Indirect cytotoxicity of a 35% hydrogen peroxide bleaching gel on cultured odontoblast-like cells

The aim of this study was to evaluate the trans-enamel and trans-dentinal effects of a 35% hydrogen peroxide (H2O2) bleaching gel on odontoblast-like cells. Enamel/dentin discs obtained from bovine incisors were mounted in artificial pulp chambers (APCs). Three groups were formed: G1- 35% H2O2; G2- 35% H2O2 + halogen light application; G3- control. The treatments were repeated 5 times and the APCs were incubated for 12 h. Then, the extract was collected and applied for 24 h on the cells. Cell metabolism, total protein dosage and cell morphology were evaluated. Cell metabolism decreased by 62.09% and 61.83% in G1 and G2, respectively. The depression of cell metabolism was statistically significant when G1 and G2 were compared to G3. Total protein dosage decreased by 93.13% and 91.80% in G1 and G2, respectively. The cells in G1 and G2 exhibited significant morphological alterations after contact with the extracts. Regardless of halogen light application, the extracts caused significantly more intense cytopathic effects compared to the control group. After 5 consecutive applications of a 35% H2O2 bleaching agent, either catalyzed or not by halogen light, products of gel degradation were capable to diffuse through enamel and dentin causing toxic effects to the cells.

Influence of bleaching treatment on flexural resistance of hybrid materials.

The aim of this study is to evaluate the flexural resistance of three types of restorative materials: compomer (Freedom), resin-modified glass-ionomer (Vitremer) and composite resin (Esthet-X), observing whether the application of bleaching agent can cause alterations of their flexural properties. Sixty samples were made using a 10 x 1 x 1 mm brass mold, and divided into three groups: G1- Freedom (SDI); G2- Vitremer (3M ESPE); G3- Esthet-X (Dentsply). On half of the samples of each group (10 samples) the bleaching treatment was applied and the other half used as control, was stored in distilled water at a temperature of 37 degrees C. Whiteness HP Maxx bleaching system was applied on the sample surface following the manufacturer's recommendations, simulating the bleaching treatment at the clinic. After this period, a flexural strength (three-point bending) test was conducted using (EMIC DL 1000) machine until the samples fractured. The data were submitted to ANOVA and Tukey tests. Of the restorative materials studied, G3-(87.24 +/- 31.40 MPa) presented the highest flexural strength, followed by G1-(61.67 +/- 21.32 MPa) and G2-(61.67 +/- 21.32 MPa). There was a statistical difference in flexural strength after the bleaching treatment. It was concluded that the use of a beaching agent can promote significant alteration of the flexural strength of these restorative materials.

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.

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.

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.

Efficacy and cytotoxicity of a bleaching gel after short application times on dental enamel

Objectives: This study aimed to evaluate and correlate the efficacy and cytotoxicity of a 35 % hydrogen peroxide (HP) bleaching gel after different application times on dental enamel. Materials and methods: Enamel/dentin disks in artificial pulp chambers were placed in wells containing culture medium. The following groups were formed: G1, control (no bleaching); G2 and G3, three or one 15-min bleaching applications, respectively; and G4 and G5, three or one 5-min bleaching applications, respectively. Extracts (culture medium with bleaching gel components) were applied for 60 min on cultured odontoblast-like MDPC-23 cells. Cell metabolism (methyl tetrazolium assay) (Kruskal-Wallis/Mann-Whitney; α = 5 %) and cell morphology (scanning electron microscopy) were analyzed immediately after the bleaching procedures and the trans-enamel and trans-dentinal HP diffusion quantified (one-way analysis of variance/Tukey's test; α = 5 %). The alkaline phosphatase (ALP) activity was evaluated 24 h after the contact time of the extracts with the cells (Kruskal-Wallis/Mann-Whitney; α = 5 %). Tooth color was analyzed before and 24 h after bleaching using a spectrophotometer according to the Commission Internationale de l'Eclairage L*a*b* system (Kruskal-Wallis/Mann-Whitney; α = 0.05). Results: Significant difference (p < 0.05) in cell metabolism occurred only between G1 (control, 100 %) and G2 (60.6 %). A significant decrease (p < 0.05) in ALP activity was observed between G2, G3, and G4 in comparison with G1. Alterations on cell morphology were observed in all bleached groups. The highest values of HP diffusion and color alterations were observed for G2, with significant difference among all experimental groups (p < 0.05). G3 and G4 presented intermediate color change and HP diffusion values with no statistically significant differences between them (p > 0.05). The lowest amount of HP diffusion was observed in G5 (p < 0.05), which also exhibited no significant color alteration compared to the control group (p > 0.05). Conclusions: HP diffusion through dental tissues and its cytotoxic effects were proportional to the contact time of the bleaching gel with enamel. However, shorter bleaching times reduced bleaching efficacy. Clinical relevance: Shortening the in-office tooth bleaching time could be an alternative to minimize the cytotoxic effects of this clinical procedure to pulp tissue. However, the reduced time of bleaching agent application on enamel may not provide adequate esthetic outcome. © 2012 Springer-Verlag Berlin Heidelberg.

