Effect of a Toothpaste for Sensitive Teeth on the Sensitivity and Effectiveness of In-office Dental Bleaching: A Randomized Clinical Trial.

OBJECTIVES: The present study aimed to evaluate the desensitizing effect of toothpaste for sensitive teeth on patient tooth sensitivity and on bleaching efficacy of the 38% hydrogen peroxide bleaching agent used for in-office bleaching compared to a regular toothpaste in a randomized clinical trial. METHODS AND MATERIALS: Forty-eight patients having maxillary right central incisors with darkness greater than A1 were selected for the present double-blind randomized clinical trial. Patients were randomly allocated into two groups: the placebo group, which used regular toothpaste, and the experimental group, which used sensitivity toothpaste. The intervention consisted of applying toothpaste with the aid of an individual tray for a period of 4 minutes daily, starting one week before the first bleaching session and interrupting use immediately after the second session. After allocation to one of the groups, individuals received in-office dental bleaching with a 40-minute application of 38% hydrogen peroxide for two sessions with an interval of one week. The incidence and intensity of sensitivity were assessed using a visual analogue scale and a numeric analogue scale. Sensitivity was measured immediately before each session, 1 hour, 24 hours, and 48 hours after each bleaching session and four weeks after the second bleaching session. Tooth shade was evaluated using a spectrophotometer and by comparison with the VITA Classical Shade Guide (Vita Zahnfabrik, Bad Säckingen, Germany). Tooth shade was evaluated before the first bleaching session, one week after the first bleaching session, one week after the second bleaching session and four weeks after the second bleaching session. Participants and professionals who performed the bleaching, shade, and sensitivity assessments were blinded to the group of patients they were treating or assessing. For the incidence of hypersensitivity, the results were evaluated by comparing the groups at different evaluation times with the Mann-Whitney test for comparison between groups, the Friedman test for repeated measures, and the Tukey test for comparison of times. Shade change on the guide was analyzed using the Mann-Whitney test for comparison between groups and the Wilcoxon test for comparison between times. Shade change by the spectrophotometer was analyzed using the t-test for comparison between groups and the paired t-test for comparison between times. All analyses were performed with a significance level of 5%. RESULTS: There was no difference in the pattern of dental hypersensitivity between groups. For all shade measures, there was no difference between the bleaching results, and no statistically significant difference was observed between the study groups. CONCLUSION: The use of arginine-based desensitizing toothpaste did not interfere with the bleaching ability of hydrogen peroxide and was not effective in reducing the sensitivity caused by in-office tooth bleaching.

The influence of methodological variables on the push-out resistance to dislodgement of root filling materials: a meta-regression analysis.

The aim of this systematic review was to evaluate the influence of several methodological variables on the push-out resistance to dislodgment of root filling materials by a meta-regression analysis of the literature. A systematic review was performed by searching the PubMed database using the terms 'push-out' and 'pushout'. Laboratory studies published before March 2015 were included. Two reviewers extracted data regarding country of origin, year of publication, tooth type, smear layer removal, root canal sealer, core material, obturation technique, sample storage, tooth portion, test machine load velocity and slice thickness. Pooled mean resistance to dislodgement of all groups from the included studies was used in a linear meta-regression of random effects (α = 0.05). Of the 850 identified studies, 53 met the inclusion criteria. A meta-regression of the 341 groups extracted from these articles was performed to analyse the influence of each variable on resistance to dislodgement (in MPa). The sealer, core material, obturation technique, slice thickness, storage time, load velocity and tooth portion significantly influence the results (P < 0.05). Irrigant solution and smear layer removal did not influence the resistance to dislodgement of the root filling materials (P > 0.05). Methodological variables such as sealer, core material, root filling technique, tooth type, tooth portion, slice thickness, storage time and load velocity influenced the resistance to dislodgment. The inclusion and standardization of all related variables could lead to a more comparable and reproducible analysis of the resistance to dislodgment of the root canal sealers.

Synthesis and characterization of a glycerol salicylate resin for bioactive root canal sealers.

AIM: To develop and characterize a salicylate resin with potential use in bioactive endodontic sealers. METHODOLOGY: Methyl salicylate, glycerol and titanium isopropoxide were added in a closed system for the transesterification reaction. The resin obtained was characterized by proton nuclear magnetic resonance spectroscopy (1H NMR) and size exclusion chromatography (SEC). To verify the applicability of the resin to the development of endodontic sealers, experimental cements were prepared by mixing glycerol salicylate resin, calcium hydroxide and methyl salicylate in the ratios of 2 : 1 : 1, 1 : 2 : 1, 1 : 1 : 2, 1 : 1 : 1, 4 : 1 : 1, 1 : 4 : 1 and 1 : 1 : 4. Setting times were measured according to ISO 6876. Features of the hardening reaction were described by micro-RAMAN spectroscopy. RESULTS: The transesterification reaction had a 72% efficiency. The (1) H NMR analysis revealed the presence of the expected functional groups (hydroxyls and aromatic rings), and the SEC confirmed the molar mass of the resin produced. The setting times of experimental sealers ranged from 70 min (ratio 1 : 1 : 1) to 490 min (ratio 1 : 1 : 4). The conversion of the salicylic groups (1 613 cm(-1) ) to salicylate salt (1 543 cm(-1) ) and the reduction in calcium hydroxide peaks (1084 and 682 cm(-1) ) were confirmed by micro-RAMAN spectroscopy, which showed the calcium chelation by the resin. CONCLUSION: The new glycerol salicylate resin was successfully synthesized and revealed a potential application in the development of endodontic sealers.