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Mohammadipour HS, Shokrollahi P, Gholami S, Bagheri H, Namdar F, Sekandari S. Do Different Tooth Bleaching-Remineralizing Regimens Affect the Bleaching Effectiveness and Enamel Microhardness In Vitro? Int J Dent 2024; 2024:6893472. [PMID: 38384326 PMCID: PMC10881252 DOI: 10.1155/2024/6893472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/27/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024] Open
Abstract
Objective Tooth bleaching may negatively affect the enamel surface properties, such as reduction in hardness values, and remineralizing agents can reverse these effects. This study evaluated the effect of remineralizing agents before, during, and after the bleaching process on enamel's whitening effectiveness and microhardness. Methods and Materials The initial color of 104 bovine incisors after immersion in tea solution was recorded, and then, the teeth were randomly divided into eight groups (n = 13). Group 1 (NC) was considered the control with no treatment, and Group 2 (B) was bleached with 40% hydrogen peroxide gel. The 3% fluorohydroxyapatite (FHA) and 2% sodium fluoride (NaF) were applied before (FHA/B, NaF/B), during (FHA + B, NaF + B) and after (B/FHA, B/NaF) the bleaching process in other groups. The final color and microhardness in three depths of 20-30, 50-60, and 100-120 µm were measured. Data were analyzed using Shapiro-Wilk, one-way ANOVA, Tukey, Games Howell, repeated measurement, and LSD tests. Results The FHA + B presented the lowest ΔE, significantly lower than other groups, except B/FHA. The ΔE in B/FHA was significantly lower than B/NaF. The bleaching significantly reduced the enamel hardness in three depths. The highest microhardness values were reported for B/NaF and NaF + B, which have no noticeable difference with NC, while FHA/B showed the lowest hardness in three depths, which was significantly lower than NC. Conclusion The application of NaF before, during, and after the bleaching improved the microhardness of bleached enamel as the unbleached one with no adverse effect on whitening effectiveness.
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Affiliation(s)
- Hamideh Sadat Mohammadipour
- Department of Restorative and Cosmetic Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Sima Gholami
- School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hosein Bagheri
- Dental Materials Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Namdar
- School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Salehe Sekandari
- Dental Research Center, Department of Cosmetic and Restorative Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Cardoso MEDOP, Takeuchi EV, Alencar CDM, de Mesquita RA, Alves EB, Silva CM. The effect of photobiomodulation therapy associated with casein phosphopeptide-amorphous calcium phosphate fluoride paste on the treatment of posthome whitening tooth sensitivity and color change: A randomized clinical trial. Clin Exp Dent Res 2024; 10:e817. [PMID: 38345511 PMCID: PMC10828902 DOI: 10.1002/cre2.817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/15/2023] [Accepted: 10/31/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE This study assessed whether combining photobiomodulation therapy (PBMT) with casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) paste can effectively reduce post-home whitening tooth sensitivity (TS) without compromising shade change. METHODS Fifty participants were selected and assigned to one of four groups: (1) PLACEBO group-received a placebo paste and PBMT simulation; (2) PBMT group-received a placebo paste + PBMT; (3) CPP-ACPF group-received CPP-ACPF paste and PBMT simulation; (4) CPP-ACPF + PBMT group-received both CPP-ACPF paste and PBMT. The participants used whitening trays containing 22% carbamide peroxide for 2 h a day for 21 days. TS was measured daily using a visual analog scale, while shade change was assessed using a spectrophotometer: before bleaching treatment (T0), after the first (T1), second (T2), and third (T3) weeks of treatment, and 30 days (T4) after completing the whitening treatment. RESULTS Intragroup analysis revealed that the PLACEBO group had the highest increase in sensitivity during the whitening treatment. The CPP-ACPF and PBMT groups showed no significant difference tooth whitening (TW) between weeks regarding aesthetic change. The CPP-ACPF and PBMT group exhibited a significant reduction in TS between the first and third and between the second and third weeks TW, but not between the first and second. Conversely, the PLACEBO group showed a higher sensitivity than the other groups (p < .05). The CPP-ACPF and PBMT groups did not differ from each other. Furthermore, the CPP-ACPF and PBMT group showed a greater decrease in sensitivity than the PLACEBO group at T1, T2, and T3 (p < .01), and was significantly differed from CPP-ACPF and PBMT groups only at T2 and T3. All groups confirmed TW effectiveness. Student's and paired t-test did not reveal any significant difference between groups (p > .05). CONCLUSION Therefore, PBMT associated with CPP-ACPF paste can reduce TS without compromising the efficacy of TW.
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Affiliation(s)
| | - Elma V. Takeuchi
- Department of Restorative Dentistry, Dental SchoolFederal University of ParáBelémParáBrazil
| | | | - Raissa A. de Mesquita
- Department of Restorative Dentistry, Dental SchoolFederal University of ParáBelémParáBrazil
| | - Eliane B. Alves
- Department of Restorative Dentistry, Dental SchoolFederal University of ParáBelémParáBrazil
| | - Cecy M. Silva
- Department of Restorative Dentistry, Dental SchoolFederal University of ParáBelémParáBrazil
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Yezdani S, Khatri M, Vidhya S, Mahalaxmi S. Effect of strontium fluorophosphate bioactive glass on color, microhardness and surface roughness of bleached enamel. Technol Health Care 2024; 32:285-292. [PMID: 37270825 DOI: 10.3233/thc-230074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Undesirable effects of tooth bleaching can alter the biomechanical properties of enamel. OBJECTIVE To determine the influence of strontium fluorophosphate bioactive glass (Sr-FPG) on color, microhardness and surface roughness of enamel bleached with 35% hydrogen peroxide. METHODS The labial enamel of 36 extracted intact human anterior teeth were divided into 3 groups (n= 12), group 1 (HP): bleaching with 35% hydrogen peroxide only, group 2 (Sr-HP): bleaching with Sr-FPG incorporated 35% hydrogen peroxide and group 3 (HP-SrFPG): bleaching with 35% hydrogen peroxide followed by remineralization with Sr-FPG. Four consecutive eight-minute applications of the bleaching gel were done twice in all the groups. Color change (ΔE), microhardness and surface roughness were evaluated at baseline, post-bleaching and post-remineralization using spectrophotometer, Vickers hardness tester and profilometric analysis respectively. RESULTS The mean ΔE among the groups was statistically similar (p> 0.05). Bleaching with HP significantly reduced microhardness (p< 0.05), whereas bleaching with Sr-HP and HP-SrFPG did not (p> 0.05). Post-bleaching microhardness in Sr-HP was significantly higher than HP-SrFPG (p< 0.05). An increased surface roughness was seen in Sr-HP bleached samples (p< 0.05). CONCLUSION The addition of Sr-FPG to hydrogen peroxide significantly improved enamel microhardness than its use post-bleaching. An increase in surface roughness was seen post-bleaching with HP and Sr-HP.
