching was performed using 35% hydrogen peroxide on the right maxillary molars for 30 min. Left molars were used as controls. Bleaching resulted in four hemimaxillae groups: normoglycaemic (N), N-bleached (NBle), diabetic (D) and D-bleached (DBle). After 2 and 30 days, rats were euthanized and hemimaxillae processed for analysis by haematoxylin and eosin and immunohistochemistry. Results within and between animals were submitted to Wilcoxon signed-rank and Mann-Whitney tests (P < 0.05). RESULTS At 2 days, the NBle group had mild, and the DBle had severe inflammatory infiltration in the pulpal tissue (P < 0.05). TNF-α and IL-6 cytokines were associated with increased immunolabelling in the bleached groups compared to nonbleached (P < 0.05). However, IL-17 had increased immunolabelling in the NBle compared to the N and DBle group (P < 0.05). At 30 days, reactionary dentine was observed in the coronal pulp of all bleached teeth and no inflammation was present (P > 0.05). TNF-α cytokines had increased immunolabelling in the DBle group compared to the D group (P < 0.05). However, for IL-6 and IL-17, no difference was observed in this period (P > 0.05). CONCLUSIONS Tooth bleaching increased IL-6 and TNF-α in the pulp tissue regardless of diabetes mellitus; however, diabetic rats had higher TNF-α levels for longer periods. Tooth bleaching influenced the increase in IL-17 in the early periods in normoglycaemic rats.
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Affiliation(s)
- L L Ferreira
- Departments of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - J E Gomes-Filho
- Departments of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - F Benetti
- Departments of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - M Carminatti
- Departments of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - E Ervolino
- Department of Basic Science, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - A L F Briso
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - L T A Cintra
- Departments of Endodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
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Hydrogen peroxide induces cell proliferation and apoptosis in pulp of rats after dental bleaching in vivo. Arch Oral Biol 2017; 81:103-109. [DOI: 10.1016/j.archoralbio.2017.04.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 03/08/2017] [Accepted: 04/17/2017] [Indexed: 10/19/2022]
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Cintra LTA, Benetti F, Ferreira LL, Gomes-Filho JE, Ervolino E, Gallinari MDO, Rahal V, Briso ALF. Penetration Capacity, Color Alteration and Biological Response of Two In-office Bleaching Protocols. Braz Dent J 2017; 27:169-75. [PMID: 27058379 DOI: 10.1590/0103-6440201600329] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 01/22/2016] [Indexed: 11/21/2022] Open
Abstract
Hydrogen peroxide (H2O2) penetrates into the dental hard tissues causing color alteration but also alterations in pulpal tissues. Hard-tissue penetration, color alteration and the pulp response alterations were evaluated for two in-office bleaching protocols with H2O2. For trans-enamel/dentin penetration and color alteration, discs of bovine teeth were attached to an artificial pulp chamber and bleached according to the groups: BLU (20% H2O2 - 1x50 min, Whiteness HP Blue); MAX (35% H2O2 - 3x15 min, Whiteness HP Maxx); Control (1x50 min, placebo). Trans-enamel/dentin penetration was quantified based on the reaction of H2O2 with leucocrystal violet and the color analyzed by CIELab System. Twenty Wistar rats were divided into two groups (BLU and MAX) and their maxillary right molars were treated according to the same protocols of the in vitro study; the maxillary left molars were used as controls. After 2 days, the animals were killed and their maxillae were examined by light microscopy. The inflammation of pulp tissue was scored according to the inflammatory infiltrate (1, absent; 2, mild; 3, moderate; 4, severe/necrosis). Data were analyzed by statistical tests (α=0.05). MAX showed higher trans-enamel/dentinal penetration of H2O2 (p<0.05). The color alteration was similar for both groups (p>0.05), and different when compared to Control group (p<0.05). MAX showed severe inflammation in the upper thirds of the coronal pulp, and BLU showed moderate inflammation (p<0.05). In-office bleaching protocols using lower concentrations of hydrogen peroxide should be preferred due to their reduced trans-enamel/dentinal penetration since they cause less pulp damage and provide same bleaching efficiency.
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Affiliation(s)
| | - Francine Benetti
- Endodontics, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | | | | | - Edilson Ervolino
- Basic Science, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | | | - Vanessa Rahal
- Restorative Dentistry, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - André Luiz Fraga Briso
- Restorative Dentistry, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
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Cavalli V, Silva BG, Berger SB, Abuna G, Marson FC, Tabchoury CPM, Giannini M. Effect of Adhesive Restoration and Bleaching Technique on the Concentration of Hydrogen Peroxide In the Pulp Chamber. Oper Dent 2017; 42:E44-E54. [DOI: 10.2341/16-079-l] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
This study aimed to quantify the concentration of hydrogen peroxide into the pulp chamber in the presence or absence of adhesive enamel restorations and to analyze the resin-dentin interface of bleached groups. Bovine incisors (120) were randomly divided into three groups according to enamel treatment (n=40 each): (1) enamel without restoration (control); (2) enamel cavities (3 mm diameter × 1.5 mm depth) restored with a silorane-based (SB) system; or (3) enamel cavities (3 mm diameter × 1.5 mm depth) restored with a dimethacrylate-based (DB) system. Restorations were thermocycled, and all groups were submitted to one application of 35% hydrogen peroxide (HP) agent for 45 minutes and subjected to four light activation methods (n=10 each): without light, light-emitting diode (LED), LED/diode laser, or halogen light. Acetate buffer solution was placed into the pulp chamber before bleaching, and this solution was collected to spectrophotometrically determine the concentration of HP that reached the pulp chamber after bleaching. Rhodamine B was added to the HP agent and applied on additional enamel samples of each group for 24 hours. Samples were sectioned mesiodistally, and the bleaching agent was traced using confocal microscopy. According to two-way analysis of variance and Tukey test (α=0.05), the HP concentration in the pulp chamber of the control group was significantly lower than that of the SB group (p<0.05), regardless of light activation. No differences were observed between DB and SB groups and between control and DB groups, except for the DB halogen light activated group, which exhibited higher HP intrapulpal concentration (p<0.05). Confocal microscopy exhibited HP diffusion through the interface of the SB and DB restored groups as well as enamel prisms in the control group. The SB restorative system increased the HP diffusion into the pulp chamber, but HP was able to diffuse even in the absence of enamel restorations.
