12-Month color stability of enamel, dentine, and enamel-dentine samples after bleaching

The study aimed to quantify the color regression of enamel (E), dentine (D), and combined enamel-dentine (ED) of differently bleached ED specimens over a period of 12 months in vitro. Two ED samples were obtained from the labial surfaces of bovine teeth and prepared to a standardized thickness with the enamel and dentine layer each 1 mm. The ED samples were distributed on four groups (each n=80), in which the different bleaching products were applied on enamel (1, Whitestrips; 2, Illumine 15%; 3, Opalescence Xtra Boost) or dentine surfaces (4, mixture of sodium perborate/distilled water). Eighty ED samples were not bleached (control). Color (L*a*b*) of ED was assessed at baseline, subsequently after bleaching and at 3, 6, and 12 months of storage after bleaching (each 20 samples/group). E and D samples were prepared by removing the dentine or enamel layer of ED samples to allow for separate color analysis. Bleaching resulted in a significant color change (Delta E) of ED specimens. Within the observation period, Delta L but not Delta b declined to baseline. L* values of E and D samples also declined and were not significantly different from control samples after 12 months, while b* values did not decrease to baseline. Generally, no differences between the bleaching agents could be observed. Color change of enamel, dentine, and combined ED of in vitro bleached tooth samples is not stable over time with regard to lightness. However, yellowness did not return to baseline within 1 year.

Enamel microabrasion followed by dental bleaching for patients after orthodontic treatment - Case reports

This article reports clinical procedures used to remove residual bonded resin and enamel stains following bracket debonding at the conclusion of orthodontic treatment. A water-cooled fine-tapered diamond bur was used for resin removal, followed by enamel surface finishing using a commercially available microabrasion paste. It was noted that residual tooth coloration remained yellowish because of enamel translucency; the yellow dentin shade showed through. Additional tooth shade lightening was achieved using carbamide peroxide dental bleaching solution in custom-formed trays. This report describes a safe and effective technique that optimizes tooth appearance at the conclusion of orthodontic therapy. Mechanical resin removal, enamel microabrasion, and tooth bleaching are employed.

The influence of time interval between bleaching and enamel bonding

Objectives: the purpose of this study was to investigate the penetration of a conventional adhesive material into enamel bleached with 16% carbamide peroxide and 38% hydrogen peroxide using optical light microscopy.Methods: Extracted human teeth were randomly divided into eight experimental groups with six specimens each, according to the bleaching material and time interval after bleaching and before the bonding procedure. Groups were designated as follows: control group, restorations in unbleached teeth; restorations performed immediately after bleaching; restorations performed 7 days after bleaching; restorations performed 14 days after bleaching; and restorations performed 30 days after bleaching. The length of resin tags was measured with an Axiophot photomicroscope at 400x magnification for the calculation of the proportion of tags of study groups compared to the respective control groups. Analysis of variance was applied for comparison between groups; data were transformed into arcsine (p < 0.05).Results: the specimens of experimental groups, in which restorations were performed 7, 14, and 30 days after bleaching, showed better penetration of adhesive material into enamel than specimens restored immediately after bleaching. There was no statistically significant difference between the bleaching materials employed or in the interaction between bleaching agent and time interval.Conclusions: This suggests that a time interval of at least 7 days should be allowed between enamel bleaching and placement of adhesive bonding agents for accomplishment of composite resin restorations.

Color alteration in teeth subjected to different bleaching techniques

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

Transenamel and transdentinal cytotoxicity of carbamide peroxide bleaching gels on odontoblast-like MDPC-23 cells

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

Transdentinal protective role of sodium ascorbate against the cytopathic effects of H2O2 released from bleaching agents

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

Cytotoxic Effects of Different Concentrations of a Carbamide Peroxide Bleaching Gel on Odontoblast-Like Cells MDPC-23

