Influence of using different toothpaste during bleaching with violet LED light (405 nm) on the colour and roughness of dental enamel: an in vitro study.

This in vitro study aimed to investigate potential changes in the color and roughness of dental enamel resulting from the use of different toothpaste formulations during bleaching with violet LED light (405 nm). Sixty specimens of bovine incisors, each measuring 6 × 6 × 3 mm, were segregated into six distinct experimental groups based on their respective treatments (n = 10): C + VL: Brushing with Colgate® Total 12 + bleaching with violet LED; LB + VL: Brushing with Colgate® Luminous White Brilliant + bleaching with violet LED; LI + VL: Brushing with Colgate® Luminous White Instant + violet LED bleaching; C: Brushing with Colgate® Total 12; LB: Brushing with Colgate® Luminous White Brilliant; LI: Brushing with Colgate® Luminous White Instant. The examined variables included alterations in color (∆L*, ∆a*, ∆b*, ∆Eab, and ∆E00), surface roughness (Ra), and scanning electron microscopy observations. No statistically significant distinctions emerged in total color variations (∆E00 and ∆E) among the groups under scrutiny. Notably, the groups that employed Colgate® Luminous White Instant displayed elevated roughness values, irrespective of their association with violet LED, as corroborated by scanning electron microscopy examinations. It can be concluded that whitening toothpastes associated to violet LED do not influence the color change of dental enamel in fifteen days of treatment. Toothpastes with a higher number of abrasive particles showed greater changes in enamel roughness, regardless of the use of violet LED.

Effectiveness of desensitizing toothpastes in reducing tooth sensitivity after tooth bleaching: a systematic review.

OBJECTIVE: To evaluate the effectiveness of desensitizing toothpastes in reducing post-bleaching tooth sensitivity. MATERIALS AND METHODS: A systematic review of randomized clinical trials was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Electronic searches were conducted in the PubMed/MEDLINE, Scopus, Web of Science, The Cochrane Library and Embase databases, using the following terms: (dentifrices OR toothpaste) AND (sensitive OR sensitivity OR dental sensitivity) AND (dental bleaching OR tooth bleaching OR dental whitening OR tooth whitening). RESULTS: Five studies involving 387 individuals undergoing in-office or at-home teeth bleaching were reviewed. Desensitizing toothpastes reduced sensitivity effectively after home bleaching with 22% carbamide peroxide and single-session in-office bleaching with 35% hydrogen peroxide. However, they were ineffective for home bleaching with 16% carbamide peroxide and in-office bleaching across two sessions with 35% or 38% hydrogen peroxide. CONCLUSION: Desensitizing toothpastes are effective for home bleaching with high concentration carbamide peroxide and single-session in-office bleaching with highly concentrated hydrogen peroxide, but ineffective for home bleaching with low concentration carbamide peroxide and two-session in-office bleaching with concentrated hydrogen peroxide.

Whitening toothpastes with hydrogen peroxide concentrations vs. at-home bleaching.

OBJECTIVES: To evaluate the effect of whitening toothpastes with different hydrogen peroxide (HP) concentrations on HP permeability, color change, and physicochemical properties, compared to at-home bleaching treatment. MATERIALS AND METHODS: Forty-nine premolars were randomized into seven groups (n = 7): untreated (control); at-home bleaching with 10% carbamide peroxide gel (AH; 10% CP) with 14 and 28 applications of 180 min each (AH [14 × 180 min] and AH [28 × 180 min]); three whitening toothpastes (3% HP; 4% HP and 5% HP) and 10% CP brushed 28 times for 90 s each (TB [28 × 90 s]). HP permeability was measured using a UV-VIS spectrophotometer and color change by a digital spectrophotometer (ΔEab, ΔE00, and ΔWID). Initial concentration, pH, and viscosity were measured through titration, digital pH meter, and rheometer, respectively. Statistical analysis included one-way ANOVA, Tukey's test, and Dunnett's test (α = 0.05). RESULTS: 4% HP group showed acidic pH, the lowest viscosity and the highest HP concentration into the pulp chamber (p < 0.05). The 10% CP groups had lower HP in the pulp chamber and greater color change than other groups (p < 0.05), except the 5% HP group in ΔEab and ΔE00. For ΔWID, the 10% CP AH groups showed greater whitening than other groups (p < 0.05). CONCLUSIONS: Whitening toothpaste with up to 5% HP resulted in higher HP permeability and less color change compared to 10% CP. Higher HP commercial concentrations in toothpaste increased whitening effect; however, acidic pH toothpastes exhibited greater HP permeability. CLINICAL RELEVANCE: Whitening toothpastes with high hydrogen peroxide concentrations were less effective than at-home bleaching, resulting in less color change and greater permeability of hydrogen peroxide, potentially increasing the risk of tooth sensitivity.

