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Gkavela G, Kakouris V, Pappa E, Rahiotis C. Effect of Bleaching Agents on Healthy Enamel, White Spots, and Carious Lesions: A Systematic Review and Meta-Analysis. Dent J (Basel) 2024; 12:140. [PMID: 38786538 PMCID: PMC11120504 DOI: 10.3390/dj12050140] [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: 03/30/2024] [Revised: 04/15/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
This systematic review examines studies focusing on tooth bleaching and its effects on healthy enamel or incipient caries and bacterial adhesion. The aim is to explore the impact of different bleaching agents on incipient caries lesions and healthy enamel. Clinical studies, in vitro studies, and observational studies that compared at least two groups were included. A search strategy was used to select studies from the MEDLINE via Pubmed and Scopus databases. Two evaluators performed data extraction, screening, and quality assessment independently. Only studies written in English were included. From 968 initial records, 28 studies were selected for a full-text evaluation. Of these, 7 studies were classified as cluster 1 (bacterial adherence on teeth), 12 studies as cluster 2 (no bacteria involved), 4 studies as cluster 3 (no teeth deployment), and 5 clinical studies were cluster 4. Of the selected studies, 6 (21.4%) supported increased bacterial attachment capacity and cariogenic dynamics, 4 (14.3%) decreased adhesion and cariogenic activity, 7 (25%) showed no difference, and 11 (39.3%) followed a different methodological approach and could not be categorized. The risk of bias appeared to be high, mainly because of the different methodologies in the studies, so we cannot reach a confident conclusion. Nevertheless, as far as carbamide peroxide bleaching is concerned, there does not seem to be a clinically significant alteration, neither in microorganism counts nor in enamel microstructure.
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Affiliation(s)
| | | | | | - Christos Rahiotis
- Department of Operative Dentistry, Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (G.G.); (V.K.); (E.P.)
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Ps S, Karumaran CS, R S A, Manuel CE, V JC, Stalin R. An In Vitro Study on the Effects of Hydrogen Peroxide-Based Bleaching Agents on Enamel: Field Emission Scanning Electron Microscopy (FESEM) With Energy Dispersive Spectroscopy (EDS) Evaluation. Cureus 2024; 16:e58318. [PMID: 38752025 PMCID: PMC11095582 DOI: 10.7759/cureus.58318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/18/2024] Open
Abstract
Aim and objective The aim of the present in vitro study is to evaluate the morphological and elemental alterations in enamel following bleaching with hydrogen peroxide-based bleaching agents of different concentrations and pH values when exposed to different treatment times. Materials and method Twenty extracted maxillary central incisors were selected for the study. Tooth samples were prepared by sectioning the tooth cervico-incisally into two halves. The teeth were divided into different groups based on the bleaching protocol and bleaching agent applied: Group IA, Group IB, Group IIA, and Group IIB. Group IA received a 35% hydrogen peroxide-based bleaching agent of pH 6 for 10 minutes with light application. Group IB received a 35% hydrogen peroxide-based bleaching agent of pH 6 for 30 minutes with light activation. Group IIA received a 40% hydrogen peroxide-based bleaching agent of pH 8.5 for 10 minutes with chemical activation. Group IIB received a 40% hydrogen peroxide-based bleaching agent of pH 8.5 for 30 minutes with chemical activation. The morphology of the enamel before and after the application of the bleaching agent was evaluated using field emission scanning electron microscopy. The elemental analysis of enamel between the control and test samples was done with the help of energy dispersive spectroscopy. Results Paired t-test was used to analyze the data obtained from the study. The test samples showed erosive alterations in enamel surface morphology and also a decrease in the concentration of minerals when compared to the corresponding control groups. Conclusions The present study evidences the erosive potential of hydrogen peroxide-based bleaching agents. It can be concluded that bleaching agents containing high concentrations of hydrogen peroxide with acidic pH can cause mineral loss and surface erosion of enamel which is extremely detrimental to the tooth integrity.
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Affiliation(s)
- Sreelakshmi Ps
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | | | - Arjun R S
- Conservative Dentistry and Endodontics, Jaya Prakash (J P) Dental Specialists, Thiruvananthapuram, IND
| | | | - Jevina Christy V
- Conservative Dentistry and Endodontics, Rajas Dental College and Hospital, Tirunelveli, IND
| | - Roselin Stalin
- Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Chennai, IND
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Lima NLB, Sette-de-Souza PH, Siqueira AHCD, Costa SGDA, Alves PVDM, Silvestre FA, Meneses NED, Santiago SL, Peixoto RF. Preemptive use of ibuprofen and desensitizer decreases immediate tooth sensitivity after in-office bleaching: A triple-blind, randomized, placebo-controlled clinical trial. J Am Dent Assoc 2024; 155:304-311. [PMID: 38244017 DOI: 10.1016/j.adaj.2023.11.011] [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] [Received: 08/16/2023] [Revised: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND The authors evaluated the synergistic analgesic effect of preemptive administration of 400 mg of ibuprofen (IBU) and potassium fluoride 2% (KF2), both in isolation or combination, on the painful perception of tooth sensitivity after tooth bleaching. METHODS Fifteen patients participated in this triple-blind, randomized, placebo-controlled clinical trial. The study used a crossover design for drug administration and a split-mouth design for desensitizer agent. Four paired groups were formed: IBU plus KF2 (IBU + KF2); IBU (IBU + placebo KF); KF2 (placebo IBU + KF2), and placebo (placebo IBU + placebo KF). The outcome measure was the perception of tooth sensitivity, assessed using a visual analog scale. Data were collected at 4 different times: immediately after tooth bleaching (baseline) and after 6, 30, and 54 hours. Statistical analysis was performed using the Friedman test and relative risk. RESULTS IBU plus KF2 was found to be more effective in reducing tooth sensitivity immediately after bleaching (baseline) compared with the placebo group (P < .05). The risk of experiencing moderate or severe tooth sensitivity was approximately 4 times higher in the placebo group than in the IBU plus KF2 group (relative risk, 4.00; 95% CI, 1.01 to 15.81; P = .025). CONCLUSIONS The combined use of 400 mg of IBU and KF2 appears to be beneficial in managing postbleaching tooth sensitivity. It provides a superior analgesic effect compared with placebo. PRACTICAL IMPLICATIONS The preemptive administration of IBU plus KF2 reduces tooth sensitivity after tooth whitening when compared with placebo. This clinical trial was registered in the Brazilian Clinical Trials Registry Platform. The registration number is U1111-1249-8191.
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Nabil M, Hasan MM, Shebl EAE. Effect of antioxidant on tooth sensitivity after bleaching. J ESTHET RESTOR DENT 2024; 36:429-436. [PMID: 38130089 DOI: 10.1111/jerd.13190] [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] [Received: 10/02/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
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.
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Affiliation(s)
- Mohamed Nabil
- Department of Restorative Dentistry, Faculty of Dentistry, Sinai University, Ismailia, Egypt
| | - Mostafa Mohamed Hasan
- Department of Restorative Dentistry, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Eman Abd Elghany Shebl
- Department of Restorative Dentistry, Faculty of Dentistry, Tanta University, Tanta, Egypt
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Mena-Serrano A, Granda-Albuja MG, Naranjo J, Fierro EA, Favoreto MW, Loguercio AD, Reis A. Effects of the application of sodium ascorbate after in-office bleaching on the penetration of hydrogen peroxide, color change, and microtensile bond strength. Braz Dent J 2023; 34:87-94. [PMID: 38133477 PMCID: PMC10759951 DOI: 10.1590/0103-6440202305214] [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] [Received: 04/17/2023] [Accepted: 08/29/2023] [Indexed: 12/23/2023] Open
Abstract
This study aimed to evaluate the effects of the application of 10% sodium ascorbate (SA) after in-office bleaching on the penetration of hydrogen peroxide (HP) into the pulp chamber, color change, and microtensile bond strength (µTBS) to the resin-enamel interface. Thirty premolars and thirty molars were randomly divided into three groups (n = 20 each). One group was exposed to deionized water (negative control). The other two groups were bleached with 35% HP in a single session for 3x15 minutes for each application. However, in only one of them, SA was applied for 10 minutes after bleaching. After, the concentration (µg/mL) of HP in each pulp chamber was evaluated by UV-Vis spectrophotometry. Color changes (ΔEab, ΔE00, and ΔWID) were evaluated with a digital spectrophotometer before and in the first week after bleaching. After treatment, molars were restored and sectioned to obtain resin-enamel interface sticks for µTBS at a crosshead speed of 1 mm/min until failure. The HP concentration and µTBS data were analyzed using one-way ANOVA and Tukey tests, and color changes were analyzed by t-tests (α = 0.05). SA application significantly improved the µTBS values and reduced the HP concentrations within the pulp chambers (p < 0.0001). The application of SA significantly interfered with the color changes after bleaching when compared to the control group (p < 0.05). Application of 10% SA after in-office bleaching successfully reduced the penetration of HP into the pulp chamber; however, it decreased color change.
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Affiliation(s)
| | | | - Jenny Naranjo
- School of Dentistry, Universidad de Las Américas, Quito, 170125, Ecuador
| | | | - Michael Willian Favoreto
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Brazil
| | - Alessandro D. Loguercio
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Brazil
| | - Alessandra Reis
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Brazil
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Américo MA, Portella FF, Zimmer R, Garcia FR, Porto DJ, Barbosa VL, Oballe H, Reston EG. Effect of a Toothpaste for Sensitive Teeth on the Sensitivity and Effectiveness of In-office Dental Bleaching: A Randomized Clinical Trial. Oper Dent 2023; 48:627-637. [PMID: 37881142 DOI: 10.2341/23-009-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES The present study aimed to evaluate the desensitizing effect of toothpaste for sensitive teeth on patient tooth sensitivity and on bleaching efficacy of the 38% hydrogen peroxide bleaching agent used for in-office bleaching compared to a regular toothpaste in a randomized clinical trial. METHODS AND MATERIALS Forty-eight patients having maxillary right central incisors with darkness greater than A1 were selected for the present double-blind randomized clinical trial. Patients were randomly allocated into two groups: the placebo group, which used regular toothpaste, and the experimental group, which used sensitivity toothpaste. The intervention consisted of applying toothpaste with the aid of an individual tray for a period of 4 minutes daily, starting one week before the first bleaching session and interrupting use immediately after the second session. After allocation to one of the groups, individuals received in-office dental bleaching with a 40-minute application of 38% hydrogen peroxide for two sessions with an interval of one week. The incidence and intensity of sensitivity were assessed using a visual analogue scale and a numeric analogue scale. Sensitivity was measured immediately before each session, 1 hour, 24 hours, and 48 hours after each bleaching session and four weeks after the second bleaching session. Tooth shade was evaluated using a spectrophotometer and by comparison with the VITA Classical Shade Guide (Vita Zahnfabrik, Bad Säckingen, Germany). Tooth shade was evaluated before the first bleaching session, one week after the first bleaching session, one week after the second bleaching session and four weeks after the second bleaching session. Participants and professionals who performed the bleaching, shade, and sensitivity assessments were blinded to the group of patients they were treating or assessing. For the incidence of hypersensitivity, the results were evaluated by comparing the groups at different evaluation times with the Mann-Whitney test for comparison between groups, the Friedman test for repeated measures, and the Tukey test for comparison of times. Shade change on the guide was analyzed using the Mann-Whitney test for comparison between groups and the Wilcoxon test for comparison between times. Shade change by the spectrophotometer was analyzed using the t-test for comparison between groups and the paired t-test for comparison between times. All analyses were performed with a significance level of 5%. RESULTS There was no difference in the pattern of dental hypersensitivity between groups. For all shade measures, there was no difference between the bleaching results, and no statistically significant difference was observed between the study groups. CONCLUSION The use of arginine-based desensitizing toothpaste did not interfere with the bleaching ability of hydrogen peroxide and was not effective in reducing the sensitivity caused by in-office tooth bleaching.
