Fracture strength of incisor crowns after intracoronal bleaching with sodium percarbonate

Effects of alpha-tocopherol antioxidant on fracture strength and adhesion of endodontically treated teeth restored after dental bleaching

This study evaluated the effect of different concentrations of alpha-tocopherol in gel form on fracture strength, hybrid layer formation, and microtensile bond strength of endodontically treated teeth bleached with 40% hydrogen peroxide (H2 O2 ). Sixty bovine incisors were randomized into one of six groups (n = 10 incisors per group) defined by the interventions carried out after endodontic treatment. In the control group, no additional intervention was carried out, while all teeth in the five intervention groups were bleached with 40% H2 O2 and subsequently treated with alpha-tocopherol at concentrations of 15% (15AT), 20% (20AT), or 25% (25AT), with 10% sodium ascorbate (10SA), or with nothing (40HP). Fracture strength was evaluated in a mechanical testing machine, hybrid layer formation was assessed using scanning electron microscopy, and bond strength was determined using microtensile bond-strength testing. Data were analyzed using Kruskal-Wallis and Dunn's tests. No statistically significant difference regarding fracture strength was observed among groups. Hybrid layer formation was greater in the 15AT group than in groups 40HP and 10SA. Teeth in groups 15AT, 20AT, and 25AT demonstrated higher bond strength than teeth in groups 40HP and 10SA. Alpha-tocopherol, preferably at 15%, effectively reverses the deleterious effects, of bleaching, on hybrid layer formation and bond strength to dentin.

Fracture strength and hybrid layer formation of endodontically-treated teeth after dental bleaching photoactivated with violet LED

OBJECTIVE

To evaluate in vitro the effect of dental bleaching using high concentration hydrogen peroxide (HP) photoactivated with violet LED on fracture strength and hybrid layer formation.

METHODS

forty endodontically-treated bovine teeth were randomized into four groups (n = 10): C - Control, HP - 35% hydrogen peroxide, HP-BL - 35% hydrogen peroxide photoactivated with blue LED, HP-VL - 35% hydrogen peroxide photoactivated with violet LED. Three bleaching sessions with an interval of 7 days between them were performed. After 10 days of the last bleaching session, the dental crowns were restored and submitted to the fracture strength test. Five specimens from each group were used to evaluate the hybrid layer formation by scanning electron microscope (SEM) images. One-way ANOVA and Kruskal-Wallis test were used for parametric and non-parametric data, respectively. Significance level of 5% was adopted to all the tests.

RESULTS

No differences on fracture strength among the groups were observed (p > 0.05). HP and HP-BL showed alterations on hybrid layer formation compared to C group (p < 0.05), but not for HP-VL (p > 0.05). No differences on hybrid layer formation were observed among HP, HP-VL and HP-BL groups (p > 0.05).

CONCLUSION

Dental bleaching, photoactivated or not, did not affect the fracture strength of endodontically-treated teeth. Regardless of the protocol used, hydrogen peroxide altered the hybrid layer formation at some level when the restoration was placed after 10 days of the last bleaching session.

Fracture resistance and bonding performance after antioxidants pre-treatment in non-vital and bleached teeth

This study aimed to evaluate the effect of antioxidant solutions on fracture strength and bonding performance in non-vital and bleached (38% hydrogen peroxide) teeth. One hundred and eighty dentin specimens were obtained, 60 for each test: fracture strength, hybrid layer thickness, and bond strength. The groups (n=10) were randomly composed according to post-bleaching protocol: REST - restoration, without bleaching; BL - bleaching + restoration; SA - bleaching, 10% sodium ascorbate solution, and restoration; AT - bleaching, 10% α-tocopherol solution, and restoration; CRAN - bleaching, 5% cranberry solution, and restoration; CAP - bleaching, 0.0025% capsaicin solution, and restoration. Data were analyzed with ANOVA, Kruskal-Wallis, Dunn, and Qui-Square tests (α=0.05). The highest fracture strength values were observed in REST (1508.96 ±148.15 N), without significant difference for the bleached groups (p>0.05), regardless of the antioxidant use. The hybrid layer thickness in the group that was not subjected to bleaching (REST) was significantly higher than in any other group. The bond strength in the bleached and antioxidants-treated groups (SA, AT, CRAN, CAP) has no differences with the bleached group without antioxidants (BL). Adhesive failures were predominant in the groups that did not receive the antioxidant application. In conclusion, the evaluated antioxidants did not show an effect on the fracture strength, hybrid layer thickness, or bond strength of dentin bleached after endodontic treatment. The application of 10% sodium ascorbate, 10% alpha-tocopherol, 5% cranberry, or 0.0025% capsaicin solutions is not an effective step and should not be considered for the restorative protocols after non-vital bleaching.

