Effect of bleaching agents on the microhardness of tooth-colored restorative materials

Effect of dental bleaching on the microhardness and surface roughness of sealed composite resins

Objectives

The aim of this in vitro study was to evaluate the microhardness and surface roughness of composite resins before and after tooth bleaching procedures.

Materials and Methods

Sixty specimens were prepared of each composite resin (Filtek Supreme XT and Opallis), and BisCover LV surface sealant was applied to half of the specimens. Thirty enamel samples were obtained from the buccal and lingual surfaces of human molars for use as the control group. The surface roughness and microhardness were measured before and after bleaching procedures with 35% hydrogen peroxide or 16% carbamide (n = 10). Data were analyzed using 1-way analysis of variance and the Fisher test (α = 0.05).

Results

Neither hydrogen peroxide nor carbamide peroxide treatment significantly altered the hardness of the composite resins, regardless of surface sealant application; however, both treatments significantly decreased the hardness of the tooth samples (p < 0.05). The bleaching did not cause any change in surface roughness, with the exception of the unsealed Opallis composite resin and dental enamel, both of which displayed an increase in surface roughness after bleaching with carbamide peroxide (p < 0.05).

Conclusions

The microhardness and surface roughness of enamel and Opallis composite resin were influenced by bleaching procedures.

Effects of 16% Carbamide Peroxide Bleaching on the Surface Properties of Glazed Glassy Matrix Ceramics

Objective

To determine the influence of the home bleaching agent, Opalescence PF, on the surface roughness and microhardness of glazed glassy matrix CAD-CAM ceramics. Materials and Methods. The 28 sintered leucite- and lithium disilicate-reinforced ceramic specimens (IPS Empress CAD and IPS e.max CAD) were divided into control and bleached groups. The home bleaching agent was applied to specimens of bleached groups for 7 days. The surface roughness and microhardness of all specimens were measured. A scanning electron microscope was used to evaluate the surface properties. The data were statistically analyzed by two-way ANOVA.

Results

The control e.max CAD showed the lowest surface roughness values. For both Empress and e.max CAD, surface roughness was significantly higher for the bleached group (p < 0.05). No significant differences in microhardness were observed.

Conclusions

According to our study, patients should be careful when using home bleaching agents because whitening agents can affect the mechanical properties of full ceramic restorations like e.max CAD and Empress CAD. Ceramic polishing may be required in clinical situations where ceramic restorations are accidentally exposed to bleaching gels.

Evaluation of the effect of home bleaching agents on surface microhardness of different glass-ionomer cements containing hydroxyapatite

Background

Home bleaching agents may exert some negative effects on surface hardness of restorative materials such as glass-ionomer cements (GICs). Since some studies have shown that some components such as hydroxyapatite (HA), as a bioactive glass, can improve the mechanical properties of dental materials, the effect of bleaching agents on surface hardness of GICs containing hydroxyapatite is questionable. This study was designed to evaluate the effect of home bleaching agents on the surface hardness of two different commercially available GICs containing hydroxyapatite.

Material and Methods

80 disk-shaped specimens were made from two different GICs, including resin modified glass-ionomer and Zirconomer. Each material was divided into four groups (n=10): 1. control, 2. 20 %wt. hydroxyapatite-containing, 3. bleached and 4. bleached 20 %wt. hydroxyapatite-containing. Group 1 and 2 specimens were stored in distilled water for 2 weeks while group 3 and 4 specimens were treated with 15% carbamide peroxide in that period. Surface hardness was tested with Vickers surface hardness tester. Data were analyzed with 3-way ANOVA and mean comparison done by post hoc Tukey tests (p<0.05).

Results

In general RMGI had a significantly highest Vickers surface hardness value among all groups. 15% carbamide peroxide reduced surface hardness compared to control groups (RMGI and Zr) significantly. In the HA-containing GICs groups, bleaching agent did not significantly changed the surface hardness value.

Conclusions

In this study we concluded that applied treatments (bleaching and adding HA) in implicit percentages reduced surface hardness of GICs. Also we suggest more studies in clinical conditions be done to verify these results.

Key words:Home bleaching, Resin Modified Glass-ionomer cement, surface hardness, Zirconia-reinforced glass ionomer, hydroxyapatite.

