The Effect of Hydrogel and Solution of Sodium Ascorbate on Bond Strength in Bleached Enamel

Effect of antioxidant on tooth sensitivity after bleaching

OBJECTIVES

This study aimed to investigate the effect of antioxidant (sodium ascorbate) on tooth sensitivity after two in-office bleaching techniques (light-activated and chemical bleaching).

MATERIALS AND METHODS

Ten patients aged 18-25 were bleached in four groups according to bleaching materials and/or antioxidant used. Group A: Maxillary right quadrant received light-activated bleaching with antioxidant. Group B: Maxillary left quadrant received light-activated bleaching without antioxidant. Group C: Mandibular right quadrant received chemical bleaching without antioxidant. Group D: Mandibular left quadrant received chemical bleaching with antioxidant. The tooth sensitivity was recorded using Numerical Rating Scale (NRS) and Schiff Scale (SS) immediately after treatment, 1 day, 1 week, 2 weeks, and 1 month follow-up periods.

RESULTS

Group B exhibited higher sensitivity values than Group A. This difference was statistically significant on the first day after treatment (p = 0.027* in NRS and p = 0.046* in SS). Furthermore, antioxidant incorporation in Group D led to a reduction in teeth sensitivity values compared to Group C. This disparity was highly significant on the first day after treatment (p = 0.001* in NRS and p < 0.001** in SS).

CONCLUSIONS

The antioxidant (10% sodium ascorbate) reduces the intensity of tooth sensitivity at the different follow-up periods, especially after 1 day from bleaching.

CLINICAL SIGNIFICANCE

Using 10% sodium ascorbate after bleaching is advisable to reduce post-operative tooth sensitivity.

The effect of propolis on the bond strength of composite resin to enamel after intracoronal bleaching with different bleaching agents

This study evaluated the effect of propolis as an antioxidant agent on bond strength to enamel after intracoronal bleaching. A total of 160 incisors were endodontically treated. Sixteen teeth were served as control, and the remaining teeth were randomly divided into three main groups according to the bleaching agent used; group 1: Sodium perborate (SP); group 2: Carbamide peroxide (CP); group 3: Hydrogen peroxide (HP). After bleaching, the samples were divided into three subgroups; subgroup A: no antioxidant agent application, subgroup B: sodium ascorbate (SA), subgroup C: propolis (PP). After the antioxidant agents application, the sample's surfaces were washed and dried. After adhesive application, composite resin cylinders were applied to enamel surfaces using tygon tubes and a shear bond strength test was performed. The use of PP significantly decreased the bond strength of composite resin to the enamel (p < 0.05). Using propolis as an antioxidant agent adversely affects the bond strength to enamel after intracoronal bleaching.

Evaluation of the Effect of Different Antioxidants on Resin Bond Strength to Enamel after Bleaching: An In Vitro Study

AIM

To compare and evaluate the efficacy of 10% sodium ascorbate (SA) solution, 10% alpha-lipoic acid (ALA) solution, 10% propolis solutions (PLS), and 10% pomegranate peel extract (PPE) solution on the shear bond strength (SBS) between composite resin and bleached enamel after 60 minutes.

MATERIALS AND METHODS

Ninety extracted teeth were divided into 6 subgroups (n = 15) based on the antioxidant applied: Group I: Bleaching + application of 10% SA solution for 60 minutes. Group II: Bleaching + application of 10% ALA solution for 60 minutes. Group II: Bleaching + application of 10% PLS for 60 minutes. Group IV: Bleaching + application of 10% PPE solution for 60 min. Group V: Positive control (PC) bleaching without antioxidant application. Group VI: Negative control (NC) specimen neither subjected to bleaching nor application of an antioxidant solution. About 35% hydrogen peroxide (HP) was used for bleaching the labial surfaces in the groups considered. Labial surfaces were then bonded with composite using a customized cylindrical mold followed by storage in distilled water for 24 hours and shear bond strength was tested using universal testing machine.

RESULTS

The mean shear bond strength values for groups I, II, III, IV, V, and VI are 5.04, 2.29, 5.02, 4.07, 1.42, and 9.08 respectively. The peak shear bond strength value is obtained for the negative control group; whereas the lowest mean SBS value is obtained for the positive control group.

CONCLUSION

All herbal extracts used in the present study have demonstrated a reversal of reduced SBS between resin composite and bleached enamel surface.

CLINICAL SIGNIFICANCE

The reduction in bond strength of adhesive restorations was conventionally overcome by delaying the bonding procedure for a specified period resulting in prolonged treatment duration and multiple appointments. Sodium ascorbate is most commonly used but it is postulated to form a porous scaffold capable of harboring bacteria. Herbal antioxidants are gaining popularity in this regard as they are naturally derived, effective and affordable phytochemicals in addition to being viable alternatives against drug-resistant strains of microorganisms.

Can antioxidant treatment replace delay in bracket bonding? An in vitro study

BACKGROUND

Deterioration in shear bond strength has been reported after immediate bracket bonding following hydrogen peroxide bleaching. This study compared the effectiveness of three antioxidant agents, namely, alpha-tocopherol, green tea extract, and sodium ascorbate, in reversing the bleaching effect and as possible alternatives to delayed bonding.

METHODS

A total of 105 extracted human premolars were arbitrarily assigned to 7 groups (n = 15 each), including group 1 as the unbleached control group and six experimental groups, which were bleached with 40% hydrogen peroxide in three sessions of 15 min each. In experimental group 2, bonding was performed immediately after bleaching, whereas in groups 3 and 4, bonding was delayed for 1 and 2 weeks, respectively; meanwhile, the specimens were immersed in artificial saliva at 37 °C. Groups 5, 6, and 7 were treated immediately after bleaching with 10% of alpha-tocopherol, green tea extract, and sodium ascorbate solutions, respectively, for 15 min. Specimens were processed using 500 thermal cycles between 5 and 55 °C, with a dwell time of 30 s after 24 h of bracket bonding, and then tested for shear bond strength. The adhesive remnant index was examined to evaluate fracture mode. One-way analysis of variance, Kruskal-Wallis H, and post hoc Tukey's honestly significant difference tests were used to compare the data. Significant results were subjected to pairwise comparisons with Bonferroni's correction-adjusted of p values ≤ 0.050.

RESULTS

Shear bond strength was significantly lower (p < 0.001) in the immediate bonding and 1-week delay groups than in the control group. However, no significant difference was detected among the 2-week delay, antioxidant-treated, and control groups (p > 0.05).

CONCLUSIONS

Application of 10% alpha-tocopherol, green tea extract, or sodium ascorbate for 15 min could restore shear bond strength after 40% hydrogen peroxide bleaching as an alternative to delay in bracket bonding.

Comparative Evaluation of Effect of Different Antioxidants on Shear Bond Strength of Composites on Bleached Enamel: An In Vitro Study

Aim

To evaluate the effect of antioxidants on the shear bond strength of composite resin to bleached enamel.