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Favoreto MW, de Souza Carneiro T, Forville H, Burey A, Simas Dreweck FD, Loguercio AD, Reis A. Use of calcium-containing bioactive desensitizers in dental bleaching: A systematic review and meta-analysis. J Am Dent Assoc 2023; 154:245-259.e12. [PMID: 36717350 DOI: 10.1016/j.adaj.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/26/2022] [Accepted: 11/28/2022] [Indexed: 01/30/2023]
Abstract
BACKGROUND Topical application of calcium-containing bioactive desensitizers (CBs) has been used to minimize bleaching-induced tooth sensitivity (TS). This study answered the research question "Is the risk of TS lower when CBs are used with dental bleaching in adults compared with bleaching without desensitizers?" TYPES OF STUDIES REVIEWED The authors included randomized clinical trials comparing topical CB application with a placebo or no intervention during bleaching. Searches for eligible articles were performed in MEDLINE via PubMed, Cochrane Library, Brazilian Library in Dentistry, Latin American and Caribbean Health Sciences Literature, Scopus, Web of Science, Embase, and gray literature without language and date restrictions and updated in September 2022. The risk of bias was evaluated using Risk of Bias Version 2.0. The authors conducted meta-analyses with the random-effects model. The authors assessed heterogeneity with the Cochrane Q test, I2 statistics, and prediction interval. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty of the evidence. RESULTS After database screening, 22 studies remained, with most at high risk of bias. No difference in the risk of TS was detected (risk ratio, 0.95; 95% CI, 0.90 to 1.01; P = .08, low certainty). In a visual analog scale, the intensity of TS (mean difference, -0.98; 95% CI, -1.36 to -0.60; P < .0001, very low certainty) was lower for the CB group. The color change was unaffected (P > .08). PRACTICAL IMPLICATIONS Although topical CB dental bleaching did not reduce the risk of TS and color change, these agents slightly reduced the TS intensity, but the certainty of the evidence is very low.
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Bizreh Y, Milly H. Effect of bioactive glass paste on efficacy and post-operative sensitivity associated with at-home bleaching using 20% carbamide peroxide: a randomized controlled clinical trial. Eur J Med Res 2022; 27:194. [PMID: 36195927 PMCID: PMC9531444 DOI: 10.1186/s40001-022-00826-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to evaluate the effect of bioactive glass (BAG) 45S5 paste on colour change and tooth sensitivity (TS) when used in combination with 20% carbamide peroxide (CP) during at-home vital tooth bleaching. Methods Twenty-four patients were selected and assigned into two experimental groups (n = 12) in a double-blind study design. Each patient received 20% CP followed by the application of either BAG paste or non-active placebo paste. The shade evaluation was performed using a digital spectrophotometer based on the CIE L*a*b* colour space system at different time points and the overall colour changes ΔE were calculated. TS was evaluated using visual analogue scale (VAS). The values of ΔE and TS were statistically analysed using paired t-test. The level of statistical significance was established at p = 0.05. Results The overall colour changes (ΔE) between baseline and each time point showed no significant differences between BAG and placebo groups (p > 0.05). The use of BAG paste significantly decreased TS reported by the participants. Conclusions The association of BAG paste with at-home bleaching treatment presents a promising method as it decreased TS and did not deteriorate bleaching efficacy. Trial registration This study was approved and registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under Registration number: ACTRN12621001334897.
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Affiliation(s)
- Yazan Bizreh
- Department of Restorative Dentistry, Faculty of Dental Medicine, Damascus University, Mazah, Damascus, Syria
| | - Hussam Milly
- Department of Restorative Dentistry, Faculty of Dental Medicine, Damascus University, Mazah, Damascus, Syria.
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Carneiro AMP, Barros APO, de Oliveira RP, de Paula BLF, Silva AM, de Melo Alencar C, Silva CM. The effect of photobiomodulation using low-level laser therapy on tooth sensitivity after dental bleaching: a systematic review. Lasers Med Sci 2022; 37:2791-2804. [PMID: 35597839 DOI: 10.1007/s10103-022-03578-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
The authors aimed to conduct a systematic review to assess data from the current literature on the effectiveness of low-level laser therapy (LLLT) in preventing tooth sensitivity (TS) after tooth whitening (DB). PRISMA guidelines for systematic reviews were followed. Clinical trials evaluating the treatment of LLLT in patients with sensitivity after tooth whitening were selected. A full bibliographic search was performed on May 4, 2021, in the following databases: Embase, MEDLINE via PubMed, SciELO, VHL Regional Portal, Web of Science, Gray Literature, Scopus, ClinicalTrials.gov and Cochrane Library. This study followed Cochrane's recommendations for analyzing risk of bias. A total of 1054 studies were found (255 studies were excluded because they were duplicates and 785 because of titles and abstracts). Only 14 articles were selected for analysis, of which eight were excluded because they had one or more exclusion criteria, resulting in six articles included in this systematic review, the vast majority being classified as low risk of bias. The studies reviewed indicated that LLLT showed promise in preventing TS after TB. However, evidence is limited and more clinical trials with low risk of bias are needed to reach a definitive conclusion on the action of LLLT in pain control after TB.
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Affiliation(s)
| | | | | | | | - Aryvelto Miranda Silva
- Department of Restorative Dentistry, Araraquara Dental School, Sao Paulo State University, Araraquara, SP, Brazil
| | - Cristiane de Melo Alencar
- Department of Restorative Dentistry, Araraquara Dental School, Sao Paulo State University, Araraquara, SP, Brazil
| | - Cecy Martins Silva
- School of Dentistry, Federal University of Pará, Augusto Correa Av, No 1, Guamá, Belém, Pará, 66075-110, Brazil. .,Dental Materials Laboratory of the Postgraduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil.
