Spectrophotometric evaluation of the effectiveness of Er,Cr:YSGG laser-assisted intracoronal tooth bleaching treatment using different power settings

Effect of Different Bleaching Methods on Monomer Release from Aged Microhybrid and Nanohybrid Resin Composites

Introduction

Recently, the application of laser-assisted bleaching has increased in dental practice. This method might affect the physical and chemical properties of resin composite and its monomer release. This study aimed to evaluate the effect of in-office, at-home, and laser-assisted bleaching on the monomer release (bisphenol A diglycidyl dimethacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA), and urethane dimethacrylate (UDMA)) from aged nanohybrid (Grandio, Voco) and microhybrid (Clearfil AP-X Esthetics, Kuraray) resin composites.

Methods

Thirty-two samples of each composite were prepared. The samples underwent aging procedure with UV light at 65°C for 100 hr. The samples were divided into 4 groups: OB: conventional in-office bleaching with Opalescence Boost PF 40% gel; HB: home bleaching with Opalescence PF 15% gel; LB: bleaching with JW Power bleaching gel followed by diode laser application; and C: control group without bleaching. Then, the samples were immersed in a solution containing 75% ethanol + 25% distilled water. The medium was renewed after 8, 16, 24 hr, and 7 days and was analyzed using high-performance liquid chromatography method to evaluate the monomer release. The data were analyzed using Two-way ANOVA and Post hoc Tukey test.

Results

The bleaching method had no effect on TEGDMA and BisGMA release in both composites while it affected UDMA release in nanohybrid composite; UDMA release was significantly higher in LB compared to control and also higher in OB and LB compared to HB. No difference was observed in the microhybrid composite in this regard.

Conclusion

Laser-assisted bleaching did not affect monomer release from microhybrid composite while it increased UDMA release from nanohybrid composite. The bleaching method had no effect on TEGDMA and BisGMA release.

Efficacy of organic and antioxidant agents to regain bond strength to bleached enamel in different dental adhesive solvents

Materials like carbamide peroxide or hydrogen peroxide are commonly used for vital teeth bleaching. However, there have been concerns regarding their effect on composite-to-bleached enamel bonding strength. The study investigated the impact of organic and antioxidant agents on composite bond strength in bleached enamel with different dental adhesive solvents. Human third molar teeth were sectioned into buccal and lingual halves. The two main adhesive solvent groups evaluated were acetone and alcohol. Each main group was divided into six groups. The positive control group received no bleaching, the negative control group consisted of bleaching with no surface deoxidization; and other experimental categories involved post-bleach treatments with 95% ethanol, sodium ascorbate (10%), acetone solution, or sodium fluoride solution (1.1%). Following the surface treatment and enamel bonding procedure, nano-hybrid composite cylinders measuring 3 × 2 mm were directly cured over the bleached enamel substrate. The shear bond test was performed after 24-h storage and 12,000 thermocycles on a universal testing machine. In this study, one-way ANOVA was used along with Tukey's HSD tests at a significance level of 0.05. The negative control groups showed significantly lower bond strength than the positive control group. Ethanol surface treatment had superior mean bonding strength in acetone and alcohol-based adhesive solvent groups. The utilization of sodium ascorbate for surface treatment resulted in a significant enhancement of adhesion between the composite material and bleached enamel surface. Sodium fluoride application showed no significant recovery in shear bond strength in both dental adhesive groups. It was concluded that hydrogen peroxide severely compromised the immediate bond strength of composite resin. Surface treatment of bleached enamel with ethanol, sodium ascorbate, and acetone solutions is an effective option for restoring bond strength.

Present status and future directions - Managing discoloured teeth

Managing tooth discolouration involves a range of different protocols for clinicians and patients in order to achieve an aesthetic result. There is an increasing public awareness in the appearance of their teeth and management of tooth discolouration may be inter-disciplinary and involve both vital and nonvital teeth. Vital teeth can be easily treated with low concentration hydrogen peroxide products safely and effectively using an external approach and trays. For endodontically treated teeth, the walking bleach technique with hydrogen releasing peroxide products is popular. However, there is an association with external cervical root resorption with higher concentrations of hydrogen peroxide of 30%-35%. There are also regulatory considerations for the use of hydrogen peroxide in certain jurisdictions internationally. Prosthodontic treatments are more invasive and involve loss of tooth structure as well as a life cycle of further treatment in the future. This narrative review is based on searches on PubMed and the Cochrane library. Bleaching endodontically treated teeth can be considered a safe and effective protocol in the management of discoloured teeth. However, the association between bleaching and resorption remains unclear although there is likely to be a relation to prior trauma. It is prudent to avoid thermocatalytic approaches and to use a base/sealer to cover the root filling. An awareness expectations of patients and multidisciplinary treatment considerations is important in achieving the aesthetic result for the patient. It is likely that there will be an increasing demand for aesthetic whitening treatments. Bleaching of teeth has also become increasingly regulated although there are international differences in the use and concentration of bleaching agents.