In Vitro Effect of Bleaching With 810 nm and 980 nm Diode Laser on Microhardness of Self-cure and Light-Cure Glass Ionomer Cements

Introduction: This study sought to assess the effect of bleaching combined with irradiation of 810 nm and 980 nm diode laser on microhardness of 2 commonly used self-cure and light-cure glass ionomer cements (GICs) in comparison with conventional bleaching (without laser). Methods: In this in vitro, experimental study, 60 samples were fabricated of A2 shade of Fuji IX and Fuji II LC GICs (n=30) and each group was divided into 3 subgroups (n=10). The first subgroups were subjected to bleaching with Opalescence Xtra Boost plus 980 nm diode laser irradiation. The second subgroups were subjected to bleaching with Opalescence Boost plus 810 nm diode laser irradiation and the third subgroups were subjected to bleaching with Opalescence Xtra Boost without laser. Microhardness was measured at baseline and after the intervention using Vickers hardness tester. The data were analyzed using two-way analysis of variance (ANOVA) (P<0.05). Results: Microhardness decreased in all subgroups after the intervention (P<0.001) irrespective of the type of GIC (P=0.201) or surface treatment (P=0.570). The baseline microhardness of the three subgroups within each group of GIC was not significantly different (P=0.456), but the baseline microhardness of conventional GIC was significantly higher than that of resin modified GIC (P=0.004). Conclusion: Bleaching with/without laser irradiation decreases the microhardness of GICs. The baseline microhardness of conventional GIC is higher than that of resin modified GIC.

Effect of two different tooth bleaching techniques on microhardness of giomer

BACKGROUND

Tooth bleaching is a safe and conservative treatment modality to improve the esthetic appearance of discolored teeth. One of the problems with the use of bleaching agents is their possible effect on surface microhardness of resin-based materials. The present study was carried out to evaluate the effect of in-office and at-home bleaching on surface microhardness of giomer.

MATERIAL AND METHODS

Seventy-five disk-shaped giomer samples (Beautifil II) were prepared and cured with a light-curing unit. The samples were randomly assigned to three groups (n=25). In group 1 (control), the samples were stored in distilled water for 14 days. The samples in groups 2 and 3 underwent a bleaching procedure with 15% carbamide peroxide (CP) (8 hours daily) and 45% CP (30 minutes daily), respectively, for 14 days. Finally, the microhardness of samples was measured with Vickers hardness tester using a 100-g force for 20 seconds. One-way ANOVA was used to compare the mean microhardness values among the study groups, followed by post hoc Tukey test for two-by-two comparison of the groups. Statistical significance was set at P<0.05.

RESULTS

One-way ANOVA showed significant differences in the mean microhardness values among the study groups (P<0.001). Based on the results of Tukey test, microhardness in the bleached groups was significantly less than that in the control group (P<0.0005). In addition, microhardness in the 45% CP group was significantly less than that in the 15% CP group (P<0.0005).

CONCLUSIONS

Use of both bleaching agents during in-office and at-home bleaching techniques resulted in a decrease in surface microhardness of giomer. The unfavorable effect of in-office bleaching (45% CP) was greater than that of at-home bleaching (15% CP). Key words:Dental restorations, hardness, tooth bleaching.

Effect of different bleaching strategies on microhardness of a silorane-based composite resin

Background. Dentists’ awareness of the effects of bleaching agents on the surface and mechanical properties of restorative materials is of utmost importance. Therefore, this in vitro study was undertaken to investigate the effects of different bleaching strategies on the microhardness of a silorane-based composite resin.

Methods. Eighty samples of a silorane-based composite resin (measuring 4 mm in diameter and 2 mm in thickness) were prepared within acrylic molds. The samples were polished and randomly assigned to 4 groups (n=20). Group 1 (controls) were stored in distilled water for 2 weeks. The samples in group 2 underwent a bleaching procedure with 15% carbamide peroxide for two weeks two hours daily. The samples in group 3 were bleached with 35% hydrogen peroxide twice 5 days apart for 30 minutes each time. The samples in group 4 underwent a bleaching procedure with light-activated 35% hydrogen peroxide under LED light once for 40 minutes. Then the microhardness of the samples was determined using Vickers method. Data were analyzed with one-way ANOVA and post hoc Tukey tests (P < 0.05).

Results. All the bleaching agents significantly decreased microhardness compared to the control group (P < 0.05). In addition, there were significant differences in microhardness between groups 2 and 4 (P = 0.001) and between groups 3 and 4 (P<0.001). However, no significant differences were detected in microhardness between groups 2 and 3 (P > 0.05).

