Effects of five carbamide peroxide bleaching gels on composite resin microhardness.

The purpose of this study was to evaluate the effects of five home bleaching products containing 15-16% carbamide peroxide on the microhardness of microhybrid composite resin Z-250 (3M/Espe). A total of 72 specimens were fabricated in cylindrical acrylic matrices (4 x 2 mm), filled with composite resin and photo-activated for 40 seconds. They were divided in 6 study groups (n = 12), according to the bleaching product: Review (SS White), Magic Bleaching (Vigodent), Opalescence (Ultradent), Whiteness Perfect (FGM), Claridex (Biodinâmica), and a control group (not bleached). Specimens were exposed to 1 cc of bleaching gel for 6 hours daily for 2 weeks. The control group specimens were kept in artificial saliva throughout this time. All the specimens were then analyzed in a microhardness tester. Knoop hardness measurements were performed, and the results were submitted to parametric statistical analysis (analysis of variance and Tukey's test). Mean Knoop values and standard deviation were: baseline, 68.52a (4.28); control, 63.42b (7.16); Whiteness Perfect, 57.57c (1.81); Magic Bleaching, 57.22c (3.84); Opalescence, 57.03cd (4.00); Claridex, 53.64de (3.33); Review 51.45e (2.82). Identical letters mean statistical equality according to Tukey's test at the 5% significance level. The products significantly decreased Z-250 (3M/Espe) microhardness.

Response of human dental pulp to calcium hydroxide paste preceded by a corticosteroid/antibiotic dressing agent

Aim: To evaluate the treatment with corticosteroid/antibiotic dressing in pulpotomy with calcium hydroxide. Methods: Forty-six premolars were pulpotomized and randomly assigned into 3 groups. In Group I pulpal wound was directly capped with calcium hydroxide, and Group II and Group III received corticosteroid/antibiotic dressing for 10 min or 48 h, respectively, before pulp capping. Teeth were processed for histological analysis after 7, 30 or 60 days to determine inflammatory cell response, tissue disorganization, dentin bridge formation and presence of bacteria. Attributed scores were analyzed by Kruskal-Wallis and Mann-Whitney tests (α=0.05). Results: On the 7th day, all groups exhibited dilated and congested blood vessels in the tissue adjacent to pulpal wound. The inflammatory cell response was significantly greater in Group III (p<0.05). On the 30th day, in all groups, a thin dentin matrix layer was deposited adjacent to the pulpal wound and a continuous odontoblast-like cell layer underlying the dentin matrix was observed. On the 60th day, all groups presented a thick hard barrier characterized by an outer zone of dystrophic calcification and an inner zone of tubular dentin matrix underlined by a defined odontoblast-like cell layer. Conclusions: Within the limitations of present study, considering that the treatment was performed in healthy teeth, it may be concluded that the use of a corticosteroid/antibiotic dressing before remaining tissue protection with calcium hydroxide had no influence on pulp tissue healing.

Effect of photochemical activation of hydrogen peroxide bleaching gel with and without TiO2 and different wavelengths

Aim: To evaluate the effect of photochemical activation of hydrogen peroxide (H2O2) bleaching gel with different wavelengths. Methods: In the study, 80 bovine incisors were used, which were stained in 25% soluble coffee and divided in 4 groups. The initial color was measured with the Easy Shade spectrophotometer by CIE Lab. An experimental 35% H2O2 bleaching gel was used, either with or without the presence of titanium dioxide (TiO2) pigment, associated with two light sources: G1 - Transparent Gel (TG) and no activation; G2 - Gel with TiO2 and activation with blue LED (l=470nm)\laser (Easy Bleach) appliance; G3 - Gel with TiO2 and activation with ultraviolet (l=345nm - UV); G4 - TG and activation with UV. Three applications of the gels were made for 10 min, and in each, 3 activations of 3 min, with interval of 30 s between them. The coloration was evaluated again and the variation in color perception (DE) was calculated. The data were submitted to one-way ANOVA and Tukey's test at 5% significance level. Results: There were significant differences between G1 and G4. The greatest E value was observed in G4 (13.37). There was no statistically significant difference (p>0.05) between the groups 2, 3 and 4. Conclusions: The presence of TiO2 particules in the bleaching gel did not interfere at the bleaching results.

