Blinded, Parallel and Randomized Clinical Evaluation of In-office Dental Bleaching with Violet LED (405-410 nm)

Clinical comparison of whitening efficacy and tooth sensitivity of different concentrations of hydrogen peroxide photoactivated with violet or blue LEDs

This study evaluated the photoactivation of hydrogen peroxide gels at different concentrations using blue or violet LED in terms of whitening efficacy and tooth sensitivity. Forty patients were randomly divided into 4 groups: HP6V (violet LED and 6% hydrogen peroxide), HP6B (blue LED and 6% hydrogen peroxide), HP35V (violet LED and 35% hydrogen peroxide), and HP35B (blue LED and 35% hydrogen peroxide). The L*, a* and b* values were measured before, 1 week and 3 months after treatment, and the ΔE and ΔWID values were calculated. Tooth sensitivity was measured using a visual analogue scale (VAS) before, immediately after, and 24 h after bleaching. The ΔE, ΔWID and bleaching sensitivity values were subjected to the ANOVA test and Bonferroni post-test. HP35V and HP35B showed higher whitening efficacy than HP6VL, while HP6V did not show statistical differences compared to the other groups. Regarding bleaching-related sensitivity, the HP6V and HP6B groups presented the lowest values when compared to HP35V and HP35B. HP6V showed whitening efficacy comparable to HP35V and HP35B but with reduced tooth sensitivity. TRIAL REGISTRATION NUMBER: NCT06165458; registration date: 12/09/2023.

Effect of antioxidant on tooth sensitivity after bleaching

OBJECTIVES

This study aimed to investigate the effect of antioxidant (sodium ascorbate) on tooth sensitivity after two in-office bleaching techniques (light-activated and chemical bleaching).

MATERIALS AND METHODS

Ten patients aged 18-25 were bleached in four groups according to bleaching materials and/or antioxidant used. Group A: Maxillary right quadrant received light-activated bleaching with antioxidant. Group B: Maxillary left quadrant received light-activated bleaching without antioxidant. Group C: Mandibular right quadrant received chemical bleaching without antioxidant. Group D: Mandibular left quadrant received chemical bleaching with antioxidant. The tooth sensitivity was recorded using Numerical Rating Scale (NRS) and Schiff Scale (SS) immediately after treatment, 1 day, 1 week, 2 weeks, and 1 month follow-up periods.

RESULTS

Group B exhibited higher sensitivity values than Group A. This difference was statistically significant on the first day after treatment (p = 0.027* in NRS and p = 0.046* in SS). Furthermore, antioxidant incorporation in Group D led to a reduction in teeth sensitivity values compared to Group C. This disparity was highly significant on the first day after treatment (p = 0.001* in NRS and p < 0.001** in SS).

CONCLUSIONS

The antioxidant (10% sodium ascorbate) reduces the intensity of tooth sensitivity at the different follow-up periods, especially after 1 day from bleaching.

CLINICAL SIGNIFICANCE

Using 10% sodium ascorbate after bleaching is advisable to reduce post-operative tooth sensitivity.

Influence of blue and violet LED and infrared laser on the temperature of bleaching protocols in different concentrations of hydrogen peroxide

BACKGROUND

The photo-acceleration of bleaching gels by lights has been extensively researched. However, the induced temperature increase during this process needs to be further evaluated to prevent damage to the dental pulp. Therefore, the objective of this study was to evaluate the surface and intrapulpal temperature kinetics of different concentrations of hydrogen peroxide (HP) gels photo-accelerated by blue or violet light and infrared laser.

METHODS

The whitening gels at concentrations of HP35, HP15, and HP6 % were irradiated with blue and violet LED/laser on the surface of a human canine tooth. The surface temperature variation (∆Ts) was evaluated using a pH meter, while the intrapulpal temperature variation (∆Ti) was assessed using a digital thermometer at intervals of 1, 15, and 30 min. Statistical analysis was conducted using a Two-way repeated measures ANOVA test, and Bonferroni post-test was applied at a significance level of 5 %.

RESULTS

All violet LED photo-accelerated groups showed a higher increase in ∆Ts compared to the blue LED/laser groups. However, there were no significant differences between the groups for ∆Ti.

