Indirect cytotoxicity of a 35% hydrogen peroxide bleaching gel on cultured odontoblast-like cells

The aim of this study was to evaluate the trans-enamel and trans-dentinal effects of a 35% hydrogen peroxide (H2O2) bleaching gel on odontoblast-like cells. Enamel/dentin discs obtained from bovine incisors were mounted in artificial pulp chambers (APCs). Three groups were formed: G1- 35% H2O2; G2- 35% H2O2 + halogen light application; G3- control. The treatments were repeated 5 times and the APCs were incubated for 12 h. Then, the extract was collected and applied for 24 h on the cells. Cell metabolism, total protein dosage and cell morphology were evaluated. Cell metabolism decreased by 62.09% and 61.83% in G1 and G2, respectively. The depression of cell metabolism was statistically significant when G1 and G2 were compared to G3. Total protein dosage decreased by 93.13% and 91.80% in G1 and G2, respectively. The cells in G1 and G2 exhibited significant morphological alterations after contact with the extracts. Regardless of halogen light application, the extracts caused significantly more intense cytopathic effects compared to the control group. After 5 consecutive applications of a 35% H2O2 bleaching agent, either catalyzed or not by halogen light, products of gel degradation were capable to diffuse through enamel and dentin causing toxic effects to the cells.

Influence of bleaching treatment on flexural resistance of hybrid materials.

The aim of this study is to evaluate the flexural resistance of three types of restorative materials: compomer (Freedom), resin-modified glass-ionomer (Vitremer) and composite resin (Esthet-X), observing whether the application of bleaching agent can cause alterations of their flexural properties. Sixty samples were made using a 10 x 1 x 1 mm brass mold, and divided into three groups: G1- Freedom (SDI); G2- Vitremer (3M ESPE); G3- Esthet-X (Dentsply). On half of the samples of each group (10 samples) the bleaching treatment was applied and the other half used as control, was stored in distilled water at a temperature of 37 degrees C. Whiteness HP Maxx bleaching system was applied on the sample surface following the manufacturer's recommendations, simulating the bleaching treatment at the clinic. After this period, a flexural strength (three-point bending) test was conducted using (EMIC DL 1000) machine until the samples fractured. The data were submitted to ANOVA and Tukey tests. Of the restorative materials studied, G3-(87.24 +/- 31.40 MPa) presented the highest flexural strength, followed by G1-(61.67 +/- 21.32 MPa) and G2-(61.67 +/- 21.32 MPa). There was a statistical difference in flexural strength after the bleaching treatment. It was concluded that the use of a beaching agent can promote significant alteration of the flexural strength of these restorative materials.

An in vitro thermal analysis during different light-activated hydrogen peroxide bleaching

This study measured the critical temperature reaching time and also the variation of temperature in the surface of the cervical region and within the pulp chamber of human teeth submitted to dental bleaching using 35% hydrogen peroxide gel activated by three different light sources. The samples were randomly divided into 3 groups (n = 15), according to the catalyst light source: Halogen Light (HL), High Intensity Diode Laser (DL), and Light Emmited Diode (LED). The results of temperature variation were submitted to the analysis of variance and Tukey test with p < 0.05. The temperature increase (mean value and standard deviation) inside the pulp chamber for the HL group was 6.8 ± 2.8°C; for the DL group was 15.3 ± 8.8°C; and for the LED group was 1.9 ± 1.0°C for. The temperature variation (mean value and standard deviation) on the tooth surface, for the group irradiated with HL was 9.1 ± 2.2°C; for the group irradiated with DL were 25.7 ± 18.9°C; and for the group irradiated with LED were 2.6 ± 1.4°C. The mean temperature increase values were significantly higher for the group irradiated with DL when compared with groups irradiated with HL and LED (p < 0.05). When applying the inferior limits of the interval of confidence of 95%, an application time of 38.7 s was found for HL group, and 4.4 s for DL group. The LED group did not achieve the critical temperatures for pulp or the periodontal, even when irradiated for 360 s. The HL and DL light sources may be used for dental bleaching for a short period of time. The LED source did not heat the target tissues significantly within the parameters used in this study. © 2010 Pleiades Publishing, Ltd.