The effect of carbamide peroxide bleaching agents on the microhardness of dental ceramics.

This study examined the effect of 10% and 16% carbamide peroxide bleaching agents on the surface microhardness of micro-particulate feldspathic ceramics (VM7 and VM13, Vita Zahnfabrik). Forty specimens (8-mm diameter, 2-mm thickness) were divided into four groups (n=10): GI-VM7 + 10% Whiteness, G2-VM7 + 16% Whiteness, G3-VM13 + 10% and G4-VM13 + 16% Whiteness. The home-use bleaching agents were applied for 8 hours on 15 days, and the specimens were stored in distilled water at 37 degrees C. The Vickers hardness number (HV) was determined for each specimen. Data were analyzed by the Wilcoxon and Mann-Whitney tests (p < 0.05). The microhardness values before exposure were: g1-433 (57); g2-486 (22); g3-509 (28); g4-518 (24), and after exposure: G1-349 (32); G2-496 (95); G3-519 (38); G4-502 (81). G2 exhibited a higher and significant difference than GI in VM7 groups, and the effect of bleaching concentration was shown to be significant by the Mann-Whitney test. And for VM13, both the Wilcoxon and Mann-Whitney tests showed no significant differences. When using 10% carbamide peroxide, the microhardness of VM7 ceramic was affected, and there were no effect on the microhardness between VM7 and VM13 ceramics when 16% carbamide peroxide was used.

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.

Association of enamel microabrasion and dentinal bleaching in recovering an adolescent patient's smile: a case report

This article presents the enamel microabrasion protocol for removing intrinsic white stains of hard texture on the enamel surface, using a 37% phosphoric acid/pumice mixture associated with a carbamide peroxide-based bleaching agent in custom-made mouth trays. We observed that these clinical procedures were safe and effective, and solved our patient's esthetic problem. © 2010 Nova Science Publishers, Inc.

Evaluation of the dentin-pulp complex after cavity preparation with ultrasonic diamond tip

The aim of this paper was to compare the dentin-pulp complex response to cavity preparation in human teeth using ultrasonic chemical vapor deposition (CVD) diamond tip and high-speed diamond bur. Class V buccal cavities were randomly prepared in 40 premolars from 14 patients aged 11 to 15 years. The cutting time was recorded and the cavities had the axial walls protected with gutta-percha and were filled with glass ionomer cement. The teeth were extracted at intervals of 0, 5, 10 and 20 days, and were decalcified, sectioned and stained by Hematoxylin & Eosin, Masson's Trichrome and Brown & Brenn techniques. The inflammatory response and cell disorganization were blindly evaluated by two examiners. The remaining dentin thickness (RDT) was measured by a linear scale using computer software. Statistical analysis by one-way ANOVA showed no statistically significant difference (P≤0.05) among the cavities prepared with either type of instrument, with mean RDT of 1132.50 mm. Cutting time and the pulp-dentin complex responses were analyzed statistically by Kruskal-Wallis and Dunn tests (P≤0.05). The ultrasonic CVD diamond tip took 5 times longer to prepare the cavities and there were no typical inflammatory pulp responses in cavities prepared with either type of cutting instrument, only mild to moderate cell disorganization was present. Even taking longer to cut the dental substrate, the ultrasonic CVD diamond tip produced similar pulp response compared to the conventional high-speed diamond bur.

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.

