Dentin hypersensitivity after teeth bleaching with in-office systems. randomized clinical trial

Purpose: To comparatively and prospectively compare in a randomized clinical trial, dentin hypersensitivity after treatment with three in-office bleaching systems, based on hydrogen peroxide at different concentrations, with and without light source activation. Methods: 88 individuals were included according to inclusion and exclusion criteria. Subjects were randomly divided into the following three treatment groups: Group 1 was treated with three 15-minute applications of hydrogen peroxide at 15% with titanium dioxide (Lase Peroxide Lite) that was light-activated (Light Plus Whitening Lase) with five cycles of 1 minute and 30 seconds each cycle, giving a total treatment time of 45 minutes; Group 2 was treated with three 10-minute applications of hydrogen peroxide at 35% (Lase Peroxide Sensy), activated by light (LPWL) same activation cycles than Group 1, with a total treatment time of 30 minutes; Group 3 was treated with only one application for 45 minutes of hydrogen peroxide at 35% (Whitegold Office) without light activation. Each subject underwent one session of bleaching on the anterior teeth according to the manufacturers' instructions. Dentin sensitivity was recorded with a visual analogue scale (VAS) at baseline, immediately after, and at 7 and 30 days after treatment using a stimulus of an evaporative blowing triple syringe for 3 seconds on the upper central incisors from a distance of 1 cm. A Kruskal-Wallis test followed by Mann-Whitney test was performed for statistical analysis. Results: All groups showed increased sensitivity immediately after treatment. Group 1 displayed less changes relative to baseline with no significant differences (P= 0.104). At 7 and 30 days after treatment, a comparison of VAS values indicated no significant differences between all groups (P= 0.598 and 0.489, respectively).

Effect of bleaching agents and soft drink on titanium surface topography

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

Effects of Laser Irradiation on Pulp Cells Exposed to Bleaching Agents

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

Effective tooth-bleaching protocols capable of reducing H2O2 diffusion through enamel and dentine

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

Evaluating the bonding of two adhesive systems to enamel submitted to whitening dentifrices.

The aim of this study was to evaluate by micro-shear bond strength test, the bond strength of composite resin restoration to enamel submitted to whitening dentifrices. Forty bovine teeth were embedded in polystyrene resin and polished. The specimens were randomly divided into eight groups (n=5), according to the dentifrice (carbamide peroxide, hydrogen peroxide and conventional dentifrice) and the adhesive system (Prime & Bond 2.1 and Adper Single Bond 2). Dentifrice was applied for 15 minutes a day, for 21 days. Thirty minutes after the last exposure to dentifrice, the samples were submitted to a bonding procedure with the respective adhesive system. After that, four buttons of resin were bonded in each sample using transparent cylindrical molds. After 24 hours, the teeth were submitted to the micro-shear bond strength test and subsequent analysis of the fracture mode. Data were submitted to analysis of variance and Fisher's PLSD test (alpha = 0.05). The micro-shear bond strength showed no difference between adhesives systems but a significant reduction was found between the control and carbamide groups (p = 0.0145) and the control and hydrogen groups (p = 0.0370). The evaluation of the failures modes showed that adhesive failures were predominant. Cohesive failures were predominant in group IV The use of dentifrice with peroxides can decrease bonding strength in enamel.

Effect of brushing with conventional versus whitening dentifrices on surface roughness and biofilm formation of dental ceramics

The aim of this study was to evaluate the effect of conventional and whitening dentifrices on the weight loss, surface roughness, and early in situ biofilm formation on the surface of dental ceramics. Standardized feldspar ceramic specimens (Vita VM7 and Vita VM13) were submitted to the following experimental conditions: no brushing; brushing without a dentifrice; brushing with a conventional dentifrice; and brushing with a whitening dentifrice. A brushing machine was used to simulate brushing. The mass and surface roughness of all specimens from the test groups were evaluated prior to and after brushing. Ten participants used an oral device for eight hours to evaluate the biofilm formed in situ on the specimens. Scanning electron microscopy was used for qualitative and quantitative analysis of the biofilm. ANOVA and Tukey tests were used to analyze the results of weight loss, surface roughness, and presence of bacteria. A one-way Kruskal-Wallis test was used for bacterial colonization results. For both ceramics, brushing with a whitening dentifrice resulted in weight loss that was significantly greater when compared to brushing without a dentifrice or with a conventional dentifrice. Increased surface roughness was noticed on VM13 ceramic samples with both dentifrices, whereas only conventional dentifrice had a significant effect on the surface roughness of VM7 samples. For both VM7 and VM13, no difference was found between the experimental conditions with regard to the presence or number of bacteria. Cocci and short rods were the predominant microbial morphotypes. Granular or fibrillar acellular material partially covered the specimens. Brushing with a whitening dentifrice resulted in significant weight loss of ceramic restorations, while brushing with both conventional and whitening dentifrices can roughen ceramic surfaces. The increase in roughness was not clinically significant to contribute to increased biofilm formation.

