Impact of Microabrasion on the Effectiveness of Tooth Bleaching

Effects of microabrasion and bleaching on color and shear bond strength of simulated stained-remineralized caries lesions

Purpose

This study investigated the effects of bleaching and microabrasion on the color and shear bond strength (SBS) of stained-remineralized caries-like lesions (s-RCLs).

Methods

Human enamel specimens were demineralized, stained (coffee/tea), then remineralized (2% NaF and artificial saliva [AS]) to create s-RCLs. Specimens were randomly divided into five groups (n = 18): G1, demineralized/AS; G2, s-RCLs/AS; G3, s-RCLs/at-home bleaching (15% carbamide peroxide [CP)], 6 h/d×7)/AS; G4, s-RCLs/microabrasion (6.6% hydrochloric acid, [1min/3cycles]/AS; and G5, s-RCLs/microabrasion and at-home bleaching/AS. Color was spectrophotometrically measured at baseline, after demineralization, after staining, and after treatment. After two weeks, the SBS was tested using a universal testing machine. Outcomes were analyzed using ANOVA models followed by Tukey's test (α = 0.05).

Results

The mean colors (ΔE) for demineralization and staining were significant (ΔE ≤ 5.9 and ≤14.4, respectively). G3 (ΔE 23.9) and G5 (ΔE 25.2) were significantly improved compared to G4 (ΔE 12.3). The SBS in G5 had the highest significant value (25.2 MPa), followed by G4 and G3 (21.5-20.6 MPa), which were significantly higher than G2 (16.8 MPa). G2, in turn, was more significant than G1 (10.9 MPa).

Conclusion

At-home bleaching (15% CP) for seven days eliminated and improved organic stains on RCLs. Faster results were achieved when combined with microabrasion. All surface treatments resulted in high SBS.

Efficacy of F-ACP-Containing Dental Mousse in the Remineralization of White Spot Lesions after Fixed Orthodontic Therapy: A Randomized Clinical Trial

Fixed appliance (FA) therapy predisposes patients to white spot lesions (WSLs). The F-ACP complex (amorphous calcium phosphate nanoparticles enriched with carbonate and fluorine and coated with citrate) has been effective for in vitro enamel remineralization. The aim of this study was to evaluate the efficacy of the F-ACP complex in remineralizing WSLs after FA therapy. One hundred and six adolescents (aged 12-20 years) were randomized into study and control groups after FA therapy. Patients in the study group were advised to use dental mousse containing F-ACP applied within Essix retainers for six months. The presence of WSLs was recorded at baseline (T0), 3 months (T1), and 6 months (T2) according to the International Caries Detection and Assessment System (ICDAS). Visual Plaque Index (VPI) and Gingival Bleeding Index (GBI) were recorded. Among 106 study participants, 91 (52 and 39 in study and control groups, respectively) completed the study. The results showed that the ICDAS score was significantly lower (p < 0.001) in the study group than in the control group between T0 and T2. The application of mousse containing the F-ACP complex inside Essix retainers for six months is effective in remineralizing white spot lesions in patients after FA therapy without side effects.

Effects of microabrasion association to at-home bleaching on hydrogen peroxide penetration and color change

PURPOSE

This study aimed to quantify the penetration of hydrogen peroxide (HP) inside the pulp cavity and color change with two different concentrations of HP to at-home bleaching associated or not with enamel microabrasion (MA).

METHODS

Forty healthy premolars were randomly divided in four groups (n = 10): only HP4%, MA + HP4%, only HP10%, MA + HP10%. The concentration (μg/ml) of HP was assessed using UV-Vis spectrophotometry. The color change (ΔEab , ΔE00 and WID ) was evaluated before and one-week after bleaching. Data were evaluated for a two-way ANOVA and the Tukey's test (α = 0.05).

RESULTS

The application of MA increased the amounts of HP inside the pulp chamber when compared to without MA, as well as PH10% when compared to PH4% (p < 0.0001). PH10% showed higher WID when compared to PH4%. No significant difference was observed when ΔEab , and ΔE00 were used.

CONCLUSIONS

The enamel MA before at-home bleaching promotes greater penetration of HP, although this procedure did not significantly affect the color change.

CLINICAL SIGNIFICANCE

Since greater penetration of HP into the pulp chamber was detected when home bleaching was applied immediately after MA, the clinician should not apply home bleaching gels in the same session when MA was performed.

Effects of Microabrasion Prior to In-office Bleaching on Hydrogen Peroxide Permeability, Color Change, and Enamel Morphology

PURPOSE

This study evaluated hydrogen peroxide (HP) diffusion within the pulp chamber, as well as color change and the surface morphology of teeth subjected to various microabrasion (MA) protocols associated or not with in-office (IO) bleaching.

METHODS

Forty sound premolars were randomly divided into the following four groups (n=10): no treatment (NC); IO bleaching only; IO immediately after MA (IMA), and IO seven days after MA (7MA). After treatments, the HP concentration (μg/mL) within the pulp chamber was determined using ultraviolet-visible (UV-Vis) spectrophotometry. The color change (ΔE*) was evaluated using the digital spectrophotometer before and 1 week after bleaching. The surface morphology was evaluated by scanning electron microscope (SEM). Data from each test were submitted to one-way ANOVA and Tukey tests (α=0.05).

RESULTS

All experimental groups exhibited higher HP concentrations compared to the NC group (p<0.00001). However, higher amounts of HP were observed for the IMA group compared to the IO and 7MA groups (p<0.00001). No significant difference in color change was observed among the groups (p<0.001). Pronounced grooves in enamel were found in the IMA and 7MA groups. However, enamel erosion areas were observed only in the 7MA group.

CONCLUSIONS

The association between MA and IO bleaching could significantly affect the amount of HP inside the pulp chamber. Therefore, it is highly recommended to wait for 1 week after MA procedures before performing IO bleaching.

Microabrasion effect on enamel susceptibility to penetration of hydrogen peroxide: an experimental and computational study

To evaluate in vitro transenamel/transdentinal of penetration of H₂O₂ after microabrasive. Computational models were performed to verify peroxide penetration and evaluate if geometric modifications could affect in vitro results. Enamel/dentin blocks from bovine incisors were prepared and randomly divided into groups (n = 15) according with abrasive (35% phosphoric acid and pumice or 6.6% hydrochloric acid and silica) and bleaching agents (16% carbamide peroxide and 35% H₂O₂). From artificial pulp chambers, the H₂O₂ concentration was measured and SEM was used for surface morphology. Numerical models were performed (Abaqus® v6.12) modifying slightly enamel/dentin thickness based on experimental data. All groups presented H₂O₂ penetration, although no significant difference was noted between the control and experimental groups (p > 0.05). The numerical analysis demonstrated the role of dental tissue thickness in the H₂O₂ penetration. Microabrasion is recommended as its association with bleaching procedures and small modifications in thicknesses of enamel/dentin can cause substantial changes in HP penetration. Such diffusion aspect is clinically relevant for the bleaching procedures since very thin enamel could present more peroxide propagation through dental tissues.

La micro-abrasion amélaire associée à l’éclaircissement externe: intérêt dans la prise en charge de la fluorose

La fluorose dentaire est une anomalie de développement qui affecte l'aspect esthétique des dents. L'association de la micro-abrasion à l'éclaircissement externe a montré des résultats satisfaisants pour l'amélioration de l'esthétique des dents atteintes de fluorose légère. L'objectif de ce travail est de mettre le point sur l'intérêt de cette association ainsi que sur ses différents effets sur la surface amélaire.