This study evaluated the cytotoxic effects of a carbamide peroxide (CP) bleaching gel at different concentrations on odontoblast-like cells. Immortalized cells of the MDPC-23 cell line (30,000 cells/cm(2)) were incubated for 48 h. The bleaching gel was diluted in DMEM culture medium originating extracts with different CP concentrations. The amount (mu g/mL) of hydrogen peroxide (H(2)O(2)) released from each extract was measured by the leukocrystal violet/horseradish peroxidase enzyme assay. Five groups (n = 10) were formed according to the CP concentration in the extracts: G1-DMEM (control); G2-0.0001 % CP (0.025 mu g/mL H(2)O(2)); G3-0.001% CP (0.43 mu g/mL H(2)O(2)); G4-0.01% CP (2.21 mu g/mL H(2)O(2)); and G5-0.1 % CP (29.74 mu g/mL H(2)O(2)). MDPC-23 cells were exposed to the bleaching gel extracts for 60 min and cell metabolism was evaluated by the NITT assay. Data were analyzed statistically by one-way ANOVA and Tukey's test (alpha = 0.05). Cell morphology was examined by scanning electron microscopy. The percentages of viable cells were as follows: G1, 100%; G2, 89.41%; G3, 82.4%; G4, 61.5%; and G5, 23.0%. G2 and G3 did not differ significantly (p > 0.05) from G1. The most severe cytotoxic effects were observed in G3 and G4. In conclusion, even at low concentrations, the CP gel extracts presented cytotoxic effects. This cytotoxicity was dose-dependent, and the 0.1% CP concentration caused the most intense cytopathic effects to the MDPC-23 cells. (C) 2009 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 9013: 907-912, 2009

Human pulp responses to in-office tooth bleaching

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

Cytotoxic effect of a 35% hydrogen peroxide bleaching gel on odontoblast-like MDPC-23 cells

Objective. This study evaluated transenamel and transdentinal cytotoxic effects of a bleaching gel on the MDPC-23 cell line.Study design. Discs obtained from bovine incisors were placed in a metallic device to simulate an in vivo pulp chamber. Groups were formed according to the enamel surface treatment: G1: 35% H(2)O(2) bleaching gel; G2: 35% H2O2 bleaching gel + halogen light; G3: halogen light; and G4: control. Cell metabolism was evaluated by the methyltetrazolium assay and cell morphology by scanning electron microscopy.Results. Cell metabolism decreased by 31.7%, 41.6%, and 11.5% in G1, G2, and G3, respectively. Cytotoxic effects observed in G2 were significantly more severe compared with G3 and G4. In G1 and G2, a smaller number of viable cells with major morphologic alterations remained adhered to dentin.Conclusion. The bleaching gel associated with light presented transenamel and transdentinal cytotoxic effects characterised by direct damage to odontoblasts and decrease of their metabolic activity. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 458-464)

Response of human pulps after professionally applied vital tooth bleaching

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Trans-enamel and trans-dentinal cytotoxic effects of a 35% H2O2 bleaching gel on cultured odontoblast cell lines after consecutive applications

To evaluate the trans-enamel and trans-dentinal cytotoxic effects of a 35% H2O2 bleaching gel on an odontoblast-like cell lines (MDPC-23) after consecutive applications.Fifteen enamel/dentine discs were obtained from bovine central incisor teeth and placed individually in artificial pulp chambers. Three groups (n = 5 discs) were formed according to the following enamel treatments: G1: 35% H2O2 bleaching gel (15 min); G2: 35% H2O2 bleaching gel (15 min) + halogen light (20 s); G3: control (no treatment). After repeating the treatments three consecutive times, the extracts (culture medium + gel components that had diffused through enamel/dentine discs) in contact with the dentine were collected and applied to previously cultured MDPC-23 cells (50 000 cells cm(-2)) for 24 h. Cell metabolism was evaluated by the MTT assay and data were analysed statistically (alpha = 5%; Kruskal-Wallis and Mann-Whitney U-test). Cell morphology was analysed by scanning electron microscopy.Cell metabolism decreased by 92.03% and 82.47% in G1 and G2 respectively. G1 and G2 differed significantly (P < 0.05) from G3. Regardless of halogen light activation, the application of the bleaching gel on the cultured odontoblast-like cells caused significantly more severe cytotoxic effects than those observed in the nontreated control group. In addition, significant morphological cell alterations were observed in G1 and G2.After three consecutive applications of a 35% H2O2 bleaching agent, the diffusion of the gel components through enamel and dentine caused severe toxic effects to cultured pulp cells.