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AL-Rawas MZ, Yew Hin B, Johari Y, Ab-Ghani Z, Husein A. Minimum Intervention in Managing Two Cases of Tetracycline Staining of Different Severity. Cureus 2022; 14:e21289. [PMID: 35186551 PMCID: PMC8845455 DOI: 10.7759/cureus.21289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2022] [Indexed: 11/23/2022] Open
Abstract
Patient dissatisfaction with tooth discoloration as a result of tetracycline therapy is not uncommon. To address patients' aesthetic demands, conservative bleaching treatments were considered before more invasive, irreversible treatments such as dental veneers or crowns. Bleaching is a relatively non-invasive, safe, and cost-effective method of achieving a desirable result. However, due to many limiting variables, including the extended duration of active bleaching, tetracycline-stained teeth are one of the most challenging cases to obtain satisfactory bleaching outcomes. This clinical report presents two cases of management of tetracycline staining of the teeth with varying degrees of severity.
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Grohe B, Mittler S. Advanced non-fluoride approaches to dental enamel remineralization: The next level in enamel repair management. BIOMATERIALS AND BIOSYSTEMS 2021; 4:100029. [PMID: 36824571 PMCID: PMC9934497 DOI: 10.1016/j.bbiosy.2021.100029] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/22/2021] [Accepted: 10/26/2021] [Indexed: 12/20/2022] Open
Abstract
In modern dentistry, a minimally invasive management of early caries lesions or early-stage erosive tooth wear (ETW) with synthetic remineralization systems has become indispensable. In addition to fluoride, which is still the non-plus-ultra in these early caries/ETW treatments, a number of new developments are in the test phase or have already been commercialized. Some of these systems claim that they are comparable or even superior to fluoride in terms of their ability to remineralize enamel. Besides, their use can help avoid some of the risks associated with fluoride and support treatments of patients with a high risk of caries. Two individual non-fluoride systems can be distinguished; intrinsic and extrinsic remineralization approaches. Intrinsic (protein/peptide) systems adsorb to hydroxyapatite crystals/organics located within enamel prisms and accumulate endogenous calcium and phosphate ions from saliva, which ultimately leads to the re-growth of enamel crystals. Extrinsic remineralization systems function on the basis of the external (non-saliva) supply of calcium and phosphate to the crystals to be re-grown. This article, following an introduction into enamel (re)mineralization and fluoride-assisted remineralization, discusses the requirements for non-fluoride remineralization systems, particularly their mechanisms and challenges, and summarizes the findings that underpin the most promising advances in enamel remineralization therapy.
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Affiliation(s)
- Bernd Grohe
- Lawson Health Research Institute, St. Joseph's Hospital, London, ON, N6A 4V2 Canada,Corresponding author at: 268 Grosvenor Street, London, ON, N6A 4V2, Canada.
| | - Silvia Mittler
- Department of Physics & Astronomy, University of Western Ontario, London, ON, N6A 3K7 Canada,Department of Chemical and Biochemical Engineering, University of Western Ontario, London, ON, N6A 5B9 Canada
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Sharda S, Gupta A, Goyal A, Gauba K. Remineralization potential and caries preventive efficacy of CPP-ACP/Xylitol/Ozone/Bioactive glass and topical fluoride combined therapy versus fluoride mono-therapy - a systematic review and meta-analysis. Acta Odontol Scand 2021; 79:402-417. [PMID: 33459095 DOI: 10.1080/00016357.2020.1869827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To compare the remineralization potential and caries preventive efficacy of CPP-ACP/bioactive glass/xylitol/ozone and topical fluoride (TF) combined therapy versus TF mono-therapy. MATERIAL AND METHODS Embase, PubMed, Scopus, Web of Science and Cochrane databases were searched. 4457 records were screened and 26 trials were included. Data from 16 trials was pooled using Review Manager 5.4. Level of significance was p < .05. The certainty of the evidence was evaluated using GRADE. RESULTS Pooled analysis of two trials for white spot lesions (WSLs) regression (SMD -0.6, 95% CI: [-1.07 to -0.14], p = .01) and three trials for post-intervention DIAGNOdent values (SMD -1.24, 95% CI: [-1.96 to -0.52], p = .0007) significantly favoured CPP-ACP-TF combined therapy over TF mono-therapy. The sub-group analysis for caries increment (SMD -0.14, 95% CI: [-0.21 to -0.07], p < .0001) and the post intervention S mutans count (SMD -0.42, 95% CI: [-0.62 to -0.23], p < .0001) significantly favours 'xylitol-TF' and 'CPP-ACP-TF' combined therapy respectively. The high/unclear risk of bias, imprecision and indirectness of the included trials presented a low certainty of evidence. CONCLUSION CPP-ACP-TF exhibits superiority over TF monotherapy in remineralizing existing lesions and demonstrates better antibacterial effect, whereas it is not more effective for preventing caries incidence. However, Xylitol exerts an added benefit over fluoride alone in preventing caries increment. The low-certainty evidence highlights the need for more good quality trials.
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Affiliation(s)
- Shweta Sharda
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arpit Gupta
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashima Goyal
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Krishan Gauba
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Burey A, Sutil E, Nunez Aldaz MA, Méndez-Bauer ML, Rezende M, Reis A, Gomes OMM, Farago PV, Loguercio AD. Assessment of the effect of experimental bleaching agent with nano-bioactive material on postoperative sensitivity: A randomized, triple blind clinical trial. J ESTHET RESTOR DENT 2021; 33:764-774. [PMID: 34160125 DOI: 10.1111/jerd.12790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/11/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This clinical study aimed to evaluate the effect of incorporating bioactive nanoparticles (n-Bm) inside an in-office bleaching gel on the risk and intensity of tooth sensitivity (TS) and on bleaching effectiveness. MATERIALS AND METHODS Sixty-six participants were selected and randomly assigned into two groups: control-only in-office gel and experimental-in-office gel with n-Bm. Teeth were bleached in two sessions (3 × 15-min). TS was recorded using a VAS and NRS. The color change was evaluated by subjective (VITA Classical and VITA Bleachedguide) and objective (Easyshade spectrophotometer) methods at baseline and 30 days after the end of treatment. The TS was evaluated by McNemar, Wilcoxon Signed Rank, and paired t test. The color changes between groups were compared using paired t test (α = 0.05). RESULTS No significant differences between the groups were observed in the risk (control = 27% [95%IC 18-39]; experimental = 21% [95%IC 13-32]) and intensity of TS, as well as in the color change (p >0.05) for any color measurement. CONCLUSION The inclusion of n-Bm into the bleaching agents did not affect the whitening effectiveness, as well as the risk and intensity of TS between groups. However, the results of the absolute risk of TS were low for both in-office gels used. CLINICAL SIGNIFICANCE Despite no significant differences between groups, both experimental bleaching agents present suitable results with low values for TS.