CONCLUSION

Although the photo-acceleration of HP35 and HP15 % gels with violet LED/laser has a greater increase in surface temperature compared to HP6 % gel, the different light systems do not significantly increase the intrapulpal temperature.

The effect of tooth bleaching using violet LED (405-410 nm) on the properties of resin-based composites

BACKGROUND

The objective of this study was to evaluate the effect of bleaching techniques, including or not the use of violet light (405-410 nm), on resin-based composites' color, surface roughness, nanohardness, and elastic modulus.

METHODS

Ninety-six disk-shaped specimens (12 mm x 2 mm; n = 12) were prepared using Filtek Z350 XT (Z350) and IPS Empress Direct (ED) resin-based composites. After 24 h, specimens were stained in red wine for 28 days. After staining, specimens were divided into four experimental groups: 40 % Hydrogen Peroxide (HP); Violet Light (VL); 40 % Hydrogen Peroxide associated with Violet Light (HP+VL), and a control group - no treatment (NT). Specimens were evaluated at six experimental times: initial (24 h after light curing); after staining and after the 1st, 2nd, 3rd, and 4th bleaching sessions regarding the color change (ΔE00, L*, a*, b*, and WID); roughness (Ra), nanohardness and elastic modulus (GPa). Two-way analysis of variance for repeated measures was performed (α=0.05 %).

RESULTS

There was a statistically significant difference between staining and the 1st bleaching session for all ED groups (p<0.05). After the last bleaching session, there were no differences between the experimental and the control groups of both resin-based composites. Bleaching using violet light did not change the roughness, nanohardness and elastic modulus of the tested resin-based composites (p>0.05).

CONCLUSIONS

Although hydrogen peroxide and violet light remove pigments from resin-based composites without affecting their surface roughness, nanohardness, and elastic modulus, the color change was similar to the one obtained by immersion in distilled water.

Surface and intra-pulpal temperature variation during tooth whitening photoactivated with LED/laser

This study evaluated the variation of surface and intra-pulpal temperature, during bleaching protocol, using LED/laser. The 35% (HP35), 15% (HP15) and 6% (HP6) gels were used associated with LED/laser applied every 1 min for 30 min in a human canine. The evaluation of surface temperature variation (∆Ts) was performed using a pHmeter and the intra-pulpal temperature variation (∆Ti) was performed using a digital thermometer, at times of 1-, 5-, 10- 15- and 30-min. Statistical analysis was performed using the two-way repeated measures ANOVA test and Bonferroni post-hoc test was used at a significance level of 5%. HP35 and HP15 showed greater temperature variation than HP6 up to 10 min of surface evaluation, showing no differences between them. In the intra-pulpal evaluation, no group showed differences throughout the procedure.

Continuous vs fractionated violet LED light protocols for dental bleaching: evaluations of color change and temperature of the dental pulp and buccal surface

BACKGROUND

Dental color change and the temperature of the pulp chamber and of the buccal surface were evaluated during bleaching with 37% carbamide peroxide (CP) with continuous vs fractionated violet LED light protocols.

METHODOLOGY

Bovine incisors received in-office bleaching for 30 minutes using different light protocols (Bright Max Whitening, MMOptics). Teeth were separated into groups (n=10): HP) 35% hydrogen peroxide (Whiteness HP, FGM)/no light; CP) 37% carbamide peroxide (Whiteness SuperEndo, FGM)/no light; CP10) CP+10 min of continuous light; CP20) CP+20 min of continuous light; CP30) CP+30 min of continuous light; CPF) CP+20 cycles of 60 s light / 30 s no light (fractionated). Color evaluations were performed at different times. Evaluations of pulp and buccal surface temperatures were performed before and throughout the 30 minutes of bleaching.

RESULTS

Generalized linear models for repeated measures over time were applied to the data (α=5%). After the 1st session, CP20 and CP30 had significantly lower b* values ​​than CP and CP10 (p=0.0071). For ΔE_ab and ΔE₀₀, CPF, CP20 and CP30 showed the highest color change among the treatments after the third bleaching (p<0.05). For temperature evaluations, CP30 showed higher pulp and buccal surface temperatures than the other protocols (p<0.0001) after 20 min.