Materials and methods

A total of 120 extracted permanent anterior teeth were split into four major groups, one among them being a control group. Group I (bleaching + without antioxidant), group II (bleaching + 10% sodium ascorbate), group III (bleaching + 5% grape seed extract), and group IV (bleaching + 5% pine bark extract). All of the groups were bleached using a gel containing 35% carbamide peroxide, and then they were divided into two subgroups depending on when the bonding operation was to be completed-subgroup A was done in 24 hours, while subgroup B took 3 weeks. The universal testing machine was used to measure the shear bond strength.

Results

Subgroup IA showed poor shear bond strength than other groups, there was no statistically significant difference between subgroup IB, IIA, and IVA. Subgroup IIIA showed the highest shear bond strength than the remaining groups. Between subgroups IIA and IIB, IIIA and IIIB, and IVA and IVB there was no statistically significant difference. This shows that delaying the bonding procedure for 3 weeks shows similar shear bond strength when compared to groups that were immediately bonded after antioxidant applying groups.

Conclusion

All the antioxidants' immediate application could reverse compromised bond strength. Among them, 5% grape seed extract shows the highest increase in shear bond strength.

How to cite this article

Maddula DC, Vasepalli M, Martha S, et al. Comparative Evaluation of Effect of Different Antioxidants on Shear Bond Strength of Composites on Bleached Enamel: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(1):87-92.

“Effect of grape seed and green tea on shear bond strength of brackets bonded to bleached enamel with and without Lase Peroxide Lite” – An in vitro study

OBJECTIVE:

To investigate the effect of antioxidants on shear bond strength of brackets bonded to bleached enamel with and without titanium dioxide nanoparticles (Lase Peroxide Lite).

MATERIALS AND METHODS:

One hundred and five human maxillary premolars were randomly divided into seven groups (n = 15). Group I served as control, in group II-A bleaching was performed with Opalescent Boost. In group II-B and C, bleaching was performed with Opalescent Boost followed by application of 5% grape seed and 10% green tea extracts, respectively. Group III-A bleaching was performed with Lase Peroxide Lite. Group III-B and III-C bleaching was performed with Lase Peroxide Lite followed by application of 5% grape seed and 10% green tea extracts, respectively. Brackets were bonded with composite resin and cured with light emitting diode (LED) light. Shear bond strength of brackets was tested with a Universal testing machine.

RESULTS:

There was statistically significant difference in the shear bond strength among the seven groups included in the study. There is a statistically significant decrease in shear bond strength in group II-A (8.2 ± 1.6 Mpa), group III-A (8.6 ± 2.1 Mpa) when compared with group I-A (15.9 ± 1.4 Mpa). Among all experimental groups, group II-A showed the lowest mean shear bond-strength values (8.2 ± 1.6 Mpa) (P < 0.005). Group III-C (14.9 ± 2.2 Mpa) has significantly higher shear bond strength.

CONCLUSION:

Bleaching reduced the shear bond strength of brackets below acceptable level while application of grape seed and green tea extracts has recovered the shear bond strength.

Use of two kinds of antioxidants to restore the bond strength of bleached enamel

OBJECTIVES

This work aimed to evaluate the ability of two kinds of antioxidants, namely, grape-seed extract and sodium ascorbate, in restoring bond strength at the resin-enamel interface after bleaching.

METHODS

Ten groups of samples with 15 teeth per group were prepared for shear-bond-strength test at the resin-enamel interface after bleaching. The groups were as follows: control; no antioxidant; 2.5%, 5%, 10%, or 15% grape-seed extract; and 2.5%, 5%, 10%, or 15% sodium ascorbate. The peak values of shear bond strength when resin was debonded from teeth and the failure modes under a microscope were recorded. Ten other groups of teeth with two teeth per group were prepared and treated in a similar approach before resin bonding. The samples were cut vertically to the bonding interface. The structures of the bonding interface were compared by scanning electron microscopy.

RESULTS

No statistically significant difference in shear bond strength was found among the no-antioxidant, 2.5% grape-seed extract, and 2.5%, 5%, or 10% sodium ascorbate groups (P>0.05), which were statistically significantly lower than the control group (P<0.05). Evidence of marginal gap was observed at the resin-enamel interface, and resin tags in enamel were short, poorly defined, and fragmented. No statistically significant difference in shear bond strength was found among 5%, 10%, or 15% grape-seed extract, 15% sodium ascorbate, and control groups (P>0.05). No evidence of discontinuity was found at the adhesion interface, and resin tags in enamel were long, well defined, and structurally intact. Failure in the adhesive joint was the major debond mode in all experimental groups.

CONCLUSIONS

Immediately after bleaching, the bond strength of dental enamel significantly decreased. Bond strength can be restored by 5% grape-seed extract or 15% sodium ascorbate in 5 min.

Comparative evaluation of 6% cranberry, 10% green tea, 50% aloe vera and 10% sodium ascorbate on reversing the immediate bond strength of bleached enamel: In vitro study

Objectives

The present study aimed to assess antioxidant activity of herbal antioxidants namely 6% cranberry extract, 10% green tea, 50% aloe vera and 10% sodium ascorbate and their effect on reversal of bond strength in bleached enamel.

Materials and method

From one hundred and twenty extracted maxillary central incisors enamel blocks of 5 ​× ​5 ​mm were prepared and arbitrarily divided into six experimental groups (n ​= ​20): Group A: no bleaching, Group B: only bleaching protocol, Group C - bleaching ​+ ​6% cranberry extract solution, Group D - bleaching +10% Green Tea extract, Group E - bleaching ​+ ​50% aloe vera extract, Group F - bleaching ​+ ​10% Sodium Ascorbate. After bleaching antioxidants were applied for 10 ​min and were subjected to bonding procedures. The specimens were sectioned into 120 small strips of size (1 ​× ​1 ​× ​8 ​mm). Sixty sticks were analyzed to micro tensile bond strength using Universal testing machine and fractured segment were observed for failure modes (Adhesive, Cohesive and Mixed) under stereomicroscope. Remaining 60 sticks were observed for interface gap between tooth and composite resin under SEM. The %AA (antioxidant activity) was assessed with spectrophotometric analysis.

Results

Data was statistically analyzed using ANOVA and Post Hoc Tukey's test. Group A (91.68 ​± ​2.24 Mpa) showed higher mean micro tensile bond strength versus group D (82.14 ​± ​1.45 Mpa), followed by group E (75.26 ​± ​1.92Mpa), group F (63.89 ​± ​1.95Mpa), group C (57.58 ​± ​1.96 Mpa) and least in group B (31.5 ​± ​1.27 Mpa). The %failure mode inferred maximum adhesive mode of failure (86.25%).

Conclusion

All the four antioxidants were able to reverse the compromised bond strength comparatively after bleaching maximum being green tea followed by aloe vera, sodium ascorbate, and minimum in cranberry.

Clinically significance-

Easily available, biocompatible, cost effectual, and potent herbal antioxidants could be used considerably for immediate esthetic cases where time is a restricting factor.

Comparative Analysis of Shear Bond Strength of Composites to the Sodium Ascorbate Hydrogel-treated Bleached Enamel Surfaces: An In Vitro Analysis

Aim

To compare the shear bond strength of composites to the sodium ascorbate hydrogel-treated bleached enamel surfaces.