Effect of bleaching agent on dental ceramics roughness.

The aim of this study was to assess the effect of bleaching agents (10% and 16% carbamide peroxide) on the roughness of two dental ceramics in vitro, and to analyze the surface by scanning electronic microscopy (SEM). Two bleaching agents (10% and 16%/Whiteness, FGM Gel) and two microparticle feldspathic ceramics (Vita VM7 and Vita VM13) were used. Forty disks of Vita VM7 and Vita VM13 ceramic were manufactured, measuring 4 mm in diameter and 4 mm high, in accordance with the manufacturers' recommendations, and were divided into 4 groups (n = 10): (1) VM7 + Whiteness 10%; (2) VM7 + Whiteness 16%; (3) VM13 + Whiteness 10%; (4) VM13 + Whiteness 16%. The bleaching agent was applied for 8 hours a day for 15 days and during the intervals the test specimens were stored in distilled water at 37 degrees C. The roughness (Ra) of the test specimens was evaluated before and after exposure to the bleaching agents using a laser roughness meter and the topographic description was analyzed by SEM. The statistical analysis of roughness data showed significant differences in the VM7 groups, using paired t-test, p = 0.05 (VM7 + Whiteness 10%: p = 0.002; VM7 + Whiteness 16%: p = 0.001) and two-sample t-test (VM7 p = 0.047), and no significant difference was found among VM13 groups. The qualitative SEM analysis showed different degrees of surface changes. The results suggest that the roughness of the tested ceramic surfaces increased after exposure to the bleaching agents.

pH-changes during intracoronal bleaching: An in vivo study

Objectives: This study aimed to measure pH changes during 14 days intracoronal bleaching with hydrogen peroxide/sodium perborate and carbamide peroxide/sodium perborate. Materials and methods: Twenty patients presenting endodontically treated central maxillary incisors with color alterations were divided in two groups (n = 10): Group CP + SP: 37% carbamide peroxide + sodium perborate paste; Group HP + SP: 30% hydrogen peroxide + sodium perborate paste. The pH values were measured using a digital microprocessor at different times: Baseline, 2, 7 and 14 days. Data were analyzed with two-way ANOVA followed by Tukey's test (α = 0.05). Results: ANOVA showed p < 0.00 which indicated significant difference between the groups. The mean values (± sd) and the results of the Tukey's test were: HP + SP/14 days-7.98 (±0.58)a; HP + SP/7 days-8.59 (±0.18)b; HP + SP/2 days-8.83 (±0.32)bc; HP + SP/Baseline-8.83 (±0.01)bc; CP + SP/Baseline-8.89 (±0.01)bc; CP + SP/14 days-9.11 (±0.58)cd; CP + SP/7 days-9.54 (±0.16)de; CP + SP/2 days-9.66 (±0.08) de. The group HP + SP resulted in significantly lower pH values compared with group CP + SP. Conclusion: It can be concluded that both associations showed alkaline pH values; however, there was significant reduction in the pH values of the 30% hydrogen peroxide associated with sodium perborate after 14 days. Clinical Significance: The association of hydrogen peroxide and carbamide peroxide with sodium perborate paste presented alkaline characteristics during the 14-day evaluated period. Thus, regarding pH changes, both associations can be considered safe as intracoronal bleaching agents.

