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Júnior NAN, Nunes GP, Gruba AS, Danelon M, da Silva LMAV, de Farias Batista G, Briso ALF, Delbem ACB. Evaluation of bleaching efficacy, microhardness, and trans-amelodentinal diffusion of a novel bleaching agent for an in-office technique containing hexametaphosphate and fluoride. Clin Oral Investig 2022; 26:5071-5078. [PMID: 35403911 DOI: 10.1007/s00784-022-04480-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/05/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study evaluated in vitro the effects of calcium gluconate (CaGlu), sodium fluoride (NaF), sodium hexametaphosphate (HMP), and NaF/TMP added to a 35% hydrogen peroxide (H2O2) bleaching gel on the color change, enamel hardness, and trans-amelodentinal diffusion. MATERIALS AND METHODS Enamel discs/bovine dentin (n = 150) were divided according to the bleaching gel: 35% H2O2 (H2O2); 35% H2O2 + 0.1% NaF (H2O2/NaF); 35% H2O2 + 1% HMP (H2O2/HMP); 35% H2O2 + 0.1% NaF + 1% HMP (H2O2/NaF/HMP), and 35% H2O2 + 2% CaGlu (H2O2/Caglu). The bleaching gels were applied three times (40 min/session) at 7-day intervals between each application. Then, color alteration (ΔE), whitening index (ΔWID), percentage of surface hardness loss (% SH), cross-sectional hardness (ΔKHN), and trans-amelodentinal diffusion were determined. Data were submitted for analysis of variance (ANOVA), followed by the Student-Newman-Keuls test (p < 0.05). RESULTS All bleaching gels showed significant color changes after treatment (p < 0.001). ΔE and ΔWID were similar among the evaluated gels. Mineral loss (% SH and ΔKHN) and trans-amelodentinal diffusion of hydrogen peroxide were lower for H2O2/NaF/HMP; the H2O2/CaGlu group presented the highest values about the other groups (p < 0.001). CONCLUSION It is possible to conclude that the addition of NaF/HMP to the in-office bleaching agent did not interfere with the bleaching efficacy and reduced enamel demineralization and H2O2 diffusion. CLINICAL SIGNIFICANCE The association of NaF/HMP to the bleaching gel can be used as a novel approach for minimizing the adverse effects of H2O2 by-products and with similar clinical efficacy.
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Affiliation(s)
- Nilson Antônio Nunes Júnior
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Amanda Scarpin Gruba
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Marcelle Danelon
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Lívia Maria Alves Valentim da Silva
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Gabriella de Farias Batista
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - André Luiz Fraga Briso
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Alberto Carlos Botazzo Delbem
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University-UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil.
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Pauli MC, Kanemaru MYS, Francisco Vieira-Junior W, Lima DANL, Bicas JL, Leonardi GR. Current status of whitening agents and enzymes in Dentistry. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-979020201000x32e19501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Karimi Z, Saoui H, Sakout M, Abdallaoui F. Effect of Vital Bleaching on Micromorphology of Enamel Surface: an in Vitro Study. Prim Dent J 2021; 10:126-131. [PMID: 33722125 DOI: 10.1177/2050168420980966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aims of this in vitro study was to investigate the effects of bleaching agents commonly used in micromorphology of the enamel surface and to assess the effect of concentration and of adding fluoride in the bleaching agents. METHODS Sixty freshly extracted intact teeth were stored in distilled water. One half of each tooth was served as control, the other part was treated with bleaching agent. Samples were randomly divided into six groups of ten, according to the bleaching agents: G1- at-home-CP10; G2- at-home-CP16; G3- at-home-CP22; G4- in-office-CP35; G5- in-office-HP40 with fluoride; G6- in-office-HP40 without fluoride. Enamel specimens for each group were then submitted to a quantitative scanning electron microscopy. Number of pores and their diameter were measured to assess porosity of enamel surface. RESULTS SEM analysis revealed enamel surface porosity after bleaching. Significant increase in number and major diameter of pores in bleached samples (p<0.001) were observed. The comparison between samples treated with 10% PC and samples treated with 22% PC showed significant increase in number of pores (p=0.006) and major diameter (p=0.001) from samples treated with 22% PC. Statistical analyses showed significant increase in the number of pores (p=0.006) from samples treated with 40% HP without fluoride compared to samples treated with 40% HP containing fluoride. CONCLUSIONS Bleaching products with low concentration cause less porosity at surface of the enamel compared to concentrated products. Adding fluoride in the bleaching agent appears to reduce porosity of enamel surface.