Materials and methods

Sixty-six extracted human maxillary first premolars were sectioned mesiodistally to obtain two nonocclusal surfaces (n = 132). The specimen in the experimental group (n = 80) were divided into four treatment groups depending upon bleaching protocols used: group I (10% FGM home bleach), group II (22% Pola Night home bleach), group III (37% light-activated in-office bleach Pola Office+), and group IV (35% Pola office in-office bleach without light activation). Specimens were subjected to the 1-minute application twice with sodium ascorbate hydrogel and were further divided into two subgroups “a” (acetone-based) and “b”(ethanol-based) depending upon the bonding agents used. The specimens of the control group (n = 52) were further divided into two treatment groups, that is, positive control and negative control. The specimens were tested using universal testing machine.

Results

The result of the present study revealed that the specimens bleached with 10% FGM home bleach showed the greatest shear bond strength and specimens bleached with 35% in-office bleach Pola Office showed the lowest shear bond strength.

Conclusion

A twice 1-minute application of sodium ascorbate hydrogel was effective to reverse the deleterious results of bleaching on enamel shear bond strength. Bonding agent containing acetone as a solvent (Prime and Bond NT) in this present study showed greater shear bond strength values than the bonding agent containing ethanol as a solvent (Adper Single Bond).

Statement of clinical relevance

The shear bond strength of composite restorative materials could be improved by applying sodium ascorbate gel to the bleached enamel surfaces.

How to cite this article

Pathak K, Kumar P, Choudhary A, et al. Comparative Analysis of Shear Bond Strength of Composites to the Sodium Ascorbate Hydrogel-treated Bleached Enamel Surfaces: An In vitro Analysis. Int J Clin Pediatr Dent 2021;14(6):741–747.

The Effect of Different Bleaching Protocols, Used with and without Sodium Ascorbate, on Bond Strength between Composite and Enamel

This in vitro study aims to evaluate whether a solution of 10% sodium ascorbate (SA) may exert a beneficial effect on the bonding of composite to enamel after using different bleaching agents and protocols. Microtensile bond strength (µTBS) was evaluated on 72 freshly extracted human central incisors, divided into eight experimental groups and one control group (total n = 9): Group 1 serves as control (nonbleached). Group 2 was bleached with 5% carbamide peroxide. Group 3 was bleached with 5% carbamide peroxide and then treated with 10% SA. Group 4 was bleached with 10% carbamide peroxide. Group 5 was bleached with 10% carbamide peroxide, then treated with 10% SA. Group 6 was bleached with 16% carbamide peroxide. Group 7 was bleached with 16% carbamide peroxide, then treated with 10% SA. Group 8 was bleached with 6% hydrogen peroxide. Group 9 was bleached with 6% hydrogen peroxide, then treated with 10% SA. All groups were restored immediately after the different treatments using a resin composite. The µTBS values were measured using a universal testing machine and statistical analysis was performed by means of normality and variance analyses, SIDAK test for univariate test and multiple comparisons, and Student test to compare µTBS values of each group with the control. The mean µTBS values in groups 2, 4, 6, 8 were significantly lower than controls. For groups 3, 5, 7, 9, subjected to antioxidant (10% SA) application, all µTBS values increased significantly. However, only for Groups 3 and 5 there was no significant difference with the control. Applying 10% SA for 10 min may improve the bond strength composite/bleached enamel just when whitening is performed with 5% and 10% carbamide peroxide.

Effect of 10% sodium ascorbate applied for different time periods on shear bond strength of composite to bleached enamel

Aims: Residual peroxide on the enamel surface and in the interprismatic spaces decreases the shear bond strength (SBS) of composite to bleached enamel. Evidence shows that 10% sodium ascorbate can efficiently neutralize the singlet oxygen generated by the bleaching agents. This study aimed to assess the effect of duration of application of sodium ascorbate on SBS of composite to bleached enamel. Materials and Methods: This in vitro experimental study was conducted on 30 sound human third molars, which were randomly divided into three groups (n=10). In group 1, the teeth were bleached for 45 minutes and were then subjected to immediate bonding and restoration with composite resin. In groups 2 and 3, the teeth were bleached, immersed in 10% sodium ascorbate solution for 5 (group 2) and 10 (group 3) minutes and were then bonded and restored with composite, and the SBS was then measured. Results: The highest SBS (14.02±8.6MPa) was noted in group 3 (immersion in 10% sodium ascorbate for 10 minutes before bonding). The lowest SBS was noted in group 1 (immediate bonding after bleaching) (p<0.05). The difference in SBS of groups 1 and 2 was not significant (p=0.4). Conclusion: Application of 10% sodium ascorbate for 10 minutes increases the SBS of composite to bleached enamel.

Effect of sodium ascorbate on bond strength and metalloproteinases activity in bleached dentin

Aim

This study evaluated the effect of sodium ascorbate (SA) on the proteolytic activity of matrix metalloproteinases (MMPs) and investigated the related effects on the bond strength of bleached dentin.

Materials and methods

Eighty freshly extracted human third molars were randomly divided according to treatment (bleaching or SA application), type of analysis (microshear or measuring MMP activity), and post-bleaching time to assess bond strength (24 hrs or 30 days). Data from both analyses were subjected to one-way analysis of variance to detect differences among groups, followed by Tukey’s multiple comparison test (p≤0.05).

Results

Dental bleaching significantly reduced bond strength values when the adhesive strategy was performed after 24 hrs (despite the SA treatment) or 30 days after the bleaching procedure. However, after 30 days, the bond strength values of the groups who received bleaching or SA application were similar to those of the unbleached group. Dental bleaching caused the activation of MMPs, and SA did not influence this activity.

Conclusion

It was concluded that SA does not affect the activity of MMPs or the bond strength in bleached dentin immediately after the bleaching treatment.

Effect of mangosteen peel extract as an antioxidant agent on the shear bond strength of orthodontic brackets bonded to bleached teeth

Introduction:

The number of patients who seek orthodontic treatment that may have a history of tooth bleaching is increasing over the time. Bleaching may influence the decrease of the bond strength of orthodontic brackets.

Objective:

To determine and prove the effect of mangosteen peel (MP) extract to reverse the reduced shear bond strength (SBS) of orthodontic brackets after bleaching.

Methods:

A total of 150 maxillary first premolar teeth were randomly divided into 6 experimental groups as follow (n=25): negative-control (N: no bleaching), positive-control (P: bleaching + no treatment), and the treatment groups (bleaching + 10% sodium ascorbate (SA), 10% (MP-10), 20% (MP-20) and 40% (MP-40) MP extract gel). After treatment, the brackets were bonded with the resin-modified glass ionomer cement, SBS testing was performed using universal testing machine, and the adhesive remnant index (ARI) was examined using stereoscopic microscope after debonding. The SBS data were analyzed by analysis of variance (Anova) and the Tukey test. For the ARI, the Kruskal-Wallis test was performed.