Effect of fluoride-treated enamel on indirect cytotoxicity of a16% carbamide peroxide bleaching gel to pulp cells

The aim of this study was to evaluate the possibility of fluoride solutions applied to enamel to protect pulp cells against the trans-enamel and transdentinal cytotoxicity of a 16% carbamide peroxide (CP) bleaching gel. The CP gel was applied to enamel/ dentin discs adapted to artificial pulp chambers (8 h/day) during 1, 7 or 14 days, followed by fluoride (0.05% or 0.2%) application for 1 min. The extracts (culture medium in contact with dentin) were applied to MDPC-23 cells for 1 h, and cell metabolism (MTT assay), alkaline phosphatase (ALP) activity and cell membrane damage (flow cytometry) were analyzed. Knoop microhardness of enamel was also evaluated. Data were analyzed statistically by ANOVA and Kruskal-Wallis tests (a=0.05). For the MTT assay and ALP activity, significant reductions between the control and the bleached groups were observed (p<0.05). No statistically significant difference occurred among bleached groups (p>0.05), regardless of fluoride application or treatment days. Flow cytometry analysis demonstrated 30% of cell membrane damage in all bleached groups. After 14 days of treatment, the fluoride-treated enamel presented significantly higher microhardness values than the bleached-only group (p<0.05). It was concluded that, regardless of the increase in enamel hardness due to the application of fluoride solutions, the treated enamel surface did not prevent the toxic effects caused by the 16% CP gel to odontoblast-like cells.

Effect of low-level laser therapy on odontoblast-like cells exposed to bleaching agent

The aim of the present study was to evaluate the effect of low-level laser therapy (LLLT) on odontoblast-like MDPC-23 cells exposed to carbamide peroxide (CP 0.01 %-2.21 μg/mL of H2O2). The cells were seeded in sterile 24-well plates for 72 h. Eight groups were established according to the exposure or not to the bleaching agents and the laser energy doses tested (0, 4, 10, and 15 J/cm2). After exposing the cells to 0.01 % CP for 1 h, this bleaching solution was replaced by fresh culture medium. The cells were then irradiated (three sections) with a near-infrared diode laser (InGaAsP-780 ± 3 nm, 40 mW), with intervals of 24 h. The 0.01 % CP solution caused statistically significant reductions in cell metabolism and alkaline phosphate (ALP) activity when compared with those of the groups not exposed to the bleaching agent. The LLLT did not modulate cell metabolism; however, the dose of 4 J/cm2 increased the ALP activity. It was concluded that 0.01 % CP reduces the MDPC-23 cell metabolism and ALP activity. The LLLT in the parameters tested did not influence the cell metabolism of the cultured cells; nevertheless, the laser dose of 4 J/cm2 increases the ALP activity in groups both with and without exposure to the bleaching agent. © 2013 Springer-Verlag London.