Evaluation of toothpastes for treating root carious lesions - a laboratory-based pilot study.

BACKGROUND: Root caries is preventable and can be arrested at any stage of disease development. The aim of this study was to investigate the potential mineral exchange and fluorapatite formation within artificial root carious lesions (ARCLs) using different toothpastes containing 5,000 ppm F, 1,450 ppm F or bioactive glass (BG) with 540 ppm F. MATERIALS AND METHODS: The crowns of each extracted sound tooth were removed. The remaining roots were divided into four parts (n = 12). Each sample was randomly allocated into one of four groups: Group 1 (Deionised water); Group 2 (BG with 540 ppm F); Group 3 (1,450 ppm F) and Group 4 (5,000 ppm F). ARCLs were developed using demineralisation solution (pH 4.8). The samples were then pH-cycled in 13 days using demineralisation solution (6 h) and remineralisation solution (pH 7) (16 h). Standard tooth brushing was carried out twice a day with the assigned toothpaste. X-ray Microtomography (XMT) was performed for each sample at baseline, following ARCL formation and after 13-day pH-cycling. Scanning Electron Microscope (SEM) and 19F Magic angle spinning nuclear magnetic resonance (19F-MAS-NMR) were also performed. RESULTS: XMT results showed that the highest mineral content increase (mean ± SD) was Group 4 (0.09 ± 0.05), whilst the mineral content decreased in Group 1 (-0.08 ± 0.06) after 13-day pH-cycling, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4 (p < 0.05). SEM scans showed that mineral contents within the surface of dentine tubules were high in comparison to the subsurface in all toothpaste groups. There was evidence of dentine tubules being either partially or completely occluded in toothpaste groups. 19F-MAS-NMR showed peaks between - 103 and - 104ppm corresponding to fluorapatite formation in Groups 3 and 4. CONCLUSION: Within the limitation of this laboratory-based study, all toothpastes were potentially effective to increase the mineral density of artificial root caries on the surface, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4.

Evaluation of total, soluble and ionic fluoride concentration in whitening and desensitizing toothpastes.

PURPOSES: Due to the popularity and increasing launch of toothpastes with whitening and sensitivity properties on the market, this study aimed to evaluate the fluoride concentrations in these products, since the concentrations of fluoride directly interfere with the anti-caries potential. METHODS: This is an experimental, in vitro study, where 37 samples from different batches (n = 3) purchased in different countries, were analysed in duplicate, via the ion-selective electrode technique to verify the concentration (µg/g or ppm F-) of total fluoride (TF), total soluble fluoride (TSF) and ionic fluoride (IF). For a comparative data analysis, ANOVA was applied followed by a Tukey's test for multiple comparisons. The level of confidence adopted was 95%. RESULTS: In the 37 assessed toothpastes, 45.9% contained NaF and 54.1% sodium monofluorophosphate (MFP). The TF found in the formulations ranged from 902.8 to 1539.4 ppm of F (mean: 1165.2 ± 179.3); fluoride concentration in the TSF fraction ranged from 708.8 to 1306.7 ppm of F (mean: 959.5 ± 162.4); IF results ranged from 101.9 to 1162.3 ppm of F (642.2 ± 294.1). Significant differences (p < 0.05) were found in the concentrations of the 59.5% assessed toothpastes in comparisons between declared and measured total fluoride (TF) concentrations, as well as in 62.2% when total fluoride (TF) and total soluble fluoride (TSF) were compared. CONCLUSIONS: In this study, most of the samples evaluated showed discrepancies when compared to the information declared by the manufacturers. In addition, the soluble concentrations found in half of the samples were lower than total concentrations and this may affect anti-caries effectiveness.