Conclusion. Bleaching agents decreased microhardness of silorane-based composite resin restorations, the magnitude of which depending on the bleaching strategy used.

Effect of Carbamide Peroxide on the Push-out Bond Strength of Different Composition Glass-Ionomer Cement to Root Canal Dentin when used as Cervical Barrier

AIM

To evaluate the effect of 37% carbamide peroxide on the bond strength of conventional or resin-modified glass-ionomer cements when used as a cervical barrier in endodontically-treated teeth.

MATERIALS AND METHODS

After root canal instrumentation and obturation, 40 specimens of the cement-enamel junction were obtained after transversal root canal sectioning from human extracted canines. The root canal specimens were standardized and filled with the following materials (n = 10, each group): G1: zinc phosphate (control), G2: Ketac glass-ionomer, G3: vitrebond glass-ionomer or G4: GC GL glass-ionomer. After 24 hours, the specimens were subjected to an application of 37% carbamide peroxide for 21 days, changed each 7 days and stored in an artificial pulp chamber. The specimens were then submitted to push-out bond strength testing with an electromechanical test machine (EMIC) and the failure mode in each specimen was analyzed with confocal microscopy (LEXT).

RESULTS

G3 and G4 showed higher bond strengths values than the other groups (p < 0.05), and were similar to each other (p > 0.05). G1 showed the lowest bond strength value (p < 0.05).

CONCLUSION

Glass-ionomer cements showed higher bond strength values than the zinc phosphate cement, and resin-modified glass-ionomer cements presented the highest push-out values to root canal dentin (GC, GL and Vitrebond).

CLINICAL SIGNIFICANCE

Glass ionomer cements are recommended to use as cervical barrier materials before the internal dental bleaching, but its efficiency is questionable.

Accounting for measurement reliability to improve the quality of inference in dental microhardness research: a worked example

OBJECTIVES

Dental microhardness experiments are influenced by unobserved factors related to the varying tooth characteristics that affect measurement reproducibility. This paper explores the appropriate analytical tools for modeling different sources of unobserved variability to reduce the biases encountered and increase the validity of microhardness studies.

MATERIALS AND METHODS

The enamel microhardness of human third molars was measured by Vickers diamond. The effects of five bleaching agents-10, 16, and 30 % carbamide peroxide, and 25 and 38 % hydrogen peroxide-were examined, as well as the effect of artificial saliva and amorphous calcium phosphate. To account for both between- and within-tooth heterogeneity in evaluating treatment effects, the statistical analysis was performed in the mixed-effects framework, which also included the appropriate weighting procedure to adjust for confounding. The results were compared to those of the standard ANOVA model usually applied.

RESULTS

The weighted mixed-effects model produced the parameter estimates of different magnitude and significance than the standard ANOVA model. The results of the former model were more intuitive, with more precise estimates and better fit.

CONCLUSIONS

Confounding could seriously bias the study outcomes, highlighting the need for more robust statistical procedures in dental research that account for the measurement reliability. The presented framework is more flexible and informative than existing analytical techniques and may improve the quality of inference in dental research.

CLINICAL RELEVANCE

Reported results could be misleading if underlying heterogeneity of microhardness measurements is not taken into account. The confidence in treatment outcomes could be increased by applying the framework presented.

Effect of organic acids in dental biofilm on microhardness of a silorane-based composite

OBJECTIVES

This study evaluated the effect of lactic acid and acetic acid on the microhardness of a silorane-based composite compared to two methacrylate-based composite resins.

MATERIALS AND METHODS

Thirty disc-shaped specimens each were fabricated of Filtek P90, Filtek Z250 and Filtek Z350XT. After measuring of Vickers microhardness, they were randomly divided into 3 subgroups (n = 10) and immersed in lactic acid, acetic acid or distilled water. Microhardness was measured after 48 hr and 7 day of immersion. Data were analyzed using repeated measures ANOVA (p < 0.05). The surfaces of two additional specimens were evaluated using a scanning electron microscope (SEM) before and after immersion.