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Affiliation(s)
- Zakaria Karimi
- Assistant Professor in Conservative Dentistry, Department of Conservative Dentistry, Faculty of Dentistry, Mohammed V Military Teaching Hospital, Morocco
| | | | - Majid Sakout
- Professor of Higher Education in Conservative Dentistry, Professor of Higher Education and head of service of conservative dentistry, Department of Conservative Dentistry, Faculty of Dentistry, Mohammed V Military Teaching Hospital, Morocco
| | - Faiza Abdallaoui
- Professor of Higher Education and Head of Service of Conservative Dentistry, Department of Conservative Dentistry, Faculty of Dentistry, Mohammed V University in Rabat, Morocco
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D’Amario M, Bernardi S, Di Lauro D, Marzo G, Macchiarelli G, Capogreco M. Debonding and Clean-Up in Orthodontics: Evaluation of Different Techniques and Micro-Morphological Aspects of the Enamel Surface. Dent J (Basel) 2020; 8:E58. [PMID: 32560482 PMCID: PMC7344892 DOI: 10.3390/dj8020058] [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: 04/29/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022] Open
Abstract
There is currently no consensus on the best way to remove adhesive remnants from teeth following debonding. The main objective of this study is to evaluate and compare the effectiveness of four adhesive resin removal (clean-up) techniques, performed with or without the use of an operative microscope. Forty human teeth were duplicated using an epoxy resin for impregnation. Brackets were bonded to teeth and debonded from teeth. Then, the samples were randomly divided into two equal groups-the naked eye group and the magnification group-and further subdivided into four equal subgroups, in order to compare the different techniques used for the clean-up. Each subgroup was formed of five natural teeth with the respective pre- and post-bonding replicas. Macro- and micro-analysis by means of a stereomicroscope and scanning electron microscopy evaluated, qualitatively and quantitatively, the adhesive remnant index and the damage index of the enamel. Overall, the magnification improved the removal of resins compared to the naked eye (p < 0.001), and the use of magnification constantly reduced resin residual and surface damage. Enamel damage and adhesive residual from the clean-up procedures represent an ascertained risk in orthodontics. The use of a magnification system improves the quality of debonding and clean-up techniques in a significant way.
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Affiliation(s)
- Maurizio D’Amario
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
| | - Sara Bernardi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
- Microscopy Center, University of L’Aquila, 67100 L’Aquila, Italy
| | - Daniele Di Lauro
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
| | - Giuseppe Marzo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
| | - Guido Macchiarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
| | - Mario Capogreco
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.D.); (D.D.L.); (G.M.); (G.M.); (M.C.)
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Muntean A, Sava S, Delean AG, Mihailescu AM, Dumitrescu LS, Moldovan M, Festila DG. Toothpaste Composition Effect on Enamel Chromatic and Morphological Characteristics: In Vitro Analysis. MATERIALS 2019; 12:ma12162610. [PMID: 31426296 PMCID: PMC6720655 DOI: 10.3390/ma12162610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/06/2019] [Accepted: 08/10/2019] [Indexed: 12/21/2022]
Abstract
The aim of this in vitro study was to assess the effect of toothpastes, with different compositions, on optical and morphological features of sound and demineralized enamel. We selected twenty-five teeth, recently extracted for orthodontic purposes, for this in vitro study. The teeth were caries free, without stains, fissures, filling or hypoplasia observed at inspection under standard conditions. Teeth were brushed (for 2–3 min, twice a day, for 21 days), with five different toothpastes (four commercially available and an experimental one) containing fluoride and hydroxyapatite. After that, teeth were demineralized with 37% orthophosforic acid (Ultra Etch®, Ultradent Products Inc., South Jordan, UT, USA) for 60 s. We repeated the brushing protocol for another 21 days on demineralized enamel. Enamel vestibular surfaces were examined using a spectrophotometer (Vita EasyShade -Vita Zahnfabrik, Bad Sackingen, Germany) and a Scanning Electron Microscope (Inspect S®, FEI Company, Hillsboro, OR, USA). Differences were statistically significant for colour parameters L* and ΔE*. SEM evaluation reveals demineralized enamel mineral gain after brushing with selected toothpastes. Toothpastes with specific ingredients can represent a balance between aesthetic and mineralization, and an oral hygiene correct algorithm is able to preserve enamel characteristics during ortodontic treatement with fixed appliances.
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Affiliation(s)
- Alexandrina Muntean
- Paediatric Dentistry Department 2, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A. Iancu Street, 400083 Cluj-Napoca, Romania
| | - Sorina Sava
- Prosthodontics and Dental Materials Department 4, Iuliu Hatieganu University of Medicine and Pharmacy, 15 V. Babes Street, 400012 Cluj-Napoca, Romania.