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Affiliation(s)
- Adrieli Burey
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Elisama Sutil
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Maira Alejandra Nunez Aldaz
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil.,Department of Restorative Dentistry, San Francisco de Quito University, Quito, Ecuador
| | - María Luján Méndez-Bauer
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil.,Research Department, School of Dentistry, University Francisco Marroquín (UFM), Cuidad de Guatemala, Guatemala
| | - Márcia Rezende
- School of Dentistry, School Paulo Picanço, Fortaleza, Ceará, Brazil
| | - Alessandra Reis
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Osnara Maria Mongruel Gomes
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Paulo Vitor Farago
- Pharmaceutical Sciences, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Alessandro D Loguercio
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
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Efficacy of MI Paste® on Bleaching-Related Sensitivity: Randomized Clinical Trial. Int J Dent 2021; 2021:9963823. [PMID: 34221018 PMCID: PMC8219434 DOI: 10.1155/2021/9963823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/03/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background To evaluate the effectiveness of MI Paste® in reducing sensitivity associated with vital tooth bleaching. Methods This randomized controlled split-mouth clinical trial included 45 subjects that were randomly divided into two groups. In Group 1, the maxillary arch was the control arch (only bleaching), while the mandibular arch was the intervention arch (bleaching and MI Paste®). In Group 2, the mandibular arch was the control arch (only bleaching), while the maxillary arch was the intervention arch (bleaching and MI Paste®). Subjects started with the control arch and then switched to the intervention arch after two weeks. Subjects were instructed to use MI Paste® in a custom tray for 5 minutes, wait for 1 hour, and then bleach overnight using a different tray. Sensitivity was measured using both a thermal sensitivity test and a daily log of sensitivity for 14 days. Shade was evaluated using a colorimeter and a shade guide. Results Immediately after treatment, the thermal test sensitivity scores for the arches bleached without MI Paste® were greater than those with MI Paste® (p=0.011). Arches not receiving the MI Paste® treatment showed significantly higher VAS sensitivity scores during the 14-day period of bleaching (p=0.002). The mean score for the 14-day period was 37.9 for the arches not treated with MI Paste® versus 27.5 for the treated arches. Both the intervention group and the control group showed significantly lighter shade relative to baseline (p < 0.001) with no significant difference between them (p=0.42). Conclusion MI Paste® significantly reduced the sensitivity associated with bleaching and did not interfere with shade change.
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Gümüştaş B, Dikmen B. Effectiveness of remineralization agents on the prevention of dental bleaching induced sensitivity: A randomized clinical trial. Int J Dent Hyg 2021; 20:650-657. [PMID: 34018341 DOI: 10.1111/idh.12524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/08/2021] [Accepted: 05/16/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aims to compare the use of different remineralization agents before in-office bleaching for decreasing bleaching induced sensitivity. METHODS A total of 64 volunteers were randomly divided into four groups. Before undergoing in-office bleaching with 38% hydrogen peroxide gel (three applications of 15 min each, one session), clinicians applied a placebo gel (control group), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), neutral sodium fluoride gel (NSF) or nano-hydroxyapatite solution (n-HAP) on all buccal surfaces of teeth. The gel was left undisturbed for 4 min. The efficacy of tooth whitening was assessed by determining the colour change using SGU. Patients recorded their tooth sensitivities on the VAS scale. Kruskal-Wallis test followed by Mann-Whitney U test was used to compare changes in tooth colour and intensity of tooth sensitivity between groups. RESULTS Overall, there was no significant difference in shade change between the groups. Control and CPP-ACP groups showed significantly higher rates of hypersensitivity than NSF and the n-HAP group (p < 0.05). CONCLUSIONS The use of a remineralization agent (n-HAP/NSF) before in-office bleaching did not affect the bleaching efficacy but did reduce tooth sensitivity. The before bleaching treatment use of an n-HAP solution can be suitable for reducing bleaching born sensitivity as well as commonly used NSF remineralizing gel before in-office tooth bleaching can reduce tooth sensitivity, the most common side effect associated with this procedure.
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Affiliation(s)
- Burak Gümüştaş
- Department of Restorative Dentistry, Faculty of Dentistry, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Benin Dikmen
- Department of Restorative Dentistry, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
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The combined use of systemic analgesic/anti-inflammatory drugs and a bioactive topical desensitizer for reduced in-office bleaching sensitivity without jeopardizing the hydrogen peroxide efficacy: a randomized, triple blinded, split-mouth clinical trial. Clin Oral Investig 2021; 25:6623-6632. [PMID: 33884504 DOI: 10.1007/s00784-021-03948-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the effect of combined systemic administration of paracetamol 500 mg/codeine phosphate 30 mg (PACO) and postoperative topical application of a bioactive desensitizer on in-office bleaching sensitivity and tooth color change. MATERIALS AND METHODS A randomized, triple-blind, split-mouth clinical trial was conducted. Forty volunteers ingested PACO (n = 20) or placebo (PLA) (n = 20). Their left/right hemiarches received topical application of a bioactive desensitizer [Nano-P™(NP)] and prophylactic paste (PAS), generating four treatment approaches: PACO/NP, PACO/PAS, PLA/NP, and PLA/PAS. Two bleaching sessions (35% hydrogen peroxide) were performed, and the PAS/NP were applied after the procedure. Sensitivity was obtained since the first bleaching session up to 7 days post-bleaching. The color change was evaluated using CIEDE2000 and whiteness index parameters up to 7 days post-bleaching. Data were analyzed using one- and two-way ANOVA/Tukey post hoc tests (p < 0.05). RESULTS The PLA/PAS showed a sensitivity average of at least two times higher than the PACO/NP. The treatment approaches promoted statistically similar bleaching patterns (p > 0.05). CONCLUSION The combined approach of systemic administration of PACO and postoperative topical application of NP reduced the level of in-office bleaching sensitivity without jeopardizing hydrogen peroxide efficacy. CLINICAL RELEVANCE Professionals can adopt the combined approach of systemic administration of analgesic/anti-inflammatory drugs and topical application of a bioactive desensitizer for decreased bleaching sensitivity caused by 35% hydrogen peroxide in-office.