RESULTS

All groups showed a reduction in microhardness after 7 day of immersion (p < 0.001). At baseline and 7 day, the microhardness of Z250 was the greatest, followed by Z350 and P90 (p < 0.001). At 48 hr, the microhardness values of Z250 and Z350 were greater than P90 (p < 0.001 for both), but those of Z250 and Z350 were not significantly different (p = 0.095). Also, the effect of storage media on microhardness was not significant at baseline, but significant at 48 hr and after 7 day (p = 0.001 and p < 0.001, respectively). Lactic acid had the greatest effect.

CONCLUSIONS

The microhardness of composites decreased after 7 day of immersion. The microhardness of P90 was lower than that of other composites. Lactic acid caused a greater reduction in microhardness compared to other solutions.

Comparative evaluation of effects of bleaching on color stability and marginal adaptation of discolored direct and indirect composite laminate veneers under in vivo conditions

Statement of Problem:

Change in color and loss of marginal adaptation of tooth colored restorative materials is not acceptable. Bleaching is commonly used for treating discolored teeth. However, the literature is scanty regarding its effect on color and marginal adaptation of direct and indirect composite laminate veneers (CLVs) under in vivo conditions.

Purpose:

Purpose of the study was to determine the effect of bleaching on color change and marginal adaptation of direct and indirect CLVs over a period of time when exposed to the oral environment.

Materials and Methods:

For this purpose, a total of 14 subjects irrespective of age and sex indicated for CLV restorations on maxillary anterior teeth were selected following the inclusion and exclusion criteria. For each subject, indirect CLVs were fabricated and looted in the first quadrant (Group 1) and direct CLV's (Group 2), were given in the second quadrant. Color change was assessed clinically using intra-oral digital spectrophotometer and marginal adaptation was assessed on epoxy resin replica of the tooth-restoration interface under scanning electron microscope. After 6 months, the subjects underwent a home bleaching regimen for 14 days using 10% carbamide peroxide. The assessment of color change and marginal adaptation was done at 6 months after veneering (0–180 days), immediately after the bleaching regimen (0–194 days) and 3 months after the bleaching regimen (0–284 days).

Results:

The difference in median color change (ΔE) between the groups was tested using Wilcoxon rank sum test while the median color change with time within the groups was tested using Wilcoxon signed rank test. The difference in the rates of marginal adaptation was tested between the groups using Chi-square/Fisher's exact test.

Bleaching led to statistically significant color change at cervical (CE), middle and incisal (IE) regions when direct and indirect composites were compared (P < 0.05). During intra-group comparison, direct CLV's showed significant color change at CE and IE regions when ΔE was compared at 180 days and 284 days (CE 10 vs. CE 30, P = 0.008, IE 10 vs. IE 30, P = 0.003). No significant differences were found when within group comparison was made for indirect laminates. Intergroup comparison between the groups showed significant difference in marginal adaptation at CE margin at all.time points (at baseline, P = 0.005; at 180 days, P = 0.007; 194 days, P = 0.025; at 284 days, P = 0.067).

Conclusion:

After bleaching, indirect CLVs performed better in terms of color stability whereas direct CLVs performed better in terms of marginal adaptation.

Clinical Significance:

Indirect composites should be preferred to direct composites as veneering materials as they have better color stability. Special attention should be given to their marginal adaptation especially in the CE region. Bleaching should be avoided in patients with composite restorations in the mouth.

Effect of 38% carbamide peroxide on the microleakage of silorane-based versus methacrylate-based composite restorations

OBJECTIVES

This study aimed to assess the effect of 38% carbamide peroxide on the microleakage of class V cavities restored with either a silorane-based composite or two methacrylate-based composites.

MATERIALS AND METHODS

A total of 96 class V cavities were prepared on the buccal surface of extracted human teeth with both enamel and dentin margins and were randomly assigned into three groups of Filtek P90 (3M-ESPE) + P90 system adhesive (3M-ESPE)(group A), Filtek Z250 (3M-ESPE) + Adper Prompt L-Pop (3M-ESPE)(group B) and Filtek Z350XT (3M-ESPE) + Adper Prompt L-Pop (group C). Half of the teeth were randomly underwent bleaching (38% carbamide peroxide, Day White, Discus Dental, applying for 15 min, twice a day for 14 day) while the remaining half (control) were not bleached. Dye penetration was measured following immersion in basic fuchsine. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests at a level of 0.05.