Description of a new laboratory evaluation method of interdental brush abrasion as a clinical hazard.

OBJECTIVES: To simulate the abrasive potential of an interdental brush when applied with toothpastes and prophylactic gels/solutions in a novel laboratory brushing simulation set-up. METHODS: A brushing device was customized to treat dentin samples mimicking a simplified interdental space with an interdental brush (ISO 2). The brushing, that is, 7200 strokes for 1 h, was performed with artificial saliva (control), a povidone-iodine solution, and slurries of chlorhexidine and fluoride gels as well as three toothpastes with different RDA values ranging from 29 to 100, respectively. The loss of dentin was profilometrically assessed and compared with ANOVA and Fishers LSD. RESULTS: While artificial saliva as control, the solution and the gel slurries showed no measurable dentin loss, toothpastes resulted in a measurable linear surface damage with respect to the actual intrinsic RDA values and ranged from 12.6 to 26.5 µm (p < 0.001). CONCLUSIONS: Any interdental cleaning product should be tailored and carefully instructed. Any over- and misuse should be avoided, which applies especially to the use of interdental brushes in combination with abrasive toothpastes.

Optimization of a Validated Protocol That Determines Bioavailable Fluoride in Toothpastes.

A validated protocol used to determine how much of total fluoride is bioavailable in toothpaste formulations was evaluated if it could be simplified regarding the following parameters: (1) concentration of the slurry (0.25-4%), (2) centrifugation speed (1,000-12,000 g) and time (1-10 min), and (3) incubation time for FPO32- ion hydrolysis and insoluble-F dissolution (15-60 min). Fresh and aged Na2FPO3/CaCO3 and fresh NaF/SiO2-based toothpastes were analyzed (n = 9). The improvements were the centrifugation at 1,000 g for 5 min is enough to separate insoluble-F and the time for FPO32- ion hydrolysis and insoluble-F dissolution can be shortened to 30 min.

Interaction between Hexametaphosphate, Other Active Ingredients of Toothpastes, and Erosion-Abrasion in Enamel in vitro.

Sodium hexametaphosphate (HMP) as toothpaste additive is claimed to reduce erosive tooth wear and to stabilize stannous ions. However, little is known about the impact of concentration and its interactions with fluoride (F) or stannous+fluoride ions (F/Sn) on enamel erosion and erosion-abrasion. In a 10 day cyclic in vitro erosion-abrasion model, 320 flat human enamel specimens were divided into ten groups (n = 32 each) and daily subjected to six erosive challenges (0.5% citric acid, 2 min) and two toothpaste suspension applications (2 min, 1:3 F-free toothpaste:mineral-salt solution, 0.23% sodium gluconate). Half of specimens per group were additionally brushed twice/day (200 g, 15 s) during suspension immersion. Nine suspensions contained HMP (0.25%, 1.75%, 3.25%), either on its own or combined with F (373 ppm F-) or F/Sn (800 ppm Sn2+, 373 ppm F-). One suspension contained sodium gluconate only (NegContr). After 10 days, specimens' surfaces were analysed with profilometry, energy dispersive X-ray spectroscopy, and scanning electron microscopy. Tissue loss (µm, mean ± standard deviation) in NegContr was 10.9 ± 2.0 (erosion), 22.2 ± 1.6 (erosion-abrasion). Under erosive conditions, only 0.25% HMP in any combination and 1.75% HMP with F/Sn reduced loss significantly (-28% to -54%); 3.25% HMP without F and F/Sn increased loss significantly (+35%). With additional abrasion, no suspension reduced loss significantly compared to NegContr, instead, in groups without F and F/Sn or with 3.25% HMP loss was increased (+15% to +30%). Conclusively, at higher concentrations, HMP increased erosive tooth wear and seemed to reduce anti-erosive effects of fluoride and stannous ions.

Cytotoxicity and genotoxicity of whitening toothpastes in buccal mucosal cells: a randomized controlled trial.