| | - Ada Gabriela Delean
- Conservative Dentistry Department 2, Iuliu Hatieganu University of Medicine and Pharmacy, 33 Motilor Street, 400001 Cluj-Napoca, Romania
| | - Ana Maria Mihailescu
- Oral Rehabilitation Department 3, Iuliu Hatieganu University of Medicine and Pharmacy, 15 V. Babes Street, 400012 Cluj-Napoca, Romania
| | - Laura Silaghi Dumitrescu
- Department of Polymeric Composites, Babes-Bolyai University, Institute of Chemistry Raluca Ripan, 30 Fantanele Str., 400294 Cluj-Napoca, Romania
| | - Marioara Moldovan
- Department of Polymeric Composites, Babes-Bolyai University, Institute of Chemistry Raluca Ripan, 30 Fantanele Str., 400294 Cluj-Napoca, Romania
| | - Dana Gabriela Festila
- Orthodontics Department 1, Iuliu Haţieganu University of Medicine and Pharmacy, 31 A. Iancu Street, 400083 Cluj-Napoca, Romania
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do Carmo Públio J, Zeczkowski M, Burga-Sánchez J, Ambrosano GMB, Groppo FC, Aguiar FHB, Lima DANL. Influence of different thickeners in at-home tooth bleaching: a randomized clinical trial study. Clin Oral Investig 2018; 23:2187-2198. [DOI: 10.1007/s00784-018-2613-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 09/04/2018] [Indexed: 02/07/2023]
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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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Correa AC, Santana TR, Nahsan FP, Loguercio AD, Faria-e-Silva AL. The Impact of a Customized Tray on In-Office Bleaching Tooth Sensitivity: A Randomized Clinical Trial. Oper Dent 2016; 41:15-22. [DOI: 10.2341/15-029-c] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective
It was recently demonstrated that using a tray over a bleaching agent reduces its pulpal chamber penetration, which can reduce tooth sensitivity. This study evaluated the effect of the sealed technique on the presence and level of sensitivity reported by patients during and after the bleaching procedure performed in office.
Methods
Forty-six patients underwent a bleaching procedure with 35% hydrogen peroxide used in a single application of 45 minutes for two sessions with an interval of seven days. A customized tray was maintained over the bleaching agent during the entire procedure in half of the patients. The sensitivity level was evaluated during and immediately after the bleaching using verbal and visual analogue scales. The shade alteration was evaluated with a bleach guide scale. The peak sensitivity after 24 hours and the presence/level at 24 hours were also evaluated using a verbal rating scale. Relative risks were calculated for all time assessments. Data on the sensitivity level for both scales were subjected to Friedman and Mann-Whitney tests (α=0.05). Data on the shades were analyzed by two-way repeated-measures analysis of variance and Tukey's test (α=0.05).
Results
The use of a customized tray increased the relative risks to the tooth measured 24 hours after each bleaching session. The sealed technique also increased the level of tooth sensitivity only at 24 hours after the first session. No difference was observed between the bleaching techniques regarding the shade evaluation.
Conclusion
Using a tray over the bleaching agent can increase the level and risk of tooth sensitivity for the first 24 hours after in-office bleaching.
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Affiliation(s)
| | - TR Santana
- Tauan R Santana, undergraduate student, Department of Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - FP Nahsan
- Flávia P Nahsan, adjunct professor, Department of Dentistry, Federal School of Dentistry of Sergipe, Aracaju, Brazil
| | - AD Loguercio
- Alessandro D Loguercio, full professor, Department of Restorative Dentistry, Ponta Grossa State University, Ponta Grossa, Brazil
| | - AL Faria-e-Silva
- André L Faria-e-Silva, adjunct professor, Department of Dentistry, Federal School of Dentistry of Sergipe, Aracaju, Brazil
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Cintra LTA, Benetti F, da Silva Facundo AC, Ferreira LL, Gomes-Filho JE, Ervolino E, Rahal V, Briso ALF. The number of bleaching sessions influences pulp tissue damage in rat teeth. J Endod 2013; 39:1576-80. [PMID: 24238450 DOI: 10.1016/j.joen.2013.08.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 08/06/2013] [Accepted: 08/06/2013] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Hydrogen peroxide tooth bleaching is claimed to cause alterations in dental tissue structures. This study investigated the influence of the number of bleaching sessions on pulp tissue in rats. METHODS Male Wistar rats were studied in 5 groups (groups 1S-5S) of 10 each, which differed by the number (1-5) of bleaching sessions. In each session, the animals were anesthetized, and 35% hydrogen peroxide gel was applied to 3 upper right molars. Two days after the experimental period, the animals were killed, and their jaws were processed for light microscope evaluation. Pulp tissue reactions were scored as follows: 1, no or few inflammatory cells and no reaction; 2, <25 cells and a mild reaction; 3, between 25 and 125 cells and a moderate reaction; and 4, 125 or more cells and a severe reaction. Results from each experimental group were compared between groups and within groups to the corresponding unbleached upper left molars and analyzed for significant differences using the Kruskal-Wallis test (P < .05). RESULTS All tissue sections showed significant bleaching-induced changes in the dental pulp. After 1 bleaching session, necrotic tissue in the pulp horns and underlying inflammatory changes were observed. The extent and intensity of these changes increased with the number of bleaching sessions. After 5 sessions, the changes included necrotic areas in the pulp tissue involving the second third of the radicular pulp and intense inflammation in the apical third. CONCLUSIONS The number of bleaching sessions directly influenced the extent of pulp damage.
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