Result:

There was significant SBS difference (p< 0.001) between various groups. The group without bleaching showed significantly higher SBS (8.19 ± 2.26 MPa) compared to others, while SBS in the group treated with 40% MP gel was significantly higher (7.93 ± 1.92 MPa) than other groups treated with antioxidants. The failure of orthodontic brackets bonded after bleaching and treatment using MP extract occurred at the enamel-adhesive interface.

Conclusion:

The application of MP extract as an antioxidant after bleaching was effective in reversing the reduced shear bond strength of orthodontic brackets after bleaching.

Effect of Two-minute Application of 35% Sodium Ascorbate on Composite Bond Strength following Bleaching

AIM

The aim of this study is to assess the effect of 35% sodium ascorbate on microtensile bond strength of dentin immediately after bleaching with 35% hydrogen peroxide.

MATERIALS AND METHODS

A total of 25 sound human 3^rd molars were collected. Teeth were randomly divided into five groups for different treatments: Group I [bleaching + immediate bonding (i.e., restoration)], group II (bleaching + delayed bonding), group III (bleaching + sodium ascorbate + immediate bonding), group IV (bleaching + sodium ascorbate + delayed bonding), and group V (bonding only). After bleaching, but before bonding, groups II and IV were stored for 1 week in deionized water at 37°C. All samples were bonded using OptiBoned FL (Kerr) and Filtek Supreme (3M/ESPE). Teeth were sectioned into 1 × 1 mm 2 bars, and microtensile bond strength was tested with a universal testing machine (Instron 8841) at a cross-head speed of 0.5 mm/minute.

RESULTS

Microtensile bond strength differed significantly across the five groups, with a significant reduction in microtensile bond strength observed for samples in group I relative to samples in any of the other treatment groups (p < 0.05).

CONCLUSION

The application of a high concentration of sodium ascorbate for a shorter time reversed the negative effect of 35% hydrogen peroxide bleaching on composite bonding strength to dentin.

CLINICAL SIGNIFICANCE

The negative effects of bleaching on composite bonding can be neutralized by the application of the reversing agent sodium ascorbate thus, increasing the efficiency of clinic chair time. This is clinically relevant for those patients requiring restorative treatment immediately after in-office bleaching.

Shear Bond Strength of Two Types of Glass Ionomer to Bleached Dentin: Effect of Delayed Bonding and Antioxidant Agent

BACKGROUND

Studies have shown a reduction in bond strength of composites and glass ionomer to bleached enamel and dentin. Several methods have been proposed to reverse compromised bond strength.

OBJECTIVE

The aim of this study was to evaluate the effect of delayed bonding and application of antioxidant agent on the bond strength of reinforced self-cured (Fuji IX) and light-cured glass ionomers (Fuji II LC) to bleached dentin.

MATERIAL

Eighty extracted third molars were randomly divided into 8 groups. Buccal dentin surfaces received different treatments: Two control groups: no treatment + bonding Fuji IX or Fuji II LC. Two immediate bonding groups: bleaching + bonding Fuji IX or Fuji II LC. Two delayed bonding groups: bleaching + 7 days delay + bonding Fuji IX or Fuji II LC. Two sodium ascorbate application groups: Bleaching + application of 10% sodium ascorbate + bonding Fuji IX or Fuji II LC. All samples were tested for shear bond strength. Two-way analysis of variance (ANOVA) was used to compare the mean and standard deviations among groups, followed by the Tukey's test for significant interaction.

RESULTS

No statistically significant difference was detected in shear bond strength of Fuji IX to bleached or normal dentin. Although a significant reduction was found shear bond strength values of Fuji II LC to bleached dentin, no significant difference was observed between no bleaching group and those treated with 10% sodium ascorbate or 7 days of delay in bonding for both types of glass ionomer.

CONCLUSION

Bleaching had no significant effect on shear bond strength of Fuji IX to dentin; this type of GI can be used immediately after bleaching.

An In-vitro Comparative Study of Shear Bond Strength of Composite Resin to Bleached Enamel using three Herbal Antioxidants

INTRODUCTION

If adhesive restorations are carried out imme-diately, the Shear Bond Strength (SBS) to bleached enamel is reduced. The use of antioxidants can be highlighted since it seems to be a more effective alternative to reduce or remove the residual oxygen and immediate improvement in SBS.

AIM

The purpose of this in-vitro study was an attempt to regain the lost bond strength, for which, the comparison of SBS of composite resin to bleached enamel was carried out using various antioxidants i.e., 5% grape seed extract, 5% pine bark extract, 5% pomegranate peel extract.

MATERIALS AND METHODS

Labial enamel surfaces of 50 extracted human maxillary central incisors were randomly divided into 5 groups based on the antioxidant used as follows: Group I (n=10): Bleaching with 40% hydrogen peroxide gel for 10 minutes, without the use of an antioxidant; Group II (n=10): Bleaching followed by the use of 5% grape seed extract solution; Group III (n=10): Bleaching followed by the use of 5% pine bark extract solution Group IV (n=10): bleaching followed by the use of 5% pomegranate extract solution; and Group V (n=10): Control group in which no Bleaching was done. SBS of the specimens was tested using universal testing machine. The data were tabulated and statistically analyzed using computer software Statistical Package for Social Sciences (SPSS) version 16.0. One-way analysis of variance (ANOVA) followed by Mann Tukey Post hoc test.

RESULTS

Mean SBS values were compared in all the groups and there was a statistically significant difference present among the groups (p<0.05). The SBS values were observed to be significantly higher in unbleached teeth (control group) followed by 5% pine bark extract, 5% grape seed extract, 5% pomegranate extract and the group in which teeth bleached with no antioxidant used.

CONCLUSION

The use of antioxidant immediately after bleaching the enamel surface, completely neutralizes the deleterious effects of bleaching and increases the SBS significantly. Among the antioxidants, 5% pine bark extract application after bleaching showed better bond strength.

Correlation between antioxidant activity and bonding strength on bleached enamel

Objective: This study used the 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) method to evaluate the percentage of antioxidant activity (%AA) of green tea (GT) and sodium ascorbate (SA) gel in three concentrations (10%, 20% and 30%), and the influence of these concentrations on the microshear bond strength (μ-SBT) values of bleached enamel, using 10% carbamide peroxide (CP).

Materials and methods: Eighty intact third molars were selected to perform the μ-SBT test, and were randomly divided into eight experimental groups: G1: positive control – no treatment; G2: negative control – bleached with CP; G3: PC +10% GT; G4: PC +20% GT; G5: PC +30% GT; G6: PC +10% SA; G7: PC +20% SA and G8: PC +30% SA. After applying the treatments, adhesive procedures were performed using Single Bond 2 and Filtek Z350XT. After 24 h, the samples were tested in a universal testing machine until fracture. The %AA was assessed in triplicate by DDPH method using a UV–VIS spectrophotometer.

Results: In the μ-SBT, ANOVA revealed no significant difference between the antioxidants evaluated (p = .625), but did reveal significant effects of the concentrations studied (p = .007). A negative correlation was observed between μ-SBT and solution concentrations. The values of %AA were from 90.58 to 96.75.

Conclusions: The reverse results occurred in μ-SBT values, only when the antioxidants were used in a 10% concentration and, %AA did not influence μ-SBT.