OBJECTIVES: To assess genotoxic and cytotoxic effect of commercially available toothpastes with the different whitening ingredients. MATERIALS AND METHODS: In vivo assessment of cytotoxicity and genotoxicity of whitening toothpastes with different ingredients using a buccal micronucleus cytome assay (BMCyt assay) comprised 199 participants randomly divided into ten groups based on used whitening or control/conventional toothpaste. The exfoliated buccal mucosal cells were collected, stained, and microscopically evaluated at baseline (T0), 30 days (T1), and 60 days (T2) after the beginning of treatment and 30 days after completing treatment (T3). Statistical evaluation was performed by repeated-measures analysis of variance (two-way ANOVA), Tukey's test, and multiple regression analysis. RESULTS: The genotoxic parameters showed no biologically significant changes in any of the observed period for the tested toothpastes, while cytotoxic parameters (number of cells with karyorrhexis and condensed chromatin) showed statistically significant difference (P < 0.05) among evaluation periods for the three peroxide-containing toothpastes. CONCLUSIONS: Peroxide-containing whitening toothpastes exhibit an increase in certain cytotoxic parameters only during the application period, which return to control values after the cessation of application. CLINICAL SIGNIFICANCE: Whitening toothpastes show no genotoxic effect, while peroxide-containing whitening toothpastes may present significant increase of cytotoxicity (measured by the number of karyorrhexis and condensed chromatin) during the application period. However, these changes observed in clinical conditions cannot be considered significant. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04460755.

Which whitening toothpaste with different contents is more effective on color and bond strength of enamel?

OBJECTIVE: To evaluate the effects of six whitening toothpastes with different whitening ingredients as follows: abrasives, polyphosphates, activated charcoal and hydrogen peroxide on the color, and shear bond strength (SBS) of enamel. MATERIALS AND METHODS: Thirty-five extracted human molars were sectioned in mesiodistal direction, providing 70 enamel specimens and randomly divided into seven groups having different whitening ingredients (n = 10). After baseline color measurements, the specimens were brushed three times daily for the 30 s. At the end of 2 weeks, spectrophotometric readings were repeated, and color change parameters were calculated. Then, composite cylinders were built on the enamel surfaces and the specimens were subjected to SBS test. Failure modes were determined under a stereomicroscope (×10). One specimen from each group was examined with scanning electron microscope (SEM). The data were statistically analyzed using Kruskal-Wallis, Wilcoxon signed, one-way-ANOVA (p = 0.05). RESULTS: Clinically acceptable color change was observed in all whitening toothpastes. There were no significant differences among the groups for Δa, ΔL, ΔE00 , and ΔWID (p > 0.05). The differences among the groups were not significant regarding SBS and failure mode distributions (p > 0.05). SEM findings were in line with the SBS test and failure mode distribution results. CONCLUSIONS: All the tested whitening toothpastes showed similar and clinically acceptable efficacy on the color change of the enamel and led to comparable SBS values. CLINICAL SIGNIFICANCE: The tested whitening toothpastes had an acceptable whitening efficacy and did not have a negative effect on the bond strength to the enamel.

Association between Level of Parental Oral Health Literacy and the Rational Use of Fluoride for Children from 0 to 4 Years of Age after Instruction: An Intervention Trial.

