Eficacia clínica de pastas y colutorios blanqueantes sin peróxidos. Hacia una revisión sistemática / Clinical efficacy of whitening toothpastes and mouthwashes without peroxides. Towards to a systematic approach

Introducción: La creciente demanda de estética dental en la sociedad, ha propiciado la venta de dentífricos y colutorios cosméticos sin peróxidos denominados ‘blanqueantes’. Se realiza una revisión de la literatura existente con el fin de esclarecer la eficacia de estos productos sin peróxidos en el aclaramiento o blanqueamiento de los dientes. Material y métodos: Realizamos una búsqueda bibliográfica en las principales bases de datos: Pubmed, Cochrane y Scopus , accediendo al texto completo mediante la red de datos BuCEA de la Universidad Complutense de Madrid. De 158 artículos encontrados, se seleccionan 17, que cumplen nuestros criterios de inclusión: ensayos clínicos aleatorizados, in vivo, en los que los pacientes usan pastas dentífricas y/o colutorios sin peróxidos. Resultados y discusión: Se analizan los resultados teniendo en cuenta si se realiza tinción previa y según la forma de aplicación de los productos blanqueantes (cepillado o enjuague). Destaca la acción de los componentes físicos (sílices) y químicos (de limonene, arginina) de los productos blanqueantes en la remoción y eliminación de manchas, que se ve favorecida por la acción mecánica del cepillado. Según los estudios incluidos en esta revisión, el uso de las productos blanqueantes sin peróxidos eliminan tinciones extrínsecas del diente, aunque no aquellas tinciones intrínsecas. Conclusiones: Son necesarios más estudios clínicos que evalúen el efecto de los productos blanqueantes sin péroxidos en pacientes con las mismas condiciones. También es necesario diferenciar entre el concepto de blanqueamiento por remoción de manchas extrínsecas del blanqueamiento interno conseguido con peróxidos (AU)

Introduction: Nowadays a growing interest in dental esthetic, has provoked an increasing sold of bleaching cosmetics products without peroxides. Because of that we realized a systematyc aproach to distinguish if these products without peroxides are efficient in teeth whitening. Material and Methods: We conduct our search in the most important medical database: Medline, Cochrane and Scopus. We used the database BuCEA of UCM to access to the complete text. From 158 articles, we selected 17 articles which folllow our inclusion criteria: clinical trial, in which patients used toothpastes and mouthwashes without peroxides. Results and discussion: The studies are analyzed in different groups, having in mind if there have been previous teeth tintion and the way of application of the whitening product (mouthwashes or teeth brush). We remarked that both of physical and chemical components of the whitening products removed and eliminated only external spots in teeth enamel. The mechanical action of teethbrushing helps to this effect. Conclusion: More clinical studies are neccessary in order to investigate the effect of these whitening products without peroxides in patients with the same conditions. We should also diferenciate between whitening removing extrinsec spots in the enamel from internal bleaching get by peroxides (AU)

Effect of 15% carbamide peroxide bleaching gel on color stability of giomer and microfilled composite resin: An in vitro comparison

Objectives: The effect of 15% carbamide peroxide bleaching gel on color stability and surface topography of a giomer and a microfilled composite resin was evaluated in the present in vitro study. Study design: Forty discs measuring 10 mm in diameter and 1 mm in thickness were prepared from a giomer and a microfilled composite resin. Each material yielded 20 discs with completely smooth surfaces. Then a spectrophotometer was used to measure L* (lightness), a* (redness, greenness) and b* (blueness, yellowness) color coordinates of all the discs. Subsequently, the specimens were subjected to 15% carbamide peroxide bleaching gel. After measuring the color coordinates once again, color changes (ÄE*) were calculated by the CIELAB system. Six specimens from each material (three specimens before bleaching agent application and three specimens thereafter) were viewed under an atomic force microscope (AFM) for surface topography evaluation. Data were analyzed by Mann-Whitney U and Kruskal-Wallis tests at á=0.05. Results: There were no statistically significant differences in color changes (ÄE*) between the two materials (P>0.05). In addition, no significant differences were detected in surface roughness between composite resin and giomer discs before and after bleaching (P>0.05 for both). However, in both materials the differences in surface roughness were significant before and after bleaching procedures (P<0.001). Conclusions: Based on the results of the present study it was concluded that 15% carbamide peroxide does not induce clinically detectable color changes in composite resin and giomer despite an increase in surface roughness (AU)

