Efeitos de diferentes sistemas de clareamento dental sobre a rugosidade e morfologia superficial do esmalte e de uma resina composta restauradora

The aim of this study was to evaluate and compare the roughness and superficial morphology of enamel and a composite restorative resin after different bleaching techniques application. Material and Methods: Bovine incisors were selected and standardized cavities were prepared on the buccal surface, which were restored with composite resin. The teeth were distributed according to the following treatments: G1- bleaching with 10% carbamide peroxide (CP); G2 - bleaching with 38% hydrogen peroxide (HP); and G3 - bleaching with 38% of HP associated to light irradiation. For G1, the bleaching gel was applied for 8 hours daily during 21 days. For G2 and G3, 3 sessions were performed, consisting of 3 applications of 15 minutes each, with 7 days of intervals between the sessions. For G3, the LED (470nm) light was used to activate the bleaching agent for 6 minutes. The surface of enamel and composite resin were evaluated before and after the bleaching procedures using a roughness tester and an atomic force microscope. Results: The results showed significant differences in surface roughness of enamel after bleaching only for G1 (Wilcoxon, p<0.05). For composite resin, neither group showed a statistical difference compared to control (Mann-Whitney, p>0.05). Conclusion: It was concluded that the increase in the roughness of enamel occurred only after bleaching therapy using a gel with 10% of CP. The bleaching procedures evaluated in this investigation did not increase the roughness or cause changes in the superficial morphology of the composite resin.

Clareamento para dentes despolpados: revisão de literatura e considerações

The esthetics of the teeth is not a privilege of our days, because concerns in that effect have been reported since 1860. Faced with an endodontically treated tooth that presents any type of color change, professionals can use intracoronary bleaching, which is more conservative attempt to restore the normal color of teeth. Bleaching aims to remove pigments by oxidizing agents and for that, various techniques were developed. Among the risks of tooth whitening the external resorption is the most severe, which occurs when the whitening penetrates through the dentin tubules to the periodontal ligament and initiates an inflammatory response. To prevent external resorption is required to place an intracoronal bleaching barrier. It is important to know the time between the bleaching treatment for restoring procedure for getting a good sealing to prevent microleakage. This study aims to review the literature about the different types of bleaching agents and their risks.

Clareamento interno em dentes despolpados como alternativa a procedimentos invasivos: relato de caso

The increasing interest of patients for a better aesthetic appearance of their smile, associated with the development of new materials and techniques, encouraged by media couverage of this concept of beauty, provided an important evolution of cosmetic dentistry. As the darkness of a single anterior tooth or a group of teeth, in most cases, impairs the appearance of the smile and there is growing appreciation of the less invasive procedures, the technique of tooth bleaching is an important option for aesthetic treatment. To have success in the bleaching treatment, it is important to have knowledge of the origin, nature and composition of the stain. Among the causes of color changes acquired post-eruptive, dental trauma, with or without pulp necrosis, is one of the most commonly encountered etiologies, characterized by a reddish-brown color. Current techniques of bleaching for teeth treated endodontically employ oxidative agent hydrogen peroxide. The objective of this paper is to describe the immediate technique of bleaching non-vital tooth by presenting a clinical case.

Observação clínica da aplicação de um produto a base de peróxido de hidrogênio a 35% não fotoativado: efeitos na sensibilidade e na alteração de cor

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Análise do efeito clareador e da sensibilidade pós operatória utilizando diferentes materiais clareadores e fontes de luz

Pós-graduação em Odontologia - FOA

Efeito citotóxico de agentes clareadores a base de peróxido de hidrogênio a 20% e 38% sobre células odontoblastóides