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Affiliation(s)
- M A Américo
- Michelle Azeredo Américo, DDS, MS, PhD, Postgraduate Program in Dentistry, Lutheran University of Brazil (Ulbra), Canoas, Brazil
| | - F F Portella
- Fernando Freitas Portella, DDS, MS, PhD, Feevale University, Novo Hamburgo, Brazil
| | - R Zimmer
- Roberto Zimmer, DDS, MS, Postgraduate Program in Dentistry, Lutheran University of Brazil (Ulbra), Canoas, Brazil and Feevale University, Novo Hamburgo, Brazil
| | - F R Garcia
- Filipe Reis Garcia, DDS, MS, PhD, Postgraduate Program in Dentistry, Lutheran University of Brazil (Ulbra), Canoas, Brazil
| | - D J Porto
- Denner Jardim Porto, DDS, Undergraduate in Dentistry, Lutheran University of Brazil (Ulbra), Canoas, Brazil
| | - V L Barbosa
- Viviane Leal Barbosa, DDS, MS, Postgraduate Program in Dentistry, Lutheran University of Brazil (Ulbra), Canoas, Brazil
| | - Hjr Oballe
- Harry Juan Rivera Oballe, DDS, MS, PhD, Postgraduate Program in Dentistry, Lutheran University of Brazil (Ulbra), Canoas, Brazil
| | - E G Reston
- *Eduardo G. Reston, DDS, MSD, PhD, head of Postgraduate Program in Dentistry, Lutheran University of Brazil (Ulbra), Canoas, Brazil
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Alanazi AM, Khan AA, Mahmood A, Tahir A, Kamal MA. The effect of ascorbic acid and cranberry on the bond strength, surface roughness, and surface hardness of bleached enamel with hydrogen peroxide and zinc phthalocyanine activated by photodynamic therapy. Photodiagnosis Photodyn Ther 2023; 43:103685. [PMID: 37390856 DOI: 10.1016/j.pdpdt.2023.103685] [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] [Received: 06/18/2023] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 07/02/2023]
Abstract
AIM To evaluate the effect of different bleaching methods 40% (hydrogen peroxide) HP and Zinc Phthalocyanine (ZP) activated by photodynamic therapy (PDT) with the utilization of diverse procedures of reversal (10% ascorbic acid and 6% cranberry solution) on bond values, surface microhardness and surface roughness of bleached enamel surface. MATERIAL AND METHODS An aggregate of 60 extracted human mandibular molars was gathered and the buccal surface of each specimen was exposed to 2 mm of enamel surface for bleaching with chemical and photoactivated agents with the use of reversal solutions. Specimens were divided into six groups (n = 10) at random- Group 1: samples bleached with 40% HP with 10% ascorbic acid (reversal agent), group 2: ZP activated by PDT with 10% ascorbic acid (reversal agent), group 3: 40% HP with 6% cranberry solution as a reversal agent, group 4: ZP activated by PDT with 6% cranberry solution, group 5: 40% HP and group 6: ZP activated by PDT with no reversal agents. Resin cement restoration was performed via etch and rinse technique and SBS was estimated by using the universal testing machine, SMH by using Vickers hardness tester, and Ra by stylus profilometer. Statistical analysis was executed using the ANOVA test and the Tukey multiple tests (p<0.05). RESULTS Enamel surface bleached with 40% HP reversed with 10% ascorbic acid displayed the highest SBS while 40% HP with no reversal agent use showed the least SBS. For SMH, ZP activated by PDT when applied on the enamel surface and reversed with 10% ascorbic acid showed the highest SMH while when bleached with 40% HP and reversed with 6% cranberry solution showed the least SMH value. For Ra, Group 3: samples bleached with 40% HP with 6% cranberry solution as reversal agent showed the highest Ra value while bleaching of enamel surface with ZP activated by PDT with 6% cranberry displayed the least Ra value. CONCLUSION Bleached enamel surface with Zinc Phthalocyanine activated by PDT with the application of 10% ascorbic acid as reversal solution has demonstrated the highest SBS and SMH with acceptable surface roughness for bonding adhesive resin to the enamel surface.
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Affiliation(s)
- Amer M Alanazi
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia.
| | - Azmat Ali Khan
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia.
| | - Amer Mahmood
- Stem cell unit department of Anatomy College of Medicine King Saud University, Saudi Arabia.
| | - Araib Tahir
- Senior Registrar in Liaquat College of Medicine and Dentistry, Pakistan.
| | - Mohammad Amjad Kamal
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, China and Enzymoics, Novel Global Community Educational Foundation, 7 Peterlee Place, Hebersham, NSW 2770, Australia.
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Femiano F, Femiano R, Scotti N, Nucci L, Lo Giudice A, Grassia V. The Use of Diode Low-Power Laser Therapy before In-Office Bleaching to Prevent Bleaching-Induced Tooth Sensitivity: A Clinical Double-Blind Randomized Study. Dent J (Basel) 2023; 11:176. [PMID: 37504242 PMCID: PMC10378209 DOI: 10.3390/dj11070176] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/22/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
INTRODUCTION The present study aimed to investigate the effectiveness of low-level laser therapy (LLLT) use before in-office bleaching to prevent an increase in the risk and intensity of tooth sensitivity. METHODS Thirty patients were selected. Before bleaching with 38% hydrogen peroxide, the participants were randomly divided into two groups of 15 subjects. Test group: the patients' teeth were subjected to a preliminary LLLT procedure by an 810 nm diode laser with 0.5 W for 30 s for an energy density of 15 J/cm2 and a group placebo. All patients were instructed to report their cold sensitivity experiences immediately, 1 h, 24 h, and 48 h after the end of bleaching via a VAS score. RESULTS The results obtained show an increase in VAS values for both groups (290 and 490 vs. 224 and 234 of baseline time of test and placebo group, respectively); afterward, the VAS value seemingly decreases at 1 h after the end of bleaching, approaching the baseline VAS for the test group (274) in comparison to the placebo group. CONCLUSIONS The use of preliminary diode LLLT could represent a valid possibility to reduce the occurrence of tooth sensitivity post-whitening and shorten recovery time in cases where tooth sensitivity occurs.
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Affiliation(s)
- Felice Femiano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Study of Campania, "Luigi Vanvitelli", 83138 Naples, Italy
| | - Rossella Femiano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Study of Campania, "Luigi Vanvitelli", 83138 Naples, Italy
| | - Nicola Scotti
- Department of Surgical Sciences, University of Turin, 10124 Torino, Italy
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Study of Campania, "Luigi Vanvitelli", 83138 Naples, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Via S. Sofia 78, 95123 Catania, Italy
| | - Vincenzo Grassia
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Study of Campania, "Luigi Vanvitelli", 83138 Naples, Italy
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Qi F, Huang H, Wang M, Rong W, Wang J. Applications of Antioxidants in Dental Procedures. Antioxidants (Basel) 2022; 11:2492. [PMID: 36552699 PMCID: PMC9774737 DOI: 10.3390/antiox11122492] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
As people are paying more and more attention to dental health, various dental treatment procedures have emerged, such as tooth bleaching, dental implants, and dental restorations. However, a large number of free radicals are typically produced during the dental procedures. When the imbalance in distribution of reactive oxygen species (ROS) is induced, oxidative stress coupled with oxidative damage occurs. Oral inflammations such as those in periodontitis and pulpitis are also unavoidable. Therefore, the applications of exogenous antioxidants in oral environment have been proposed. In this article, the origin of ROS during dental procedures, the types of antioxidants, and their working mechanisms are reviewed. Additionally, antioxidants delivery in the complicated dental procedures and their feasibility for clinical applications are also covered. Finally, the importance of safety assessment of these materials and future work to take the challenge in antioxidants development are proposed for perspective.
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Affiliation(s)
| | | | | | | | - Jing Wang
- School of Chemistry and Chemical Engineering, Shandong University of Technology, 266 Xincun Road, Zibo 255000, China
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10
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Effect of an experimental desensitizing gel on bleaching-induced tooth sensitivity after in-office bleaching—a double-blind, randomized controlled trial. Clin Oral Investig 2022; 27:1567-1576. [PMID: 36418502 PMCID: PMC9685084 DOI: 10.1007/s00784-022-04778-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/06/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the risk and intensity of tooth sensitivity (TS), and the efficacy of in-office bleaching after applying an experimental desensitizing gel composed of 10% calcium gluconate, 0.1% dexamethasone acetate, 10% potassium nitrate, and 5% glutaraldehyde. MATERIAL AND METHODS In a split-mouth, double-blind, placebo-controlled study, 50 participants had their upper hemiarches randomized into experimental and placebo groups. Desensitizing and placebo gels were applied for 10 min before in-office bleaching (35% hydrogen peroxide, 1 × 50 min; two bleaching sessions; 1-week interval). TS was recorded immediately after bleaching, 1, 24, and 48 h after each session, with a 0-10 visual analogue scale (VAS) and a five-point numerical rating scale (NRS). The color was recorded in all groups at baseline, 1 week after each session, and 1 month after the end of bleaching using shade guide units (ΔSGUs) and a spectrophotometer (ΔEab, ΔE00, and ΔWID). RESULTS Most participants (96%) felt some discomfort during treatment regardless of the study group. The odds ratio for pain was 0.65 (95% CI 0.1 to 4.1; p = 1.0). The intensity of TS did not differ between groups (p > 0.31), and it was only 0.34 VAS units lower in the experimental group. A significant color change occurred in both groups regardless of the group. CONCLUSIONS The desensitizing experimental gel applied before in-office bleaching did not reduce the risk and the intensity of TS and did not affect color change. CLINICAL RELEVANCE Although the experimental desensitizing agent with varying mechanisms of action did not jeopardize the color change, it did not reduce the risk or intensity of in-office bleaching. CLINICAL TRIAL REGISTRATION NUMBER RBR-7T7D4D.