An inadequate level of oral health literacy (OHL) can hinder the understanding of dental information, which can have a negative impact on health promotion actions, such as the rational use of fluoride. The aims of the present study were (1) to look for association between parents/guardians' OHL and the amount of fluoride toothpaste used for children from zero to four years of age; (2) to compare the effect of different modes of educational interventions on the amount of fluoride toothpaste used for children from zero to four years of age; and (3) to assess the ability of parents/guardians to choose a toothpaste with adequate fluoride concentration, after the educational intervention. A randomized intervention study was conducted with parents/guardians of children from zero to four years of age (n = 145). The participants answered the Oral Health Literacy Adults Questionnaire and a questionnaire addressing sociodemographic characteristics. The participants were allocated to four intervention groups based on type of counseling (written, oral, written + photograph, and oral + photograph), with randomization stratified by level of OHL. The participants were instructed to place the adequate amount of toothpaste on a toothbrush for children from zero to four years of age (smear of 0.125 mg) before and after the intervention. The correct choice of toothpaste was also evaluated by the interpretation of the labels of four toothpastes of different brands and with different concentrations of fluoride. Associations between variables were tested using the Student's t test and one-way ANOVA. Level of OHL was associated with the amount of fluoride toothpaste deposited prior to the educational intervention (p = 0.021) and the percentage of approximation to the appropriate amount of fluoride toothpaste (p < 0.05). The choice of toothpaste was associated with schooling (p = 0.031). In conclusion, parents/guardians with adequate OHL better quantified fluoride toothpaste before and after the educational intervention and also came closer to the appropriate amount of toothpaste after the educational intervention. No significant differences in the final amount of toothpaste placed on the toothbrush were found among the intervention groups. The choice of the correct toothpaste was associated with a higher level of schooling.

Effect of a Toothpaste Containing Surface Pre-Reacted Glass-Ionomer Filler on the Remineralization of Artificial Carious Enamel Lesions in situ.

This study evaluated the remineralizing effect of a toothpaste containing surface pre-reacted glass-ionomer (S-PRG) filler on demineralized enamel in situ. For this, 180 bovine enamel samples were demineralized by using a microcosm biofilm model for 3 days. Thereafter, the samples were randomly signed to 15 healthy volunteers and to 3 cross-over in situ phases corresponding to the following treatments: (1) toothpaste containing 1,500 ppm F as NaMFP (positive control, Colgate®Cavity Protection), (2) toothpaste containing 5% S-PRG filler (Shofu®), and (3) placebo toothpaste (negative control prepared by Shofu®). Four demineralized enamel blocks were fixed into each palatal appliance per phase. The volunteers wore the appliances for 5 days and were trained to brush their teeth 2 times for 2 min a day, while one drop of the toothpaste's slurry (1:3) was dripped on each sample for the same period. The surface hardness and TMR analyses were done and analyzed by ANOVA/Tukey and t test (p < 0.05). S-PRG filler and Colgate® toothpastes were equally able to improve 2-2.5× enamel remineralization by the analysis of % surface hardness recovery. However, S-PRG toothpaste was the only one able to significantly improve ΔΔZ (the integrated mineral loss recovery: 1,489 ± 503 %vol.µm) compared to placebo (1,050 ± 467 %vol.µm), while Colgate® did not differ from placebo. No differences were seen between the groups with respect to ΔLD. S-PRG filler and Colgate® toothpastes show similar potential to remineralize the lesion surface. However, S-PRG toothpaste is better to recover mineral loss at the subsurface area.

Color stability and microhardness alteration of irradiated dental enamel treated with a high fluoride concentration toothpaste.

OBJECTIVES: Radiotherapy (RT) is a kind of head and neck cancer (HNC) treatment, which is associated to the habit of smoking and can develop collateral effects in the oral cavity, such as the increase of caries prevalence. This study evaluated the color alteration, the microhardness, and the remineralizing potential of high fluoride concentration toothpastes on irradiated teeth. MATERIALS AND METHODS: Forty bovine teeth were used (6 × 6 × 2 mm) and after color (EasyShade, VITA) and microhardness initial readings were separated into two groups: exposed to cigarette smoke and non-exposed. All samples were submitted to RT (30 Gy) and to cariogenic challenge. New color and microhardness readings were done. After RT (60 Gy), the samples were submitted to simulated toothbrushing (73,000 cycles = 5 years of brushing) with two different toothpastes: conventional (1450 ppm) and high fluoride concentration (5000 ppm). Final color and microhardness readings were done after brushing. Data were analyzed with 2-way ANOVA with repeated measures and Tukey's test (p < .05). RESULTS: There was no color difference after RT, nor after brushing (p > .05). However, after brushing, microhardness values increased for the samples treated with high fluoride concentration toothpaste (p < .05). CONCLUSION: Radiotherapy did not influence the teeth color, and the high fluoride concentration toothpaste presented remineralizing potential; therefore, it could be used on the caries prevention related to HNC radiation. CLINICAL RELEVANCE: Considering its remineralizing potential, toothpastes with high fluoride concentration could be a proper alternative for caries prevention in patients undergoing radiotherapy.