Effect of calcium hydroxide on pH changes of the external medium after intracoronal bleaching

Aim: This in vitro study evaluated the effect of calcium hydroxide on pH changes of the external medium after intracoronal bleaching. Materials and methods: A total of 50 extracted human premolars were prepared and filled with gutta-percha and endodontic sealer. The teeth were randomly divided into five groups according to the bleaching agents employed: (a) Sterile cotton pellet with distilled water (control group); (b) sodium perborate and distilled water; (c) sodium perborate and 10% carbamide peroxide; (d) sodium perborate and 35% hydrogen peroxide; (e) 35% hydrogen peroxide. The teeth were stored in vials containing distilled water and the pH values of the medium surrounding the teeth were analyzed. After 7-day storage, the bleaching agent was removed and replaced by calcium hydroxide, and the distilled water was changed, in which the teeth were kept stored for further 14 days. Measurement of pH of the external medium (distilled water) was performed 7 days after insertion of the bleaching agents, immediately, 7 and 14 days after insertion of the calcium hydroxide. Data were submitted to statistical analysis by the two-way ANOVA and Tukey,s test. Results: There were pH changes of the external medium at 7-day period after bleaching procedures. These results confirmed the diffusion of bleaching agents to the external medium. Conclusion: Calcium hydroxide increased the external medium pH and was effective for pH alkalinization after intracoronal bleaching. Clinical significance: Intracoronal bleaching of endodontically treated teeth may cause cervical root resorption. A possible explanation for this process is the passage of bleaching agents to the periodontal tissues yielding an inflammatory process. In an attempt to keep the neutrality of the periodontal pH, the calcium hydroxide has been recommended.Results of this study showed that this material should be always used after intracoronal bleaching.

Pulp tissue dissolution when the use of sodium hypochlorite and EDTA alone or associated

Purpose: The aim of the present study was to evaluate the tissue dissolving capacity of various concentrations of sodium hypochlorite either alone or in combination with 17% EDTA. Methods: Eighty bovine pulp fragments were prepared, and their weight was determined using a precision balance. Each pulp fragment was immersed for 2 hours in a solution/mixture that was based on the following groups: G1-saline solution; G2-0.5% NaOCl; G3-1.0% NaOCl; G4-2.5% NaOCl; G5-17% EDTA; G6-0.5% NaOCl+17% EDTA; G7-1.0% NaOCl+ 17% EDTA; and G8-2.5% NaOCl+17% EDTA. The final weight was measured, and the weight loss was calculated. A statistical analysis was performed using either the Student's t-test for paired samples or an ANOVA and Tukey tests (P<0.05 was considered to be significant). Results: We measured a significant difference between the sample weight before and after treatment for each of the tested groups (P<0.05). The 2.5% sodium hypochlorite solution (G4) completely dissolved the pulp tissue within the test period. NaOCl+EDTA was less effective than sodium hypochlorite alone at dissolving the pulp tissue (P<0.05), and EDTA alone (G5) did not markedly dissolve the pulp tissue. Conclusion: Using EDTA together with NaOCl reduced the tissue dissolving properties compared with NaOCl alone, regardless of the concentration of NaOCl that was used. © 2011 Só et al.; licensee EDIPUCRS.

Modelling thermodynamic properties of banana waste by analytical derivation of desorption isotherms

Banana is an agricultural product of great economic importance for various developing countries. The relationship between moisture content and water activity provides useful information for the processing and storage of banana waste. The water activity and moisture content of three banana (Mussa spp. Haploid AAB cv. Nanica) waste items were analyzed to determine the desorption isotherms at six different temperatures (20, 30, 40, 50, 60 and 70°C). The desorption isotherms of the peel, pedicel and pulp of overripe bananas were determined in wide ranges of moisture content (0.001-6.360 kg kg-1 d.b.) and water activity (0.02-0.907). The theoretical GAB model was used for modelling the desorption isotherms. An analytical solution of the Clausius-Clapeyron equation was proposed to compute the isosteric heat of sorption, the differential entropy and Gibbs' free energy by way of the GAB model when the effect of temperature on the hygroscopic equilibrium was considered. © 2012 de Gruyter. All rights reserved.