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Vochikovski L, Rezende M, Maran BM, de Paula J, Machado LB, Kossatz S, Loguercio AD, Reis A. Combined Bleaching Technique Versus At-home Bleaching-A Single-blind Randomized Controlled Trial. Oper Dent 2022; 47:247-257. [PMID: 35653595 DOI: 10.2341/20-283-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare the efficacy, color stability, and tooth sensitivity (TS) of combined bleaching, using a modified protocol with at-home bleaching. METHODS Eighty participants were randomized into two groups. In the combined group, a desensitizing gel was applied (10 minutes) prior to in-office bleaching (35% hydrogen peroxide (H2O2), 2×15 minute applications) and at-home bleaching (4% H2O2, 2×30 minutes for 21 days) started the next day. In the at-home group, only the at-home bleaching was performed. Color was recorded at the beginning and postbleaching with two scales (VITA Classical and Bleachedguide) and Easyshade spectrophotometer. The TS was recorded daily with a 0-10 visual analogue scale (VAS) and five-point numeric rating scale (NRS). RESULTS A 40% lower risk (RR=1.4; 95% CI 1.1-1.9) was observed in the at-home group. Higher color change and intensity of TS [mean difference 2.3 (95% CI 1.3-3.3) in the VAS] was observed in the first week for the combined group. After the end of the protocol, a bleaching degree was detected for both groups, with no significant difference between both groups (p>0.05). CONCLUSION The combined group produced a slightly higher degree of color change than at-home bleaching but with a higher risk and intensity of TS.
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Affiliation(s)
- L Vochikovski
- Laína Vochikovski, MS, PhD student, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - M Rezende
- Márcia Rezende, DDS, MS, PhD, Department of Restorative Dentistry, Paulo Picanço School of Dentistry, Fortaleza, Ceará, Brazil
| | - B M Maran
- Bianca Medeiros Maran, DDS, MS, PhD, professor, Department of Restorative Dentistry, School of Dentistry, State University of Western Paraná, Cascavel, Paraná, Brazil; Postgraduate Program in Dentistry, School of Dentistry, University of North Paraná, Londrina, Paraná, Brazil
| | - Jsm de Paula
- Jéssica Samantha Martins de Paula, undergraduate student, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - L B Machado
- Layslle Batista Machado, undergraduate student, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - S Kossatz
- Stella Kossatz, DDS, MS, PhD, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - A D Loguercio
- *Alessandro D Loguercio, DDS, MS, PhD, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - A Reis
- Alessandra Reis, DDS, PhD, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
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de Barros Silva PG, Filho ELC, Nigri FMN, Dantas TS, de Miranda Candeiro GT, Neri JR. Photobiomodulation Reduces Pain-Related Symptoms Without Interfering in the Efficacy of In-Office Tooth Bleaching: A Systematic Review and Meta-Analysis of Placebo-Controlled Clinical Trials. Photobiomodul Photomed Laser Surg 2022; 40:163-177. [DOI: 10.1089/photob.2021.0105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Paulo Goberlânio de Barros Silva
- Department of Dentistry, University Center Christus, Fortaleza, Brazil
- Graduate School of Dentistry, University Center Christus, Fortaleza, Brazil
| | - Edson Luiz Cetira Filho
- Department of Dentistry, University Center Christus, Fortaleza, Brazil
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | | | | | - George Táccio de Miranda Candeiro
- Department of Dentistry, University Center Christus, Fortaleza, Brazil
- Graduate School of Dentistry, University Center Christus, Fortaleza, Brazil
| | - Jiovanne Rabelo Neri
- Department of Dentistry, University Center Christus, Fortaleza, Brazil
- Graduate School of Dentistry, University Center Christus, Fortaleza, Brazil
- Graduate School of Dentistry, University of Fortaleza, Fortaleza, Brazil
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13
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Mayer-Santos E, Bachiega-Silva B, Twiaschor CV, Shimokawa CAK, Marinho GB, Junior AB, Zanin F, Brugnera AP, Ramalho KM, de Freitas PM. Blinded, Parallel and Randomized Clinical Evaluation of In-office Dental Bleaching with Violet LED (405-410 nm). Photodiagnosis Photodyn Ther 2022; 38:102739. [PMID: 35123016 DOI: 10.1016/j.pdpdt.2022.102739] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/12/2022] [Accepted: 01/24/2022] [Indexed: 11/25/2022]
Abstract
This clinical study evaluated the effect of bleaching performed with violet LED light (405-410 nm), either combined with hydrogen peroxide (HP) gel, or not, on color change, dental sensitivity, participants' satisfaction and impact on their quality of life. A hundred participants were divided into one of the groups (n = 25): G1 - 35% HP (4 sessions, 1x/week); G2 - violet LED (4 sessions, 1x/week); G3 - violet LED (4 sessions, 2x/week); G4 - hybrid technique (violet LED + 35% HP; 4 sessions, 1x/week). Color evaluation was performed with colorimetric tests (objective and subjective), before, 14 days and 3 months after completion. Additionally, satisfaction with treatment, impact on quality of life (OHIP-14) and dental sensitivity were recorded. The data were submitted to statistical analysis, considering a significance level of 5%, with the exception of the data from the questionnaire on satisfaction (descriptive analysis). Two-way ANOVA and Tukey tests showed that there was no difference between color variation resulting from techniques used in G1 and G4; those used in G2 and G3 did not differ and were less effective for bleaching than those of the other groups, in both subjective and objective evaluations. Regarding tooth sensitivity, subjects in G2 and G3 experienced no sensitivity, while those in G4 showed lower sensitivity values than those in G1. With respect to quality of life, only subjects in G1 and G2 showed a significant positive impact. Among the evaluated techniques, the hybrid type seemed to be a good alternative, showing effective bleaching with less tooth sensitivity.
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Affiliation(s)
- Eric Mayer-Santos
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo; São Paulo, Brazil.
| | - Bruno Bachiega-Silva
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo; São Paulo, Brazil
| | - Caroline Vale Twiaschor
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo; São Paulo, Brazil
| | | | - Giovanna Bueno Marinho
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo; São Paulo, Brazil
| | | | | | | | | | - Patricia Moreira de Freitas
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo; São Paulo, Brazil; Department of Restorative Dentistry, School of Dentistry, University of São Paulo; São Paulo, Brazil
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Benahmed AG, Gasmi A, Menzel A, Hrynovets I, Chirumbolo S, Shanaida M, Lysiuk R, Shanaida Y, Dadar M, Bjørklund G. A review on natural teeth whitening. J Oral Biosci 2021; 64:49-58. [PMID: 34915121 DOI: 10.1016/j.job.2021.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Discoloration of teeth occurs for various reasons. Common ingredients like substances from tea and coffee, as well as antibiotics like tetracycline, or food dyes, can percolate into the teeth, and, as such, these stains may persist in the porous structure of the enamel. Smoking is also contributory to dental discoloration, with toxins of tobacco smoke accumulating in a similar way. With aging, teeth tend to be discolored with accumulation of various stains in addition to the enamel gradually eroding to expose the yellow dentin. HIGHLIGHT This review focused on the effect of several natural ingredients with teeth-whitening properties and their daily clinical application. Metabolic dental bleaching mechanisms, as well as tooth discoloration and decay, were also reviewed. The current scientific literature (mostly from 2000 to 2020) was consolidated from manuscripts retrieved from Scopus, PubMed, ResearchGate, and Google Scholar. CONCLUSION Natural teeth whitening effectively lightens the natural color of teeth without eroding dental surfaces. On the other hand, commercially available whiteners containing hydrogen peroxide and carbamide peroxide, in high concentrations, can lead to deproteinization and demineralization of teeth through oxidation processes. If used extensively, these compounds may cause a number of adverse effects. Alternative natural teeth-whiteners include ingredients like lemons, strawberries, oranges, papaya, and other fruits. Such natural ingredients offer a milder and safer way of whitening teeth than whiteners containing hydrogen peroxide or carbamide peroxide.
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Affiliation(s)
| | - Amin Gasmi
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
| | | | - Ihor Hrynovets
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine; CONEM Ukraine Life Science Research Group, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; CONEM Scientific Secretary, Verona, Italy
| | - Mariia Shanaida
- I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Roman Lysiuk
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine; CONEM Ukraine Life Science Research Group, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Yurii Shanaida
- I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Mo I Rana, Norway.
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15
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Moran BM, Ziegelmann PK, Berger SB, Burey A, de Paris Matos T, Fernández E, Loguercio AD, Reis A. Evaluation of Tooth Sensitivity of In-office Bleaching with Different Light Activation Sources: A Systematic Review and a Network Meta-analysis. Oper Dent 2021; 46:E199-E223. [PMID: 35486507 DOI: 10.2341/20-127-l] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES A systematic review and network meta-analysis were performed to answer the following research question: Are there differences in the risk and the intensity of tooth sensitivity (TS) among eight light activation systems for in-office bleaching in adults? METHODS Randomized controlled trials (RCTs) that compared at least two different in-office bleaching light activations were included. The risk of bias (RoB) was evaluated with the RoB tool version 1.0 from the Cochrane Collaboration tool. A random-effects Bayesian mixed treatment comparison (MTC) model was used independently for high- and low-concentration hydrogen peroxide. The certainty of the evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach. A comprehensive search was performed in PubMed, Bridge Base Online (BBO), Latin American and Caribbean Health Sciences Literature database (LILACS), Cochrane Library, Scopus, Web of Science, and grey literature without date and language restrictions on April 23, 2017 (updated on September 26, 2019). Dissertations and theses, unpublished and ongoing trials registries, and IADR (International Association for Dental Research) abstracts (2001-2019) were also searched. RESULTS After title and abstract screening and the removal of duplicates, 32 studies remained. Six were considered to be at low RoB, three had high RoB, and the remaining had an unclear RoB. The MTC analysis showed no significant differences among the treatments in each network. In general, the certainty of the evidence was graded as low due to unclear RoB and imprecision. CONCLUSION There is no evidence that the risk and intensity of TS are affected by light activation during in-office bleaching.