RESULTS

No significant differences were found between composites in the control groups in enamel (p = 0.171) or dentin (p = 0.094) margins. After bleaching, microleakage of Z250 (in enamel [p = 0.867] or dentin [p = 0.590] margins) and Z350 (in enamel [p = 0.445] or dentin [p = 0.591] margins) did not change significantly, but the microleakage of P90 significantly increased in both enamel (p = 0.042) and dentin (p = 0.002) margins.

CONCLUSIONS

No significant differences were noted between the bleached and control subgroups of two methacrylate-based composites in enamel or dentin margins. Microleakage of silorane-based composite significantly increased after bleaching.

Effects of home bleaching on surface hardness and surface roughness of an experimental nanocomposite

Objective:

Home bleaching agents may not be safe for composite resins. The purpose of this study was to evaluate the effects of 10 and 20% Opalescence^® PF home bleaching agents on the surface roughness and hardness of universal nanocomposite (Filtek Z350), anterior nanocomposite (KeLFiL), and nanohybrid composite (TPH 3).

Materials and Methods:

Fifty-four composite resin samples with 18 samples for each type of composite resin were prepared using acrylic molds (4 × 2 mm). Each type of composite resin was further divided into three groups [n = 6 controls were placed in distilled water for 14 days and the other two groups of n = 6 were bleached with 10 and 20% carbamide peroxide (CP), respectively for 14 days]. Surface hardness of the composite resin was tested with a Vickers hardness tester, whereas surface roughness was tested with atomic force microscopy (AFM).

Results:

There were significant changes in the surface hardness of KeLFiL and TPH 3. However, all the tested materials showed no significant changes in the surface roughness.

Conclusion:

After 14 days of home bleaching treatment, there was no adverse effect on the surface roughness of all three composite resins, although the surface hardness for KeLFiL and TPH 3 were significantly reduced.

Effects of temperature and in-office bleaching agents on surface and subsurface properties of aesthetic restorative materials

OBJECTIVES

To investigate the effects of in-office bleaching agents on surface and subsurface properties of dental materials at different environmental temperatures.

METHODS

Four composite resins, a compomer, a conventional glass-ionomer cement (CGIC), and an industrially sintered ceramic material were evaluated in the present study. Four groups of each material (n=10) were treated: bleaching with 40% hydrogen peroxide at 25°C and 37°C, stored in artificial saliva at 25°C and 37°C. The specimens from bleaching groups were bleached for two sessions, each of two 20 min application, at respective temperatures. After bleaching, the surface and subsurface (0.1-0.5mm) microhardness were evaluated using a Vickers microhardness tester. The substance loss was determined by surface profilometry. The data were statistically analyzed with ANOVA and the Tukey's post hoc test.

RESULTS

All materials were found to have surface softening after bleaching, and bleaching effects on surface micorhardness increased at 37°C compared with 25°C, except for the ceramic. After being bleached at 37°C, the microhardness values of flowable composite resin significantly reduced at a depth of 0.1mm compared with control specimen stored at 37°C. No significant difference was found between the control and bleached specimens with respect to substance loss for any of the materials.

CONCLUSION

The influence of environmental temperature on the in-office bleaching effects on surface and subsurface microhardness of dental materials was material-dependent. However, no substance loss was detected due to the tested bleaching regimen.

CLINICAL SIGNIFICANCE

Environmental temperature should be considered when evaluating the possible bleaching effects on restorative materials. Moreover, dentists should be aware that there might be a need for polishing of restorative materials in clinical situations in which restorations are accidentally exposed to bleaching gels.

The effect of bleaching on toothbrush abrasion of resin composites

AIM

This experimental study was designed to focus on the effects of bleaching on toothbrush abrasion in three types of composites with different filler size.

MATERIALS AND METHODS

Forty eight disks were prepared from three types of composite and divided into 6 groups. In the first three groups the abrasion test was done. The remaining groups were bleached and the abrasion test was performed. The weight of the samples before and after abrasion was measured. Statistical analysis was done with one-way ANOVA and Duncan test.

RESULTS

There was a significant difference in abrasion of composites with different filler size (P < 0.05). The most amount of abrasion was observed in Z100 after being bleached. An increase in abrasion was noticed in all three types of tested composite after bleaching.

CONCLUSION

According to the findings, it is suggested to use a nano filled resin composite for restoration if the bleaching treatment is required.