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Affiliation(s)
- V Cavalli
- Vanessa Cavalli, DDS, MS, PhD, associate professor, Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - BG Silva
- Bruna G Silva, DDS, MS student, Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - SB Berger
- Sandrine B Berger, DDS, MS, PhD, associate professor, Department of Restorative Dentistry, University of North Parana, Londrina, Brazil
| | - G Abuna
- Gabriel Abuna, DDS, MS, PhD student, Department of Dental Materials, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - FC Marson
- Fabiano Carlos Marson, DDS, MS, PhD, associate professor, Department of Operative Dentistry, Faculty Ingá, Maringá, Brazil
| | - CPM Tabchoury
- Cinthia P. M. Tabchoury, PharmD, MS, PhD, associate professor, Department of Physiological Sciences, Piracicaba Dental School University of Campinas, Piracicaba, Brazil
| | - M Giannini
- Marcelo Giannini, DDS, MS, PhD, associate professor, Department of Restorative Dentistry Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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49
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Roderjan DA, Stanislawczuk R, Hebling J, Costa CADS, Reis A, Loguercio AD. Response of human pulps to different in-office bleaching techniques: preliminary findings. Braz Dent J 2017. [PMID: 26200147 DOI: 10.1590/0103-6440201302282] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This study evaluated a whitening effect and the likely side effect (tooth sensitivity and pulp response) of human teeth subjected to different in-office bleaching (IOB) techniques and materials, mainly the presence of calcium in the IOB materials. A calcium-free (CF) and a calcium-containing (CC) 35% hydrogen peroxide (HP) gels were evaluated. The CF was refreshed every 15 minutes, three times (CF 3-15) or in a single 45-min application (CF 1-45) at one bleaching appointment. The CC was used only in a single 45-min application (CC 1-45). Each technique was applied in 5 mandibular incisors scheduled for extraction for different patients. In control group, no tooth bleaching was performed. The tooth colour (TC) and tooth sensitivity (TS) were recorded at baseline and after IOB. The teeth were extracted 2 days after the application of IOB and subjected to histological analysis. The data was submitted to appropriate statistical analysis (α=0.05). The changes of TC were similar between groups and statistically different from the control (p<0.05). However, TS of groups bleached with CF was statistically higher than that recorded for CC and the control (p<0.05). In CF 3-15 and CF 1-45 groups, the coronal pulp tissue exhibited partial necrosis associated with tertiary dentin deposition. In CC 1-45 group smaller area of necrosis occurred only in three bleached teeth in which tertiary dentin deposition was observed. The calcium-containing 35%HP gel could be preferable for in-office bleaching because it caused less tooth sensibility and pulp damage.
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Affiliation(s)
- Douglas Augusto Roderjan
- Department of Restorative Dentistry, School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brasil
| | - Rodrigo Stanislawczuk
- Department of Restorative Dentistry, School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brasil
| | - Josimeri Hebling
- Department of Orthodontics and Pediatric Dentistry, Araraquara Dental School, Universidade Estadual Paulista, Araraquara, SP, Brasil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, Araraquara Dental School, Universidade Estadual Paulista, Araraquara, SP, Brasil
| | - Alessandra Reis
- Department of Restorative Dentistry, School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brasil
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brasil
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Vaz MM, Lopes LG, Cardoso PC, Souza JBD, Batista AC, Costa NL, Torres ÉM, Estrela C. Inflammatory response of human dental pulp to at-home and in-office tooth bleaching. J Appl Oral Sci 2016; 24:509-517. [PMID: 27812622 PMCID: PMC5083029 DOI: 10.1590/1678-775720160137] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/05/2016] [Indexed: 12/04/2022] Open
Abstract
Tooth bleaching is a technique of choice to obtain a harmonious smile, but bleaching agents may damage the dental pulp.
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Affiliation(s)
- Maysa Magalhães Vaz
- Universidade Federal de Goiás, Faculdade de Odontologia, Goiânia, GO, Brasil
| | | | | | | | | | - Nádia Lago Costa
- Universidade Federal de Goiás, Faculdade de Odontologia, Goiânia, GO, Brasil
| | | | - Carlos Estrela
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, GO, Brasil
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