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In vitro evaluation of the efficacy of two bleaching procedures

Objective: In vitro comparison of the efficacy of two bleaching procedures, one based on carbamide peroxide (CP)and the other on hydrogen peroxide (HP), simulating clinical conditions.Study Design: Two groups of 20 teeth in each group were selected. Group A: 22% CP, one hour a day for 21 consecutivedays. Group B: 37.5% HP, in 2 treatment sessions with an one week interval between each session. At eachsession the product was applied three successive times for eight minutes. Colour was recorded before treatment,when it was finished and one week after finishing it, with the Vita EasyShade spectrophotometer. CIEL*a*b* andΔE were established at each moment in the study. Intra-group data was compared using the paired t-test and intergroupdata with the independent groups t-test. Scores from the Vita Classical guide provided with the device wererecorded and the colour improvement percentage was calculated.Results: In both groups significant whitening was achieved by the end of treatment. Lightness remained significantlyhigh when treatment was finished and one week after in both groups. The percentage of bleaching wassignificantly higher in group A.Conclusions: Both 22% CP and 37.5% HP were effective for bleaching teeth. Bleaching effect was greater in CPgroup (AU)

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Do depressive symptoms correlate with oxidative stress in a sample of healthy college students?

Background and Objectives: Major depression and sub-threshold depressive symptoms are associated with health crisis. Oxidative stress may be a mechanism for major depression. In the present study, we examined the relationship between the degree of depressive symptoms and oxidative status using a reliable and inexpensive method that evaluates endogenous hydroperoxides. Methods: We conducted a cross-sectional study in 54 non-smoking college students and measured serum reactive oxygen metabolites (ROMs) and the biological antioxidant potential (BAP) as an index of oxidative status. Depressive symptoms were assessed by the Beck Depression Inventory (BDI). Results: The concentrations of ROMs did not differ between the lower BDI group (BDI < 14) and the higher BDI group (BDI > 14) (282.7 - 59.84 U.CARR vs 307.7 - 67.51 U.CARR, z = -1.19, P = 0.239). We did find a significant relationship between ROM concentration values and higher BDI scores (rho = 0.30, P = 0.042). BAP levels in the higher BDI group were not significantly greater than those in the lower BDI group (z = -0.108, P = 0.287). There was no significant correlation between BAP and depressive symptoms (rho = 0.22, P = 0.140). Moreover, we conducted a multiple regression analysis to control for gender difference and difference in sleep perception of the previous night between the two BDI groups. However, depressive symptoms were not significantly predicted by ROM concentrations (b = 0.28, P = 0.076). Conclusions: While results of the present study demonstrated a slight correlation between depressive symptoms and oxidative stress, this linkage could not be confirmed after controlling for significant confounding factors. This result should be verified in a larger sample (AU)

Melatonin and oxidative stress

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In vivo evaluation of the effects of 10% carbamide peroxide and 3.5% hydrogen peroxide on the enamel surface

Objectives: Bleaching of vital teeth performed at home by the patient under the dentist’s supervision, using low-concentration peroxides and custom-fitted trays specifically designed for this purpose, is one of several options for this type of dental treatment, whether alone or in combination with another in-office bleaching technique. The objective of this study is to analyse the effect on the enamel surface of two bleaching products recommended for this technique. Materials & methods: Two bleaching products were used: VivaStyle (Vivadent), a 10% carbamide peroxide, and FKD (Kin), a 3.5% hydrogen peroxide. They were applied in trays to the anterior teeth of 20 patients (10 in each group). The application times were 2 and 3 hours a day respectively for 28-33 days. Replicas of the tooth surfaces before and after treatment were obtained. These were observed with a scanning electron microscope. Results: The images obtained showed that the tooth surfaces remained entire and the enamel surface structures remained normal. Conclusions: The results show that neither of the products affects the enamel surface: no post-operatory changes were observed

