Correlation between pH and surface structural changes on human enamel submitted to different tooth whitening agents

The intense valuation of an esthetic pleasant smile guided the dentistry to bleached tooth due the popularity of whitening treatments. The consequence of it is an increasing interest in searching the effect of peroxides in hard dental tissues. The aim of this work was to analyze qualitatively in vitro the human enamel after three different bleaching treatments: Opalescence PF 10%, White Class 7.5% and Opalescence Xtra Boost 38%, correlating the structural changes in the surface of the enamel with its respective pH. A total of 40 sound human pre-molars were randomly divided into four groups of 10 elements, which had been immersed in artificial saliva during all the experiment. Bleaching protocols followed the recommendations of the respective manufacturers. Each bleached sample and control group were submitted to a scanning electronic microscopy analysis and compared with one another. Bleaching agents used in this experiment had modified the morphologic aspect of the surface of the dental enamel; however, it did not have correlation between the degrees of severity of the alterations and pH. There is a correlation between hydrogen peroxide concentration and changes in the enamel, where G4 showed more severe alterations, followed for G3 and G2.

Sistemas cerámicos puros parte 2: materiales, propiedades ópticas y consideraciones clínicas

While dentistry continues to advance, the aesthetic techniques have evolved in proceedings more effective, functional and biocompatible. Meanwhile, cosmetic dentistry has become a bit more complex and technically difficult. With improvement of the properties (physical and optical) of the ceramics and the establishment of a working protocol, ceramic restorations have become increasingly popular. Currently there are several ceramic systems have excellent optical properties such as opalescence, fluorescence, translucency, chromaticity, which allow the restoration to mimic the tooth structure. From the physical point of view has restored biomechanical integrity and strengthening the remaining tooth structure. All this has led the profession to experience the use of new ceramic systems ranging from conventional feldspathic ceramics to modem ceramic reinforced, injected or computer-aid made. The material selection should be based on clinical need, aesthetic and functional requirements, restoration site, prosthetic design and laboratory techniques. In this article we will deal with the characteristics of the materials, their optical properties and clinical considerations for proper selection.

Influence of standard load micro and nanopatterned in surface roughness of bleached teeth and submitted to different surface treatments?

The aim of this study was evaluate the dental enamel after whitening treatment with Opalescence Boost PF® 38%, correlating the structural alterations in the surface of the enamel with its respective pH and verify if whitened teeth submitted to different finishing and polishing techniques show similar surface texture to healthy teeth (control group). Sixty premolars were divided in 6 groups (n = 10), which had been immersed in artificial saliva during all the experiment. Protocol whitening was performed according to the manufacturer recommendations, and then the specimens were submitted to different polishing technique with Sof-Lex Pop On® disks, Flex Diamond® felt disks using two different micrometric polishing pastes (Enamelize® and Diamond Polish®) and two nanometric polishing pastes (Lummina-E Diamond and Lummina-E Alumina), according to the groups. Representative specimens were analyzed in scanning electronic microscopy (SEM). Whitening gel used in this experiment had modified the morphologic aspect of the enamel surface. It was found that two nanometric polishing pastes (G5 and G6) promoted a less rough surface compared to control group even after the whitening process.

Efetividade e sensibilidade com uso de géis clareadores experimental e comercial à base de peróxido de carbamida

Pós-graduação em Odontologia Restauradora - ICT

Penetration of hydrogen peroxide and degradation rate of different bleaching products

This study's aim was to evaluate the degradation rate of hydrogen peroxide (H2O2) and to quantify its penetration in tooth structure, considering the residence time of bleaching products on the dental enamel. For this study, bovine teeth were randomly divided according to the bleaching product received: Opalescence Xtra Boost 38%, White Gold Office 35%, Whiteness HP Blue 35%, Whiteness HP Maxx 35%, and Lase Peroxide Sensy 35%. To analyze the degradation of H2O2, the titration of bleaching agents with potassium permanganate was used, while the penetration of H2O2 was measured via spectrophotometric analysis of the acetate buffer solution, collected from the artificial pulp chamber. The analyses were performed immediately as well as 15 minutes, 30 minutes, and 45 minutes after product application. The data of degradation rate of H2O2 were submitted to analysis of variance (ANOVA) and Tukey tests, while ANOVA and Fisher tests were used for the quantification of H2O2, at the 5% level. The results showed that all products significantly reduced the concentration of H2O2 activates at the end of 45 minutes. It was also verified that the penetration of H2O2 was enhanced by increasing the residence time of the product on the tooth surface. It was concluded that the bleaching gels retained substantial concentrations of H2O2 after 45 minutes of application, and penetration of H2O2 in the dental structure is time-dependent.

