Evaluation of different mechanical cleaning protocols associated with 2.5% sodium hypochlorite in the removal of residues from the post space.

Aims: This study evaluated the effectiveness of different mechanical protocols using rotary brush (RB), ultrasonic tip, and oscillatory system (OS) associated with 2.5% sodium hypochlorite (NaOCl) in the removal of residues and dentin permeability in the cervical and apical segments of the post space. Settings and Design: Experimental in vitro study. Methods: Forty roots from human first molars were prepared and divided into four groups according to the cleaning protocols: Control (CO), NaOCl 2.5% conventional irrigation with a syringe; RB associated with NaOCl 2.5%; ultrasonic tip (US) associated with NaOCl 2.5%; OS associated with NaOCl 2.5%. Statistical Analysis Used: The persistence of residues was evaluated by scanning electron microscopy and data submitted to Kruskal-Wallis and Dunn tests, and dentin permeability evaluated by confocal microscopy and date submitted to ANOVA one-way and Tukey's tests (P = 0.05). Results: There were no differences in residue cleaning among the CO, RB, US, and OS groups, regardless of the analyzed root segment (P > 0.05). When comparing groups, dentin permeability in the CO group was significantly lower in the cervical segment (P < 0.05). Conclusions: The OS group promoted the highest permeability value in the apical segment. RB, US, and OS are similar in removing residues from the post space. However, OS results in higher dentin permeability in the apical segment.

Fracture strength and hybrid layer formation of endodontically-treated teeth after dental bleaching photoactivated with violet LED.

OBJECTIVE: To evaluate in vitro the effect of dental bleaching using high concentration hydrogen peroxide (HP) photoactivated with violet LED on fracture strength and hybrid layer formation. METHODS: forty endodontically-treated bovine teeth were randomized into four groups (n = 10): C - Control, HP - 35% hydrogen peroxide, HP-BL - 35% hydrogen peroxide photoactivated with blue LED, HP-VL - 35% hydrogen peroxide photoactivated with violet LED. Three bleaching sessions with an interval of 7 days between them were performed. After 10 days of the last bleaching session, the dental crowns were restored and submitted to the fracture strength test. Five specimens from each group were used to evaluate the hybrid layer formation by scanning electron microscope (SEM) images. One-way ANOVA and Kruskal-Wallis test were used for parametric and non-parametric data, respectively. Significance level of 5% was adopted to all the tests. RESULTS: No differences on fracture strength among the groups were observed (p > 0.05). HP and HP-BL showed alterations on hybrid layer formation compared to C group (p < 0.05), but not for HP-VL (p > 0.05). No differences on hybrid layer formation were observed among HP, HP-VL and HP-BL groups (p > 0.05). CONCLUSION: Dental bleaching, photoactivated or not, did not affect the fracture strength of endodontically-treated teeth. Regardless of the protocol used, hydrogen peroxide altered the hybrid layer formation at some level when the restoration was placed after 10 days of the last bleaching session.

Effect of non-vital tooth bleaching photoactivated with blue or violet LED on color and microhardness.

BACKGROUND: To evaluate the efficacy of dental bleaching protocols using 35% hydrogen peroxide photoactivated with violet LED on color and microhardness of endodontically treated teeth. METHODS: Forty specimens were selected and randomized into 4 groups (n = 10): C - Control, HP - 35% hydrogen peroxide, HP + BL - 35% hydrogen peroxide + blue LED, HP + VL - 35% hydrogen peroxide + violet LED. Three bleaching sessions were performed for each group. Color analysis was performed 7 days after each bleaching session. Two-way repeated measure ANOVA and Bonferroni test were used to evaluate the effect of different bleaching protocols and evaluation times on the dependent variables (∆E and ∆L). Dentin microhardness was measured 24 h after the third bleaching session. Data were evaluated by ANOVA and Tukey's test at a significance level of 5%. RESULTS: Differences on ∆E and ∆L were verified after the first and second bleaching sessions (p < 0.05) and showed stability after the third one, for all the groups. No differences were observed among HP, HP + BL, and HP + VL groups, regardless of the evaluation time (p > 0.05). HP and C showed the greatest and smallest reduction in dentin microhardness (p < 0.05), respectively. No difference between HP + BL and HP + VL protocols (P > 0.05) was observed. CONCLUSIONS: High concentration hydrogen peroxide (35%) photoactivated with violet LED bleached endodontically treated teeth effectively. However, the same protocol negatively affected the dentin microhardness, but not in the same level of 35% HP solely used.

Effectiveness and color stability of non-vital dental bleaching photoactivated by violet LED on blood-stained teeth.