The aim of this in vitro study was to evaluate the trans-enamel and transdentinal cytotoxic effects of two in-office tooth bleaching techniques that employ bleaching gels containing 20% and 38% of H2 O2 on cultured odontoblast-like cell line (MDPC-23). Sixty enamel/dentin discs were obtained from bovine central incisors and placed individually in artificial pulp chambers. Six groups were formed according to the following enamel treatments: G1- 20% H2 O2 (1 application); G2- 20% H2 O2 (2 applications); G3- 38% H2 O2 (1 application); G4- 38% H2 O2 (2 applications); G5- 38% H2 O2 (3 applications); and G6- control (no treatment). In G1 and G2, the bleaching gel was left in contact with the enamel surface for 45 min in each application. However, in G3, G4, and G5 the bleaching gel was applied for only 10 min per application. After the last application, the extracts were collected and applied on previously cultured cells (30.000 cells/cm2 ) for 24 h. Cell metabolism was evaluated by the MTT assay and cell morphology was analysed by scanning electron microscopy. Cell metabolism decreased by 96.29%; 96.11%; 96.42%; 95.62%; and 97.18% in G1, G2, G3, G4, and G5, respectively. All treated groups differed significantly from non-treated control group (G6) (p < 0.05). However, the difference in cell metabolism among treated groups was not significant statistically. In addition, significant morphological cell alterations were observed in all treated groups. Under the tested experimental conditions, the extracts collected after both tooth bleaching techniques evaluated in this study caused severe toxic effects on cultured odontoblast-like cell MDPC-23.

Efeito de um gel de peróxido de carbamida a 10% sobre a resistência de união de restaurações adesivas à dentina

The present study aimed to analyze the effects of tooth bleaching with 10% carbamide peroxide (CP) gel on the bond strength of resin composite restorations to dentin. Material and Methods: Twenty cavities were prepared on the buccal surface of bovine teeth. After acid etching and application of bonding agent on dentin and enamel, the cavities were restored with composite resin. The specimens were divided into groups according to treatment on the surface of enamel / restoration: G1 - control (no treatment) and G2 (10% PC gel application for 8h/day during 14 days). After this period, the teeth were cut to produce beams with 0.81 mm2 cross-sectional area, which were subjected to microtensile test. The fractures were examined with a stereomicroscope and classified as cohesive in resin or dentin, adhesive, or mixed. Results: The statistical analysis (ANOVA / χ2) revealed that the factor treatment interfered with the bond strength, which was significantly higher for specimens of G2 (p <0.05). Adhesive fractures occurred in most of specimens of both groups with values ranging from 48.3% to 75%. Mixed fractures were the second more frequent in G1 and cohesive resin failure in G2. Conclusion: It was concluded that tooth bleaching with 10% of PC increased the bond strength of adhesive restorations to dentin.

Evaluation of the bleached human enamel by scanning electron microscopy

Since bleaching has become a popular procedure, the effect of peroxides on dental hard tissues is of great interest in research. Purpose: The aim of this in vitro study was to perform a qualitative analysis of the human enamel after the application of in-office bleaching agents, using Scanning Electron Microscopy (SEM). Materials and Methods: Twenty intact human third molars extracted for orthodontic reasons were randomly divided into four groups (n=5) treated as follows: G1- storage in artificial saliva (control group); G2- four 30-minute applications of 35% carbamide peroxide (total exposure: 2h); G3- four 2-hour exposures to 35% carbamide peroxide (total exposure: 8h); G4- two applications of 35% hydrogen peroxide, which was light-activated with halogen lamp at 700mW/cm2 during 7min and remained in contact with enamel for 20min (total exposure: 40min). All bleaching treatments adopted in this study followed the application protocols advised by manufacturers. Evaluation of groups submitted to 35% carbamide peroxide was carried out after two time intervals (30 minutes and 2 hours per session), following the extreme situations recommended by the manufacturer. Specimens were prepared for SEM analysis performing gold sputter coating under vacuum and were examined using 15kV at 500x and 2000x magnification. Results: Morphological alterations on the enamel surface were similarly detected after bleaching with either 35% carbamide peroxide or 35% hydrogen peroxide. Surface porosities were characteristic of an erosive process that took place on human enamel. Depression areas, including the formation of craters, and exposure of enamel rods could also be detected. Conclusion: Bleaching effects on enamel morphology were randomly distributed throughout enamel surface and various degrees of enamel damage could be noticed. Clinical significance: In-office bleaching materials may adversely affect enamel morphology and therefore should be used with caution.