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Sbaraini A, Adams GG, Reynolds EC. Experiences of oral health: before, during and after becoming a regular user of GC Tooth Mousse Plus ®. BMC Oral Health 2021; 21:14. [PMID: 33413323 PMCID: PMC7792129 DOI: 10.1186/s12903-020-01360-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/09/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Clinical trials and laboratory studies from around the world have shown that GC Tooth Mousse Plus® (TMP) is effective in protecting teeth from tooth decay and erosion, buffering dental plaque pH, remineralising white spot lesions and reducing dentine hypersensitivity. However, no other study has assessed the experiences of oral health, before, during and after individuals becoming regular users of TMP. The aim of this study was to identify how participants' oral health status changed after introducing TMP into their oral hygiene routine. METHODS A qualitative study using Charmaz's grounded theory methodology was conducted. Fifteen purposively sampled regular users of TMP were interviewed. Transcripts were analysed after each interview. Data analysis consisted of transcript coding, detailed memo writing, and data interpretation. RESULTS Participants described their experiences of oral health and disease, before, during and after introducing TMP into their daily oral hygiene routine, together with the historical, biological, financial, psychosocial, and habitual dimensions of their experiences. Before becoming a regular user of TMP, participants described themselves as having a damaged mouth with vulnerable teeth, dry mouth, and sensitivity. Various aspects of participants' histories were relevant, such as, family history and history of oral disease. Having a damaged mouth with vulnerable teeth, dry mouth and sensitivity was explained by those elements. Despite some initial barriers, once being prescribed TMP by a dental professional, a three-fold process of change was initiated: starting a new oral hygiene routine, persevering daily, and experiencing reinforcing outcomes. This process led to a fundamental lifestyle change. Participants transitioned from having a damaged mouth with vulnerable teeth to having a comfortable mouth with strong teeth; at the same time participants felt empowered by this newly found status of being able to keep their teeth for life. Barriers and facilitators for incorporating TMP on daily oral hygiene routine were also identified. CONCLUSIONS Participants valued having a comfortable mouth with strong teeth, which did not require repeated restorations. Seeing concrete results in their mouths and experiencing a more comfortable mouth boosted adherence to daily applications of TMP, which was maintained over time.
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Affiliation(s)
- Alexandra Sbaraini
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, VIC 3010 Australia
| | - Geoffrey G. Adams
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, VIC 3010 Australia
| | - Eric C. Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, VIC 3010 Australia
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Li B, Liu C, Fang ZH, Cao Y, Zhou Z, Lu H. Acidic Monetite Complex Paste with Bleaching Property for In-depth Occlusion of Dentinal Tubules. Int J Nanomedicine 2021; 16:31-45. [PMID: 33442248 PMCID: PMC7797332 DOI: 10.2147/ijn.s287393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 12/05/2020] [Indexed: 12/17/2022] Open
Abstract
Background Dentin hypersensitivity (DH) is a common dental clinical condition presented with a short and sharp pain in response to physical and chemical stimuli. Currently no treatment regimen demonstrates long-lasting efficacy in treating DH, and unesthetic yellow tooth color is a concern to many patients with DH. Aim To develop a bi-functional material which can occlude dentinal tubules in-depth and remineralize dentin for long-lasting protection of the dentin–pulp complex from stimuli and bleach the tooth at the same time. Methods A mixture containing CaO, H3PO4, polyethylene glycol and H2O2 at a specific ratio was mechanically ground using a planetary ball. The mineralizing complex paste was characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM). Dentin was exposed to the synthesized paste for 8 h and 24 h in vitro. The mineralizing property was evaluated using SEM and microhardness tests. Red tea-stained tooth slices were exposed to the synthesized paste for 8 h and 24 h in vitro. The bleaching effect was characterized by a spectrophotometer. Results The complex paste had very a fine texture, was injectable, and had a gel-like property with 2.6 (mass/volume) % H2O2 concentration. The X-ray diffraction pattern showed that the inorganic phase was mainly monetite (CaHPO4). The mineralizing complex paste induced the growth of inorganic crystals on the dentin surface and in-depth occlusion of dentin tubules by up to 80 μm. The regenerated crystals were integrated into the dentin tissue on the dentin surface and the wall of dentinal tubules with a microhardness of up to 126 MPa (versus 137 Mpa for dentin). The paste also bleached the stained dental slices. Conclusion The mineralizing complex paste is a promising innovative material for efficient DH management by remineralizing dentin and in-depth occlusion of dentin tubules, as well as tooth bleaching.
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Affiliation(s)
- Bolin Li
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School & Hospital of Stomatology, Hebei Medical University, Shijiazhuang 050017, People's Republic of China
| | - Chunyan Liu
- Department of Orthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School & Hospital of Stomatology, Hebei Medical University, Shijiazhuang 050017, People's Republic of China.,School of Dentistry, University of Detroit Mercy, Detroit, Michigan 48208, USA
| | - Ze-Hui Fang
- School & Hospital of Stomatology, Anhui Medical University, Hefei 230032, People's Republic of China
| | - Ying Cao
- School & Hospital of Stomatology, Anhui Medical University, Hefei 230032, People's Republic of China
| | - Zheng Zhou
- School of Dentistry, University of Detroit Mercy, Detroit, Michigan 48208, USA
| | - Haiyan Lu
- Department of Orthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School & Hospital of Stomatology, Hebei Medical University, Shijiazhuang 050017, People's Republic of China
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Parreiras SO, Favoreto MW, Lenz RE, Serra ME, Borges CPF, Loguercio AD, Reis A. Effect of Prior Application of Desensitizing Agent on the Teeth Submitted to In-Office Bleaching. Braz Dent J 2020; 31:236-243. [PMID: 32667516 DOI: 10.1590/0103-6440202003365] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/07/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to quantify the penetration of hydrogen peroxide, color change evaluation, surface morphology, and composition after application of desensitizing agents before in-office bleaching. Fifty premolars were sectioned, an acetate buffer was placed in the pulp chamber and divided into five groups (n=10). In the positive control group, only the in-office bleaching gel was used, and in the negative control group, no treatment was used. Three different desensitizing agents were applied: Desensibilize KF2%® group; Mi Paste® group, and Desensibilize Nano-P® group. The bleaching procedure was carried out with 35% HP. The absorbance of the resulting solution was determined in a spectrophotometer. Color change was assessed by using a digital spectrophotometer. Four additional premolars were assigned to the same groups above for analysis under scanning electron microscope, as well as to evaluate the elemental composition with X-ray dispersive energy spectrometry. Data were subjected to ANOVA and Tukey's test (α=0.05). All products reduced the penetration of HP in the pulp chamber. Mi Paste and Nano P were the products that yielded the lowest HP penetration, which was similar to the negative control group (p<0.001). No significant difference was detected in color change (p<0.001). Concerning enamel morphology, the groups that were analyzed after bleaching were observed a greater deposition of desensitizing agents on the surface. The use of desensitizing agents before tooth bleaching seems to be an alternative to reduce adverse effects of the tooth.