Influência de agentes clareadores na resistência de união de um sistema restaurador ao esmalte em função do tempo de armazenamento em saliva artificial

Pós-graduação em Odontologia Restauradora - ICT

Influência do tratamento clareador e envelhecimento induzido sobre o brilho, cor, dureza e rugosidade superficial de resinas compostas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação clínica da efetividade do clareamento de consultório sem troca do gel clareador

Esse trabalho teve como objetivo avaliar, clinicamente, a efetividade de dois agentes clareadores aplicados sobre a superfície dentária durante 45 minutos, sem troca do gel. Foram selecionados 10 pacientes de acordo com os critérios de inclusão e exclusão, e a arcada superior dos pacientes foi dividida em duas hemiarcadas (n = 10): na hemiarcada direita (HD), foi aplicado o peróxido de hidrogênio a 35% (PH) Clàriant Office (Angelus); e, na hemiarcada esquerda (HE), o PH 38% Opalescence Boost (Ultradent). Foram realizadas duas sessões clínicas, de 45 minutos cada, com intervalo de uma semana entre as sessões. Inicialmente, ao tratamento clareador, os pacientes receberam profilaxia, moldagem para guia de mensuração de cor com silicone de condensação e avaliação de cor por meio de um aparelho espectrofotômetro Vita Easyshade (Vita Zhanfabrik, Alemanha). Após 14 dias do término do tratamento clareador, foi realizada a mensuração final da cor dos dentes. Os dados foram submetidos ao teste t e de Tukey (p < 0,05). Os resultados demonstraram não haver diferença estatisticamente significativa entre as hemiarcadas quanto à efetividade do clareamento (p = 0,146) e nem quanto à sensibilidade. Pode-se concluir que a aplicação dos materiais avaliados sem troca do gel, por 45 minutos, foi eficaz em promover o clareamento de dentes vitais e com baixa sensibilidade dentária.

Avaliação clínica da nova técnica de clareamento no consultório sem a remoção do gel clareador

Este trabalho teve como objetivo avaliar longitudinalmente um novo protocolo para técnica de clareamento de dentes vitais em consultório. Foram selecionados 20 pacientes, com critérios preestabelecidos, e divididos aleatoriamente, de acordo com o produto utilizado, em 2 grupos (n=10): Grupo 1 — Opalescence Xtra Boost (Ultradent); e Grupo 2 — White Gold Office (Dentsply). Os agentes clareadores foram aplicados apenas uma vez, durante 45min, e cada paciente submetido a duas sessões clareadoras. Para avaliação da cor inicial dos dentes, após 1 mês e após 3 meses do tratamento clareador, foi utilizada a escala de cor Vita Clássica, ordenada pela luminosidade. Concluiu-se que não há diferença no clareamento ou sensibilidade dentária entre os grupos, sendo desnecessária a troca do gel clareador e/ou a utilização de fonte de luz para os agentes clareadores avaliados.

Dental bleaching with a 10% hydrogen peroxide product: a six-month clinical observation

Context: The possibility of bleaching vital teeth with peroxide-based products considerably revolutionized esthetic dentistry. Aim: The aim of this clinical study was to evaluate tooth color change and dental sensitivity after exposure to preloaded film containing a 10% hydrogen peroxide whitening system (Opalescence Trθswhite Supreme). Materials and Methods: A total of 13 volunteers, aged 18 to 25 years, participated in this study. The patients used the whitening system once a day for 60 minutes during the 8-day study. For maxillary incisors and canines, the color change was visually evaluated with the Vita color scale before, immediately, and six months after the treatment. Tooth sensitivity was evaluated during the daily gel applications. All whitening applications were done in office and under the supervision of a dental professional. Statistical Analysis Used: The results were analyzed using the Friedman Test (nonparametric repeated measures ANOVA) at a level of 5%, and Dunn's Multiple Comparison Test at the level of 5%. Results: It was verified that the original mean color values observed at the baseline analysis differed significantly from those observed immediately after bleaching, as well as from those seen in the analysis at six months ( P = 0.001). There was no significant difference between the mean color values observed in the immediate time and in the analysis at six months ( P = 0.474). No tooth sensitivity was observed in any patients. Conclusion: It was concluded that the bleaching technique using the 10% hydrogen peroxide system was effective in a short period of time without tooth sensitivity during applications.