Anterior restorations in bleached teeth: Difficulty establishing the color after bleaching

It is becoming more common for patients to look for cosmetic procedures in dental offices. The search for lost or desired esthetics by patients is increasingly frequent and the professional must be able to meet this demand. To do this, dentists not only need to return the tooth back to its normal functioning state but also promote esthetic excellence. In this context, the association of cosmetic procedures, such as teeth whitening and restorative procedures, such as direct adhesive restorations is very common. The composite resins employed nowadays allow the reproduction of various optical properties of natural teeth. With these composite resins, it is possible to reproduce features such as translucency, opacity and specific features of the dental element, to bring back the esthetic harmony of the smile. This article reports a clinical case demonstrating the placement, in a stratified manner, of composite resins in bleached teeth, as well as the reproduction of optical and natural aspects of the teeth. In order to achieve esthetic and functional success of the restored procedure, it is important to be familiar with the new techniques and new materials in the marketand above all, we must know when and where to use them.

Efficacy and cytotoxicity of a bleaching gel after short application times on dental enamel

Objectives: This study aimed to evaluate and correlate the efficacy and cytotoxicity of a 35 % hydrogen peroxide (HP) bleaching gel after different application times on dental enamel. Materials and methods: Enamel/dentin disks in artificial pulp chambers were placed in wells containing culture medium. The following groups were formed: G1, control (no bleaching); G2 and G3, three or one 15-min bleaching applications, respectively; and G4 and G5, three or one 5-min bleaching applications, respectively. Extracts (culture medium with bleaching gel components) were applied for 60 min on cultured odontoblast-like MDPC-23 cells. Cell metabolism (methyl tetrazolium assay) (Kruskal-Wallis/Mann-Whitney; α = 5 %) and cell morphology (scanning electron microscopy) were analyzed immediately after the bleaching procedures and the trans-enamel and trans-dentinal HP diffusion quantified (one-way analysis of variance/Tukey's test; α = 5 %). The alkaline phosphatase (ALP) activity was evaluated 24 h after the contact time of the extracts with the cells (Kruskal-Wallis/Mann-Whitney; α = 5 %). Tooth color was analyzed before and 24 h after bleaching using a spectrophotometer according to the Commission Internationale de l'Eclairage L*a*b* system (Kruskal-Wallis/Mann-Whitney; α = 0.05). Results: Significant difference (p < 0.05) in cell metabolism occurred only between G1 (control, 100 %) and G2 (60.6 %). A significant decrease (p < 0.05) in ALP activity was observed between G2, G3, and G4 in comparison with G1. Alterations on cell morphology were observed in all bleached groups. The highest values of HP diffusion and color alterations were observed for G2, with significant difference among all experimental groups (p < 0.05). G3 and G4 presented intermediate color change and HP diffusion values with no statistically significant differences between them (p > 0.05). The lowest amount of HP diffusion was observed in G5 (p < 0.05), which also exhibited no significant color alteration compared to the control group (p > 0.05). Conclusions: HP diffusion through dental tissues and its cytotoxic effects were proportional to the contact time of the bleaching gel with enamel. However, shorter bleaching times reduced bleaching efficacy. Clinical relevance: Shortening the in-office tooth bleaching time could be an alternative to minimize the cytotoxic effects of this clinical procedure to pulp tissue. However, the reduced time of bleaching agent application on enamel may not provide adequate esthetic outcome. © 2012 Springer-Verlag Berlin Heidelberg.