Influence of 10% sodium ascorbate gel application time on composite bond strength to bleached enamel

Objective To analyze bond strength to bleached enamel following application of 10% sodium ascorbate gel. Material and methods Forty third molars were allocated into five groups (n = 8): GP - unbleached specimens restored with composite resin; GN - specimens restored immediately after bleaching; and G15; G30 and G60 (test groups) - bleached specimens treated with 10% sodium ascorbate gel for 15, 30 and 60 min before restoration. The teeth were sectioned and the buccal and lingual faces were restored. After storage in distilled water (37 °C/24 h), sticks of ±0.8 mm² were tested in tensile (0.5 mm/min). Fractures were observed and classified. Data (in MPa) were analyzed with one-way ANOVA and Tukey tests (α = 0.05). Results No differences were found among GP (26 ± 6.0), G15 (23 ± 7.3), G30 (25 ± 6.1) and G60 (25 ± 5.1), with GN (15 ± 5.5) showing the lowest bond strength (p < 0.0001). Conclusion The application of 10% sodium ascorbate gel for 15 min after bleaching with 37.5% hydrogen peroxide restored the bonding to enamel.

Effect of 10% sodium bicarbonate on bond strength of enamel and dentin after bleaching with 38% hydrogen peroxide

AbstractIntroductionBy-products of hydrogen peroxide degradation released during dental bleaching influence the polymerization of adhesive systems and composite resins, causing a reduction in shear bond strength to the tooth.Objectivethe aim of this article was to evaluate the effect of 10% sodium bicarbonate (SB), applied for different lengths of time, on the shear bond strength to enamel and dentin after bleaching.Material and methodEnamel and dentin blocks were divided into groups (n=10): (1) control: no bleaching; (2) immediate: bleaching immediately followed by restoration; (3) 14-day: bleaching, restoration 14 days later; (4) SB for 10 minutes: bleaching, SB gel for 10 minutes, immediately followed by restoration; (5) SB for 20 minutes: bleaching, SB gel for 20 minutes, immediately followed by restoration. A 38% hydrogen peroxide gel (Opalescence Boost/Ultradent) was used. After application of the adhesive system, composite resin cylinders were mounted on the surface of the substrates in order to test shear bond strength. Result: ANOVA and Tukey tests showed significantly higher mean enamel bond strength values for the 14-day follow-up group and without significant differences for control group. Mean bond strength values obtained for the other groups were intermediate. When testing dentin, the Tukey test revealed a significantly higher mean bond strength value for the 14-day follow-up group when compared with application of SB for 20 minutes.ConclusionSB gel applied was unable to reverse the low bond strength to enamel and dentin after bleaching treatment.

The Effect of 3% Phosphate Ascorbyl Gel on Bond Strength of Composite Resin to Enamel treated with 35% Hydrogen Peroxide

OBJECTIVE

To evaluate the effect of 3% phosphate ascorbyl gel (PA) in different times onto the microshear bond strength of composite resin (CR) to bovine enamel treated with 35% hydrogen peroxide (HP).

MATERIALS AND METHODS

Thirty enamel blocks of bovine incisors were made and divided into 5 groups (n = 6) with three specimens per group (n = 18), according to treatment: G1= No bleaching + CR; G2 = HP + CR after 15d; G3 = HP + CR after 24 hours; G4 = HP + PA (15 min) + CR after 24 hours; G5 = HP + PA (2 hours) + CR after 24 hours. The resin cylinders were made by Tygon matrices. Microshear bond strength test was performed using universal testing machine with a 50N load at a speed of 0.5 mm/min. Fracture modes were assessed by a stereomicroscope 40 ×. Microshear bond strength values were submitted to the analysis of variance (ANOVA) one-way and Tukey test (p < 0.05).

RESULTS

G1 had significant results when compared to G3 and G5 (p < 0.01). However, G2, G3, G4 and G5 have showed no significant differences among groups (p > 0.05). Failure modes were categorized into adhesive (90%) and mixed (10%).

CONCLUSION

The use of 3% phosphate ascorbyl gel for 15 minutes was able to improve bond strength of composite resin to bleached bovine enamel, but when 3% phosphate ascorbyl gel was applied during 40 minutes it negatively interfered in the adhesion of the resin to bleached bovine enamel.

Antioxidants in Endodontics: A Strategic Review

Over the past few decades, the free radicals and antioxidants have attracted tremendous importance in the field of dentistry. Depending on the level of free radicals in the body, they can either be harmful or helpful. Antioxidants are the substances that interact with and stabilize free radicals thereby protecting cells from the damage caused by free radicals. The indigenous antioxidants may be useful in preventing the harmful effects of oxidative stress. The present article presents a review on the free radicals formation, their role in disease pathogenesis, antioxidants and their potential role in endodontics.

Effect of three different antioxidants on the shear bond strength of composite resin to bleached enamel: An in vitro study

Objective:

The effect of 10% sodium ascorbate, 10% grape seed extract, and 10% pine bark extract on the shear bond strength of composite resin to bleached enamel was evaluated.

Materials and Methods:

Ninety recently extracted human premolars were divided into six groups of 15 teeth each. Except Group I (negative control), the labial enamel surface of all specimens in the other groups were bleached with 37.5% hydrogen peroxide. After bleaching, Group II specimens were stored in artificial saliva for 3weeks before composite bonding. Immediately following bleaching; Groups III, IV, and V specimens were treated with antioxidants 10% sodium ascorbate, 10% grape seed extract, and 10% pine bark extract, respectively, for 10 min and bonded with composite resin. In Group VI (positive control), the composite bonding was done immediately after bleaching. All specimens were stored in deionized water for 24 h at 37΀C before shear bond strength testing. The data obtained were tabulated and statistically analyzed using analysis of variance (ANOVA) and Duncan's multiple range test.

Results:

The unbleached teeth showed the highest shear bond strength followed by the bleached teeth treated with the antioxidant 10% pine bark extract.

Conclusion:

Within the limitations of this study, it was observed that the use of antioxidants effectively reversed the compromised bond strength of bleached enamel. Among the antioxidants, 10% pine bark extract application after bleaching showed better bond strength.

Effect of Sodium Ascorbate and Delayed Bonding on the Bond Strength of Silorane and Two-step Self-etch Adhesive Systems in Bleached Enamel

Background and aims. Studies have shown decreased bond strength of composite resin to human and bovine bleached enamel. This study evaluated the effect of sodium ascorbate and delayed bonding on the bond strength of two adhesive systems to bleached enamel.

Materials and methods. The labial surfaces of 150 sound bovine incisor teeth were abraded with abrasive paper. The teeth were randomly divided into 8 groups: A: control; B: bleached with 35% hydrogen peroxide; C: bleached with 35% hydrogen peroxide + sodium ascorbate gel; and D: bleached with 35% hydrogen peroxide + delayed bonding. In groups A‒D, silorane adhesive system and Filtek silorane composite resin were used. In groups E‒H, the same preparation methods of groups A-D were used. Two-step self-etch Clearfil SE Bond adhesive systems and AP-X composite resin were administered. Shear bond strength of each group was measured. Two samples were prepared for each surface preparation for ultra-structural evaluation. Two-way ANOVA and Tukey test were used for data analysis at P<0.05.