Assessment of the mechanical properties of glass ionomer cements for orthodontic cementation

OBJECTIVE: To evaluate the mechanical properties of three glass ionomers cements (GICs) used for band cementation in Orthodontics. METHODS: Two conventional glass ionomers (Ketac Cem Easy mix/3M-ESPE and Meron/Voco) and one resin modified glass ionomer (Multi-cure Glass ionomer/3M-Unitek) were selected. For the compressive strength and diametral tensile strength tests, 12 specimens were made of each material. For the microhardness test 15 specimens were made of each material and for the shear bond strength tests 45 bovine permanent incisors were used mounted in a self-cure acrylic resin. Then, band segments with a welded bracket were cemented on the buccal surface of the crowns. For the mechanical tests of compressive and diametral tensile strength and shear bond strength a universal testing machine was used with a crosshead speed of 1,0 mm/min and for the Vickers microhardness analysis tests a Microdurometer was used with 200 g of load during 15 seconds. The results were submitted to statistical analysis through ANOVA complemented by Tukey's test at a significance level of 5%. RESULTS: The results shown that the Multi-Cure Glass Ionomer presented higher diametral tensile strength (p < 0.01) and compressive strength greater than conventional GICs (p = 0.08). Moreover, Ketac Cem showed significant less microhardness (p < 0.01). CONCLUSION: The resin-modified glass ionomer cement showed high mechanical properties, compared to the conventional glass ionomer cements, which had few differences between them.

The effect of a 10% carbamide peroxide bleaching agent on the microhardness of four types of direct resin-based restorative materials

PURPOSE

This in vitro study was undertaken to evaluate the effect of a 10% carbamide peroxide bleaching agent on the microhardness of four types of direct resin-based restorative materials.

MATERIALS AND METHODS

Thirty disk-shaped specimens (10.0 mm diameter × 2.0 mm depth) of each material, including a microhybrid resin composite (Z250), a nanofilled resin composite (Z350), a silorane-based low-shrink resin composite (P90), and a hybrid resin composite (Valux Plus), were fabricated and then polished with medium, fine, and superfine polishing discs. After being polished, specimens were cleaned with distilled water for 2 min in an ultrasonic bath to remove any surface debris and then stored in distilled water at 37°C for 24 hours. Specimens from each material were divided into three groups (n=10). One group was selected as a control group (nontreated with bleaching agent). The other two groups were treated with bleaching agent for 14 days (group A) and for 14 days followed by immersion in artificial saliva for 14 days (group B). The top surfaces of the specimens in the different groups were also subjected to the Vickers hardness test with a load of 300 g and 15-second dwell time. Data were analyzed with a one-way analysis of variance and Tukey's HSD test (α = 0.05).

RESULTS

There was a general reduction of Vickers hardness numbers (VHN) values of treated groups compared with the control group for each material used, but this reduction was minimal, with no significant difference between groups in Z250, whereas the other three materials (Z350, P90, and Valux Plus) showed a significant reduction of VHN of treated groups compared with the control group. Conversely, the findings showed no significant difference between treated groups A and B in all materials used except P90.

CONCLUSION

A 10% carbamide peroxide bleaching agent had an adverse effect on the microhardness of nanofilled, silorane-based low-shrink, and hybrid types of resin-based composite materials compared with the microhybrid type.

Effect of at-home whitening strips on the surface roughness and color of a composite and an ormocer restorative material

PURPOSE

Oxygenating agents like carbamide peroxide or H(2) O(2) are commonly used whitening agents. They have varying influence on the color and surface roughness of resin-based restorative materials and teeth. The aim of this study was to evaluate the effect of an at-home peroxide whitening agent applied through a whitening strip on the color and surface roughness of a nanofilled composite resin and an ormocer-based resin.

MATERIALS AND METHODS

Disc-shaped (2 mm thick, 10 mm diameter) nanofilled resin composite (n = 10) and ormocer (n = 10) specimens were prepared. All specimens were treated with a whitening strip. Whitening procedures were performed applying a 6.5% hydrogen peroxide whitening strip (Crest White Strips Professional) for 30 minutes twice each day for a period of 21 consecutive days. During the test intervals, the specimens were rinsed under running distilled water for 1 minute to remove the whitening agents and immersed in 37°C distilled water until the next treatment. Surface roughness and color of the specimens were measured with a profilometer and a colorimeter, respectively, before and after whitening. Color changes were calculated (ΔE) using L*, a*, and b* coordinates. Repeated measures of variance analysis and Duncan test were used for statistical evaluation (α= 0.05).