Impact of different intraorifice barriers on fracture resistance of non-vital bleached teeth

Background and Aim

This study aimed to evaluate the effects of bleaching agents on the fracture resistance of endodontically treated teeth using different intraorifice barrier (IOB) materials.

Materials and Methods

The endodontic treatment was performed for 160 mandibular premolars, and then, the teeth were divided into four groups according to the IOB: Ionoseal, Biodentine, ProRoot MTA, and TheraBase. Then, these teeth were subdivided into four subgroups (n = 10) based on the bleaching agents as distilled water (control), hydrogen peroxide 35% (HP), sodium perborate (SP), and carbamide peroxide 37% (CP). The access cavities were restored with composite resin after applying the bleaching agents for 7 days. The fracture resistance test was performed using a universal testing machine. Data were statistically analyzed, and the significance level was set at 5%. A scanning electron microscope was used to evaluate the effect of bleaching agents on the surfaces of IOBs.

Results

The highest fracture resistance values were observed in Biodentine groups with significant differences compared to Ionoseal and ProRoot MTA (P <.05). The distilled water groups showed significantly the highest fracture resistance compared to SP and HP groups (P <.05). There was no significant difference between SP, HP, and CP groups (P >.05). It was demonstrated that the morphological surface of the intact IOBs (control) was different from the surface of IOBs treated with bleaching agents.

Conclusion

The intracoronal bleaching procedures affected negatively the fracture resistance of the endodontically treated teeth.

Effects of the Ratio between Pigment and Bleaching Gel on the Fracture Resistance and Dentin Microhardness of endodontically treated Teeth

INTRODUCTION

The aim of this study was to evaluate the effects of bleaching gel using 35% hydrogen peroxide (HP), associated with red carmine pigment (RC), in the 3:1 or 1:1 ratio, on fracture resistance and dentin microhardness of endodontically treated teeth.

MATERIALS AND METHODS

A total of 40 lower incisors were endodontically treated and divided into four groups (n = 10), according to the bleaching protocol: G1 (HP3), 35% HP + RC (3:1); G2 (HP1), 35% HP + RC (1:1); G3 (positive), 38% HP; and G4 (negative), unbleached. Four dental bleaching sessions were performed. The dental crowns were restored after the last session and submitted to the fracture resistance test. Totally, 60 specimens from the endodontically treated lower incisor crowns were prepared to evaluate the effects on dentin microhardness. The analysis was measured (in Knoop) prior to and after the last dental bleaching session using similar bleaching protocols.

RESULTS

G2 presented the lowest fracture resistance (p < 0.05). The other groups were similar to each other (p > 0.05). No difference was observed in the reduction of dentin microhardness among the groups (p > 0.05).

CONCLUSION

A 1:1 ratio (bleaching gel:pigment) caused a significant fracture resistance reduction in relation to the other protocols. No effect on the dentin microhardness reduction was observed.

CLINICAL SIGNIFICANCE

The pigment addition to the bleaching agent accelerates the bleaching chemical reaction. However, no studies have evaluated the ideal proportion to optimize tooth bleaching.

Fracture resistance of simulated immature teeth after internal bleaching procedures

The aim of this study was to evaluate the fracture resistance of simulated immature teeth after internal bleaching. The teeth were assigned as follows (n = 12/group); Group-1: The pulp chamber was filled with ProRootMTA and bleached intracoronally with sodium perborate mixed with 37% carbamide peroxide gel; Group-2: The pulp chamber was filled with ProRootMTA without bleaching; Group-3: The pulp chamber was filled with Biodentine and bleached intracoronally as Group-1; Group-4: The pulp chamber was filled with Biodentine without bleaching; and Group-5: Teeth received no intervention (control). The specimens were loaded vertically until root fracture occurred. The data were analysed with Kruskal-Wallis and Dunn tests. There was no significant difference between the fracture resistances of the experimental groups (P > 0.05). However, all experimental groups had significantly lower fracture resistance than the control group (P < 0.05). Neither the tested calcium silicate cements nor the bleaching procedures had a significant impact on fracture resistance values.

Effect of tooth whitening strips on fatigue resistance and flexural strength of bovine dentin in vitro

Objective

To determine the effects of whitening strips on bovine dentin fatigue resistance and flexural strength in vitro.