Results. The interaction between the adhesive system type and surface preparation protocol was significant (P=0.014), withsignificant differences in shear bond strengths in terms of the adhesive systems (P<0.01). There were significant differences in shear bond strength in terms of surface preparation techniques irrespective of the adhesive system (P<0.01).

Conclusion. The results showed that bleaching with 35% hydrogen peroxide decreased the shear bond strength values with both adhesive systems, and a one-week delay in bonding and 10% sodium ascorbate for10 minutes restored the bond strength in both adhesive systems.

Effects of Green Tea Application Time on Bond Strength after Enamel Bleaching

This study evaluated the effect of green tea application time on the bond strength of enamel after enamel bleaching. Enamel samples were obtained from 80 third molars and randomly divided into 7 experimental groups (G1-G7) and 1 group without treatment (G8): G1, bleached with 10% carbamide peroxide (CP); G2, CP + 10% sodium ascorbate gel (SA) for 15 min; G3, CP + SA for 30 min; G4, CP + SA for 60 min; G5, CP + 10% green tea gel (GT) for 15 min; G6, CP + GT for 30 min; G7, CP + GT for 60 min. The CP was applied onto the enamel surface for 8 h for 14 days. The SA was applied in groups 2, 3 and 4, and the GT was applied in groups 5-8 according to the above described application times. Immediately after treatment, the specimens were bonded with Adper Single Bond 2 and Filtek Z350XT. The specimens were prepared to microtensile bond strength analysis. Fracture mode analysis was performed using a stereoscopic loupe. The data were statistically analyzed by two-way analysis of variance, the Tukey's and Dunnett's tests (=5%). The means (standard deviation) were: G1, 23.3 (3.2); G2, 25.2 (3.9); G3, 26.4 (5.4); G4, 30.2 (4.5); G5, 26.6 (3.4); G6, 22.0 (5.4); G7, 31.4 (3.3); G8, 31.4 (3.2). All groups had a high percentage of adhesive failures. In conclusion, the bond strength values were higher than the value in the bleached group only when the antioxidants were applied for 60 min.

Influence of exposure time to saliva and antioxidant treatment on bond strength to enamel after tooth bleaching: an in situ study

Objectives

This study evaluated the influence of different exposure times to saliva in situ in comparison with an antioxidant treatment on composite resin bond strength to human enamel restored after tooth bleaching.

Material and Methods

Forty human teeth specimens measuring 5x5 mm were prepared and randomly allocated into 5 groups with 8 specimens each: Gct (control group, restored on unbleached enamel); Gbl (restored immediately after bleaching); Gsa (bleached, treated with 10% sodium ascorbate gel for 60 min and restored); G7d (bleached, exposed to saliva in situ for 7 days and restored); and G14d (bleached, exposed to saliva in situ for 14 days and restored). Restored samples were cut into 0.8 mm² sticks that were tested in microtensile. Specimens were microscopically analyzed and failure modes were classified as adhesive, cohesive, or mixed. Pretest and cohesive failures were not considered in the statistical analysis, which was performed with one-way ANOVA and Tukey's post-hoc test (α=0.05), with the dental specimen considered as the experimental unit.

Results

Mean bond strength results found for Gbl in comparison with Gct indicated that bleaching significantly reduced enamel adhesiveness (P<0.01). However, no statistically significant differences were found between Gct, Gsa and G7d (P>0.05). Bond strength found for G14d was significantly higher than for Gsa (P<0.01). Fractures modes were predominantly of a mixed type.

Conclusions

Bonding strength to bleached enamel was immediately restored with the application of sodium ascorbate and exposure to human saliva in situ for at least 7 days. Best results were obtained with exposure to human saliva in situ for 14 days. Treatment with sodium ascorbate gel for 60 min may be recommended in cases patients cannot wait for at least 7 days for adhesive techniques to be performed.

Tooth-bleaching procedures and their controversial effects: A literature review

AIM

This review article will help clinicians improve their understanding of the history of bleaching procedures, bleaching types, components, mechanisms, and their effects on soft tissue, tooth structures, resin composite, and bonding.

METHODS

The controversial issues about bleaching procedures and their effects are reviewed. Additionally, the consequences of pre- and post-bleaching on the bonding potential of composite resin restorations to tooth structure are discussed.

CONCLUSION

The overall goal of the paper is to help reduce risks for patients.

Effect of Sodium Ascorbate on Resin Bonding to Sodium Perborate–bleached Dentin

This was an in vitro study to evaluate the effect of sodium ascorbate on the microshear bond strength (MSBS) of resin composite to sodium perborate–bleached dentin. Molar dentin sections were divided into six groups: 1) control, 2) sodium perborate (SP) bleach and immediate bonding, 3) SP and 30 second sodium ascorbate (SA); 4) SP and 1 minute SA; 5) SP and 2 minute SA; and 6) SP and 7 day delay before bonding. They were further divided into two-step self-etching (Clearfil SE Bond) or all-in-one self-etching (Xeno IV) adhesive systems. Resin composite microtubes were bonded according to dentin location—center, pulp horn, and peripheral positions—and an MSBS test was carried out. Failure mode was determined using light microscopy and scanning electron microscopy. There were no significant differences between the treatment types/groups. MSBSs were significantly higher for two-step self-etching adhesive compared with all-in-one self-etching adhesive (p=0.028). For the all-in-one adhesive, MSBSs at the center and pulp horn positions were significantly lower than the peripheral positions (p&lt;0.001). All-in-one groups had significantly more adhesive failures than two-step adhesive groups (p=0.015). The odds of adhesive failure were higher at the pulp horn position than the peripheral position (p=0.004). Sodium perborate bleaching of dentin had no effect on MSBS or mode of failure for either two-step or all-in-one self-etching adhesives; therefore, the effect of sodium ascorbate was negligible. The two-step adhesive groups demonstrated the highest MSBS, and the all-in-one groups, when bonded to center and pulp horn dentin, exhibited the lowest MSBS.

Effect of Epigallocatechin Gallate on shear bond strength of composite resin to bleached enamel: an in vitro study

Objectives

The aim of this study was to determine the effect of epigallocatechin gallate (EGCG) on the shear bond strength of composite resin to bleached enamel.

Materials and Methods

Ninety enamel surfaces of maxillary incisors were randomly divided into 9 groups as follows: G1: control (no bleaching); G2: bleaching; G3: bleaching and storage for seven days; G4 - 6: bleaching and application of 600, 800 and 1,000 µmol of EGCG-containing solution for 10 minutes, respectively; G7 - 9: bleaching and application of 600, 800 and 1,000 µmol of EGCG-containing solution for 20 minutes, respectively. The specimens were bleached with 30% hydrogen peroxide gel and a composite resin cylinder was bonded on each specimen using a bonding agent. Shear bond strength of the samples were measured in MPa. Data was analyzed using the two-way ANOVA and Tukey HSD tests (α = 0.05).