Objetivos: El blanqueamiento de los dientes vitales que realiza el/la paciente en su domicilio bajo la supervisión del/de la dentista con férulas individualizadas especialmente diseñadas para ello y peróxidos de baja concentración, es una opción de entre las que integran esta terapéutica odontológica, ya sea, como tratamiento único o combinada con otra modalidad de blanqueamiento en la consulta. El objetivo del presente trabajo es analizar el efecto que producen sobre la superficie del esmalte dos productos blanqueadores indicados para esta técnica. Diseño del estudio: Se emplearon dos productos blanqueadores, el VivaStyle (Vivadent), peróxido de carbamida al 10%, y el FKD (Kin), peróxido de hidrógeno al 3,5%, que se aplicaron mediante férulas sobre los dientes anteriores de 20 pacientes (10 en cada grupo). El tiempo de aplicación de cada producto fue de 2 y 3 horas al día respectivamente durante 28-33 días. Se obtuvieron réplicas de las superficies dentales antes y después del tratamiento, las cuales fueron observadas con un microscopio electrónico de barrido. Resultados: Las imágenes obtenidas muestran la integridad de la superficie dental, con el mantenimiento de las estructuras normales de la superficie del esmalte. Conclusiones: Los resultados obtenidos muestran que ninguno de los dos productos alteran la superficie del esmalte, no observándose, pues, cambios postoperatorios

Blanqueamiento vital domiciliario: comparación de tratamientos con peróxido de hidrógeno y peróxido de carbamida / At-home vital bleaching: a comparison of hydrogen peroxide and carbamide peroxide treatments

El blanqueamiento de los dientes vitales que realiza el/la paciente domiciliariamente con férulas bajo supervisión del/de la dentista es una alternativa interesante entre las que integran este tipo de terapéutica odontológica, ya sea, de forma aislada o combinada con alguna de las modalidades de tratamiento en la consulta. En este procedimiento blanqueador se usan peróxidos de baja concentración que se aplican sobre el esmalte dentario mediante una cubeta individualizada especialmente diseñada para ello. El objetivo del presente trabajo es analizar y comparar dos productos blanqueadores comerciales de diferente concentraciónindicados para esta técnica, VivaStyle (Vivadent) y FKD (Kin); el primero de ellos es un peróxido de carbamida al 10%, mientras que el segundo es un peróxido de hidrógeno al 3,5%. Se analizan los parámetros que deben ser controlados durante la puesta en práctica de este tipo de procedimiento y se presentan 6 casos (3 de ellos tratados con uno de los productosmencionados y los otros 3 con el otro) en los que se constata su capacidad blanqueadora y la aparición y la intensidad de hipersensibilidad postoperatoria. Los resultados obtenidos muestran que ambos productos son eficaces para la función para la que han sido desarrollados. En general, la hipersensibilidad dentaria es mínima

Tray bleaching of vital teeth performed at home by the patient under the dentist’s supervision, whether alone or in combinationwith any of the in-office techniques, provides an interesting alternative to other methods employed in this type of dental treatment. This bleaching procedure applies low-concentration peroxides to the enamel by means of a custom-made mouth tray specifically designed for this purpose. The aim of this study is to examine and compare two commercially-available bleaching products, at equivalent concentrations, for use in this technique: VivaStyle (Vivadent) and FKD (Kin); the former is a 10% carbamide peroxide and the latter a 3.5% hydrogen peroxide formulation. It examines the parameters that must be monitored during the application of this type of procedure and presents 6 cases (3 treated with one of the above-mentioned products and the other 3 with the other), establishing the bleaching power of the products and the appearance and intensity of post-operatory hypersensitivity. The results obtained show that both products are effective for the purpose for which they were designed. In general, dental hypersensitivity was minimal