Materials and methods

A total of eighty bovine dentin specimens (2x2x17mm) were treated with either: control glycerine gel on plastic film wrap or whitening strips containing 9.5% hydrogen peroxide. Treatment was applied for 30 minutes, twice a day, for 1- or 4-weeks. After the last treatment, ten specimens per group were randomly selected to undergo fatigue testing (10⁶ cycles, 3Hz, 20N) while the other ten were subjected to flexural strength testing after ten days of storage in artificial saliva. Kaplan-Meier method with a log rank test, Wilcoxon test and Cox regression were used to assess fatigue test results (p<0.05). One-way ANOVA and Tukey’s tests were used to compare the flexural strength results (p<0.05).

Results

There were significant differences in survival during the fatigue test among the groups (p<0.001). Treatment (control or bleach) was a significant factor for specimen survival (p<0.001, Exp(B) = 33.45). There were significant differences in mean flexural strength (p<0.001). No significant difference was found between “1-wk control” and “4-wk control”. The mean flexural strength and fatigue resistance of the “4-wk bleach” were significantly lower than all the other groups.

Conclusions

The use of whitening strips reduced the fatigue resistance and flexural strength of bovine dentin in vitro. Until the effect of whitening strips on mechanical properties of human dentin is fully elucidated, it remains prudent to advise patients to avoid excessive direct use of whitening strips on dentin.

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.

Fracture resistance of endodontically-treated teeth submitted to bleaching treatment with hydrogen peroxide and titanium dioxide nanoparticles photoactivated by LED-laser

Objective: The aim of this study was evaluate the fracture resistance of endodontically-treated teeth after bleaching treatment using 15% hydrogen peroxide plus titanium dioxide nanoparticles (15HPTiO2) photoactivated by LED-laser, in comparison with protocols using 35% hydrogen peroxide (35HP), 37% carbamide peroxide (37CP) or sodium perborate (SP). Material and method: After endodontic treatment, fifty bovine extracted incisors were divided into five groups (n = 10): G1- without bleaching; G2- 35HP; G3- 37CP; G4- 15HPTiO2 photoactivated by LED-laser and G5- SP. In G2 and G4, the bleaching protocol was applied in 4 sessions, with a 7 day interval between each session. In G3 and G5, the materials were kept in the pulp chamber for 21 days, but replaced every 7 days. After 21 days, the crowns were subjected to compressive load at a cross head speed of 0.5 mm/min, applied at 135° to the long axis of the root using an eletromechanical testing machine, until fracture. The data were submitted to ANOVA and Tukey tests (p = 0.05). Result: The bleaching treatment in endodontically-treated teeth with 15HP plus TiO2 nanoparticles and photoactivated by LED-laser caused reduction of the fracture resistance similarly provided by 35HP, 37CP or SP (p>0.05). All bleaching treatments reduced the fracture resistance compared to unbleached teeth (p<0.05). Conclusion: All bleaching protocols reduced the fracture resistance of endodontically-treated teeth, but there were no differences between each other.

Fracture resistance of teeth submitted to several internal bleaching protocols

AIM

The aim of this study was to evaluate the fracture resistance of teeth submitted to several internal bleaching protocols using 35% hydrogen peroxide (35HP), 37% carbamide peroxide (37CP), 15% hydrogen peroxide with titanium dioxide nanoparticles (15HPTiO2) photoactivated by LED-laser or sodium perborate (SP).

MATERIALS AND METHODS

After endodontic treatment, fifty bovine extracted teeth were divided into five groups (n = 10): G1-unbleached; G2-35HP; G3-37CP; G4-15HPTiO2 photoactivated by LED-laser and G5-SP. In the G2 and G4, the bleaching protocol was applied in 4 sessions, with 7 days intervals between each session. In the G3 and G5, the materials were kept in the pulp teeth for 21 days, but replaced every 7 days. After 21 days, the teeth were subjected to compressive load at a cross head speed of 0.5 mm/min, applied at 135° to the long axis of the root using an eletromechanical testing machine, until teeth fracture. The data were submitted to ANOVA and Tukey tests (α = 5%).

RESULTS

The 35HP, 37CP, 15HPTiO2 and SP showed similar fracture resistance teeth reduction (p > 0.05). All bleaching treatments reduced the fracture resistance compared to unbleached teeth (p < 0.05).

CONCLUSION

All bleaching protocols reduced the fracture resistance of endodontically-treated teeth, but there were no differences between each other.

CLINICAL SIGNIFICANCE

There are several internal bleaching protocols using hydrogen peroxide in different concentrations and activation methods. This study evaluated its effects on fracture resistance in endodontically-treated teeth.