Impact of desensitizing/whitening toothpastes on tooth color change after abrasion and erosion-abrasion.

OBJECTIVE: To evaluate the impact of desensitizing toothpastes (D), their whitening versions (DW) and whitening toothpastes (W) on tooth color change. METHODS: Tooth specimens were allocated into 11 groups (n = 10): 1. Artificial saliva (control); 2. Sensodyne Repair & Protect (SRP-D); 3. Sensodyne Repair & Protect Whitening (SRP-DW); 4. Colgate Sensitive Pro-Relief (CSPR-D); 5. Colgate Sensitive Pro-Relief Real White (CSPR-DW); 6. Colgate Total 12 (CT12); 7. Colgate Total 12 Whitening (CT12-W); 8. Sensodyne True White (ST-W); 9. Curaprox Black Is White (CB-W); 10.Oral-B 3D White Perfection (OB3D-W) and 11. Erosion-only. They were submitted to two models: A. abrasion; B. erosion/abrasion. Color change (ΔE00 ), ΔL, Δa, and Δb were determined with a spectrophotometer. Data were statistically evaluated (α = 0.05). RESULTS: For both models, ∆E00 of D did not differ significantly from DW. An overall decrease in luminosity (-∆L) and increase (+∆b) in yellowness of the tooth occurred. In abrasion, all groups reduced redness (-∆a) and only SRP-DW differed from control (p = 0.016), but for ∆E00 , ∆L and ∆b, all toothpastes did not differ from the control. In erosion/abrasion, CB-W showed significantly lower ∆E00 and ∆b than the control (∆E00 : p = 0.026; ∆b: p = 0.005) and SRP-D (∆E00 : p = 0.028; ∆b: p = 0.025). Only SRP-DW, CSPR-DW, ST-W, CB-W, and erosion-only had increased redness (+∆a), but none differed from control. CONCLUSIONS: The toothpastes did neither promote whitening nor avoid the yellowish aspect of the tooth after abrasion and erosion-abrasion, regardless of their claim. CLINICAL SIGNIFICANCE: Desensitizing and/or whitening toothpastes induced similar changes on tooth color, without promoting whitening effect or reduction in its yellowish aspect.

Antibacterial effect of an herbal toothpaste containing Bamboo salt: a randomized double-blinded controlled clinical trial.

BACKGROUND: The inclusion of herbal antibacterial agents in the composition of toothpastes is becoming increasingly popular, due to lower side effects. The present study intended to investigate the antibacterial efficacy of a herbal toothpaste containing Bamboo salt on cariogenic oral bacteria. METHODS: The present double-blinded parallel randomized controlled clinical trial was conducted on 60 dental students (age range: 18-30). Following the baseline saliva sampling, the participants were randomly assigned into the case and control groups, to use the Bamboo salt herbal toothpaste and conventional non-herbal toothpaste, respectively. They were instructed to brush their teeth twice a day using the Bass technique. Saliva sampling was repeated after four weeks. The salivary counts of Streptococcus mutans and Lactobacillus at baseline and 4-week follow-up were determined and presented as the logarithm of colony-forming units per milliliter (log CFU/mL). RESULTS: A significant decrease in salivary Streptococcus mutans and Lactobacillus was observed using both toothpastes (*P < 0.001). The difference between the antibacterial efficacy of two toothpaste types on Streptococcus mutans and Lactobacillus was not statistically significant (P = 0.530, and P = 0.137, respectively). CONCLUSION: Due to the comparable efficacy of the investigated herbal toothpaste with conventional toothpaste, it potentially qualifies as a complementary agent for self-care oral hygiene procedures. TRIAL REGISTRATION: This trial was registered in the "Iranian Registry of Clinical Trials" (IRCT20210414050964N1) on 21/06/2021.

Evaluation of Charcoal and Sea Salt-Lemon-based Whitening Toothpastes on Color Change and Surface Roughness of Stained Teeth.