A propósito del tratamiento de la halitosis / About a bad breath treatment

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Efecto del peróxido de carbamida al 10 por ciento sobre el esmalte dentario / Effect of 10 por ciento carbamida peroxide of the enamel surface

El objetivo de este estudio fue identificar los cambios topográficos que produce el peróxido de carbamida al 10 por ciento sobre la superficie del esmalte y comparar los efectos de tres blanqueadores (Opalescence, Platinum, Receta Magistral de Farmacias Ahumada), utilizando microscopía electrónica de barrido. Se utilizaron 10 molares, que fueron partidos en cuatro trozos cada uno, siendo tres de ellos tratados con los blanqueadores y uno dejado como control. Posteriormente se observaron con microscopio electrónico de barrido. Todas las muestras tratadas con los blanqueadores mostraron alteraciones topográficas de la superficie del esmalte, desde la formación de una capa amorfa, desmineralización tipo I de Silverstone, hasta formación de poros profundos (AU)

Oxidación de los lípidos contenidos en la nutrición parenteral total / Oxidation of the lipids contained in Total Parenteral Nutrition (TPN)

Los componentes de las mezclas de nutrición parenteral son susceptibles de oxidarse. La oxidación de los lípidos poliinsaturados origina lipoperóxidos que son tóxicos. Esta toxicidad tiene especial repercusión en neonatos, por la inmadurez de sus sistemas de defensa contra procesos oxidativos y en enfermos críticos, quienes poseen un incremento del metabolismo oxidativo.Se revisan los trabajos donde se evalúa: toxicidad de lipoperóxidos, factores que intervienen en la oxidación de las mezclas de nutrición parenteral y los métodos analíticos para la determinación de peróxidos en mezclas de nutrición parenteral.Entre los factores que influyen en la peroxidación de las mezclas de nutrición parenteral cabe destacar: cantidad de ácidos grasos poliinsaturados, presencia de bisulfito, multivitaminas y contenido de polisorbatos en las mismas, temperatura, tipo de bolsa y exposición a la luz. Los métodos analíticos encontrados para analizar peroxidos en mezclas de NPT son: yodométrico, cromatografía líquida de alta resolución, ensayo del ácido tiobarbitúrico y oxidación del catión ferroso en presencia de naranja de xilenol. Según el método, la determinación será de peróxidos totales o únicamente de lipoperóxidos.En la Bibliografía no hay una concentración de peróxidos por debajo de la cual pueda considerarse segura la mezcla de nutrición parenteral (AU)

The components used in parenteral nutrition mixtures are subject to oxidation. The oxidation of polyunsaturated lipids leads to the formation of toxic lipoperoxides. This toxicity is of particular significance in newborn children, because of the lack of maturity of their defensive systems against oxidative processes, and also in critically-ill patients, whose oxidative metabolism is increased. A review of the literature is effected to assess the following: toxicity of lipoperoxides, factors involved in the oxidation of parenteral nutrition mixtures and the analytical methods used to determine the peroxides present in parenteral nutrition mixtures. The factors influencing the oxidation of parenteral nutrition mixtures include: the amount of polyunsaturated fatty acids, the presence of bisulphite, vitamin complexes and their polysorbate content, temperature, type of bag and exposure to light. The analytical methods found for the analysis of peroxides in TPN mixtures are: iodine measurement analysis, high resolution liquid chromatography, the thiobarbituric acid test, and oxidation of the ferrous cation in the presence of xylenol orange. Depending on the method, it is possible to determine total peroxides or only lipoperoxides. The literature reviewed does not establish a threshold level of peroxide concentration below which a parenteral nutrition mixture can be considered safe (AU)