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Affiliation(s)
| | | | - Rubia Elisa Lenz
- School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Maria Eduarda Serra
- School of Chemistry, UniversidadeEstadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | | | | | - Alessandra Reis
- School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
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C. de Silva C, de M. Alencar C, de Paula BLF, de A. Jassé FF, Araújo JLN, Silva CM. Photobiomodulation vs. Placebo on Post-Bleaching Sensitivity and Color Change: A Split-Mouth Clinical Study. Open Dent J 2020. [DOI: 10.2174/1874210602014010267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective:
This study aimed to investigate the efficiency of Photobiomodulation (PBM) with low-level LASER therapy compared to placebo in post-bleaching sensitivity and color change during a three-week office bleaching treatment.
Methods:
A split-mouth model was used to evaluate 21 subjects. The right and left hemi-archs were randomized to one of two groups: GP (placebo): simulated LASER application followed by tooth bleaching with 35% hydrogen peroxide; and GL: treated with PBM followed by tooth bleaching with 35% hydrogen peroxide. A four-degree modified Visual Analog Scale (VAS) was used to assess tooth sensitivity after the application of an evaporative stimulus (stimulated pain). In addition, a daily questionnaire was used to measure unstimulated pain. The color change was measured using a spectrophotometer. The Friedman and Wilcoxon tests were used to analyze data sensitivity. Color results were statistically analyzed using Analysis Of Variance (ANOVA) followed by the Tukey post-hoc test.
Results:
There was no significant difference between GP and GL for stimulated pain evaluation (p> 0.05). However, there was a significant difference between the groups for unstimulated pain evaluation (p≤ 0.05). In addition, ΔE data did not reveal any significant difference in tooth color between groups at any time (p> 0.05).
Conclusion:
PBM prevented post-bleaching sensitivity compared to placebo, based on the daily pain assessment questionnaires. PBM did not compromise the quality of bleaching treatments.
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Is there evidence for Novamin application in remineralization?: A Systematic review. J Oral Biol Craniofac Res 2020; 10:87-92. [PMID: 32190542 DOI: 10.1016/j.jobcr.2020.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 11/23/2022] Open
Abstract
Background Calcium sodium phosphor-silicate material, a type of bio-glass was originally developed as an implant material to regenerate bone and recently adapted for use in oral care products (NovaMin Technology Inc.). Novamin is used for many dental problems like hypersensitivity, gingivitis, bleeding, non-carious lesions, carious lesions, whitening and is currently emerging as one of the treatment modality for the remineralization of the tooth. Since the prescription of these novel materials to the patients are based on cost effectiveness, efficacy and effectiveness, a clinician should make decision based on best available evidence. Hence, the objective of this review is to find out the current evidence available on the use of Novamin as an agent for remineralization. Materials and methods Relevant articles were searched and screened from several databases including PubMed, Cochrane review, Science Direct and trip which were published till 1988 to July 2017; The articles relevant to the objective of this review were included (RCT's) and articles out of interest of this review were excluded. The primary outcome for the chosen studies is the remineralization capacity of Novamin. Data extraction is done independently and jointly by 3 authors using data collection forms. Studies obtained were evaluated using the Cochrane Collaboration tools for accessing risk bias. The assessment of the quality of the evidence and the bias risk was obtained using the Grading of Recommendations Assessment Development and evaluation System. Results The articles from the database obtained for further review was N = 1. According to the study reviewed, the baseline comparisons using decalcification index obtained between Novamin study group (ReNew) and the control group (Crest) yield a P-value of 0.97 whereas after a 3 months interval follow up the value is 0.0403 suggesting there was a trend towards improvement in white spot lesions in the control group and at 6 months' time point the p-value is 0.81 concluding that there are no significant difference of remineralization process obtained by using traditional toothpaste and Novamin. Conclusion Review shows that Novamin has significantly less clinical evidence to prove its effectiveness as a remineralization agent in treating both carious and non-carious lesion. Hence, better designed clinical trials should be carried out in the future before definitive recommendations can be made.
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Almassri HNS, Zhang Q, Yang X, Wu X. The effect of oral anti-inflammatory drugs on reducing tooth sensitivity due to in-office dental bleaching: A systematic review and meta-analysis. J Am Dent Assoc 2019; 150:e145-e157. [PMID: 31561766 DOI: 10.1016/j.adaj.2019.05.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 05/16/2019] [Accepted: 05/22/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND The authors' aim was to evaluate the effectiveness of anti-inflammatory drugs on tooth sensitivity (TS) during and after in-office dental bleaching procedures. TYPES OF STUDIES REVIEWED The authors selected randomized controlled trials in which the investigators compared anti-inflammatory drugs with a placebo to evaluate in-office dental bleaching TS. The authors performed an electronic search by using PubMed, ScienceDirect, and Embase. In addition, the authors searched other Web sites, such as ClinicalTrials.gov, to identify ongoing studies. RESULTS The authors included 7 randomized controlled trials (324 adults) in the review. According to the extracted data, the authors performed the meta-analysis by using risk ratios and their 95% confidence intervals or by using the mean difference with a 95% confidence interval. The authors used the Cochrane Collaboration's tool to assess study quality. After the evaluation, the authors considered 6 studies to be high quality and a single study to be low quality. The overall results of the evaluation process revealed the absence of a clinically significant effect of anti-inflammatory drugs. CONCLUSIONS AND PRACTICAL IMPLICATIONS The results of this analytic process indicated that anti-inflammatory drugs have no clinically significant effect on the TS that occurs due to in-office bleaching. Readers must analyze these results carefully given the limitations of this review, such as the small samples size and the heterogeneity among the studies in some stages of the evaluation process. The results of this analytical study highlight the need for more clinical studies to reach a significant conclusion because TS is one of the most important reasons for the cessation of bleaching treatment.