Conservative reconstruction of the smile by orthodontic, bleaching, and restorative procedures

The following is a clinical case report of a patient whose chief complaint was the presence of generalized spacing in the maxillary anterior segment following orthodontic treatment. After meticulous clinical analyses and discussions of the clinical procedures to be adopted, dental bleaching was performed in both arches with 10% hydrogen peroxide (Opalescence Trèswhite Supreme 10% Hydrogen Peroxide - Ultradent Products, Inc., South Jordan, USA) after the conclusion and stabilization of orthodontic treatment. Then, the orthodontic appliance was removed and the diastemas in the maxillary anterior teeth were closed with Amelogen Plus (Ultradent Products, Inc., South Jordan, USA) resin composite. It was observed that the association of orthodontic, bleaching, and restorative procedures was capable of restoring dental shape, function, and esthetics, allowing the patient to smile without hesitation.

Effect of bleaching on sound enamel and with early artificial caries lesions using confocal laser microscopy

The aim of this study was to evaluate effect of bleaching agents on sound enamel (SE) and enamel with early artificial caries lesions (CL) using confocal laser scanning microscopy (CLSM). Eighty blocks (4 × 5 × 5 mm) of bovine enamel were used and half of them were submitted to a pH cycling model to induce CL. Eight experimental groups were obtained from the treatments and mineralization level of the enamel (SE or CL) (n=10). SE groups: G1 - unbleached (control); G2 - 4% hydrogen peroxide (4 HP); G3 - 4 HP containing 0.05% Ca (Ca); G4 - 7.5% hydrogen peroxide (7.5 HP) containing amorphous calcium phosphate (ACP). CL groups: G5 - unbleached; G6 - 4 HP; G7 - 4 HP containing Ca; G8 - 7.5 HP ACP. G2, G3, G6, G7 were treated with the bleaching agents for 8 h/day during 14 days, while G4 and G8 were exposed to the bleaching agents for 30 min twice a day during 14 days. The enamel blocks were stained with 0.1 mM rhodamine B solution and the demineralization was quantified using fluorescence intensity detected by CLSM. Data were analyzed using ANOVA and Fisher's tests (α=0.05). For the SE groups, the bleaching treatments increased significantly the demineralization area when compared with the unbleached group. In the CL groups, no statistically significant difference was observed (p>0.05). The addition of ACP or Ca in the composition of the whitening products did not overcome the effects caused by bleaching treatments on SE and neither was able to promote remineralization of CL.

Shelf Life of Fresh and Pasteurized Organic Passion Fruit (Passiflora Edulis F. Flavicarpa Deg.) Pulp

The shelf life of the organic passion fruit pulp, both fresh and pasteurized at 70C and 90C and stored under refrigeration, was evaluated. The heat treatment did not affect the sensory and physicochemical characteristics of the pasteurized pulps when compared with the fresh pulp, except for the ascorbic acid content. The pulps were also microbiologically safe. The pulps pasteurized at 70 and 90C were suitable for consumption for a minimum shelf-life period of 207 days of storage under refrigeration and for the fresh pulp it was attributed a shelf-life period of 60 to 90 days. The pulp pasteurized at 70C showed higher acceptance scores for all the attributes and purchase intention scores, suggesting a more stable behavior and higher sensory quality. Practical Applications: This work intended to evaluate the influence of the minimum pasteurization on the sensory acceptance and microbiological and physicochemical characteristics of the organic passion fruit pulp stored under refrigeration, with the aim to identify the shelf life. Heat treatment is one of the processes used for food preservation. Lower pasteurization temperature than that used by the Brazilian industries and storage under refrigeration showed to be appropriate for passion fruit pulp quality. In this way, the microbiological, physicochemical and sensory features of passion fruit were preserved. This work can be used as a reference for passion fruit pasteurization, which is able to increase the shelf life of this fruit while preserving its desirable original features. Journal Compilation © 2012 Wiley Periodicals, Inc.