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Affiliation(s)
- B M Moran
- *Bianca M Maran, DDS, MS, PhD, professor, Department of Restorative Dentistry, School of Dentistry, State University of Western Paraná, Cascavel, Paraná, Brazil; Postgraduate Program in Dentistry, School of Dentistry, University of North Paraná, Londrina, Paraná, Brazil
| | - P K Ziegelmann
- Patrícia K Ziegelmann, DDS, MS, PhD, associate professor, Statistics Department and Post-Graduation Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - S B Berger
- Sandrine Bittencourt Berger DDS, MS, PhD, professor, Department of Restorative Dentistry, School of Dentistry, University of North Paraná, Londrina, Paraná
| | - A Burey
- Adrieli Burey, DDS, MS, PhD student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - T de Paris Matos
- Thalita de Paris Matos, DDS, MS, PhD student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - E Fernández
- Eduardo Fernández, DDS, MS, PhD, professor, Department Restorative Dentistry, University of Chile, Santiago de Chile, Chile; Professor, Universidad Autónoma de Chile, Instituto de Investigaciones Biomédicas, Santiago de Chile Chile
| | - A D Loguercio
- Alessandro D Loguercio, DDS, MS, PhD, adjunct professor, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - A Reis
- Alessandra Reis, DDS, MS, PhD, adjunctive professor, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
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Silva LM, da Costa Lacerda ÍA, Dos Santos DB, Herkrath FJ, da Silva KL, Loguercio AD, de Moura Martins L. Is the at-home bleaching treatment applied only on the lingual surface as effective as that on the buccal surface? A randomized clinical trial. Clin Oral Investig 2021; 26:1551-1560. [PMID: 34410498 DOI: 10.1007/s00784-021-04128-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/03/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This double-blind randomized clinical trial compared the effectiveness and bleaching sensitivity (BS) of at-home dental bleaching performed on the buccal surface and on the lingual surface. METHODS Using a split-mouth design, 25 patients were assigned to two bleaching groups: 10% hydrogen peroxide (White Class 10%, FGM) applied once daily for 60 min to the buccal surface (BSB) and 10% hydrogen peroxide (White Class 10%, FGM) applied once daily for 60 min to the lingual surface (LSB), both for 14 days. The color was evaluated before bleaching, after the first and second weeks, and 1 month after the bleaching using Vita Classical and Vita Bleachedguide scales and a Vita Easyshade spectrophotometer. BS was recorded daily using a 0-4 numerical rating scale and a 0-10 visual analogue scale. The following statistical tests were used: color changes (Mann-Whitney), absolute risk of BS (McNemar's exact), and the intensity of BS (Mann-Whitney). In all statistical tests, the significance level was 5%. RESULTS Significant bleaching was observed after the end of bleaching in both groups, with higher bleaching effectiveness for BSB when compared to LSB (p < 0.05). Regarding BS, no significant difference was observed between groups (p = 1.00). CONCLUSIONS The 10% hydrogen peroxide (White Class 10%, FGM) applied in at-home bleaching performed on the lingual surface did not promote a similar result of color change compared to on the buccal surface. Regarding BS, there was no significant difference between the groups. CLINICAL RELEVANCE The at-home bleaching performed on the lingual surface promotes a lower result in the color change. BS is similar between the groups. CLINICAL TRIAL REGISTRATION NUMBER RBR-283byt.
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Affiliation(s)
- Luciana Mendonça Silva
- School of Dentistry, Graduate Program in Dentistry, Federal University of Amazonas, Manaus, AM, Brazil
| | | | | | - Fernando José Herkrath
- Instituto Leônidas E Maria Deane, Fundação Oswaldo Cruz, State University of Amazonas, Manaus, AM, Brazil
| | - Karine Letícia da Silva
- Departament of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | | | - Leandro de Moura Martins
- School of Dentistry, Graduate Program in Dentistry, Federal University of Amazonas, Manaus, AM, Brazil
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17
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Oliveira PHC, Oliveira LHC, Oliveira MRC, Moriyama C, de Paula E, de Vito Moraes AG, De Melo Deanna A, Zanin FAA, Gomes AO, Brugnera Junior A, Bussadori SK. In Vitro Evaluation of the Effectiveness of Dental Bleaching with Carbamide Peroxide and Violet Light. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:535-543. [PMID: 34342514 DOI: 10.1089/photob.2020.4824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The aim of the current study was to use the CIELab system to evaluate the performance of the whitening treatment involving violet light-emitting diode (LED) combined with a home 10% and 22% carbamide peroxide dental bleaching technique on dental enamel. Methods: Fifty blocks of bovine dental enamel were divided into five groups: control group (control), receiving only LED irradiation; Whitening 10%, receiving 10% carbamide peroxide treatment; Whitening 10%+VL, receiving 10% carbamide peroxide treatment combined with LED irradiation; Whitening 22%, receiving 22% carbamide peroxide treatment; and Whitening 22%+VL, receiving 22% carbamide peroxide treatment combined with violet LED irradiation. Color tests were performed before the protocols, after 1 week and after 2 weeks of treatment by using a spectrophotometer and the CIELab parameters: L*, (a*) and (b*). The Whitening 10%, Whitening 10%+VL, Whitening 22% and Whitening 22%+VL groups were submitted to 10% and 22% carbamide peroxide 8 h per day for 14 days, whereas the Control was only stored in artificial saliva. For irradiation in the Control, Whitening 10%+VL, and Whitening 22%+VL groups, we used violet LED at a wavelength of 405-410 nm activated for 60 permanent seconds and 30 sec of pause once per week. As all data exhibited normal distribution, the comparisons were performed by using two-way repeated-measures analysis of variance. A post hoc t-test was employed, followed by the Ryan-Holm stepdown Bonferroni procedure. Results: After 1 week, the Whitening 22%+VL group differed significantly from all other groups in relation to hue, while no difference was found between the remaining groups (p < 0.05). Analyzing lightness, the Whitening 22%+VL and Whiteness10%+VL groups differed from the other groups (p > 0.05). In the 2nd week, the Whitening 22%+VL groups differed significantly from all other groups (p < 0.05) in hue, chroma, and lightness. The comparative analysis of bleaching times within the same group revealed significant differences in the Whitening 22%+VL group between baseline and week 1, baseline and week 2, as well as weeks 1 and 2 in terms of hue (p > 0.05). In the Whitening 22%+VL group, significant differences (p < 0.05) were found between baseline and week 2 as well as between weeks 1 and 2 in chroma (p > 0.05). In the Whitening 22%+VL group, statistically significant differences (p < 0.05) were found between baseline and week 1, baseline and week 2, as well as between weeks 1 and 2 in lightness. In the Whitening 10%+VL group, statistically significant differences (p < 0.05) were found between baseline and week 1, between baseline and week 2, as well as between weeks 1 and 2 in lightness. Conclusions: Tooth whitening treatment involving 10% and 22% carbamide peroxide combined with violet light promoted changes in the three axes of color (ΔH, ΔC, and ΔL) of the specimens evaluated. The use of the gel bleach alone was more efficient when the higher concentration was used. When violet light was combined with the gel, the lower concentration was more efficient.
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Affiliation(s)
| | | | | | - Caroline Moriyama
- Department of Pediatric Dentistry and Graduate Program in Dentistry, Metropolitan University of Santos, Santos, Brazil
| | - Eloisa de Paula
- Department of Pediatric Dentistry and Graduate Program in Dentistry, Metropolitan University of Santos, Santos, Brazil
| | - André Guaraci de Vito Moraes
- Department of Pediatric Dentistry and Graduate Program in Dentistry, Metropolitan University of Santos, Santos, Brazil.,Department of Biomaterials and Oral Biology at University of São Paulo, São Paulo, Brazil
| | - Alessandro De Melo Deanna
- Graduate Program in Biophotonics Applied to Health Sciences, University of Nove de Julho, São Paulo, Brazil
| | | | - Andréa Oliver Gomes
- Graduate Program in Rehabilitation Sciences, University of Nove de Julho, São Paulo, Brazil
| | - Aldo Brugnera Junior
- Institute of Physics of São Carlos, University of the São Paulo, São Paulo, Brazil
| | - Sandra Kalil Bussadori
- Graduate Program in Biophotonics Applied to Health Sciences, University of Nove de Julho, São Paulo, Brazil.,Graduate Program in Rehabilitation Sciences, University of Nove de Julho, São Paulo, Brazil
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18
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Olmedo DERP, Kury M, Resende BA, Cavalli V. Use of antioxidants to restore bond strength after tooth bleaching with peroxides. Eur J Oral Sci 2021; 129:e12773. [PMID: 33724583 DOI: 10.1111/eos.12773] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 11/09/2020] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Abstract
This review compiles the literature on the antioxidants used after tooth bleaching with either low or high-concentrated carbamide and hydrogen peroxide to recover the bond strength. Antioxidants used in bleached teeth are mainly natural and non-enzymatic, except for catalase. Commonly, antioxidants are applied to remove any reactive oxygen species (ROS) residues left from bleaching gels, which adversely affect adhesive procedures, such as restorations or orthodontic brackets bonding. Even though sodium ascorbate, the most thoroughly investigated antioxidant, showed the most efficient bond strength recovery at 10% concentration, its performance depends on the type of solution and the application time. Natural extracts, such as proanthocyanidins and green tea, showed satisfactory results in the reversal of bond strength at 5% and 10% concentrations, respectively. Sodium ascorbyl phosphate, α-tocopherol, and catalase exhibited promising results, but further research is required. The adhesive system type plays an important role in the outcome of enamel bond strength after the antioxidant application. The postponement of either restorations or orthodontic brackets cementation following bleaching procedures seems to be efficiently replaced by antioxidant application prior to bonding procedures. However, the efficacy of using an antioxidant to recover bond strength depends on its type and application time.