Results

The maximum and minimum mean shear bond strength values were observed in G1 and G2, respectively. Time and concentration of EGCG showed no significant effects on bond strength of the groups (p > 0.05). Multiple comparison of groups did not reveal any significant differences between the groups except for G2 and all the other groups (p < 0.05).

Conclusions

There is a significant decrease in bond strength of composite resin to enamel immediately after bleaching. A delay of one week before bonding and the use of EGCG increased bond strength of composite resin to bleached enamel.

Does the time interval after bleaching influence the adhesion of orthodontic brackets?

Objective

To test the null hypothesis that no difference exists between the effects of at-home bleaching and in-office bleaching on shear bond strength (SBS) with bracket bonding at 4 different time intervals after dental bleaching.

Methods

Ninety extracted human premolars were randomly divided into 9 groups (n = 10) according to the bleaching methods used (at-home bleaching and in-office bleaching) and the storage time in artificial saliva (30 min, 1 day, 2 weeks, and 3 weeks before bonding). The control group was stored in artificial saliva for 7 days. Brackets were bonded with the Transbond XT adhesive system, and SBS testing was performed. The adhesive remnant index (ARI) was used to assess the amount of resin remaining on the enamel surfaces after debonding. The SBS data were analyzed by analysis of variance (ANOVA) and the Tukey test. For the ARI, the Kruskal-Wallis test was performed. Significance for all statistical tests was predetermined to be p < 0.05.

Results

The SBS of the unbleached group was significantly higher (p < 0.05) than that of the bleached groups (except for the group bonded 30 min after at-home bleaching).

Conclusions

The null hypothesis was not totally rejected. All bleaching groups tested had decreased SBS of the brackets to the enamel, except for the group bonded 30 min after at-home bleaching. The SBS returned to values close to those of the unbleached enamel within 3 weeks following bleaching.

Can green tea be used to reverse compromised bond strength after bleaching?

The objective of this study was to evaluate the antioxidant effect of green tea on microtensile bond strength (μTBS) to bleached enamel. Forty-two human third molars were randomly divided into six experimental groups (n = 7 each group): group 1, no treatment; group 2, bleaching (10% carbamide peroxide); group 3, bleaching + 10% sodium ascorbate gel (SA); group 4, bleaching + 10% green tea gel (GT); group 5, SA; and group 6, GT. In groups 2, 3, and 4, bleach was applied onto the enamel surface for 6 h, every day for 14 d. In groups 3 and 5, SA was applied for 1 h; and in groups 4 and 6, GT was applied for 1 h. Immediately after treatment, the specimens were bonded with Adper Single Bond 2 and Filtek Z350 XT. The μTBS of the specimens was tested using a universal testing machine. Fracture mode analysis of the bonded enamel surface was performed using scanning electron microscopy. The mean μTBS values for each group were: group 1, 33.2 ± 5.8 MPa; group 2, 22.6 ± 5.5 MPa; group 3, 30.0 ± 5.2 MPa; group 4, 31.6 ± 3.8 MPa; group 5, 29.1 ± 4.2 MPa; and group 6, 32.2 ± 4.5 MPa. All groups had a higher percentage of mixed failures. In conclusion, green tea can be used as an alternative antioxidant on bleached enamel before bonding procedures.

Evaluation and comparison of bond strength to 10% carbamide peroxide bleached enamel following the application of 10% and 25% sodium ascorbate and alpha-tocopherol solutions: An in vitro study

Aim:

To evaluate and compare composite bond strength to carbamide peroxide bleached enamel following the application of 10% and 25% sodium ascorbate and alpha-tocopherol solutions.

Materials and Methods:

Sixty premolars were divided into six groups. Groups I and VI served as unbleached and bleached controls respectively. Groups II, III, IV and V served as the experimental groups and were subjected to 10% carbamide peroxide bleaching followed by 10 min application of 10% and 25% sodium ascorbate and 10% and 25% alpha-tocopherol solutions, respectively. Following composite bonding, shear bond strength was determined and the results were analyzed using ANOVA and Tukey highest significant difference test.

Results:

Only Group IV showed significantly lower bond strength when compared to Group I (unbleached control). When compared to Group VI (bleached control), except Group IV, groups II, III and V showed significantly higher bond strength. However, there was no statistically significant difference between the experimental groups corresponding to 10% and 25% and similar concentrations of sodium ascorbate and alpha-tocopherol solutions.

Conclusion:

Following 10% carbamide peroxide bleaching, except 10% alpha tocopherol, 10 min application of 10% and 25% sodium ascorbate and 25% alpha-tocopherol solutions significantly improves the shear bond strength of composite resin to enamel.

Effective application duration of sodium ascorbate antioxidant in reducing microleakage of bonded composite restoration in intracoronally-bleached teeth

OBJECTIVES

The aim of this study was to determine an appropriate application duration of sodium ascorbate (SA) antioxidant gel in reducing microleakage of bonded composite restoration in intracoronally-bleached teeth.

MATERIALS AND METHODS

Eighty endodontically-treated human incisors were randomly divided into eight groups: control, no bleaching; IB and DB, immediate and delayed bonding after bleaching, respectively; S10m, S60m, S24h, S3d and S7d, bleaching + SA gel for 10 min, 60 min, 24 hr, 3 day and 7 day, respectively. For bleaching, a mixture of 30% hydrogen peroxide and sodium perborate was applied for 7 day. All access cavities were restored using One-Step adhesive (Bisco Inc.) and then Aelite LS Packable composite (Bisco Inc.). The bonded specimens were subjected to 500 thermal cycles, immersed in 1% methylene blue for 8 hr, and longitudinally sectioned. Microleakage was assessed with a 0 - 4 scoring system and analyzed using nonparametric statistical methods (α = 0.05).

RESULTS

Group IB showed a significantly higher microleakge than the control group (p = 0.006) and group DB a statistically similar score to the control group (p > 0.999). Although groups S10m, S60m, and S24h exhibited significantly higher scores than group DB (p < 0.05), the microleakage in groups S3d and S7d was statistically similar to that in group DB (p = 0.771, p > 0.999).

CONCLUSIONS

Application of SA gel for 3 day after nonvital bleaching was effective in reducing microleakage of composite restoration in intracoronally-bleached teeth.

Evaluation of the effect of concentration and duration of application of sodium ascorbate hydrogel on the bond strength of composite resin to bleached enamel

Aim:

The effect of different concentrations of hydrogel of sodium ascorbate on bond strength of bleached enamel for varying periods of time and the mode of failure was evaluated.

Materials and Methods:

Seventy enamel surfaces were obtained from 35 human extracted premolars. Specimens were divided into four groups: no bleaching (control), bleaching with carbamide peroxide gel, bleaching and application of 10% / 20% sodium ascorbate hydrogel for 30, 60, 120 min. Surfaces were bonded with a total etch bonding system and composite resin. Specimens were tested for shear bond strength. Mode of failure was determined by stereomicroscope. Data were analyzed using a two-way analysis of variance, and Scheffe's post hoc test.

Results:

Sodium ascorbate hydrogel application following bleaching increased the resin-enamel bond strength and was directly proportional to its duration of application. However, there was no difference in bond strength with an increase in the concentration of sodium ascorbate hydrogel.