Occurrence of sensitivity during at-home and in-office tooth bleaching therapies with or without use of light sources

The aim of this study was to evaluate the effect of tooth bleaching with 10% carbamide peroxide (CP) or 35% hydrogen peroxide (HP), with or without quartz-tungsten-halogen light or hybrid source LED/infrared laser exposition on the occurrence duration, intensity and location of tooth sensitivity Forty patients were selected and randomly divided into four groups: GI--home bleaching with CP for 4 hours a day, over the course of 3 weeks; GII--three sessions of HP with three 10-minute applications at each session and no light source; GIII--the same procedure as GII with quartz-tungsten-halogen light irradiation; GIV--the same procedure as GII with LED/laser light irradiation. The evaluation included an appointment with each patient before and after each HP bleaching session or each weekly CP bleaching and 7, 30 and 180 days after the end of treatment. The Kruskal-Wallis test revealed that the duration and intensity of post-treatment sensitivity were significantly higher for HP than for CP (p< 0.05), and symptoms were located predominantly in anterior teeth. All bleaching methods generated sensitivity, which was more frequent in anterior teeth. However, treatment with CP generated lower sensitivity than treatment with HP independently of the light sources.

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.

Bleaching gels containing calcium and fluoride: Effect on enamel erosion susceptibility

This in vitro study evaluated the effect of 35 hydrogen peroxide (HP) bleaching gel modified or not by the addition of calcium and fluoride on enamel susceptibility to erosion. Bovine enamel samples (3 mm in diameter) were divided into four groups (n = 15) according to the bleaching agent: control-without bleaching (C); 35 hydrogen peroxide (HP); 35 HP with the addition of 2 calcium gluconate (HP + Ca); 35 HP with the addition of 0.6 sodium fluoride (HP + F). The bleaching gels were applied on the enamel surface for 40 min, and the specimens were subjected to erosive challenge with Sprite Zero and remineralization with artificial saliva for 5 days. Enamel wear was assessed using profilometry. The data were analyzed by ANOVA/ Tukey's test (P 0.05). There were significant differences among the groups (P = 0.009). The most enamel wear was seen for C (3.37 ± 0.80 μm), followed by HP (2.89 ± 0.98 μm) and HP + F (2.72 ± 0.64 μm). HP + Ca (2.31 ± 0.92 μm) was the only group able to significantly reduce enamel erosion compared to C. The application of HP bleaching agent did not increase the enamel susceptibility to erosion. However, the addition of calcium gluconate to the HP gel resulted in reduced susceptibility of the enamel to erosion. © 2012 Alessandra B. Borges et al.

A hydrogel scaffold that maintains viability and supports differentiation of dental pulp stem cells

Objectives: The clinical translation of stem cell-based Regenerative Endodontics demands further development of suitable injectable scaffolds. Puramatrix™ is a defined, self-assembling peptide hydrogel which instantaneously polymerizes under normal physiological conditions. Here, we assessed the compatibility of Puramatrix™ with dental pulp stem cell (DPSC) growth and differentiation. Methods: DPSC cells were grown in 0.05-0.25% Puramatrix™. Cell viability was measured colorimetrically using the WST-1 assay. Cell morphology was observed in 3D modeling using confocal microscopy. In addition, we used the human tooth slice model with Puramatrix™ to verify DPSC differentiation into odontoblast-like cells, as measured by expression of DSPP and DMP-1. Results: DPSC survived and proliferated in Puramatrix™ for at least three weeks in culture. Confocal microscopy revealed that cells seeded in Puramatrix™ presented morphological features of healthy cells, and some cells exhibited cytoplasmic elongations. Notably, after 21 days in tooth slices containing Puramatrix™, DPSC cells expressed DMP-1 and DSPP, putative markers of odontoblastic differentiation. Significance: Collectively, these data suggest that self-assembling peptide hydrogels might be useful injectable scaffolds for stem cell-based Regenerative Endodontics. © 2012 Academy of Dental Materials.