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Affiliation(s)
- Dorcas E R P Olmedo
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Matheus Kury
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Bruna A Resende
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Vanessa Cavalli
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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19
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In-office bleaching with low/medium vs. high concentrate hydrogen peroxide: A systematic review and meta-analysis. J Dent 2020; 103:103499. [PMID: 33068711 DOI: 10.1016/j.jdent.2020.103499] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/25/2020] [Accepted: 10/10/2020] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To answer the following research question: "Dolow/medium hydrogen peroxide (HP) concentrations used for in-office bleaching in patients with permanent dentition have similar color change and bleaching sensitivity (BS) to high HP concentrations?" DATA Randomized controlled trials that compared low/medium vs. high concentrate HP were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. Meta-analyses were conducted for color change (ΔE*ab, ΔSGU/SGU), risk, and intensity of BS, using the random-effects model. Heterogeneity was assessed with the Cochrane Q test, I2 statistics, and prediction interval. The GRADE assessed the certainty of the evidence. SOURCES Search was performed in PubMed, Cochrane Library, BBO, LILACS, Scopus, Web of Science and grey literature on 15th September 2018 (updated on 13th May 2020). STUDY SELECTION 25 studies remained. Five were at low RoB; thirteen were at unclear RoB, and seven were at high RoB. The risk of having BS was, on average, 33 % lower (RR = 0.67; 95 % CI 0.51 to 0.86) for low/medium concentrate HP than high HP. No significant difference in color change was detected among groups, except from the subgroup low vs. high HP for the immediate color change, but this difference is not clinically relevant. The certainty of evidence for color change was low and very low, and moderate for the BS. CONCLUSIONS Low and medium hydrogen peroxide concentrate products for in-office bleaching have lower risk and intensity of bleaching sensitivity than the high concentrate hydrogen peroxide group, with no difference in color change efficacy. CLINICAL SIGNIFICANCE The use of low concentrate hydrogen peroxide products may produce the same color change efficacy with the bonus of having lower risk and intensity of bleaching sensitivity. However, the ideal concentration at which this occurs is yet unknown and deserves further investigations. No funding. PROSPERO CRD42018108266.
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Rezende M, da Silva KL, Miguel TC, Farago PV, Loguercio AD, Martins LD, Reis A. Prior Application of 10% Potassium Nitrate to Reduce Postbleaching Sensitivity: A Randomized Triple-Blind Clinical Trial. J Evid Based Dent Pract 2020; 20:101406. [PMID: 32473797 DOI: 10.1016/j.jebdp.2020.101406] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 08/07/2019] [Accepted: 08/20/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To evaluate if the topical application of 10% potassium nitrate applied before in-office bleaching is effective to reduce the risk and intensity of tooth sensitivity (TS), as well as to evaluate if its application can jeopardize color change. MATERIALS AND METHODS A randomized, split-mouth triple-blind clinical trial was conducted on 43 young patients with incisors A2 or darker. Half of the patient's upper arch received either the application of a 10% potassium nitrate or placebo gel for 10 min in a university setting. In-office bleaching was performed in three 15-min applications in two clinical sessions (1-week interval) using 35% hydrogen peroxide. Risk and intensity of TS was recorded with a 0-4 Numeric Rating Scale and a 0-10 Visual Analogue Scale during bleaching, 1 hour, 24 hours, and 48 hours after bleaching. Color was evaluated before and 1 month after bleaching with shade guides (Vita Classical and Vita Bleachedguide) and a spectrophotometer. The risk of TS (McNemar's test) and intensity of TS (Wilcoxon signed-rank for Numeric Rating Scale and paired t-test for Visual Analogue Scale) were statistically evaluated. Color change was compared using paired t-test. Significant level was set at 5%. RESULTS No significant difference was observed in the absolute risks of TS between groups (RR = 1.11; 95% CI 0.97 to 1.27; P = .12), which exceeded 87% for both groups. Similarly, no difference in TS intensities was detected (P > .05). Significant whitening was observed with all color measurement instruments with no difference between groups (P > .05). CONCLUSION The topical application of 10% potassium nitrate, before in-office bleaching, did not reduce the risk and intensity of TS and did not jeopardize color change.
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Affiliation(s)
- Márcia Rezende
- School of Dentistry, Paulo Picanço School of Dentistry, Fortaleza, Ceará, Brazil
| | | | | | - Paulo Vitor Farago
- School of Pharmacy, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | | | | | - Alessandra Reis
- State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil.
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21
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Martins LM, Lima e Souza LA, Sutil E, da Silva LM, Silva JOS, Reis A, Loguercio AD. Clinical Effects of Desensitizing Prefilled Disposable Trays in In-office Bleaching: A Randomized Single-blind Clinical Trial. Oper Dent 2020; 45:E1-E10. [DOI: 10.2341/18-149-c] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
This study aimed to evaluate the desensitizing effect of a prefilled disposable tray containing potassium nitrate and fluoride on the self-reported tooth sensitivity (TS) and the bleaching efficacy of 40% hydrogen peroxide bleaching agent used for in-office bleaching in comparison with potassium nitrate and fluoride gel applied in a conventional-delivered tray system in an equivalence clinical trial.
Methods and Materials:
Seventy-eight patients, with a right maxillary canine darker than A3, were selected for this single-blind (evaluators), randomized clinical trial. Teeth were bleached in two sessions with a one-week interval in between. Before in-office bleaching, the prefilled disposable tray or conventional tray containing potassium nitrate and fluoride was used for 15 minutes. Subsequently, the bleaching agent was applied in two 20-minute applications (per the manufacturer's directions) in each session. The color change was evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easyshade Advance Spectrophotometer) methods at baseline and 30 days after the first bleaching session. TS was recorded for up to 48 hours using a 0-10 visual analog scale. The absolute risk was evaluated by chi-square test, while the intensity of TS was evaluated by McNemar test (α=0.05). Color change in shade guide units and ΔE was analyzed by Student t-test for independent samples (α=0.05).
Results:
Significant whitening was observed in both groups after 30 days of clinical evaluation. The use of different methods of desensitizer in a tray did not influence the absolute risk and intensity of TS (p>0.05), although a tendency of lower risk of TS with the prefilled disposable tray containing potassium nitrate and fluoride was observed.
Conclusion:
The use of a prefilled disposable tray containing potassium nitrate and fluoride before the application of the in-office bleaching product did not affect the whitening degree and decreased self-reported TS when compared with a conventional-delivered tray system.
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Affiliation(s)
- LM Martins
- Leandro de Moura Martins, DDS, Ms, PhD, professor, Faculdade de Odontologia, Universidade Federal do Amazonas, Manaus, Brazil
| | - LA Lima e Souza
- Larissa Alves Lima e Souza, DDS, MS, Faculdade de Odontologia, Universidade Federal do Amazonas, Manaus, Brazil
| | - E Sutil
- Elisama Sutil, DDS, Ms student, University Estadual de Ponta Grossa, Restorative Dentistry, Ponta Grossa, Brazil
| | - LM da Silva
- Luciana Mendonça da Silva, DDS, PhD, professor, Faculdade de Odontologia, Universidade Federal do Amazonas, Manaus, Brazil
| | - JOS Silva
- Luciana Mendonça da Silva, DDS, PhD, professor, Faculdade de Odontologia, Universidade Federal do Amazonas, Manaus, Brazil
| | - A Reis
- Alessandra Reis, DDS, PhD, professor, State University of Ponta Grossa, Restorative Dentistry, Ponta Grossa, Brazil
| | - AD Loguercio
- Alessandro D Loguercio, DDS, Ms, PhD, professor, State University of Ponta Grossa, Restorative Dentistry, Ponta Grossa, Brazil. Professor, Faculdad de Ciencias de la Salud Eugenio Espejo, University UTE, Quito, Ecuador
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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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Peixoto ADC, Vaez SC, Soares KD, Ferreira LF, Loguercio AD, Faria-E-Silva AL. Preemptive Use of Piroxicam on Tooth Sensitivity Caused By In-Office Bleaching: A Randomized Clinical Trial. Braz Dent J 2019; 30:498-504. [PMID: 31664303 DOI: 10.1590/0103-6440201902762] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 06/13/2019] [Indexed: 12/11/2022] Open
Abstract
This clinical trial evaluated the effect of preemptive use of the non-steroidal anti-inflammatory drug piroxicam in a single dose 30 min prior to in-office bleaching on the prevention of tooth sensitivity (TS) reported by patients. Fifty patients were submitted to two sessions of in-office tooth bleaching with 35% hydrogen peroxide used for 2 sessions, each consisting of a single 45-min application, with an interval of 7 days between session. Thirty minutes prior to the procedure, the patient randomly received a single dose of piroxicam (200 mg) or placebo in a double-blind, randomized, crossover design. The TS was evaluated using verbal rate (VRS) and visual analog (VAS) scales during the bleaching procedure and at 24 h after each session. The color changes were assessed by the Vita Bleachedguide scale 1 week after each bleaching session. Risk of TS was calculated from the VRS and analyzed by the McNemar test, while the level of TS was analyzed by the Mann-Whitney test. For the VAS, t-tests were used to compare data from the treatments at each assessment time. Data regarding color changes were subjected to Wilcoxon and Mann-Whitney tests (α=0.05). The preemptive administration of piroxicam did not affect the risk and level of TS compared to placebo, irrespective of the assessment time. The treatment sequence did not affect bleaching effectiveness. In conclusion, the administration of a single dose of piroxicam prior to in-office tooth bleaching was unable to significantly reduce the risk and level of TS.