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Costa R, Moraes S, Lemos C, SoutoMaior JR, Vasconcelos BDE, Pellizzer EP. Effect of Analgesic Drugs on Tooth Sensitivity Induced by In-office Dental Bleaching: A Systematic Review and Meta-analysis. Oper Dent 2019; 45:E66-E76. [PMID: 31750804 DOI: 10.2341/18-250-l] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This systematic review evaluates the effect of preemptive analgesia on tooth sensitivity induced by in-office tooth bleaching. METHODS The review was structured based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. The methods were recorded at PROSPERO (CRD42018095440). Randomized clinical trials, studies published in English, and studies in which the efficacy of preemptive analgesia with analgesic and anti-inflammatory medications prior to in-office tooth bleaching was compared with that of placebo were included. PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library were used for searching. The electronic search provided 373 articles, and seven of them were selected based on the inclusion criteria. RESULTS Immediately after time point, a significant reduction of dental sensitivity was observed in the drug group compared to the control group (p=0.02; mean difference [MD]: -0.90; confidence interval [CI]: -1.63 to -0.16), while there was no significant difference at up to one-hour (p=0.22; MD: -0.42; CI: -1.09 to -0.25), at 1-24-hour (p=0.88; MD: -0.05; CI: -0.61 to 0.72), or 24-48-hour (p=0.69; MD: 0.05; CI: -0.21 to 0.32) time points. The incidence of sensitivity during the procedure was not statistically different between the groups (p=0.64; MD: 0.91; CI: 0.92 to 1.15). The nonsteroidal anti-inflammatory drug group showed a statistically significant reduction (p=0.04; MD: -0.69; CI: -1.36 to -0.03) in tooth sensitivity compared with the other groups. CONCLUSIONS This systematic review and meta-analysis demonstrated that the medications analyzed did not interfere with the incidence of sensitivity symptoms. Regarding the intensity, no difference was observed between the drug and placebo groups at the up to one-hour, 1-24-hour, or 24-48-hour time points, and there was a statistically significant difference at the zero-hour time point in favor of the drug group. However, based on the variables that influenced this result, it should be considered with prudence because a small difference was observed.
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Llena C, Esteve I, Rodríguez-Lozano FJ, Forner L. The application of casein phosphopeptide and amorphous calcium phosphate with fluoride (CPP-ACPF) for restoring mineral loss after dental bleaching with hydrogen or carbamide peroxide: An in vitro study. Ann Anat 2019; 225:48-53. [DOI: 10.1016/j.aanat.2019.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 10/26/2022]
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Barbosa JG, Benetti F, de Oliveira Gallinari M, Carminatti M, da Silva ABD, Lopes INI, Briso ALF, Cintra LTA. Bleaching gel mixed with MI Paste Plus reduces penetration of H 2O 2 and damage to pulp tissue and maintains bleaching effectiveness. Clin Oral Investig 2019; 24:1299-1309. [PMID: 31302769 DOI: 10.1007/s00784-019-03009-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 07/03/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES MI Paste Plus remineralizer (Rem) strengthens dental structures after bleaching. We investigated the effect of Rem on the penetration of hydrogen peroxide (H2O2), bleaching effectiveness, and pulp inflammation after bleaching. MATERIALS AND METHODS Bovine disks were grouped as follows (n = 10): control (untreated), bleached (Ble; 35% H2O2, 30 min), Ble-Rem (H2O2 followed by Rem, 30 min), Rem-Ble (Rem followed by H2O2), Rem-Ble-Rem (Rem before and after H2O2), and Ble+Rem (mixture of Rem with H2O2, 1:1, 30 min). The penetration of H2O2 was quantified and bleaching efficacy was analyzed. Upper rat molars (n = 10) received the same treatments at random. The rats were euthanized after two days and 30 days, and their jaws were removed for histological analysis. Statistical tests were performed (P < 0.05). RESULTS The bleached groups, except Ble+Rem (P > 0.05), showed significant H2O2 penetration compared with control (P < 0.05). Color alteration analysis showed that ΔL and ΔE were significantly higher in the bleached groups than those in control (P < 0.05); the Δb of the bleached groups differed from that of control at 24 h (P < 0.05). At two days, necrosis or inflammation was observed in the bleached groups compared with control (P < 0.05), except Ble+Rem, which was similar to control (P > 0.05). At 30 days, tertiary dentin formation was significant in the bleached groups (P < 0.05), except Ble+Rem (P > 0.05). CONCLUSION The mixture of MI Paste Plus and bleaching gel reduces H2O2 penetration and pulp damage and maintains bleaching effectiveness. CLINICAL RELEVANCE Because bleaching can damage dental tissues, we studied a new bleaching protocol that reduces damage to the pulp tissue while maintaining bleaching efficiency: a single application of 30 min of MI Paste Plus mixed with 35% H2O2 bleaching gel (1:1).
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Affiliation(s)
- Jéssica Galbiati Barbosa
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
| | - Francine Benetti
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
- Restorative Dentistry, School of Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Marina Carminatti
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
| | - Anna Beatriz Dias da Silva
- Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
| | | | - André Luiz Fraga Briso
- Department of Restorative Dentistry, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil
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de Paula B, Alencar C, Ortiz M, Couto R, Araújo J, Silva C. Effect of photobiomodulation with low-level laser therapy combined with potassium nitrate on controlling post-bleaching tooth sensitivity: clinical, randomized, controlled, double-blind, and split-mouth study. Clin Oral Investig 2018; 23:2723-2732. [PMID: 30361793 DOI: 10.1007/s00784-018-2715-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/17/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the effect of photobiomodulation with low-level laser therapy (PBM-LLLT) combined with 5% potassium nitrate (KNO3) on controlling tooth sensitivity (TS) after in-office tooth bleaching. MATERIALS AND METHODS Fifty volunteers were selected based on the inclusion and exclusion criteria and were randomly allocated into four groups: G1 (control): placebo gel application, 35% hydrogen peroxide bleaching (HP35) and mock PBM-LLLT without light emission; G2: placebo gel application, bleaching with HP35 and PBM-LLLT; G3: application of KNO3, bleaching with HP35 and mock PBM-LLLT; and G4: application of KNO3, bleaching with HP35 and PBM-LLLT. A pain assessment questionnaire was used to evaluate TS during the 21 days of treatment. The Friedman test was used for intragroup analysis, and the Wilcoxon and Mann-Whitney tests were used for intergroup comparisons. RESULTS The intragroup evaluation showed significant differences among the evaluation times in all groups (p ≤ 0.05). The highest pain sensitivity levels were recorded on the 1st, 8th, and 15th days. In G1, TS manifested for up to 3 days after each bleaching session, while G2, G3, and G4 presented TS only on the days of the bleaching sessions. Intergroup analysis showed that TS manifestation differed significantly between G1 and the other groups (p ≤ 0.05) but did not differ significantly among G2, G3, and G4 (p ≥ 0.05). CONCLUSION PBM-LLLT and KNO3 are effective at reducing pain sensitivity after tooth bleaching, but no synergistic effect between these treatments was observed for the different evaluation periods. CLINICAL RELEVANCE The effect of PBM-LLLT combined with KNO3 on post-bleaching tooth sensitivity is similar to their individual use alone.
