Effects of in-office bleaching agent combined with different desensitizing agents on enamel

Abstract Objective: To analyze color change, microhardness and chemical composition of enamel bleached with in-office bleaching agent with different desensitizing application protocols. Materials and Methods: One hundred and seventeen polished anterior human enamel surfaces were obtained and randomly divided into nine groups (n = 13). After recording initial color, microhardness and chemical composition, the bleaching treatments were performed as G1: Signal Professional White Now POWDER&LIQUID FAST 38% Hydrogen peroxide(S); G2: S+Flor Opal/0.5% fluoride ion(F); G3: S+GC Tooth Mousse/Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) paste(TM); G4: S+UltraEZ/3% potassium nitrate&0.11% fluoride(U); G5: S+Signal Professional SENSITIVE PHASE 1/30% Nano-Hydroxyapatite (n-HAP) suspension(SP); G6: S-F mixture; G7: S-TM mixture; G8: S-U mixture; G9: S-SP mixture. Color, microhardness and chemical composition measurements were repeated after 1 and 14 days. The percentage of microhardness loss (PML) was calculated 1 and 14 days after bleaching. Data were analyzed with ANOVA, Welch ANOVA, Tukey and Dunnett T3 tests (p<0.05). Results: Color change was observed in all groups. The highest ΔE was observed at G7 after 1 day, and ΔE at G8 was the highest after 14 days (p<0.05). A decrease in microhardness was observed in all groups except G6 and G7 after 1 day. The microhardness of all groups increased after 14 days in comparison with 1 day after bleaching (p>0.05). PML was observed in all groups except G6 and G7 after bleaching and none of the groups showed PML after 14 days. No significant changes were observed after bleaching at Ca and P levels and Ca/P ratios at 1 or 14 days after bleaching (p>0.05). F mass increased only in G2 and G6, 1 day after bleaching (p<0.05). Conclusions: The use of desensitizing agents containing fluoride, CPP-ACP, potassium nitrate or n-HAP after in-office bleaching or mixed in bleaching agent did not inhibit the bleaching effect. However, they all recovered microhardness of enamel 14 days after in-office bleaching.

Comparação de diferentes pré-tratamentos de superfície na remineralização de esmalte com flúor em tratamento de lesões com mancha branca e sua resistência após desafio ácido / Comparison of different pretreatments on remineralization of enamel white spot lesions with fluoride and its resistance after new acidic challenge

A aplicação de flúor tópico é a principal estratégia de natureza química para a remineralização de lesões incipientes (LI) clinicamente visíveis como manchas brancas (MB) por cárie. Abordagens para aumentar a retenção de F no substrato pode favorecer sua ação e para isso, tratamentos prévios da superfície do esmalte podem ser usados. O objetivo deste trabalho foi comparar a capacidade de remineralização do flúor sem e com pré-tratamento do esmalte com ácido fosfórico e nitrato de alumínio e a sua resistência após novo desafio. Sessenta espécimes de esmalte bovino foram preparados (6mm x 4mm) e selecionados por meio de análise de microdureza de superfície (MS). LI foram produzidas através de ciclagem Desmineralização-Remineralização (DES-RE) e os espécimes divididos aleatoriamente em cinco grupos, de acordo com o tratamento (n=12): V- controle (verniz de fluoreto de sódio 5% por 4 horas), F (sem pré-tratamento); P-F(condicionamento ácido com ácido fosfórico por 30s); Al-F (nitrato de alumínio a 0,05M por 1min); P-Al-F (condicionamento com ácido fosfórico a 37% + nitrato de alumínio a 0,05M). Os tratamentos foram repetidos semanalmente durante quatro semanas. Após o tratamento, os espécimes foram submetidos à nova ciclagem ácida. Após cada etapa, nova MS foi realizada e ao final das análises, um corte transversal dos espécimes foi realizado. Uma das metades foi submetida à análise da microdureza longitudinal (ML) e a outra preparada para realização da microrradiografia transversal (TMR) para a análise de conteúdo mineral perdido. O percentual de perda de dureza de superfície (%PDS) foi analisado por ANOVA a 2 critérios de medidas repetidas e Tukey e o percentual de perda de dureza longitudinal (%PDL) por ANOVA a 3 critérios de medidas repetidas e Tukey (p<0,05). Os dados de TMR no parâmetro LD (profundidade da lesão) foram analisados por ANOVA a dois critérios (p<0,05). Os resultados mostraram que a ciclagem DES-RE resultou em significante %PDS e %PDL em todos os grupos. Grupo F revelou menor perda de MS após tratamento e, F, Al-F e P-Al-F, mostraram menor perda de dureza final, após o novo desafio ácido. Na análise de %PDL, o grupo V apresentou menor perda de dureza final quando comparado com os demais grupos, nas diferentes profundidades. A análise do conteúdo mineral não revelou nenhuma diferença entre os tratamentos e fases. Nenhum dos pré tratamentos propostos foram capazes de otimizar a atuação do gel APF na remineralização de MB.(AU)