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Affiliation(s)
| | - Savil Costa Vaez
- Graduate Program in Health Sciences, UFS - Universidade Federal de Sergipe, Aracaju, SE, Brazil
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25
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Kikly A, Jaâfoura S, Sahtout S. Vital laser‐activated teeth bleaching and postoperative sensitivity: A systematic review. J ESTHET RESTOR DENT 2019; 31:441-450. [DOI: 10.1111/jerd.12482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/17/2019] [Accepted: 03/27/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Amira Kikly
- Assistant professor, Department of Conservative OdontologyFaculty of Dental Medicine, University of Monastir Monastir Tunisia
- ABCDF LaboratoryFaculty of Dental Medicine, University of Monastir Monastir Tunisia
| | - Sabra Jaâfoura
- Assistant professor, Department of Dental BiomaterialsFaculty of Dental Medicine, University of Monastir Monastir Tunisia
- ABCDF LaboratoryFaculty of Dental Medicine, University of Monastir Monastir Tunisia
| | - Saida Sahtout
- Professor, Department of Conservative OdontologyFaculty of Dental Medicine, University of Monastir Monastir Tunisia
- ABCDF LaboratoryFaculty of Dental Medicine, University of Monastir Monastir Tunisia
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Martini EC, Parreiras SO, Szesz AL, Coppla FM, Loguercio AD, Reis A. Bleaching-induced tooth sensitivity with application of a desensitizing gel before and after in-office bleaching: a triple-blind randomized clinical trial. Clin Oral Investig 2019; 24:385-394. [DOI: 10.1007/s00784-019-02942-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/02/2019] [Indexed: 01/24/2023]
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27
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Hortkoff D, Bittencourt BF, Nadal JM, Gomes OM, Rezende M, de Almeida Farhat PB. Clinical Study of Bleaching Gel Storage Temperature on Tooth Color and Sensitivity. Oper Dent 2019; 44:459-468. [PMID: 30702403 DOI: 10.2341/17-302-c] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of this triple-blind, split-mouth, randomized clinical trial was to evaluate the bleaching efficacy and tooth sensitivity of an in-office bleaching agent submitted to different storage temperatures (room temperature at 21.04°C±3.13°C or refrigeration at 5°C). METHODS AND MATERIALS Thirty volunteers were selected who had central incisors with color A2 or higher. The volunteers' maxillary hemi-arches received either the bleaching treatment with room temperature or refrigerated storage temperatures (two sessions of 3×15 minutes, one-week interval). Color variation was evaluated by subjective (Vita Classic and Vita Bleachedguide) and objective methods (Vita Easyshade spectrophotometer). Tooth sensitivity was evaluated with the visual analog scale (0-10) and the numerical rating scale (five points). The consistency of bleaching gels was evaluated by flow test, and pH was measured, both in triplicate. Color variation (SGU) and ΔE were analyzed by paired t-test (α=0.05). The absolute risk of pain was assessed by McNemar test (α=0.05), data from the numerical rating scale by the Wilcoxon signed-rank test (α=0.05), and visual analog scale by paired t-test. Comparison between the times within each group was analyzed by Friedman test. Gel consistency and pH were analyzed by one-way analysis of variance and Tukey post-test. RESULTS Regarding the absolute risk of tooth sensitivity, no significant difference was observed between the groups. The relative risk for tooth sensitivity was 1.13 (95%, confidence interval 0.70-1.82). Both tooth sensitivity scales were statistically similar. The results of the subjective evaluation (Vita Classic: p=0.73, Vita Bleachedguide: p=1.00) and the objective evaluation (p=1.00) of bleaching efficacy corresponded to the hypothesis of equality between groups after bleaching. Both pH values were around 7, and for the consistency test, there were significant differences between the groups (p=0.002). CONCLUSIONS Storage temperature of the analyzed in-office bleaching agent had no influence on tooth color effectiveness and tooth sensitivity.
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Vaz VTP, Jubilato DP, Oliveira MRMD, Bortolatto JF, Floros MC, Dantas AAR, Oliveira Junior OBD. Whitening toothpaste containing activated charcoal, blue covarine, hydrogen peroxide or microbeads: which one is the most effective? J Appl Oral Sci 2019; 27:e20180051. [PMID: 30673027 PMCID: PMC6438662 DOI: 10.1590/1678-7757-2018-0051] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 09/18/2018] [Indexed: 11/21/2022] Open
Abstract
The efficacy of whitening toothpastes is questionable and controversial. Clinicians, patients and researchers have expressed concern with whitening toothpastes due to the risk of wearing the dental structure and the potential for disappointment if the advertised cosmetic results are not achieved. Objective: This study compared the whitening performance of toothpastes with different whitening technologies after initial and continued use. Material and Methods: Ninety bovine incisors were stained using a concentrated solution of black tea. They were randomly distributed into 6 groups, according to the toothpaste whitening technology: activated charcoal (B&W), blue covarine (WAD), hydrogen peroxide (LWA), microbeads (Oral B 3D White Perfection – 3DW) and optimized abrasives (XW4D). They were compared to a traditional toothpaste without a whitening agent (TA – control). Specimens underwent a brushing machine with controlled pressure, time and temperature. A calibrated examiner measured the color using a VITA-Classical scale before the first brushing cycle (T0), after the first brushing cycle (TI), and after a brushing cycle that simulates continuous use (TCU). Whitening performance was evaluated by the difference of shades (ΔSGU) between T0–TI and T0–TCU timepoints, using the Kruskal-Wallis and Dunn's non-parametric test. The Wilcoxon test was used to evaluate the cumulative effect (α=0.05). Results: Statistically significant differences were observed between toothpastes in both TI and TCU (p<0.05). The time of use also had a significant effect (p<0.05). Conclusion: Only WAD and 3DW showed whitening performance after the first use (TI). The greatest whitening performance after continuous use was obtained by WAD, followed by LWA and 3DW. The use of conventional toothpaste (TA) promotes no tooth whitening. Clinical relevance: Microbead abrasives (3DW) and blue covarine (WAD) were the active technology tested that presented the best global tooth whitening performance.
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Affiliation(s)
- Vanessa Torraca Peraro Vaz
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araraquara, Departamento de Dentística Restauradora, Araraquara, SP, Brasil
| | - Dandara Proba Jubilato
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araraquara, Departamento de Dentística Restauradora, Araraquara, SP, Brasil
| | - Morgana Regina Mendonça de Oliveira
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araraquara, Departamento de Dentística Restauradora, Araraquara, SP, Brasil
| | - Janaina Freitas Bortolatto
- University of Toronto, Faculty of Dentistry, Department of Clinical Sciences - Restorative, Toronto, Canada
| | | | - Andrea Abi Rached Dantas
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araraquara, Departamento de Dentística Restauradora, Araraquara, SP, Brasil
| | - Osmir Batista de Oliveira Junior
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araraquara, Departamento de Dentística Restauradora, Araraquara, SP, Brasil
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Coppla FM, Rezende M, de Paula E, Farago PV, Loguercio AD, Kossatz S, Reis A. Combination of Acetaminophen/Codeine Analgesics Does Not Avoid Bleaching-Induced Tooth Sensitivity: A Randomized, Triple-Blind Two-Center Clinical Trial. Oper Dent 2018; 43:E53-E63. [PMID: 29504880 DOI: 10.2341/17-092-c] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Bleaching-induced tooth sensitivity (TS) is highly prevalent. OBJECTIVE This study aimed to determine if the combination of opioids and nonopioids analgesics (Tylex) may provide a better analgesic effect. METHOD A triple-blind, parallel, randomized two-center clinical trial was conducted with 105 healthy patients who received either a placebo or a combination of acetaminophen/codeine. The first dose of Tylex 30 mg (acetaminophen 500 mg/codeine 30 mg) or placebo was administered one hour before the in-office bleaching (35% hydrogen peroxide), and extra doses were administered every six hours for 48 hours. The TS was recorded using a visual analog scale of 0 to 10 and a numeric rating scale of 0 to 4 in different periods: during bleaching, one hour up to 24 hours, and 24 hours up to 48 hours postbleaching. The color was measured before and one month after dental bleaching with a visual shade guide (Vita Classical), Vita Bleachedguide 3D-MASTER, and the spectrophotometer Vita Easyshade. The absolute risk of TS was evaluated using the Fisher exact test. Data of TS intensity with numeric rating scale of the two groups were compared with the Mann-Whitney U-test and the Friedman test, while data from the visual analog scale were evaluated by two-way repeated measures analysis of variance and the Tukey test for pairwise comparison. The color changes between groups were compared using the Student t-test (α=0.05). RESULTS No significant differences between the groups were observed in the risk and intensity of TS. The overall absolute risk of TS was approximately 96%. No significant differences between groups were observed in terms of color change ( p>0.05) for any scale. CONCLUSION The use of an acetaminophen/codeine combination prior to in-office bleaching does not reduce the risk and intensity of bleaching-induced TS.
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Calheiros APC, Moreira MS, Gonçalves F, Aranha ACC, Cunha SR, Steiner-Oliveira C, Eduardo CDP, Ramalho KM. Photobiomodulation in the Prevention of Tooth Sensitivity Caused by In-Office Dental Bleaching. A Randomized Placebo Preliminary Study. Photomed Laser Surg 2018; 35:415-420. [PMID: 28783465 DOI: 10.1089/pho.2017.4282] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE Analyze the effect of photobiomodulation in the prevention of tooth sensitivity after in-office dental bleaching. BACKGROUND DATA Tooth sensitivity is a common clinical consequence of dental bleaching. Therapies for prevention of sensitivity have been investigated in literature. MATERIALS AND METHODS This study was developed as a randomized, placebo blind clinical trial. Fifty patients were selected (n = 10) and randomly divided into five groups: (1) control, (2) placebo, (3) laser before bleaching, (4) laser after bleaching, and (5) laser before and after bleaching. Irradiation was performed perpendicularly, in contact, on each tooth during 10 sec per point in two points. The first point was positioned in the middle of the tooth crown and the second in the periapical region. Photobiomodulation was applied using the following parameters: 780 nm, 40 mW, 10 J/cm2, 0.4 J per point. Pain was analyzed before, immediately after, and seven subsequent days after bleaching. Patients were instructed to report pain using the scale: 0 = no tooth sensitivity, 1 = gentle sensitivity, 2 = moderate sensitivity, 3 = severe sensitivity. RESULTS There were no statistical differences between groups at any time (p > 0.05). More studies, with others parameters and different methods of tooth sensitivity analysis, should be performed to complement the results found. CONCLUSIONS Within the limitation of the present study, the laser parameters of photobiomodulation tested in the present study were not efficient in preventing tooth sensitivity after in-office bleaching.
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Affiliation(s)
| | | | - Flávia Gonçalves
- 1 School of Dentistry, Ibirapuera University (UNIB) , São Paulo, Brazil
| | | | - Sandra Ribeiro Cunha
- 2 Department of Restorative Dentistry, University of São Paulo (USP) , São Paulo, Brazil
| | - Carolina Steiner-Oliveira
- 3 Department of Pediatric Dentistry, Piracicaba Dental School, University of Campinas (UNICAMP) , Piracicaba, São Paulo, Brazil
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Pre-operative use of dexamethasone does not reduce incidence or intensity of bleaching-induced tooth sensitivity. A triple-blind, parallel-design, randomized clinical trial. Clin Oral Investig 2018; 23:435-444. [DOI: 10.1007/s00784-018-2452-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 04/16/2018] [Indexed: 11/25/2022]
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Parreiras SO, Szesz AL, Coppla FM, Martini EC, Farago PV, Loguercio AD, Reis A. Effect of an experimental desensitizing agent on reduction of bleaching-induced tooth sensitivity: A triple-blind randomized clinical trial. J Am Dent Assoc 2018; 149:281-290. [PMID: 29439773 DOI: 10.1016/j.adaj.2017.10.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 10/24/2017] [Accepted: 10/24/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND In this randomized study, split-mouth, triple-blind clinical trial, the authors evaluated the efficacy of a desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde applied before in-office bleaching with 35% hydrogen peroxide (HP). METHODS Treatment with the desensitizing or placebo control gels was randomly assigned to one-half of the maxillary teeth of 42 patients in a split-mouth design. The desensitizing gels were applied and maintained in contact with the tooth enamel for 10 minutes, followed by 2 HP bleaching sessions separated by 1 week. The primary outcome variable was pain intensity assessed with a numeric rating scale and a visual analog scale. Color was evaluated by means of a digital spectrophotometer and a value-oriented shade guide. RESULTS The difference in risk of developing tooth sensitivity between the desensitizing gel group (31.7%, 95% confidence interval [CI], 19.6 to 46.9) and the control group (70.7%; 95% CI, 55.5 to 82.3%) was statistically significant (P < .0001), as well as the difference in pain intensity in the first 24 hours (P < .001). No statistically significant difference was found in color change between teeth that received the desensitizing gel and those that received the placebo gel. CONCLUSIONS Application of desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde before HP whitening reduced the risk and severity of dental sensitivity, without altering the effectiveness of whitening. PRACTICAL IMPLICATIONS A single application of desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde can reduce tooth sensitivity after dental bleaching systems.