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Affiliation(s)
- Brennda de Paula
- Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil
| | - Cristiane Alencar
- Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil
| | - Mariángela Ortiz
- Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil
| | - Roberta Couto
- Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil
| | - Jesuína Araújo
- School of Dentistry, Federal University of Pará, Belém, PA, Brazil
| | - Cecy Silva
- Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil. .,Faculdade de Odontologia, Universidade Federal do Pará, Avenida Augusto Correa, no 1, Guamá, Belém, PA, 66075-110, Brazil.
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Effect of CPP-ACP on efficacy and postoperative sensitivity associated with at-home vital tooth bleaching using 20% carbamide peroxide. Clin Oral Investig 2018; 23:1555-1559. [PMID: 30121734 DOI: 10.1007/s00784-018-2574-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 08/09/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To evaluate CPP-ACP effect on colour change and tooth sensitivity (TS) associated with at-home vital tooth bleaching using 20% carbamide peroxide (CP). METHODS A randomised double-blind placebo-controlled clinical trial was conducted to measure the TS and tooth colour change of 24 patients at 3-day, 7-day, 14-day and 30-day periods. The participants were instructed to apply 20% CP (7 days-04 h each) followed by the application of either CPP-ACP or non-active placebo paste, delivered by the bleaching custom tray (7 days-30 min each). Lightness (L*), redness (a*) and yellowness (b*) were measured using a digital spectrophotometer and the overall colour changes ∆E were calculated. ∆E and TS values were statistically analysed. The level of statistical significance was established at p = 0.05. RESULTS No significant differences were detected between CPP-ACP and placebo groups regarding the ∆E. The ∆E measurements presented significant differences within CPP-ACP groups between 3-day vs. 14-day and 30-day measurements. The CPP-ACP application reduced significantly the TS reported by the participants at 3-day when compared with the placebo group. CONCLUSION The application of CPP-ACP paste during at-home tooth bleaching with 20% CP was beneficial since its use reduced the TS and presented no deteriorating effect on the colour change. CLINICAL RELEVANCE The current findings are of importance for clinicians to manage TS reported by patients when a high CP bleaching agent is used.
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Alencar CDM, De Paula BLF, Araújo JLN, Alves EB, De Albuquerque Jassé FF, Silva CM. Effect of low-level laser therapy combined with 5000 parts per million fluoride dentifrice on postbleaching sensitivity: A clinical, randomized, and double-blind study. J ESTHET RESTOR DENT 2018; 30:352-359. [PMID: 30079637 DOI: 10.1111/jerd.12386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The aim of this double-blind, randomized, controlled clinical study was to assess the efficacy of low-level laser therapy (LLLT) combined with 5000 ppm fluoride dentifrice on postbleaching sensitivity in teeth exposed to 35% hydrogen peroxide for four weeks. MATERIALS AND METHODS Twenty-five volunteers were evaluated using the split-mouth model in which the right and left maxillary/mandibular quadrants were randomized and allocated to one of two groups: GPLACEBO, in which the laser tip was positioned without the emission of light (placebo effect) + 5000 ppm sodium fluoride, or GLASER, which comprised LLLT + 5000 ppm sodium fluoride. For both groups, LLLT and placebo were used before bleaching, whereas fluoride was applied after bleaching. LLLT was applied at two points: on the central cervical and medial regions of the incisors, canines, and premolars in the corresponding hemi-arch. At each point, 60 J/cm2 was applied for 16 seconds with an irradiance of 3.75 W/cm2 using the therapeutic infrared device. To assess tooth sensitivity, a modified visual analogue scale was used after an evaporative stimulus, and a daily pain questionnaire was also applied. RESULTS The Wilcoxon and Friedman tests demonstrated a significant difference in the incidence of sensitivity pain between GPLACEBO and GLASER (P ≤ .05), with different evaluation times. CONCLUSION Teeth treated with laser therapy in combination with the topical use of sodium fluoride at each bleaching session demonstrated less sensitivity compared with the application of sodium fluoride only. CLINICAL SIGNIFICANCE The use of a low-level laser therapy in combination with topical use of sodium fluoride improves symptoms of dentin sensitivity at each bleaching session.
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Affiliation(s)
- Cristiane De Melo Alencar
- Department of restorative dentistry, School of Dentistry, Federal University of Pará, Belém, Pará, Brazil
| | | | | | - Eliane Bemerguy Alves
- Department of restorative dentistry, School of Dentistry, Federal University of Pará, Belém, Pará, Brazil
| | | | - Cecy Martins Silva
- Department of restorative dentistry, School of Dentistry, Federal University of Pará, Belém, Pará, Brazil
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Meyer F, Amaechi BT, Fabritius HO, Enax J. Overview of Calcium Phosphates used in Biomimetic Oral Care. Open Dent J 2018; 12:406-423. [PMID: 29988215 PMCID: PMC5997847 DOI: 10.2174/1874210601812010406] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/23/2018] [Accepted: 05/14/2018] [Indexed: 11/24/2022] Open
Abstract
Background: The use of biomimetic agents is an emerging field in modern oral care. Promising biomimetic substances for such applications are calcium phosphates, because their chemical composition is very similar to that of the mineral phase in human teeth, especially of natural enamel. Examples for their application include the remineralization of early caries lesions and repair of small enamel defects. Objective: This review provides an interdisciplinary view on calcium phosphates and their applications in biomimetic oral care. The aim of this work is to give an overview of in vivo and in situ studies comparing several calcium phosphates in preventive dentistry that can be used as a knowledge base for the development of innovative alternative oral care concepts. Methods: Books, reviews, and original research papers with a focus on in vivo and in situ studies were included. The databases PubMed® and SciFinder® were used for literature search. Calcium phosphates that are frequently utilized in oral care products are covered in this review and were used as search terms alone and together with the following key words: in vivo, in situ, caries, clinical study, and remineralization. From 13,470 studies found, 35 studies complied with the inclusion criteria and were used for this review. Results: Published in vivo and in situ studies demonstrate calcium phosphates’ potential in enamel remineralization. However, more studies are needed to further substantiate existing results and to extend and refine the application of calcium phosphates in modern oral care. Conclusion: Calcium phosphates represent an innovative biomimetic approach for daily oral care because of their high similarity to natural enamel that will broaden the range of future treatments in preventive dentistry.
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Affiliation(s)
- Frederic Meyer
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, 703 Floyd Curl Drive, San Antonio, Texas 78229-3900, USA
| | - Helge-Otto Fabritius
- Max-Planck-Institut für Eisenforschung GmbH, Microstructure Physics and Alloy Design, Max-Planck-Straße 1, 40237 Duesseldorf, Germany
| | - Joachim Enax
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
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