The topical fluoride is the main chemical strategy to remineralize incipient caries lesions (ICL) visible as carious white spot lesions (WSL). Approaches to increase the fluoride retention may favor its action and therefore, enamel pretreatments can be used for this purpose. The aim of this study was to compare the potential of fluoride remineralization with and without previous enamel pretreatment with aluminum nitrate and phosphoric acid as well as their resistance after a new acid challenge. Sixty bovine enamel specimens were prepared (6mm x 4mm) and selected by the surface hardness (SH) analysis. The ICL were produced using DE-RE cycling and the specimens were randomized in five groups, according to the treatment (n=12): Vcontrol (5% sodium fluoride varnish during 4h), and four groups previously preatreated with topical application of acidulated phosphate fluoride (APF) during 4min: F (without pretreatment), P-F (phosphoric acid etching during 30s), Al-F (0.05M aluminum nitrate during 1min); P-Al-F (phosphoric acid etching + aluminum nitrate). The treatments were performed weekly during four weeks. After the treatment, the specimens were submitted to the new acid challenge. After each step, a new SH analysis was performed followed by the transversal cut of the specimens. A half was submitted to the longitudinal cross-sectional hardness analysis (LH) and the other half was prepared to transverse microradiography assessments (TMR) to determine the loss of mineral content. The percentage of surface mineral loss (%SH) was analyzed using two-way repeated-measures ANOVA and the percentage of crosssectional mineral loss (%LH) by the three-way repeated-measures ANOVA and Tukey (p<0.05). Data of TMR analysis by LD (lesion depth) parameter was analyzed with two-way ANOVA (p<0.05). The results showed significant %SH and %LH after DE-RE cycling for all groups. F group showed the lowest %SH after treatment, with no significant difference to Al-F and P-Al-F after the new acid challenge. V group showed the lowest %LH compared to the other groups, in the different depths, suggesting more resistance. Mineral content assessment did not reveal any difference among treatments and phases. None pretreatments were able to increase the potential of fluoride remineralization.(AU)

Mechanical properties of composites as functions of the syringe storage temperature and energy dose

Objective: To investigate the mechanical properties of different classifications of composites indicated for posterior application as functions of the storage condition and of the energy dose. Material and Methods: Specimens (8x2x2 mm) were obtained according to the factors: I) Composites (3M ESPE): Filtek P60, Filtek Z350XT, and Filtek Silorane; II) Syringe storage conditions: room temperature, aged, oven, refrigerator, and freezer; and III) Energy dose: 24 J/cm2 and 48 J/cm2. After photoactivation, the specimens were stored at 37ºC for 24 h. After storage, a three-point bending test was carried out in a universal testing machine at 0.5 mm/min. Flexural strength (S) and flexural modulus (E) were calculated. Data were analyzed by three-way ANOVA and Tukey's test (α=0.05). Results: Different storage conditions significantly affected the silorane composite for S; conversely, no effects were noted in terms of E. The accelerated aging protocol significantly increased the S of Filtek P60 and Filtek Silorane, whereas storage in the oven significantly decreased the S for all of the composites tested. Filtek P60 was the only composite not affected by the lower storage temperatures tested for S, whereas for the silorane this parameter was impacted at the same conditions. The factor "dose" was not statistically significant. Conclusions: The syringe storage at different temperature conditions proved to influence mostly the flexural strength, a clinically important characteristic considering the posterior indication of the materials tested. The silorane composite should not be stored at lower temperatures. .

Avaliação da eficácia de um agente dessensibilizante a base de nitrato de potássio / Evaluation of the effectiveness of a desensitizing agent made of potassium nitrate

A hipersensibilidade dentinária (HSD) é uma condição dolorosa comumem muitos pacientes periodontais, sendo caracterizada por dor curta eforte em resposta a diferentes estímulos, sejam estes térmicos, evaporativos,táteis, osmóticos ou químicos. Seu tratamento pode consistir nainterrupção da resposta neural ou através da oclusão dos túbulos dentinários,por métodos profissionais (aplicação de agentes dessensibilizantes naforma de gel, aplicação de resinas, vernizes, agentes adesivos, realizaçãode tratamento endodôntico ou cirurgia) ou caseiros (enxaguatórios oudentifrícios). O objetivo deste estudo foi avaliar a eficácia de um agentedessensibilizante a base de nitrato de potássio (UltraEZ). Para a realizaçãodeste trabalho foram avaliados 20 dentes de dez pacientes da Faculdadede Odontologia São Leopoldo Mandic que apresentavam HSD. Os dentesforam submetidos a três tipos de testes: 1) estímulo mecânico com sondaexploradora; 2) jato de ar comprimido com seringa tríplice; 3) jato de águacom seringa tríplice. O grau de HSD foi avaliado com a utilização de umaescala de medida verbal (EMV). Cada dente foi submetido a três aplicaçõesdo agente dessensibilizante com intervalos regulares de sete dias. A cadaretorno foi executada nova avaliação do grau de HSD. Os resultados obtidosforam submetidos à análise estatística. Foram observadas diferençasestatisticamente significantes quando comparados os valores obtidos dehipersensibilidade dentinária nas segunda e terceira semanas em relaçãoà avaliação inicial e primeira semana (p < 0,05). Concluiu-se que o agentedessensibilizante foi eficaz no tratamento da HSD.

Efficacy of a dentifrice containing 5 per cent potassium nitrate and 1500 PPM sodium monofluorophosphate in a precipitated calcium carbonate base on dentinal hypersensitivity / Eficácia do dentifrício contendo 5 por cento de nitrato de potássio e 1500 ppm de monofluorofosfato de sódio na base do carbonato de cálcio na hipersensibilidade dentinária

The effect on dentinal hypersensitivity from the use of a dentifrice containing 5.0 per cent potassium nitrate, 1500 ppm sodium monofluorophosphate in a precipitated calcium carbonate (PCC) base over an eight-week period was compared to a placebo dentifrice without potassium nitrate. A total of forty-eight subjects were entered into the study and stratified into two balanced groups according to their baseline mean thermal (air blast) and tactile (Yeaple Probe) sensitivity scores. The two groups were randomly assigned to use either the potassium nitrate/PCC dentifrice or a placebo dentifrice without potassium nitrate. The two groups were well balanced with regard to their mean baseline thermal tactile sensitivity scores, sex and age...