RESULTS

The average surface roughness of composite increased from 1.4 Ra to 2.0 Ra, and from 0.8 Ra to 0.9 Ra for the ormocer material; however, these changes in roughness after whitening were not significant (p > 0.05). Also, when two materials were compared, the surface roughness of restorative materials was not different before and after whitening (p > 0.05). L* and b* values for each material changed significantly after whitening (p < 0.05). ΔE values (before/after whitening) calculated for composite (11.9) and ormocer (16.1) were not significantly different from each other (p > 0.05).

CONCLUSIONS

The tested whitening agent did not affect the surface roughness of either resin-based restorative material. Both materials became brighter after whitening. The behavior of the materials in the yellow/blue axis was opposite to each other after whitening. Each material had clinically unacceptable color change after whitening (ΔE > 5.5); however, the magnitude of the color change of materials was similar (p > 0.05). According to the results of this study, with the use of materials tested, patients should be advised that existing composite restorations may bleach along with the natural teeth, and replacement of these restorations after whitening may not be required.

Influence of Hydrogen Peroxide Bleaching Gels on Color, Opacity, and Fluorescence of Composite Resins

The aim of the present study was to evaluate the effect of 20% and 35% hydrogen peroxide bleaching gels on the color, opacity, and fluorescence of composite resins. Seven composite resin brands were tested and 30 specimens, 3-mm in diameter and 2-mm thick, of each material were fabricated, for a total of 210 specimens. The specimens of each tested material were divided into three subgroups (n=10) according to the bleaching therapy tested: 20% hydrogen peroxide gel, 35% hydroxide peroxide gel, and the control group. The baseline color, opacity, and fluorescence were assessed by spectrophotometry. Four 30-minute bleaching gel applications, two hours in total, were performed. The control group did not receive bleaching treatment and was stored in deionized water. Final assessments were performed, and data were analyzed by two-way analysis of variance and Tukey tests (p&lt;0.05). Color changes were significant for different tested bleaching therapies (p&lt;0.0001), with the greatest color change observed for 35% hydrogen peroxide gel. No difference in opacity was detected for all analyzed parameters. Fluorescence changes were influenced by composite resin brand (p&lt;0.0001) and bleaching therapy (p=0.0016) used. No significant differences in fluorescence between different bleaching gel concentrations were detected by Tukey test. The greatest fluorescence alteration was detected on the brand Z350. It was concluded that 35% hydrogen peroxide bleaching gel generated the greatest color change among all evaluated materials. No statistical opacity changes were detected for all tested variables, and significant fluorescence changes were dependent on the material and bleaching therapy, regardless of the gel concentration.

Effect of different light curing methods on mechanical and physical properties of resin-cements polymerized through ceramic discs

OBJECTIVE

The aim of this study was to compare the polimerization ability of three different light-curing units (quartz tungsten halogen, light-emitting diodes and plasma arc) and their exposure modes (high-intensity and soft-start) by determination of microhardness, water sorption and solubility, and diametral tensile strength of 5 dual-curing resin cements.

MATERIAL AND METHODS

A total of 720 disc-shaped samples (1 mm height and 5 mm diameter) were prepared from different dual-curing resin cements (Duolink, Nexus, Bifix-QM, Panavia F and RelyX Unicem). Photoactivation was performed by using quartz tungsten halogen (high-power and soft-up modes), light-emitting diode (standard and exponential modes) and plasma arc (normal and ramp-curing modes) curing units through ceramic discs. Then the samples (n=8/per group) were stored dry in the dark at 37°C for 24 h. The Vickers hardness test was performed on the resin cement layer with a microhardness tester (Shimadzu HMV). For sorption and solubility tests; the samples were stored in a desiccator at 37°C and weighed to a constant mass. The samples were weighed both before and after being immersed in deionized water for different periods of time (24 h and 7 days) and being desiccated. The diametral tensile strength of the samples was tested in a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed statistically by nonparametric Kruskal Wallis and Mann-Whitney U tests at 5% significance level.

RESULTS

Resin cement and light-curing unit had significant effects (p<0.05) on microhardness, diametral tensile strength, water solubility and sorption. However, no significant differences (p>0.05) were obtained with different modes of LCUs.