AIM: To compare the efficacy of two naturally based commercially available whitening toothpastes charcoal and sea salt-lemon on stain removal of teeth in terms of color change and surface roughness. MATERIALS AND METHODS: Twenty-seven intact bovine incisors were selected and randomly allocated into three main groups (n = 9) according to the tested toothpaste [I: Signal Complete 8 Charcoal; II: sea salt-lemon essence Closeup natural smile; and III: Signal Complete 8 Original (control)]. Following 4 successive days of staining protocol, each specimen in its corresponding group was brushed with the toothpaste using toothbrush simulator apparatus for three brushing cycles. Color assessment using Vita Easyshade spectrophotometer and surface roughness (Ra) measurement using contact type profilometer were performed for each specimen at baseline, after staining, and after each tooth brushing cycle. RESULTS: Nonparametric color data and parametric surface roughness data were analyzed. The color difference (ΔE) from after-staining protocol to different tooth brushing cycles (1,2,3) showed no significant difference on each cycle between the tested groups (p >0.05). While for color difference (ΔE) from baseline to the last tooth brushing cycle 3, the difference between groups was statistically significant where group II, sea salt-lemon-based toothpaste, had a significantly lowest (ΔE 00) value (p <0.001) indicating more whitening effect in relation to others. However, a significant increase in surface roughness was present in all tested groups (p <0.001); meanwhile, there was no significant difference between tested groups (p >0.05). CONCLUSION: After three tooth brushing cycles, none of the natural whitening toothpastes or conventional toothpastes produced had effective whitening results nor completely removed the stains back to the initial baseline tooth color. Sea salt-lemon-based whitening toothpaste had a whitening effect better than the charcoal-based toothpaste. All of the tested toothpastes increased the degree of surface roughness. CLINICAL RELEVANCE: Charcoal and sea salt-lemon-based whitening toothpastes do not guarantee to whiten nor completely remove the stains back to normal and their effects on enamel surface roughness should be highly clinically considered and managed.

Effectiveness of CPP-ACP and fluoride products in tooth remineralization.

OBJECTIVES: To compare the effectiveness of the casein phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP) in the in situ remineralization of enamel exposed with two different degrees of preformed enamel lesions. METHODS: One hundred and sixty 3 × 3 × 2 mm human enamel slabs were demineralized and divided into two subgroups according to the baseline surface hardness (SH = B1≤150 and B2 >150). During each of four 10-day experimental periods, 10 participants wore intra-oral removable acrylic palatal expanders with four human enamel slabs with preformed lesions (B1 and B2): CO1 and CO2-Control: silica dentifrice without fluoride; MP1 and MP2: MI Paste; MPP1 and MPP2: MI Paste Plus; and FD1 and FD2: Fluoride dentifrice. The Knoop hardness test (50/15s Micromet 2001, Buehler) was performed after demineralization (B1 and B2) and after treatment (T1 and T2). RESULTS: SH was higher in all treatment groups, when compared with the controls, except for CO2 (Mann-Whitney Wilcoxon Test; p < 0.05). The %SH was similar between MPP2 and FD2 and between MPP2 and MP2; however, FD2 and MPP2 products were more effective in microhardness recovery. In B1, all treatment groups were similar. CONCLUSION: MPP and FD are more effective in preventing demineralization in enamel subsurface lesions.

Dentifrices or gels containing MMP inhibitors prevent dentine loss: in situ studies.