Fracture strength of incisor crowns after intracoronal bleaching with sodium percarbonate

Objectives: To compare the fracture resistance of bovine teeth after intracoronal bleaching with sodium percarbonate (SPC) or sodium perborate (SP) mixed with water or 20% hydrogen peroxide (HP). Materials and methods: Fifty extracted bovine teeth were divided into four experimental groups (G1G4) and one control (n = 10) after endodontic treatment. Following root canal obturation, a glass ionomer barrier was placed at the cementoenamel junction. After that, the pulp chambers were filled with: G1 SP with water; G2 SP with 20% HP; G3 SPC with water; and G4 SPC with 20% HP. No bleaching agent was used in the control group. Coronal access cavities were sealed with glass ionomer and specimens were immersed in artificial saliva. The bleaching agents were replaced after 7 days, and teeth were kept in artificial saliva for an additional 7 days, after which the pastes were removed and the coronal access cavities were restored with glass ionomer. Crowns were subjected to compressive load at a cross head speed of 0.5 mm min-1 applied at 135 degrees to the long axis of the root by an EMIC DL2000 testing machine, until coronal fracture. Data were statistically analysed by anova and Tukey test. Results: No differences in fracture resistance were observed between the experimental groups (P > 0.05). However, all experimental groups presented lower fracture resistance than the control group (P < 0.05). Conclusion: SPC and SP led to equal reduction on fracture resistance of dental crowns, regardless of being mixed with water or 20% HP.

The Effect of Power Bleaching Actived by Several Light Sources on Enamel Microhardness

The purpose of this study was to evaluate the influence of different light sources for in-office bleaching on surface microhardness of human enamel. One hundred and five blocks of third molars were distributed among seven groups. The facial enamel surface of each block was polished and baseline Knoop microhardness of enamel was assessed with a load of 25 g for 5 s. Subsequently, the enamel was treated with 35% hydrogen peroxide bleaching agent and photo-activated with halogen light (group A) during 38 s, LED (group B) during 360 s, and high intensity diode laser (group C) during 4 s. The groups D (38 s), E (360 s), and F (4 s) were treated with the bleaching agent without photo-activated. The control (group G) was only kept in saliva without any treatment. Microhardness was reassessed after 1 day of the bleaching treatment, and after 7 and 21 days storage in artificial saliva. The mean percentage and standard deviation of microhardness in Knoop Hardness Number were: A 97.8 +/- 13.1 KHN; B 95.5 +/- 12.7 KHN; C 84.2 +/- 13.6 KHN; D 128.6 +/- 20.5 KHN; E 133.9 +/- 14.2 KHN; F 123.9 +/- 14.2 KHN; G 129.8 +/- 18.8 KHN. Statistical analysis (p < 0.05; Tukey test) showed that microhardness percentage values were significantly lower in the groups irradiated with light when compared with the non-irradiated groups. Furthermore, the non-irradiated groups showed that saliva was able to enhance the microhardness during the measurement times. The enamel microhardness was decreased when light sources were used during the bleaching process and the artificial saliva was able to increase microhardness when no light was used.

Comparative assessment of the organization of the colors of the Vita Classical color pallet by digital images and visual analysis for dental bleaching

New formularizations, techniques and devices have become the dental whitening most safe and with better results. Although this, the verification of the levels whitening is being continued for visual comparison, that is an empirical, subjective method, subject to errors and dependent of the individual interpretation. Normally the result of the whitening is express for the amplitude of displacement between the initial and the final color, being take like reference the tonalities of a scale of color commanded of darkest for more clearly. Although to be the most used scale, the ordinance of the Vita Classical (R) - Vita, according to recommendations of the manufacturer, reveals inadequate for the evaluation of the whitening. From digital images and of algorithm OER (ordinance of the reference scale), especially developed for the ScanWhite (C), the ordinance of the tonalities of the scale Vita Classical (R) was made. For such, the values of the canals of color R, G, and B of medium part average of the crowns was adopted as reference for evaluation. The images had been taken with the camera Sony Cybershoot DSC F828. The results of the computational ordinance had been compared with the sequence proposal for the manufacturer and with the earned one for the visual evaluation, carried through by 10 volunteers, under standardized conditions of illumination. It statistics analyzes demonstrated significant differences between the ordinances.