BACKGROUND: Few studies have investigated the effect of violet LED irradiation associated or not with bleaching agents on blood-stained teeth. This in vitro study aimed to evaluate the whitening efficacy and color stability of non-vital dental bleaching using 35% hydrogen peroxide (HP) photoactivated with violet LED (VL) compared to 35% HP alone and 35% HP photoactivated with blue LED (BL). METHODS: Fifty bovine dental crowns were used to obtain specimens of 5 × 5 × 2 mm. After selection based on a previous colorimetric analysis, the specimens were blood-stained and randomly assigned into five groups (n = 10): control (no treatment); 35% HP, 35% HP/BL; 35% HP/VL; and VL. Three bleaching sessions were performed and the colorimetric analysis (∆Eab, ∆L, and ∆WID) was recorded after 7 days, 30 days, and 9 months of the last bleaching session. Two-way repeated measures ANOVA followed by Bonferroni post-hoc test was used at a significance level of 5%. RESULTS: 35% HP, 35% HP/BL, and 35% HP/VL showed higher values of ∆Eab, ∆L, e ∆WID (P < 0.05), without intra- and intergroup differences (P > 0.05). C and VL were similar in all the evaluation times (P > 0.05), showing lower values of ∆Eab, ∆L, and ∆WID (P < 0.05). CONCLUSIONS: 35% HP/VL can be a viable alternative for dental bleaching in endodontically-treated teeth, showing bleaching efficacy similar to 35% HP solely used, even after a 9-month follow-up. VL used alone was not effective to bleach blood-stained teeth.

Influence of Bleaching Agent Containing Bioactive Glass on Color and Microhardness of Bovine Enamel

To try to reduce the deleterious effects of tooth whitening, bioactive materials have been used. Forty enamel/dentin blocks were stained on dark tea and randomly assigned into four groups (n=10): control group (unbleached), HP35 % (35 % hydrogen peroxide), BG45S5 (Bioglass 45S5® incorporated into HP35 %), and BIO (Biosilicate® incorporated into HP35 %). Colorimetric analysis and microhardness evaluation was performed at baseline, 24 hours and 7 days after the final whitening session. Two-way ANOVA for repeated measures and Bonferroni test was used at a significance level of 5 %. All the coordinates (ΔL*, Δa*, Δb*, ΔE00 and WID) showed a difference between the control group and the experimental ones (p0.05), which suggest a color stability over a week. In contrast, after 7 days, the WID showed that control and PH35 % were different than the other groups (p 0.05). The microhardness did not change over time (p>0.05), except for 35 % HP. In conclusion Bioglass 45S5® and Biosilicate® prevented enamel damage without negatively affect the whitening efficacy.

Para intentar reducir los efectos nocivos del aclaramiento dental, se han usado materiales bioactivos. Cuarenta bloques de esmalte/dentina se tiñeron con té oscuro y se asignaron al azar en cuatro grupos (n=10): grupo de control (sin blanquear), HP35% (peróxido de hidrógeno al 35 %), BG45S5 (Bioglass 45S5® incorporado en HP35%) y BIO (Biosilicato® incorporado a HP35%). El análisis colorimétrico y la evaluación de la microdureza se realizaron al inicio del estudio, 24 horas y 7 días después de la última sesión de blanqueamiento. Se utilizó ANOVA de dos vías para medidas repetidas y la prueba de Bonferroni a un nivel de significancia del 5 %. Todas las coordenadas (ΔL*, Δa*, Δb*, ΔE00 y WID) mostraron diferencia entre el grupo control y el experimental (p0.05), lo que sugiere una estabilidad del color durante una semana. En cambio, a los 7 días, el WID mostró que el control y el PH35 % eran diferentes a los demás grupos (p 0.05). La microdureza no cambió con el tiempo (p>0.05), excepto para 35 % HP. En conclusión Bioglass 45S5® y Biosilicate® previnieron el daño del esmalte sin afectar negativamente la eficacia del blanqueamiento.

Microstructural effect of a laser-activated bleaching agent containing titanium dioxide on human enamel.

AIM: This study aimed to evaluate the effect of a laser-activated bleaching agent containing titanium dioxide (TiO2) nanoparticles on enamel roughness and hardness. MATERIALS AND METHODS: Twenty human premolars were randomized into two groups according to the bleaching treatments performed: HP - 35% hydrogen peroxide and HP + TiO2 - 30% hydrogen peroxide containing TiO2 light-activated by diode laser (980 nm). It was performed two bleaching sessions with an interval of 7 days. Microhardness and roughness of the enamel were assessed at three times: T0 - Before 1st appointment, T1 - after 2nd appointment, and T2-7 days after 2nd appointment. RESULTS: The HP + TiO2 did not cause changes on enamel roughness and hardness and presented the same effects of the HP. CONCLUSIONS: Both bleaching agents showed no difference between them. Then, it is possible to conclude that both are viable for clinical use during in-office dental bleaching technique regarding the microstructural changes that they might cause.

Violet LED for non-vital tooth bleaching as a new approach.

Different light sources have been used during dental bleaching procedures. More recently, a violet LED system was introduced as a promising and viable light source, which is capable to promote dental bleaching without chemical agents, although this light source could be also associated to a bleaching agent. This case report aimed to present the association of a violet LED and a bleaching agent over a discolored non-vital tooth. After anamnesis, clinical and radiographic examinations, a dental bleaching protocol was proposed as follow: 15 applications of the violet LED during 60 s (Bright Max Whitening, MMOptics) with 30 s interval between them. Before the last 5 applications, 35% hydrogen peroxide gel (Whiteness HP Maxx, FGM) was applied inside the pulp chamber and on enamel surface of the tooth (vestibular and palatal surfaces) and then the last 5 irradiations were performed. Three sessions were performed, with 7-days interval. Color assessment using a VITA classical scale and VITA EasyShade® spectrophotometer was carried out. After dental bleaching, color changed (tooth 21) from A3.5 to B2. The protocol used in this case report showed to be satisfactory for the non-vital tooth bleaching.