CONCLUSION

Fractionated or continuous application of violet LED for 20 or 30 min leads to greater effectiveness of color change. All protocols with the application of LED led to an increase in pulp and buccal surface temperatures during bleaching, although the fractionated application appeared to be safer than the use of continuous light.

Influence of violet LED and fluoride-containing carbamide peroxide bleaching gels on early-stage eroded/abraded teeth

PURPOSE

This study evaluated enamel with early-stage erosion/abrasion following bleaching with 20% and 45% carbamide peroxide (CP) gels containing fluoride (F) and irradiated with violet LED (LED).

METHODS

Enamel blocks were immersed in 1% citric acid (5 min) and artificial saliva (120 min) three times to produce early-stage enamel erosion. Simulated toothbrushing was performed only after the first saliva immersion, to provoke enamel abrasion. The erosive/abraded enamel samples were submitted to (n=10): LED/CP20, CP20, LED/CP20_F, CP20_F, LED/CP45, CP45, LED/CP45_F, CP45_F, LED, and control (without treatment). The pH of the gels was assessed, and color (ΔE₀₀) and whiteness index (ΔWI_D) changes were calculated after cycling (T₁), and 7 days from bleaching (T₂). Enamel surface roughness average (Ra) and Knoop microhardness (kg/mm², %SHR) were evaluated at baseline (T₀) at T₁ and T_2. Scanning electron microscopy evaluated the enamel surface morphology at T₂.

RESULTS

The gels' pH was neutral and CP20 and CP45 exhibited no differences in ΔE₀₀ and ΔWI_D (p>0.05) but LED increased these parameters for CP20_F and CP45. Erosion/abrasion significantly decreased mean kg/mm², and the LED group was the only one not increasing microhardness after bleaching (p>0.05). None of the groups fully recovered the initial microhardness. All groups exhibited %SHR similar to the control (p>0.05) and the increase in Ra was detected only after erosion/abrasion. CP20_F groups exhibited a more preserved enamel morphology.

CONCLUSION

Light irradiation combined with low-concentrated CP gel promoted a bleaching effect comparable to the high-concentrated CP. The bleaching protocols did not adversely impact the surface of early-stage eroded/abraded enamel.

Physicochemical evaluation of hydrogen peroxide bleaching gels containing titanium dioxide catalytic agent, and their influence on dental color change associated with violet LED

BACKGROUND

The purpose of this study was: 1) to analyze the physical-chemical properties of hydrogen peroxide (HP) agents at 7.5% (HP7) and 35% (HP35), and the association with or without TiO₂ nanotubes; 2) to evaluate dental bleaching effectiveness by using HP7 and HP35 together with or without TiO₂ nanotubes, and applied with or without violet LED (VL).

METHODOLOGY

80 bovine incisors were treated according to groups (n = 10): HP35; HP35 + VL; HP35T (HP35 + TiO₂); HP35T + VL; HP7; HP7 + VL; HP7T (HP7 + TiO₂); HP7T + VL. Bleaching effectiveness was measured at 4 time points according to the Vita Classical, CIEL*a*b*, CIEDE2000, and WI_D parameters. HP35, HP35T, HP7, and HP7T were evaluated for mass change, pH, mean particle size (P), polydispersity (PDI), and zeta potential (ZP), over 6 months of storage.

RESULTS

The pH of HP35 thickener was higher when associated to TiO₂. At baseline, both of the bleaching gels containing TiO₂ had lower P, PDI, and PZ (p < 0.05). All groups showed a significant decrease in Vita Classical color scores (p = 0.0037). There was a higher L* value, and lower b* values for HP7 when associated to VL after the 3rd session. (p < 0.05). HP35T showed higher color change (ΔE_ab, ΔE₀₀), and lower a* value in the presence of VL (p < 0.05). ΔWI_D presented lower values for both gels, when TiO₂ was incorporated (p ≤ 0.05).

CONCLUSION

The incorporation of TiO₂ to the bleaching gel showed good stability with minimal variations in physical-chemical properties. The color change in HP35 was more effective than in HP7, but the VL boosted the bleaching effectiveness of HP7, whereas TiO₂ did not increase bleaching effectiveness.