Effect of whitening toothpaste on titanium and titanium alloy surfaces

Dental implants have increased the use of titanium and titanium alloys in prosthetic applications. Whitening toothpastes with peroxides are available for patients with high aesthetic requirements, but the effect of whitening toothpastes on titanium surfaces is not yet known, although titanium is prone to fluoride ion attack. Thus, the aim of the present study was to compare Ti-5Ta alloy to cp Ti after toothbrushing with whitening and conventional toothpastes. Ti-5Ta (%wt) alloy was melted in an arc melting furnace and compared with cp Ti. Disks and toothbrush heads were embedded in PVC rings to be mounted onto a toothbrushing test apparatus. A total of 260,000 cycles were carried out at 250 cycles/minute under a load of 5 N on samples immersed in toothpaste slurries. Surface roughness and Vickers microhardness were evaluated before and after toothbrushing. One sample of each material/toothpaste was analyzed by Scanning Electron Microscopy (SEM) and compared with a sample that had not been submitted to toothbrushing. Surface roughness increased significantly after toothbrushing, but no differences were noted after toothbrushing with different toothpastes. Toothbrushing did not significantly affect sample microhardness. The results suggest that toothpastes that contain and those that do not contain peroxides in their composition have different effects on cp Ti and Ti-5Ta surfaces. Although no significant difference was noted in the microhardness and roughness of the surfaces brushed with different toothpastes, both toothpastes increased roughness after toothbrushing.

Effects of LED-laser hybrid light on bleaching effectiveness and tooth sensitivity: A randomized clinical study

The study evaluated the effectiveness and the sensitivity of in-office tooth bleaching with the use of a hybrid photo-activation system composed by LEDs and lasers. 40 patients, both genders, aged 18 through 25 years, were randomly distributed into two treatment groups: group I, 35% hydrogen peroxide, with a total bleaching time of 135 min divided into three sessions, and group II, 35% hydrogen peroxide and photo-thermal catalysis by an LED-laser system (300 mW cm-2), for a total bleaching time of 72 min divided into three sessions. The treatment efficiency was measured by reflectance spectroscopy and sensitivity by a visual analog scale (VAS). The final luminosity value (ΔL), color variation (ΔE) and sensitivity (S) resulting from the treatments were analyzed by the generalized estimating equations method (GEEs), and Bonferroni post hoc multiple comparisons at 5% significance. The two groups presented similar colors (ΔE) and luminosities (ΔL) after treatment. Group I presented a greater sensitivity index (37.6 ± 5.9%) compared to group II (11.1 ± 3.3%), statistically significant at p < 0.05. The use of LED-laser hybrid light, as a catalyst of the bleaching agents, showed a significant decrease of provoked tooth sensitivity and a treatment time reduced by 53%, with the same aesthetic results as without a light source. © 2013 Astro Ltd.

Effects of Light Activation, Agent Concentration, and Tooth Thickness on Dental Sensitivity After Bleaching