Laminados cerâmicos em dentes tratados endodonticamente: considerações restauradoras e endodônticas com finalidade protética

A harmonia e beleza de um sorriso podem ser comprometidos pela presença de apenas um dente da região anterior que se apresente escurecido, mesmo que os demais elementos estejam alinhados e com forma adequada. A alteração de coloração, mesmo que mínima, sendo na região frontal é capaz de gerar um ponto de tensão e de desequilíbrio no sorriso, concentrando o olhar do observador no local1,2,3. Logo, a demanda dos pacientes por um sorriso estético, belo e harmonioso aumenta o desafio do profissional que visa integrar as características ópticas de um dente anterior despolpado e escurecido com os demais dentes polpados e sem manchamentos significativos. O clareamento é a alternativa mais conservadora para resolver o escurecimento em dentes despolpados. Apesar de resultados satisfatórios, alguns clínicos e autores relutam em assumir, como rotina, os procedimentos de clareamento para dentes despolpados, pelo alto índice de recidiva de escurecimento4,5. Mas, é importante lembrar que as recidivas descritas, normalmente, não contemplam um retorno aos valores inicias de manchamento. Deve ser feito um bom planejamento, levando em considerações fatores como a idade do paciente, o grau de escurecimento, o tempo em que o dente se encontra escurecido e a dificuldade em se alcançar o clareamento do dente, que são determinantes para o sucesso do tratamento clareador e para estabelecer a longevidade do clareamento obtido. Por isso, não são todos os dentes despolpados que apresentam alteração de cor que podem ser clareados, devendo ser avaliados com precisão os critérios estabelecidos3. Os dentes tratados endodonticamente e escurecidos, muitas vezes, necessitam da reintegração estética, associando as técnicas de clareamento com procedimentos restauradores ou, dependendo da condição do dente, a escolha imediata por procedimentos restauradores diretos ou indiretos.

Efeito da ativação química do gel de peróxido de carbamida a 10% no clareamento dental

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Clareamento com peróxido de hidrogênio a 35% ativado por diversas fontes de energia: análise térmica e microdureza do esmalte

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Clareamento dental com perôxido de hidrogênio contendo nano partículas de óxido de titânio como semicondutor: efeito de concentrações, tempos e formas de ativação

Pós-graduação em Ciências Odontológicas - FOAR

Clareamento dentário x autoestima x autoimagem

Dental changes that compromise facial harmony can have serious consequences on the social image of the patient. Depending on the emotional significance for the individual it can change interpersonal relationships, causing profound changes in their patterns of self-acceptance and self-image, with profound effects on their self-esteem of the patient. The search for tooth whitening as cosmetic factor for a harmonic smile grew sharply in the last decade. Although the color of the tooth represents only one aspect in the set of determinants of facial harmony, it is a strong factor because it is quickly perceived. This study aims to report the clinical case of a patient with spots on their upper central incisors. For the patient these spots have compromised her smile, causing harm and discomfort in their everyday social and professional relationships.

Avaliação clínica do clareamento no consultório: técnica de aplicação única do agente clareador

This study aimed to evaluate the clinical effectiveness of two bleaching agents without changing the whitening gel during the clinic session 1X45minutos. 10 patients were selected according to the criteria of inclusion and exclusion and upper arch of the patients were divided into two quadrants (n: 10), G1: gel clareador Clàriant Office (hidrogênio35 Angellus) peroxide% (PH) in superior right side (LD) and the gel WhitenessHp Blue (FGM) PH 35% on the superior left side (LE. 2 clinical sessions were accomplished, 45 minutes each, with an interval of one week between sessions. At first the bleaching treatment patients received prophylaxis, molding to guide measurement of color with condensation silicon and the color evaluation through the apparel spectrophotometer VITA Easyshade (Vita Zhanfabrik, Alemanhã). 14 days after the end of the bleaching treatment was performed the measurement final color of the teeth. The patients reported sensitivity in scale 0-4. The result showed that through T Test comparing quadrants presented no statistical differences (p>0,05) in relation to coloration and dental sensibility. It can be concluded that the materials evaluated are effective for bleaching vital teeth with low tooth sensibility.