Different esthetic techniques used in combination to improve the smile

This is a clinical case report of a patient who presented with dental stains in the buccal and proximal aspects of the anterior teeth. Buccal stains were removed using the enamel microabrasion technique, and vital tooth bleaching with carbamide peroxide was also performed. Restorative procedures employing composite resin were done for a better result in the proximal aspect of teeth. Clinical significance: The authors observed the combination of these esthetic techniques improved the patient's smile. Today, dental esthetics attempts to imitate natural teeth by making them white, well-shaped, and aligned with no spots. This has enabled the development of several esthetic techniques, such as microabrasion to remove dental enamel surface stains and surface irregularities,1-6 and vital tooth bleaching to treat yellowish teeth.7 The enamel microabrasion technique uses different abrasive agents associated with chemical solutions,1,2,4,6 allowing the removal of intrinsic, hard-texture stains, and different coloring spots on the enamel surface, as well as correction of irregularities on the dental buccal surface.1,8 The various microabrasive products include the Opalustre® (Ultradent Products, http://www.ultradent.com)or Prema® Compound (Premier Dental Products, http://www.premusa.com), a low-concentration hydrochloric acid product associated with silica microparticles that is certainly effective for microabrasion technique,4,6,9,10 providing a good safety profile for the patient and professional. The microabrasion technique also promotes micro-reduction on the adamantine surface.4,5,10 In some cases, after its completion, microabrasion may cause teeth to become darker or yellowish because of the thinner remaining enamel surface, leading to more evident observation of the dentinal tissue, which in general determines tooth color. In these clinical conditions, correction of the color pattern of dental elements can be obtained with carbamide peroxide products applied in custom trays, such as the bleaching products Whiteness Perfect at 10% or 16% (FGM Productos Odontologicos, http://www.fgm.ind.br) or Opalescence® at 10% or 15% (Ultradent Products), with a considerable margin of clinical success, provided it is well indicated, well performed, and supervised by the professional.4,6,9,10 Considering all the aforementioned aspects, the authors present a clinical case about a dental-enamel microabrasion technique used to remove buccal enamel surface stains associated with dental vital bleaching and restorative procedures in the proximal aspect of anterior teeth. - See more at: https://www.dentalaegis.com/cced/2010/08/different-esthetic-techniques-used-in-combination-to-recover-the-smile#sthash.McFoH7El.dpuf

Comparative clinical study of the effectiveness of different dental bleaching methods - two year follow-up

This study evaluated color change, stability, and tooth sensitivity in patients submitted to different bleaching techniques. Material and methods: In this study, 48 patients were divided into five groups. A half-mouth design was conducted to compare two in-office bleaching bleaching techniques (with and without light activation): G1: 35% hydrogen peroxide (HP) (Lase Peroxide - DMC Equipments, Sao Carlos, SP, Brazil) + hybrid light (HL) (LED/Diode Laser, Whitening Lase II DMC Equipments, Sao Carlos, SP, Brazil); G2: 35% HP; G3: 38% HP (X-traBoost - Ultradent, South Jordan UT, USA) + HL; G4: 38% HP; and G5: 15% carbamide peroxide (CP) (Opalescence PF - Ultradent, South Jordan UT, USA). For G1 and G3, HP was applied on the enamel surface for 3 consecutive applications activated by HL. Each application included 3x3' HL activations with 1' between each interval; for G2 and G4, HP was applied 3x15' with 15' between intervals; and for G5, 15% CP was applied for 120'/10 days at home. A spectrophotometer was used to measure color change before the treatment and after 24 h, 1 week, 1, 6, 12, 18 and 24 months. A VAS questionnaire was used to evaluate tooth sensitivity before the treatment, immediately following treatment, 24 h after and finally 1 week after. Results: Statistical analysis did not reveal any significant differences between in-office bleaching with or without HL activation related to effectiveness; nevertheless the time required was less with HL. Statistical differences were observed between the result after 24 h, 1 week and 1, 6, 12, 18 and 24 months (integroup). Immediately, in-office bleaching increased tooth sensitivity. The groups activated with HL required less application time with gel. Conclusion: All techniques and bleaching agents used were effective and demonstrated similar behaviors.

Propriedades óticas dos sistemas cerâmicos atuais e suas aplicações em dentes naturais

A estética representa uma qualidade cada vez mais requisitada pela sociedade na atualidade. A busca pela aparência ideal expandiu-se também na medicina dentária, aumentando as exigências por resultados perfeitos. A medicina dentária tem desenvolvido novas técnicas e novos materiais com a ambição de reproduzir as propriedades estéticas e funcionais dos dentes naturais. Os sistemas totalmente cerâmicos têm sido alvo de grande entusiasmo dado as suas características inerentes. O seu potencial na reabilitação oral estética tem derrotado as suas antecessoras metalocerâmicas. À semelhança do esmalte e da dentina, os sistemas totalmente cerâmicos exibem boas propriedades óticas de translucidez, opacidade, fluorescência e opalescência, resultado da interação com a luz. Ainda que não seja possível dissociar as propriedades óticas das propriedades mecânicas de um dente natural para o sucesso de uma restauração, a heterogeneidade das cerâmicas têm sido exitosas enquanto sistema que combina diferentes propriedades para diferentes indicações clínicas. Esta variabilidade deve-se a diferentes composições químicas e a diferentes processos de fabricação, entre outros, que acentuam ou atenuam qualidades em cada sistema totalmente cerâmico. Este trabalho pretende abordar e comparar os sistemas cerâmicos atuais (cerâmicas com base em sílica, cerâmicas com base de alumina, cerâmicas com base em zircónia) de acordo com as suas propriedades óticas e a consequente aplicação clínica tendo em conta as características dos dentes naturais.