Ultrasonic activation of internal bleaching agents

Aim: To evaluate the effectiveness of ultrasonic activation of bleaching agents during ex vivo internal bleaching. Methodology: Fifty canine human teeth were artificially stained, root filled and divided into five groups (n = 10) that received SP - sodium perborate plus deionized water (control group), CP - 37% carbamide peroxide gel, CPUS - 37% carbamide peroxide gel plus ultrasonic application, HP - 35% hydrogen peroxide gel or HPUS - 35% hydrogen peroxide gel plus ultrasonic application. In groups CP and HP, the bleaching agent was left inside the pulp chamber for three applications of 10 min. In groups CPUS and HPUS, the same process was performed, but ultrasonic vibration was applied to the bleaching agent by an alloy tip for 30 s, with 30 s intervals. Two sessions were performed. The colour was measured initially and after each session by an intraoral dental spectrophotometer. The variation (Δ) of the colour parameters based on the CIELab system L*, a* and b*, and the colour alteration ΔE* were calculated after first and second section. Data were analysed by one-way anova and Tukey's test. Results: There was no significant difference amongst groups for ΔL*, Δa* and ΔE*, but there was a significant difference for Δb* in the first and second sessions (P = 0.0006 and 0.0016, respectively). After the first session, Δb* was significantly greater for groups HP and HPUS, without a significant difference between them. For the second session, group HPUS had the greatest Δb* values, but they were similar to groups HP and SP; group CP had the lowest values, which were similar to groups CPUS and SP. Conclusion: Ultrasonic activation of bleaching agents during ex vivo internal bleaching was no more effective than conventional internal bleaching procedures, without activation. © 2012 International Endodontic Journal.

Photoelectrocatalysis based on Ti/TiO2 nanotubes removes toxic properties of the azo dyes Disperse Red 1, Disperse Red 13 and Disperse Orange 1 from aqueous chloride samples

This work describes the efficiency of photoelectrocatalysis based on Ti/TiO2 nanotubes in the degradation of the azo dyes Disperse Red 1, Disperse Red 13 and Disperse Orange 1 and to remove their toxic properties, as an alternative method for the treatment of effluents and water. For this purpose, the discoloration rate, total organic carbon (TOC) removal, and genotoxic, cytotoxic and mutagenic responses were determined, using the comet, micronucleus and cytotoxicity assays in HepG2 cells and the Salmonella mutagenicity assay. In a previous study it was found that the surfactant Emulsogen could contribute to the low mineralization of the dyes (60% after 4h of treatment), which, in turn, seems to account for the mutagenicity of the products generated. Thus this surfactant was not added to the chloride medium in order to avoid this interference. The photoelectrocatalytic method presented rapid discoloration and the TOC reduction was ≥87% after 240min of treatment, showing that photoelectrocatalysis is able to mineralize the dyes tested. The method was also efficient in removing the mutagenic activity and cytotoxic effects of these three dyes. Thus it was concluded that photoelectrocatalysis was a promising method for the treatment of aqueous samples. © 2013 Elsevier Ltd.

Effect of carbamide peroxide bleaching gel on composite resin flexural strength and microhardness

This study investigated the effect of 16% carbamide peroxide (Whiteness Perfect/FGM) on the Vickers microhardness and flexural strength of the restorative composites Filtek Z100 (hybrid), Filtek Z350 (nanofill), Brilliant (micro-hybrid) and Opallis (micro-hybrid). Discshaped (4×2 mm; n=5) and bar-shaped (12×2×1 mm; n=10) specimens of each restorative material were randomly divided into 2 groups: (G1) 16 weeks stored in distilled water; (G2) 16 weeks stored in distilled water, with 16% carbamide peroxide application during 6 h per day for the last 4 weeks. The mechanical properties were evaluated using a Vickers microhardness tester and a mechanical testing machine. Data were analyzed by twoway ANOVA and Tukey's (HSD) post-hoc test (α=0.05). Filtek Z100 presented the highest microhardness value, followed by Filtek Z350 and finally by Brilliant and Opallis (p=0.00). Filtek Z100 and Brilliant exhibited the highest flexural strength value, followed by Filtek Z350 and Opallis (p=0.00). Bleaching treatment decreased significantly microhardness of Brilliant and Opallis (p=0.00). The flexural strength of all studied materials was not affected by the home bleaching (p=0.28).