CONCLUSION

The study indicates that polymerization of resin cements with different light-curing units may result in various polymer structures, and consequently different mechanical and physical properties.

Effect of Bleaching on Microhardness of Esthetic Restorative Materials

High-concentration carbamide peroxide containing home bleaching may cause a varying influence on the microhardness of esthetic restorative materials.

Influence of Carbamide Peroxide on the Flexural Strength of Tooth-colored Restorative Materials: An In Vitro Study at Different Environmental Temperatures

The flexural strength of dental materials can be affected by carbamide peroxide. The environmental temperature can be thought to be a factor influencing the bleaching effects on dental materials.

Effect of four bleaching regimens on color changes and microhardness of dental nanofilled composite

Objective. The purpose of this study was to compare the color changes and microhardness of a nanocomposite after four bleaching regimens. Materials. Twenty-five specimens (n = 25) were made with a nanocomposite resin (Filtek Supreme XT). The specimens were divided into five groups equally (n = 5): bleaching groups and control group, as follows: G1: artificial saliva at 37°C; (control) G2: hydrogen peroxide (HP) at 7%; G3: hydrogen peroxide (HP) at 35%; G4: carbamide peroxide (CP) at 10%; G5: carbamide peroxide (CP) 35%. Color measurements were made with spectrophotometer using CIELAB color scale. The Vickers hardness (VHN) measurements were performed at the top surface. The data were analyzed with two-way Analysis of Variance. Results. ΔE and VHN mean values into the groups were not statistically different, however, the VHN mean values before and after storage and bleaching showed statistically significant differences. Conclusion. Nanocomposite samples showed no significant alteration (color and microhardness) after bleaching. Thus, no replacement of restorations is required after bleaching.

Effects of carbamide peroxide on the staining susceptibility of tooth-colored restorative materials

This study investigated the effects of an at-home bleaching gel containing 15% carbamide peroxide on the susceptibility of tooth-colored restorative materials to different staining solutions. The tooth-colored restoratives used in this study were a nano resin composite (Filtek Z350), a packable resin composite (Filtek P60), a polyacid-modified composite (Dyract AP) and a glass-ionomer cement (Ketac Molar Easymix). Each material was equally divided into two groups (n = 34): the bleaching group and the control group. This study included two treatment segments. In the first part (days 1-14), the specimens of the bleaching group were bleached with 15% carbamide peroxide gels for eight hours daily, while the specimens in the control group were stored in deionized water. Subsequently, four specimens from each group were randomly selected for observation under an environmental scanning electron microscope. In the second part (days 15-42), the samples were not bleached. Instead, they were stored in five different kinds of solutions. Color measurements for each sample were taken at six different time periods using a spectrophotometer. The data was then analyzed using SPSS statistical software. After two-weeks of bleaching, all the specimens showed statistically significant color changes compared with the control specimens. Furthermore, the bleaching agents seriously affected the surface morphology of Dyract AP and Ketac Molar Easymix. Following exposure to the staining solutions, it was found that the bleached restorative materials exhibited greater staining susceptibility than the control materials. Filtek Z350 and P60 exhibited the best color stability, while Dyract AP exhibited the least color stability.

Cosmetic dentistry

PURPOSE OF REVIEW

Patients seeking the expertise of facial plastic surgeons for facial aesthetic improvement may also desire or benefit from dental aesthetic procedures. This paper reviews current treatment options available in cosmetic dentistry.

RECENT FINDINGS

Many techniques exist to improve dental aesthetics in color, position, shape, size, alignment and overall smile appearance. Although orthodontic therapy is still an important modality for smile aesthetics, some simpler procedures can provide acceptable aesthetic results. Comparison of external dental bleaching techniques reveals similar long-term results for in-office and at-home bleaching; in-office treatments, however, may provide the benefit of faster results. Internal dental bleaching is an effective method for correcting nonvital teeth coloration. Enamel shaping via either direct tooth contouring or the application of resins or veneers to tooth surfaces can correct defects, asymmetries and shape or rotation problems. Veneers or crowns are also options to correct intrinsic dental stains not amenable to bleaching techniques. Treatments to refine gingival margins and borders are another proven beneficial cosmetic procedure.

SUMMARY

A myriad of techniques exist to correct a patient's particular concerns. Correction of discoloration is usually feasible as is the improvement of a patient's smile and overall dental aesthetics.