Conclusion:

Immediate bonding of composite resin to bleached enamel is possible after treatment with antioxidant sodium ascorbate hydrogel.

Effect of 10% sodium ascorbate on the calcium: Phosphorus ratio of enamel bleached with 35% hydrogen peroxide: an in vitro quantitative energy-dispersive X-ray analysis

Objectives:

The study assessed quantitatively the calcium and phosphorous loss from the enamel surface following bleaching with 35% hydrogen peroxide and reversal with 10% sodium ascorbate using energy-dispersive X-ray analysis (EDAX).

Materials and Methods:

Eight non-carious, freshly extracted human permanent maxillary central incisors without any visible defects were used. Each specimen was bleached with 35% hydrogen peroxide activated by light and reversed with sodium ascorbate antioxidant gel. The calcium and phosphorous content in weight percent of sound, bleached and reversed enamel was acquired using EDAX. The Ca/P ratio was calculated from the obtained data. One-way ANOVA followed by Post Hoc Tukey test was used for comparing the Ca/P ratio of sound, bleached and reversed enamel.

Results:

All the samples subjected to bleaching using 35% hydrogen peroxide showed a statistically significant decrease in the Ca/P ratio as compared with samples in which no bleaching procedure was performed (P-value < 0.01). The striking finding was that there was a significant increase in the Ca/P ratio on application of sodium ascorbate antioxidant gel when compared with the bleached enamel (P-value < 0.01).

Conclusion:

The authors concluded that 35% hydrogen peroxide causes a significant decrease in the Ca/P ratio. This decrease in the Ca/P ratio can be restored by the application of 10% sodium ascorbate antioxidant gel.

Effect of 10% sodium ascorbate hydrogel and delayed bonding on shear bond strength of composite resin and resin-modified glass ionomer to bleached enamel

OBJECTIVE

The aim of this study was to comparatively investigate the neutralizing effect of antioxidant treatment and delayed bonding after bleaching with hydrogen peroxide on the shear bond strength of a composite resin (CR) and resin-modified glass ionomer (RmGI) to enamel.

MATERIALS AND METHODS

Ninety-six freshly extracted human 3rd molars with flat enamel surfaces were divided into six experimental groups (n=12/group) and two control groups (n=12/group). After initial preparation, specimens in Groups 1 and 5 (control groups) were not bleached and the buccal enamel surface of specimens were bonded immediately with CR and RmGI. The samples of the remaining groups were all bleached six hours a day for seven days consecutively. Immediately after bleaching, groups two and six specimens were bonded with CR and RmGI. Groups 3 and 7 specimens were immersed in distilled water at 37°C for 7 days and the specimens in Groups 4 and 8 were treated with 10% sodium ascorbate as an antioxidant agent after bleaching. Specimens in Groups 3 and 4 were bonded with CR and Groups 7 and 8 specimens were bonded with RmGI immediately. After specimens were bonded, the shear bond strength (SBS) was measured. The SBS data analyses were subjected to one-way analysis of variance (ANOVA) followed by Tukey test for comparison of specific mean values.

RESULTS

The mean SBS value in Group 2 (immediately bonded with CR after bleaching) was significantly lower than other CR groups (P=0.045). RmGI did not bond to buccal enamel surface of specimens in group 6. There was no significant difference between other groups bonded with RmGI (P>0.05).

CONCLUSIONS

Applying 10% sodium ascorbate hydrogel and one week delay before bonding resulted in reversal of reduced bond strength of CR and RmGI to bleached enamel.

Effect of antioxidant treatment on the shear bond strength of composite resin to bleached enamel

INTRODUCTION

This study examined the antioxidant treatment on the shear bond strength of composite resin to enamel after bleaching with two different bleaching systems.

MATERIALS AND METHODS

Seventy flat enamel surfaces were prepared from freshly extracted human molars using a low speed diamond saw. Then the specimens were divided into seven random groups (n = 10) to apply different procedures; namely, bleaching with White Smile and bonding with composite resin (G1), bleaching with White Smile, treatment with ascorbic acid and bonding with composite resin (G2), bleaching with White Smile, immersing in artificial saliva for 2 weeks and bonding with composite resin (G3), bleaching with Opalesence and bonding with composite resin (G4), bleaching with Opalesence, treatment with ascorbic acid and bonding with composite resin (G5) and bleaching with Opalesence, immersing in artificial saliva for 2 weeks and bonding with composite resin (G6). Another group was used as a control group. Shear bond test was performed on all specimens and data were analyzed using one way ANOVA and Bonferroni's test (p < 0.05).

RESULTS

Bond strengths of bleached specimens were significantly lower than those of non-bleached specimens. No statistical difference was found in bond strength between the bleached and non-bleached groups when the antioxidant treatment was carried out.

CONCLUSION

Ten per cent ascorbic acid treatment was found to be an effective method to reverse the compromised bond strength.

Effect of fluoridated carbamide peroxide gels on enamel microtensile bond strength

The aim of this study was to examine the resin bond strength on enamel treated with different fluoridated bleaching agents. Forty-eight bovine incisors were divided into four groups to receive bleaching treatments, over a 14-d period, as follows: no treatment; 10% carbamide peroxide (CP) bleaching; 10% CP containing 0.11% fluoride; and 10% CP containing 0.37% fluoride. Immediately, and 7 and 14 d after bleaching, the enamel surfaces were respectively bonded with composite and sectioned to create resin-enamel beams. These beams were subjected to the microtensile bond strength (microTBS) test, then assessed for failure mode under scanning electron microscopy. The results showed that the 0.37% fluoridated group demonstrated a microTBS equivalent to that of the unbleached group at all stages. Non-fluoridated and 0.11% fluoridated groups showed a weaker microTBS after bleaching but regained the bond strength after 14 or 7 d of storage, respectively. In the non-fluoridated group, adhesive failure was the predominant fracture pattern that comprised the enamel prism demineralization change and widely dispersed voids on the resin-enamel interfaces. No evident enamel erosion and fewer microporosities were found in the 0.37% fluoridated group. Accordingly, treatment with 0.37% fluoridated CP maintained the microTBS as effectively as the unbleached enamel. Additional fluoride in the bleaching agents may facilitate subsequent restorative treatment by inhibiting enamel demineralization.

Effect of 10% Sodium Ascorbate and 10% α-tocopherol in Different Formulations on the Shear Bond Strength of Enamel and Dentin Submitted to a Home-use Bleaching Treatment

A significant reduction in bond strength of restorative materials to dentin and enamel after home-use bleaching treatment has been reported. Antioxidizing agents may be a procedure to increase bond strength values. Although no reversal of bond strength values was found for sodium ascorbate, alpha-tocopherol formulated in solution resulted in a significant increase in bond strength of bleached enamel.

Reversal of Compromised Bonding in Bleached Enamel Using Antioxidant Gel

Dental bond strength is significantly reduced when bonding is performed immediately after bleaching treatments. It has also been reported that the application of an antioxidant after bleaching treatment improves the adhesive bond strength of oxidized enamel tissue. The application of an antioxidant in gel form by the patient makes the application process easier and shortens time spent in the clinic.