Over-the-counter products in tooth bleaching: A scoping review.

OBJECTIVE: To map and summarize the current scientific evidence concerning the active ingredients, effectiveness, and adverse effects of over-the-counter (OTC) bleaching products. DATA AND SOURCE: This study was conducted according to the PRISMA-ScR guidelines for scoping reviews and registered on the Open Science Framework platform. STUDY SELECTION: Database searches were conducted in PubMed/MEDLINE, Embase, and Scopus up to January 2024. All in vitro, in situ, and clinical studies evaluating the effectiveness and adverse effects of OTC bleaching products were included. A descriptive analysis of the included studies was performed. RESULTS: A total of 88 studies were included. Most of them were in vitro studies (n = 49), followed by randomized clinical trials (n = 28). The main OTC bleaching products identified were whitening or stain-removing toothpastes (n = 42), followed by whitening strips (n = 39). Most clinical studies indicate that whitening strips are effective in improving tooth color and providing whitening benefits. In contrast, the bleaching effectiveness of toothpastes, mouth rinses and whitening trays was mainly supported by in vitro studies. The main adverse effects associated with OTC bleaching agents were tooth sensitivity and gingival irritation. CONCLUSION: A wide variety of OTC bleaching products is available for consumer self-administered use. Clinical studies have mainly confirmed the bleaching effectiveness of whitening strips, while the validation for toothpastes, mouth rinses and whitening trays has mainly relied on in vitro studies. Nevertheless, the use of OTC bleaching products may result in adverse effects, including tooth sensitivity, gingival irritation, and enamel surface changes. CLINICAL SIGNIFICANCE: Some over-the-counter bleaching products may have whitening properties supported by clinical studies, particularly those containing hydrogen or carbamide peroxide. Nonetheless, clinicians must be aware of the potential risks associated with excessive self-administration of these products, which may result in adverse effects.

Glutaraldehyde-based desensitizer does not influence postoperative sensitivity and clinical performance of posterior restorations: A 24-month randomized clinical trial.

OBJECTIVES: To evaluate the influence of a glutaraldehyde-based desensitizer (GL) on postoperative sensitivity (POS) in posterior bulk-fill resin composite restorations using an adhesive applied in the self-etch (SE) and etch-and-rinse (ER) strategies; and to assess the clinical performance of the restorations. METHODS: Posterior resin composite restorations (n = 228) at least 3 mm deep were inserted in 57 subjects using a split-mouth design. The adhesive was applied with/without prior application of a GL. A resin composite was used for all restorations. Spontaneous POS (risk and intensity), as well as POS caused by stimulation with an air blast and assess the response to horizontal and vertical percussion was assessed using two scales in the baseline and after 7, 14, and 30 days. In addition, some parameters were evaluated using FDI criteria up to 24 months of clinical service. RESULTS: No significant POS was observed (p > 0.05). A higher absolute risk and intensity of spontaneous POS was observed within 7 days (35.1%), without statistically significant differences among groups. At 24 months 5 restorations were considered clinically unsatisfactory, and 73 restorations showed minor discrepancies in adaptation, with no significant differences between groups (p > 0.05). SIGNIFICANCE: A GL agent does not influence POS in posterior restorations with bulk-fill resin composite. It may be considered a dispensable clinical step in the restorative protocol.

Postoperative sensitivity in posterior resin composite restorations with prior application of a glutaraldehyde-based desensitizing solution: A randomized clinical trial.

OBJECTIVES: To evaluate the effect of a glutaraldehyde-based desensitizer on the postoperative sensitivity (POS) in posterior resin composite restorations up to 12 months using a universal adhesive (Tetric N-Bond Universal) with selective enamel etching (SE) or an etch-and-rinse (ER) strategy. METHODS: Class I and class II resin composite restorations (n = 220) at least 3 mm deep were inserted in 55 subjects. The universal adhesive was applied using the SE (self-etch strategy on dentin with selective enamel etching) or the ER strategy, with or without prior application of a glutaraldehyde-based desensitizer (Gluma Desensitizer - GL) to form groups SEGL and ERGL. A bulk-fill resin composite (Tetric NCeram Bulk Fill) was used for all restorations. Spontaneous POS was assessed 7 days after the restorative procedure using the Visual Analog Scale (VAS) and the Numeric Rating Scale (NRS). After 7, 14, and 30 days of completing each restoration, the subjects were reassessed to evaluate POS caused by stimulation with an air blast, horizontal and vertical percussion. In addition, marginal discoloration, marginal adaptation, fracture, and recurrence of caries were evaluated using the FDI (World Dental Federation) criteria after 7 days and at 12 months. RESULTS: No significant spontaneous or stimuli-induced POS was observed when restorations with or without GL were compared (p>0.05). A higher risk of spontaneous POS was observed within 7 days (40.0%; 95% CI 28.1 to 53.1), without statistically significant differences among groups. None of the participants reported POS at 12 months, however five restorations were considered clinically unsatisfactory (p > 0.05). CONCLUSIONS: The previous application of GL did not significantly reduce spontaneous or stimuli-induced POS in posterior resin composite restorations at any time, regardless of the adhesive strategy used. CLINICAL SIGNIFICANCE: The use of a glutaraldehyde-based desensitizing agent did not generate lower incidence of postoperative sensitivity in resin composite posterior restorations.

Microtensile Bond Strength of Bulk-fill Resin Composite Restorations in High C-factor Cavities.

AIM: To evaluate the microtensile bond strength (µTBS) and the fracture modes of four bulk-fill resin composites (Tetric EvoCeram Bulk Fill/Ivoclar Vivadent, Filtek Bulk Fill/3M ESPE, Venus Bulk Fill/Heraus Kulzer, and Filtek Bulk Fill Flow/3M ESPE) and one conventional incrementally filled resin composite (Filtek Z250/3M ESPE) inserted in class I cavities, after 24 hours and 6 months of water storage. MATERIALS AND METHODS: In all, 30 sound human extracted molars were divided into five restorative groups. Standardized class I cavities were prepared and restored following the manufacturer's instructions. The restored teeth were then assigned into one of the storage times (24 hours or 6 months). The molars were then cut into 1 mm2 sticks and submitted to µTBS. All fractured specimens were analyzed under a stereomicroscope (40×). Data were submitted to analysis of variance (ANOVA) and the Tukey post hoc test was applied for comparison between groups; and paired t test for comparison within storage times (p = 0.05). RESULTS: After 24 hours of storage, statistically significant differences were observed between Filtek Z250 and Filtek Bulk Fill Flow groups. However, after 6 months, no statistical differences were observed between groups. Additionally, no differences were observed for the µTBS between the storage times. Adhesive failures were the most frequent fracture mode after 24 hours (54%) and 6 months (43%), the resin cohesive fracture mode showed 16% for 24 hours and 14% for 6 months, the dentin cohesive fracture mode showed 14% for 24 hours and 26% for 6 months, and the mixed fracture mode showed 16% for 24 hours and 17% for 6 months. CONCLUSION: Bulk-fill resin composites obtained similar µTBS in high C-factor cavities as conventional incrementally filled resin composites. No bond strength reduction was observed after 6 months of storage. CLINICAL SIGNIFICANCE: Single increment restorations in high C-factor cavities with bulk-fill resin composites did not reduce µTBS after 24 hours or 6 months of storage. The comparable results to the conventional incrementally filled resin composites and the reduction in the operative time, make the bulk-fill resin composites a restorative option for posterior teeth restorations.