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Diniz A, Lima S, Tavarez RR, Borges AH, Pinto S, Tonetto MR, Loguercio AD, Bandéca MC. Preventive Use of a Resin-based Desensitizer Containing Glutaraldehyde on Tooth Sensitivity Caused by In-office Bleaching: A Randomized, Single-blind Clinical Trial. Oper Dent 2018; 43:472-481. [PMID: 29570018 DOI: 10.2341/17-020-c] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the risk and intensity of bleaching-induced tooth sensitivity (TS) after in-office bleaching following topical application of a resin-based glutaraldehyde desensitizer. METHODS Thirty-three patients were randomly assigned to the experimental (Gluma Desensitizer Liquid, Heraeus Kulzer, Hanau, Germany) and placebo groups. The placebo or Gluma Desensitizer Liquid was applied for one minute prior to application of an in-office bleaching gel. Bleaching was performed with 35% hydrogen peroxide gel (three applications × 15 minutes each) over two sessions, one week apart. The color of the anterior teeth was evaluated before and 21 days after treatment using the VITA Classical shade guide, Bleachedguide 3D, and Easyshade spectrophotometer. TS during and after the bleaching was recorded according to the visual analog (VAS) and numerical rating (NRS) scales. All data were submitted to statistical analysis (α=0.05). RESULTS There was no significant difference in absolute risk or intensity of TS between the two groups (risk and VAS, p=0.93 and 0.31, respectively; NRS, p≥0.45). At the end of the bleaching protocol, tooth whitening was observed in both groups, as evident from color change in shade guide units (ΔSGU, 4.1-7.1; both guides) and overall color change (ΔE, 7.4-9.3 units); however, there were no significant differences in whitening between the two groups ( p>0.11). CONCLUSION Gluma Desensitizer Liquid was not able to reduce the risk or intensity of TS. Bleaching efficacy was not affected by application of the desensitizer.
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Tooth sensitivity with a desensitizing-containing at-home bleaching gel-a randomized triple-blind clinical trial. J Dent 2018; 72:64-70. [PMID: 29551346 DOI: 10.1016/j.jdent.2018.03.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 03/13/2018] [Accepted: 03/14/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Desensitizing agents are usually included in the composition of bleaching agents to reduce bleaching-induced tooth sensitivity (TS). This randomized clinical trial (RCT) evaluated the risk and intensity of TS and color change after at-home bleaching with a desensitizing-containing (3% potassium nitrate and 0.2% sodium fluoride) and desensitizing-free 10% carbamide peroxide (CP) gel (Whiteness Perfect, FGM). METHODS A triple-blind, within-person RCT was conducted on 60 caries-free adult patients. Each participant used the gel in a bleaching tray for 3 h daily for 21 days in both the upper and lower dental arches. The absolute risk and intensity of TS were assessed daily through the 0-10 VAS and NRS scale for 21 days. Color change was recorded using shade guides (Vita Classical and Vita Bleachedguide) and the Easyshade spectrophotometer at baseline, weekly and 30 days after the end of the bleaching. The risk and intensity of TS were evaluated by the McNemar and Wilcoxon Signed Rank tests, respectively. Color change (ΔSGU and ΔE) were evaluated by the Mann-Whitney test and a paired t-test, respectively (α = 0.05). RESULTS No difference in the TS and color change was observed (p > 0.05). CONCLUSIONS The incorporation of potassium nitrate and sodium fluoride in 10% carbamide peroxide at-home bleaching gel tested in this study did not reduce the TS and did not affect color change (RBR-4M6YR2).
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Fernandes MT, Vaez SC, Lima CM, Nahsan FP, Loguércio AD, Faria-e-Silva AL. Preemptive Use of Naproxen on Tooth Sensitivity Caused by In-Office Bleaching: A Triple-Blind, Crossover, Randomized Clinical Trial. Oper Dent 2017; 42:486-496. [DOI: 10.2341/16-100-c] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
A triple-blind, randomized, crossover clinical trial evaluated prior use of nonsteroidal anti-inflammatory naproxen on sensitivity reported by patients undergoing in-office tooth bleaching.
Methods and Materials:
Fifty patients were subjected to two sessions of in-office tooth bleaching with 35% hydrogen peroxide in a single application of 40 minutes for two sessions, with an interval of seven days between applications. One hour prior to the procedure, each patient randomly received a single dose of naproxen (500 mg) or placebo. The patient's sensitivity level was evaluated during and immediately after the bleaching using two scales (verbal and visual analog); the verbal scale only was repeated after 24 hours. The effectiveness of the bleaching procedures was evaluated with the Bleachedguide scale. Relative risk to sensitivity was calculated and adjusted by session, while comparison of overall risk was performed by the McNemar test. Data on the sensitivity level for both scales and shade were subjected to the Friedman, Wilcoxon, and Mann-Whitney tests (α=0.05).
Results:
The use of naproxen only decreased the absolute risk and intensity of tooth sensitivity reported immediately after the second session. On the other hand, no measurable effect was observed during or 24 hours after either session. The sequence of drug administration did not affect the bleaching effectiveness.
Conclusions:
Preemptive use of naproxen only reduced tooth sensitivity reported by patients immediately after the second session of bleaching.
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Affiliation(s)
- MT Fernandes
- Micaelle T Fernandes, MSc, graduate student, Graduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - SC Vaez
- Savil C Vaez, MSc, graduate student, Graduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - CM Lima
- Cláudio M Lima, professor, Department of Pharmacy, Federal University of Sergipe, Lagarto, Brazil
| | - FP Nahsan
- Flavia P Nahsan, DDS, PhD, professor, Department of Dentistry, Federal University of Sergipe, Lagarto, Brazil
| | | | - AL Faria-e-Silva
- Andre L Faria-e-Silva, DDS, MSc, PhD, Department of Dentistry, Federal University of Sergipe, Aracaju, Brazil
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Loguercio AD, Maran BM, Hanzen TA, Paula AMD, Perdigão J, Reis A. Randomized clinical trials of dental bleaching - Compliance with the CONSORT Statement: a systematic review. Braz Oral Res 2017; 31:e60. [PMID: 28902240 DOI: 10.1590/1807-3107bor-2017.vol31.0060] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 05/22/2017] [Indexed: 12/17/2022] Open
Abstract
We reviewed the literature to evaluate: a) The compliance of randomized clinical trials (RCTs) on bleaching with the CONSORT; and b) the risk of bias of these studies using the Cochrane Collaboration risk of bias tool (CCRT). We searched the Cochrane Library, PubMed and other electronic databases, to find RCTs focused on bleaching (or whitening). The articles were evaluated in compliance with CONSORT in a scale: 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the number of studies by journal, follow-up period, country and quality assessments were performed with CCRT for assessing risk of bias in RCTs. 185 RCTs were included for assessment. More than 30% of the studies received score 0 or 1. Protocol, flow chart, allocation concealment and sample size were more critical items, as 80% of the studies scored 0. The overall CONSORT score for the included studies was 16.7 ± 5.4 points, which represents 52.2% of the maximum CONSORT score. A significant difference among journal, country and period of time was observed (p < 0.02). Only 7.6% of the studies were judged at "low" risk; 62.1% were classified as "unclear"; and 30.3% as "high" risk of bias. The adherence of RCTs evaluating bleaching materials and techniques to the CONSORT is still low with unclear/high risk of bias.
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Affiliation(s)
- Alessandro Dourado Loguercio
- Universidade Estadual de Ponta Grossa - UEPG, School of Dentistry, Department of Restorative Dentistry, Ponta Grossa, Paraná, Brazil
| | - Bianca Medeiros Maran
- Universidade Estadual de Ponta Grossa - UEPG, School of Dentistry, Department of Restorative Dentistry, Ponta Grossa, Paraná, Brazil
| | - Taíse Alessandra Hanzen
- Universidade Estadual de Ponta Grossa - UEPG, School of Dentistry, Department of Restorative Dentistry, Ponta Grossa, Paraná, Brazil
| | - Alexandra Mara de Paula
- Universidade Estadual de Ponta Grossa - UEPG, School of Dentistry, Department of Restorative Dentistry, Ponta Grossa, Paraná, Brazil
| | - Jorge Perdigão
- University of Minnesota, Department of Restorative Sciences, Minneapolis, MN, United States of America
| | - Alessandra Reis
- Universidade Estadual de Ponta Grossa - UEPG, School of Dentistry, Department of Restorative Dentistry, Ponta Grossa, Paraná, Brazil
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Rezende M, De Geus JL, Loguercio AD, Reis A, Kossatz D. Clinical Evaluation of Genotoxicity of In-office Bleaching. Oper Dent 2016; 41:578-586. [DOI: 10.2341/15-207-c] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective: The aim of this study was to evaluate the genotoxicity of in-office bleaching with 35% hydrogen peroxide in epithelial cells from the gingival and lip tissues.