OBJECTIVES: Evaluate the effect of dentifrices or gels containing MMP inhibitors on dentine loss in situ. MATERIALS AND METHODS: Acrylic palatal appliances containing bovine dentine blocks were divided into two rows, corresponding to the groups erosion (ERO) and erosion associated with abrasion (ERO+ABR). For ERO, the appliances were immersed in a cola drink for 5 min, 4 times/day, while for ERO+ABR, the blocks were brushed for 15 sec with a dentifrice slurry after the second and third erosive challenges. Ten volunteers took part in study 1 (S1), where the dentifrices evaluated contained 1100 ppm fluoride as NaF, 0.61% green tea extract, or 0.012% chlorhexidine digluconate. Thirteen volunteers participated in study 2 (S2), in which the treatment was performed only once (1 min) with gels containing 400 µM EGCG (EGCG400), 0.012% chlorhexidine, 1 mM FeSO4, 1.23% F (NaF), placebo, or received no treatment. Dentine loss was analyzed by profilometry (µm). RESULTS: Regarding S1, ERO+ABR induced significantly higher dentine loss compared with ERO and all dentifrices tested led to significantly lower dentine loss when compared with placebo. For S2, regardless of the conditions or times of evaluation, gels containing EGCG, CHX, or FeSO4 led to significantly less wear compared with the other groups. CONCLUSION: Both dentifrices and gels containing MMP inhibitors significantly reduced dentine loss. CLINICAL RELEVANCE: Dentifrices and gels containing MMP inhibitors are able to increase the protection against dentine wear, although gels have a better effect when compared with fluoride gel, lasting up to 10 days after a single application.

Efficacy of whitening toothpaste containing blue covarine: A double-blind controlled randomized clinical trial.

OBJECTIVE: This randomized clinical trial evaluated the efficacy and safety of a blue-covarine whitening toothpaste on tooth bleaching. SUBJECTS AND METHODS: Seventy-five subjects with shade mean C1 or darker were randomized into three groups (n = 25): CT-conventional toothpaste, WT-whitening toothpaste, and CP10-10% carbamide peroxide. Subjects from CT and WT brushed their teeth twice/day for 2 weeks. CP10 used bleaching gel for 4 hours/night for 2 weeks. Tooth shade and CIELab parameters were measured at baseline, after the first application, 2- and 4-week. ΔE*ab and ΔE00 were calculated. Subjects' perception about tooth color appearance, tooth sensitivity (TS), and gingival irritation (GI) were also assessed. RESULTS: At all evaluation periods, it was not observed differences between WT and CT considering tooth shade (P > 0.7) or CIELab parameters (P > 0.3). At 2- and 4-week, ΔE*ab and ΔE00 were higher for CP10 than WT or CT (P = 0.001). WT and CT reported major dissatisfaction with tooth color appearance than CP10 (P = 0.001). At 1- and 2-week, WT experienced GI and TS similar to CT, both lower than CP10 (P < 0.01). CONCLUSION: There were no significant differences in the whitening efficacy between whitening and conventional toothpastes. Neither of the dentifrices was as effective as at-home bleaching. CLINICAL SIGNIFICANCE: The silica-based toothpaste containing blue covarine evaluated in this study did not give significant tooth whitening benefits over 2 weeks of use.

Investigation the effects of whitening toothpastes on color change of resin-based CAD/CAM blocks.

INTRODUCTION: Some colorant foods and beverages cause undesired discoloration on dental restorations. The aim of this study was to investigate the effect of whitening kinds of toothpaste with different active ingredients on the color change of resin-based CAD/CAM blocks. MATERIAL AND METHODS: In the study, resin-based CAD/CAM block samples sized 1.5 × 7 × 12 mm, were prepared. Then, to simulate the time-dependent color change, the samples were immersed in coffee (Nescafe Classic, Nestlé) for 14 days. After the color change values of the samples colored in coffee were measured by spectrophotometer, the samples were brushed with different types of whitening toothpastes for 4 minutes. Statistical analysis of the color change (ΔE00 ) was performed using the one-way analysis of variance (ANOVA). RESULTS: Color differences occurring on all resin-based CAD/CAM blocks immersed in coffee for 14 days exceeded the 50%:50% perceptibility threshold (PT) (ΔE00 :0.8). There was no statistical significant difference between the whitening toothpastes containing activated charcoal, hydrogen peroxide (HP), blue covarine pigment, and microparticles in color improvement on resin-based CAD/CAM blocks (P > .05). CONCLUSION: It has been verified that the discoloration on resin-based CAD/CAM blocks exhibiting color difference above the PT after coffee immersion can be reduced by utilizing toothpastes containing whiteners. CLINICAL SIGNIFICANCE: Color changes that occur over time in resin-based CAD/CAM blocks can be a clinical problem. These color changes in the materials can be reduced below the PT level using whitening toothpastes.