Effect of carbamide peroxide bleaching gel on composite resin flexural strength and microhardness

This study investigated the effect of 16% carbamide peroxide (Whiteness Perfect/FGM) on the Vickers microhardness and flexural strength of the restorative composites Filtek Z100 (hybrid), Filtek Z350 (nanofill), Brilliant (micro-hybrid) and Opallis (micro-hybrid). Discshaped (4×2 mm; n=5) and bar-shaped (12×2×1 mm; n=10) specimens of each restorative material were randomly divided into 2 groups: (G1) 16 weeks stored in distilled water; (G2) 16 weeks stored in distilled water, with 16% carbamide peroxide application during 6 h per day for the last 4 weeks. The mechanical properties were evaluated using a Vickers microhardness tester and a mechanical testing machine. Data were analyzed by twoway ANOVA and Tukey's (HSD) post-hoc test (α=0.05). Filtek Z100 presented the highest microhardness value, followed by Filtek Z350 and finally by Brilliant and Opallis (p=0.00). Filtek Z100 and Brilliant exhibited the highest flexural strength value, followed by Filtek Z350 and Opallis (p=0.00). Bleaching treatment decreased significantly microhardness of Brilliant and Opallis (p=0.00). The flexural strength of all studied materials was not affected by the home bleaching (p=0.28).

Toxic effects of daily applications of 10% carbamide peroxide on odontoblast-like MDPC-23 cells

Background. Tooth bleaching has been widely studied, mainly due to the possible undesirable effects that can be caused by this esthetic procedure. The cytotoxicity of the bleaching agents and its components to pulp cells has been demonstrated in several researches. The aim of this study was to evaluate the toxic effects of successive applications of 10% carbamide peroxide (CP) gel on odontoblast-like cells. Materials and methods. Enamel-dentin discs obtained from bovine incisors were adapted to artificial pulp chambers (APCs). The groups were formed as follows: G1: Without treatment (control group); G2: 10% carbamide peroxide, CP (five applications/one per day); G3: 10% CP (one unique application); and G4: 35% hydrogen peroxide, HP (three applications of 15 min each). After treatment, cell metabolism (MTT), alkaline phosphatase (ALP) activity and plasma membrane damage (flow cytometry) were analyzed. Results. Reductions in cell metabolism and alkaline phosphatase activity along with severe damage of the cytoplasmic membrane were noted in G2. In G3, no damage was observed, compared to the control group. Intermediary values of toxicity were obtained after 35% HP application. Conclusion. It can be concluded that one application of 10% CP did not cause toxic effects in odontoblast-like cells, but the successive application of this product promoted severe cytotoxic effects. The daily application of the bleaching agents, such as used in the at-home bleaching technique, can increase the damages caused by this treatment to the dental pulp cells. © 2013 Informa Healthcare.

The Number of Bleaching Sessions Influences Pulp Tissue Damage in Rat Teeth

Introduction: Hydrogen peroxide tooth bleaching is claimed to cause alterations in dental tissue structures. This study investigated the influence of the number of bleaching sessions on pulp tissue in rats. Methods: Male Wistar rats were studied in 5 groups (groups 1S-5S) of 10 each, which differed by the number (1-5) of bleaching sessions. In each session, the animals were anesthetized, and 35% hydrogen peroxide gel was applied to 3 upper right molars. Two days after the experimental period, the animals were killed, and their jaws were processed for light microscope evaluation. Pulp tissue reactions were scored as follows: 1, no or few inflammatory cells and no reaction; 2, <25 cells and a mild reaction; 3, between 25 and 125 cells and a moderate reaction; and 4, 125 or more cells and a severe reaction. Results from each experimental group were compared between groups and within groups to the corresponding unbleached upper left molars and analyzed for significant differences using the Kruskal-Wallis test (P < .05). Results: All tissue sections showed significant bleaching-induced changes in the dental pulp. After 1 bleaching session, necrotic tissue in the pulp horns and underlying inflammatory changes were observed. The extent and intensity of these changes increased with the number of bleaching sessions. After 5 sessions, the changes included necrotic areas in the pulp tissue involving the second third of the radicular pulp and intense inflammation in the apical third. Conclusions: The number of bleaching sessions directly influenced the extent of pulp damage. © 2013 American Association of Endodontists.

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

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência de uma substância antioxidante na união de materiais resinosos à dentina após a realização de clareamento

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

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

Estudo in vitro em MEV da morfologia do esmalte, dentina, cemento e da junção amelocementária humanos antes e após a clareação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)