Examining three bleaching systems, this in vivo clinical trial evaluated the relationship among tooth sensitivity, light activation, and agent concentration, and it correlated dental sensitivity with tooth thickness.Materials and Methods: Eighty-seven volunteer patients were included. Inclusion criteria were the presence of anterior teeth without restorations as well as the absence of a previous bleaching experience and absence of non-carious cervical lesions or dental pain. Exclusion criteria included pregnancy or breastfeeding, a maximum of TF3 hypoplasia, tetracycline-fluorosis stains, malpositioned teeth, orthodontic treatment, periodontal disease, and/or analgesic/anti-inflammatory intake. Patients were randomly assigned to three bleaching groups: Group A (n=25) was treated with 15% H2O2 and nitrogenous-titanium-dioxide and was light activated (Lase Peroxide Lite, DMC, SaoCarlos, Sao Paulo, Brazil); Group B (n=27) was treated with 35% H2O2 and was light activated (Lase Peroxide Sensy, DMC); and Group C (n=35) was treated with 35% H2O2 (White Gold Office, Dentsply, 38West Clark Ave., Milford, USA) without light activation. Tooth sensitivity (TS) was self-reported by the patients using the visual analog scale (VAS) at baseline (TSO), immediately after treatment (TSI), and at seven days after treatment (TS7). In 46 patients, tooth thickness was determined by computed tomography. TSO, TSI, and TS7 were compared between the A and B groups to determine the effect of concentration and between the B and C groups to determine the effect of light using analysis of covariance. The correlation between tooth thickness and TSI was determined by Spearman Rho test (SPSS 15).Results: Eighty-seven patients were evaluated at baseline, and 61 were evaluated at seven days. Separated by groups, tooth sensitivity, expressed as VAS value at the time points TS0, TS1, and TS7, respectively, were as follows: Group A: 13.76 +/- 13.53, 24.40 +/- 25.24, and 5.94 +/- 5.5; Group B: 15.07 +/- 18.14, 42.4 +/- 31.78, and 8.68 +/- 17.99; and Group C: 10.80 +/- 14.83, 31.51 +/- 29.34, and 7.24 +/- 9.2. Group A showed significantly lower tooth sensitivity than group B at TSI (p=0.032). No differences were observed in the tooth sensitivities between groups B and C. No correlation was encountered between tooth thickness and tooth sensitivity immediately after treatment (Rho=-0.088,p=0.563). The median tooth thickness was 2.78 +/- 0.21 mm.Conclusions: Increases in the concentration of bleaching agents directly affect tooth sensitivity, and LED/laser activation and tooth thickness are not correlated with tooth sensitivity after dental bleaching.

Clinical comparison between the bleaching efficacy of 37% peroxide carbamide gel mixed with sodium perborate with established intracoronal bleaching agent

Objective. The aim was to evaluate the bleaching efficacy of sodium perborate/37% carbamide peroxide paste and traditional sodium perborate/distilled water for intracoronal bleaching. Study design. Thirty patients with dark anterior teeth were divided into 2 groups (n = 15): group A: sodium perborate/ distilled water; and group B: sodium perborate/37% carbamide peroxide paste. The bleaching treatment limited each patient to the maximum of 4 changes of the bleaching agent. Initial and final color shades were measured using the Vita Lumin shade guide. Results. Data was analyzed with Wilcoxon test for initial and final comparison according to the bleaching agent, demonstrating efficacy of the bleaching treatment with both agents. Mann-Whitney test was used for comparison of the efficacy of the bleaching agents, showing that there was no significant difference between them. Conclusion. The sodium perborate/37% carbamide peroxide association for intracoronal bleaching has proven to be as effective as sodium perborate/distilled water. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: e43-e47)

AFM analysis of bleaching effects on dental enamel microtopography

The purpose of this in vitro study was to test a new methodology to evaluate the effects of 35% hydrogen peroxide agent on the microtopography of sound enamel using an atomic force microscope (AFM). The buccal sound surfaces of three extracted human lower incisors were used, without polishing the surfaces to maintain them with natural morphology. These unpolished surfaces were subjected to bleaching procedure with 35% hydrogen peroxide that consisted of 4 applications of the bleaching agent on enamel surfaces for 10 min each application. Surface images were obtained in a 15 mu m x 15 mu m area using an AFM. The roughness (Ra and RMS) and the power spectral density (PSD) were obtained before and after the bleaching treatment. As results we could inquire that the PSD analyses were very suitable to identifying the morphological changes on the surfaces, while the Ra and RMS parameters were insufficient to represent the morphological alterations promoted by bleaching procedure on enamel. The morphological wavelength in the range of visible light spectrum(380-750 nm) was analyzed, showing a considerable increase of the PSD with the bleaching treatment. (C) 2009 Elsevier B. V. All rights reserved.