Methods and Materials: Thirty volunteers with central incisors shade A1 or darker were selected for this study. The gingival tissue of the teeth to be bleached was isolated with a light-polymerized resin dam, and the 35% hydrogen peroxide gel was administered during three 15-minute applications over the course of the 45-minute application period. Two bleaching sessions with a one-week interval in between were performed. Exfoliated oral mucosa gingival epithelial cells and upper lip lining were collected at baseline and one month after the in-office dental bleaching. The scraped cells were placed on clean glass slides and smears were prepared. After staining with Giemsa solution, two blinded examiners performed cell and micronuclei counts under a 100× optical microscope. Tooth sensitivity was evaluated using the Visual Analogue Scale (VAS). Shade evaluation was recorded before and one month after the bleaching treatment with the value-oriented shade guide Vita Bleachedguide 3D-MASTER and the spectrophotometer Vita Easyshade. Data from the shade guide units and the micronuclei (MN) frequency were subjected to a Mann-Whitney test (α=0.05). The overall difference between before and one month after the bleaching treatment (ΔE and ΔSGU), absolute risk, and intensity of tooth sensitivity (TS) were calculated, as was the 95% confidence interval (CI).
Results: The frequency of MN was not increased after bleaching with 35% hydrogen peroxide in both study groups (p>0.05). The absolute risk of TS of the participants was 93% (95% CI, 79%-98%), with a mean VAS intensity of 5.7 ± 2.9 (95% CI, 4.6-6.8). Meaningful whitening was observed after bleaching. The change in shade guide units in the Bleachedguide 3D-MASTER was 2.3 ± 1.4. In terms of ΔE, the change in color was 7.7 ± 3.5.
Conclusions: The in-office bleaching did not induce DNA damage to the gingival and lip tissue during the bleaching period. Although effective whitening was observed, most of the participants experienced TS.
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Affiliation(s)
- M Rezende
- Márcia Rezende, DDS, MS, postdoctoral student, Department of Restorative Dentistry, University Estadual de Ponta Grossa, Ponta Grossa, Brazil
| | - JL De Geus
- Juliana Larocca De Geus, DDS, MS, doctoral student, Department of Restorative Dentistry, University Estadual de Ponta Grossa, Ponta Grossa, Brazil
| | - AD Loguercio
- Alessandro Dourado Loguercio, DDS, MS, PhD, professor, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Brazil
| | - A Reis
- Alessandra Reis, DDS, PhD, professor, School of Dentistry, Department of Restorative Dentistry, University Estadual de Ponta Grossa, Ponta Grossa, Brazil
| | - D Kossatz
- Stella Kossatz, DDS, MS, PhD, professor, School of Dentistry, Department of Restorative Dentistry, University Estadual de Ponta Grossa, Ponta Grossa, Brazil
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Effect of low-level laser therapy on tooth sensitivity induced by in-office bleaching. Lasers Med Sci 2016; 31:713-9. [DOI: 10.1007/s10103-016-1913-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 02/16/2016] [Indexed: 10/22/2022]
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Lima AF, Marques MR, Soares DG, Hebling J, Marchi GM, de Souza Costa CA. Antioxidant therapy enhances pulpal healing in bleached teeth. Restor Dent Endod 2016; 41:44-54. [PMID: 26877990 PMCID: PMC4751206 DOI: 10.5395/rde.2016.41.1.44] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 12/13/2015] [Indexed: 01/18/2023] Open
Abstract
Objectives The purpose of this study was to evaluate the histopathological effects of an antioxidant therapy on the pulp tissue of rat teeth exposed to a bleaching gel with 35% hydrogen peroxide. Materials and Methods Forty rats were subjected to oral ingestion by gavage of distilled water (DW) or ascorbic acid (AA) 90 min before the bleaching therapy. For the bleaching treatment, the agent was applied twice for 5 min each to buccal surfaces of the first right mandibular molars. Then, the animals were sacrificed at 6 hr, 24 hr, 3 day, or 7 day post-bleaching, and the teeth were processed for microscopic evaluation of the pulp tissue. Results At 6 hr, the pulp tissue showed moderate inflammatory reactions in all teeth of both groups. In the DW and AA groups, 100% and 80% of teeth exhibited pulp tissue with significant necrosis and intense tissue disorganization, respectively. At 24 hr, the AA-treated group demonstrated a greater regenerative capability than the DW group, with less intense inflammatory reaction and new odontoblast layer formation in 60% of the teeth. For up to the 7 day period, the areas of pulpal necrosis were replaced by viable connective tissue, and the dentin was underlined by differentiated odontoblast-like cells in most teeth of both groups. Conclusions A slight reduction in initial pulpal damage during post-bleaching was promoted by AA therapy. However, the pulp tissue of AA-treated animals featured faster regenerative potential over time.
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Affiliation(s)
- Adriano Fonseca Lima
- Dental Research Division, School of Dentistry, Paulista University, Sao Paulo, SP, Brazil
| | - Marcelo Rocha Marques
- Department of Morphology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Diana Gabriela Soares
- Department of Physiology and Pathology, Araraquara School of Dentistry, University Estadual Paulista, Araraquara, SP, Brazil
| | - Josimeri Hebling
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Giselle Maria Marchi
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, Araraquara School of Dentistry, University Estadual Paulista, Araraquara, SP, Brazil
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Predictive factors on the efficacy and risk/intensity of tooth sensitivity of dental bleaching: A multi regression and logistic analysis. J Dent 2015; 45:1-6. [PMID: 26612623 DOI: 10.1016/j.jdent.2015.11.003] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/11/2015] [Accepted: 11/17/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of this study was to identify predictor factors associated with the whitening outcome and risk and intensity of bleaching-induced tooth sensitivity from pooled data of 11 clinical trials of dental bleaching performed by the same research group. METHODS The individual patient data of several published and ongoing studies about dental bleaching was collected and retrospectively analyzed. At the patient-level, independent variables (bleaching techniques [at-home and in-office protocols], sex, age and baseline tooth color in shade guide unit [SGU]) as well as dependent variables (color change in shade guide units (ΔSGU), color change in the CIEL*a*b* system (ΔE), risk and intensity of TS in a visual analog scale) were collected. Multivariable linear regression and multivariable logistic regression models were carried out using backward elimination whenever the p-values were higher than 0.05. RESULTS A significant relationship between baseline color and age on color change estimates was detected (p<0.001). Every increase of one SGU in the baseline color resulted in an increase of approximate 0.66 in the final ΔSGU and 2.48 for the ΔE. For every increase of one year in the participant's age we observed a decrease of the whitening degree of 0.07 for the final ΔSGU and 0.69 for the ΔE. The bleaching technique was shown to be a significant predictor of ΔSGU (p<0.001) but not of ΔE. In regard to TS, baseline color and bleaching technique are significant predictors (p<0.001). The risk of TS for at-home bleaching was 51% (95% CI 41.4-60.6) and for the in-office 62.9% (95% CI 56.9-67.3). CONCLUSIONS Younger patients with darker teeth reach a higher degree of whitening. Patient with darker teeth and submitted to at-home bleaching presents lower risk and intensity of TS. CLINICAL SIGNIFICANCE The baseline color of the teeth and the patient's age is directly related to the effectiveness of dental bleaching and TS.
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Kose C, Calixto AL, Bauer JRO, Reis A, Loguercio AD. Comparison of the Effects of In-office Bleaching Times on Whitening and Tooth Sensitivity: A Single Blind, Randomized Clinical Trial. Oper Dent 2015; 41:138-45. [PMID: 26509229 DOI: 10.2341/15-085-c] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The objective of the present study was to compare the bleaching efficacy (BE) and tooth sensitivity (TS) of in-office bleaching applied under different time protocols. METHODS AND MATERIALS Fifty-three patients were randomly distributed into three groups: the bleaching agent was applied in one (1×15), two (2×15), or three (3×15) 15-minute applications. The labial surfaces of the anterior teeth were bleached using a 35% hydrogen peroxide gel. Two bleaching sessions with a one-week interval between were performed. The shade evaluation was performed with a visual shade guide and spectrophotometer before and 30 days after bleaching. Participants recorded TS with a five-point verbal scale. Color change was analyzed by one-way analysis of variance and Tukey tests. The absolute risk of TS and TS intensity were evaluated by the Fisher exact and Friedman/Kruskal-Wallis tests, respectively (α= 0.05). RESULTS Significant whitening was observed in all groups, with statistically lower BE for the 1×15 group (p<0.05). The absolute risk of TS (95% confidence interval) was lower for the 1×15 group than for the other groups (p<0.05). The TS intensity of the 3×15 group was statistically higher than that associated with the other protocols (p<0.05). CONCLUSIONS A single 15-minute application produced less TS but reduced BE. The protocol with 2×15 produced a degree of BE similar to that of the 3×15 group, but with reduced overall TS intensity.
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Effect of preventive use of nonsteroidal anti-inflammatory drugs on sensitivity after dental bleaching. J Am Dent Assoc 2015; 146:87-93.e1. [DOI: 10.1016/j.adaj.2014.10.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 10/23/2014] [Accepted: 10/24/2014] [Indexed: 11/23/2022]
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Santana MAP, Nahsan FPS, Oliveira AHDA, Loguércio AD, Faria-e-Silva AL. Randomized Controlled Trial of Sealed In-Office Bleaching Effectiveness. Braz Dent J 2014; 25:207-11. [DOI: 10.1590/0103-6440201300072] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/03/2014] [Indexed: 11/21/2022] Open
Abstract
Regardless of the high success rate, patients commonly report the occurrence of tooth sensitivity during the in-office bleaching procedures. Recently, it has been demonstrated that using a customized tray (called sealed in-office bleaching technique) reduces peroxide penetration. The aim of this randomized clinical study was to evaluate tooth sensitivity and bleaching efficacy of sealed bleaching, in comparison with a conventional in-office technique. Twenty patients were randomized allocated in two groups in which 35% hydrogen peroxide gel was used in a single 45-min application. For the sealed technique, a customized bleaching tray was fabricated and carefully positioned over the bleaching agent during the session. The color was recorded at a baseline, 7 and 28 days after the bleaching session, using Vita Easy Shade spectrophotometer. Tooth sensitivity was recorded during (20 and 40 min) and immediately after the treatment using a visual analogue scale. The bleaching efficacy was evaluated by repeated-measures ANOVA, while the absolute risk of tooth sensitivity and its intensity were evaluated by Fisher's exact and Mann-Whitney tests, respectively (α=0.05). No significant difference on bleaching efficacy was observed between the conventional (7.4 and 8.1 ΔE) and sealed techniques (7.8 and 8.3 ΔE) at both evaluation periods. No significant difference was observed regarding the absolute risk of tooth sensitivity (p=0.15). Sealed technique showed a significant decrease of sensitivity intensity after 40 min (p=0.03). Sealed bleaching technique was able to reduce the sensitivity intensity during the bleaching procedure, without jeopardizing the bleaching efficacy
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