EFFECTS OF ACID ETCHING ON COLOR CHANGES AND SURFACE MORPHOLOGY OF ENAMEL TO BE BLEACHED WITH DIFFERENT TECHNIQUES.

Aims - to compare the color changes, the surface roughness and morphology of the enamel bleached with two different bleaching solutions (chemical and laser activated), preceded or not with acid etching. Thirty teeth of bovine prepared and haphazardly assigned to 2 groups (n=15) depending on bleaching technique. Each group subdivided to 3 subgroup (n=5) consistent with acid etching by 37% phosphoric acid. Atomic force microscopy and VITA easy shade spectrophotometer were performed twice for all the specimens before and after bleaching. ANOVA, the Paired sample t-test, and the independent sample t-test used for statistical analysis. As for the color changes, the groups that were bleached by the chemical method, the difference among the three subgroups was statistically significant. This also applies to the groups bleached with the laser method. When comparing the results of the chemical bleaching subgroups with the laser bleaching ones, the difference was not significant. Roughness results showed significant differences between certain subgroups and non-significant differences among others. However, the difference was statistically significant between the chemical and laser groups, laser technique resulted in less surface roughness than the chemical one. Acid etching before bleaching produced better colour change in both the chemical and laser assisted bleaching. In chemical bleaching, surface roughness was higher when acid etching was used. This was also true for laser bleaching technique. In general, laser assisted bleaching produced less surface roughness than chemical bleaching.

Effect of fluoride or chitosan toothpaste and at-home bleaching in enamel roughness, tooth color, and staining susceptibility.

PURPOSE: To evaluate how fluoride- or chitosan-based toothpaste used during at-home bleaching affects enamel roughness, tooth color, and staining susceptibility. METHODS: Bovine enamel blocks were submitted to a 14-day cycling regime considering a factorial design (bleaching agent x toothpaste, 2 x 3), with n=10: (1) bleaching with 16% carbamide peroxide (CP) or 6% hydrogen peroxide (HP), and (2) daily exposure of a fluoride (1,450 ppm F-NaF) toothpaste (FT), chitosan-based toothpaste (CBT), or distilled water (control). Then, 24 hours after the last day of bleaching procedure the samples were exposed to a coffee solution. Color (ΔEab, ΔE00, L*, a*, b*) and roughness (Ra, µm) analyses were performed to compare the samples initially (baseline), after bleaching, and after coffee staining. The results were evaluated by linear models for repeated measures (L*, a*, b*, and Ra), 2-way ANOVA (ΔEab, ΔE00) and Tukey's test (α= 0.05). RESULTS: After the at-home bleaching procedure (toothpaste vs. time, P< 0.0001), the toothpaste groups presented a statistically lower Ra than the control (CBT 0.05). After coffee exposure, CBT presented lower ΔEab and ΔE00 values in the HP groups (toothpaste, P< 0.0001), and lower b* and a* values in the CP groups (toothpaste vs. time, P= 0.004). CLINICAL SIGNIFICANCE: Fluoride or chitosan delivered by toothpaste can reduce surface alterations of the enamel during at-home bleaching, without affecting bleaching efficacy.

Examination of cytotoxic and antimicrobial effect of whitening toothpastes: an in vitro study.

OBJECTIVE: Toothpastes are widely used to protect oral and teeth health. This study aims to examine the cytotoxic and antimicrobial effects of whitening toothpastes. METHODS: In this study, extracts were prepared according to ISO 10993-12:2021 standard (0.2 g/mL) using whitening and conventional toothpastes. The prepared extracts were added to human gingival fibroblast cell lines (HGF-1) in different dilutions (1:1, 1:2, 1:4, 1:8, 1:16, and 1:32) and a cytotoxicity test was performed. Antimicrobial analysis of toothpastes was performed on Streptococcus mutans, Staphylococcus aureus, and Candida albicans using the hole-plate diffusion method. Cell viability and microbial analysis data were examined using two-way analysis of variance (ANOVA) and Tukey post-hoc test (p < 0.05). RESULTS: Toothpastes with sodium lauryl sulfate (SLS) in their composition showed statistically more toxic effects (p < 0.05). The activated carbon toothpastes without SLS showed over 90% cell viability after dilution. Although the dilution rate of toothpastes containing SLS increased, cell viability remained below 70%. All toothpastes used in the study showed antimicrobial effects on S. mutans, S. aureus, and C. albicans. Toothpaste containing hydrogen peroxide and SLS produced more antibacterial effects than activated carbon, blue covarine, microparticles, and conventional toothpaste. CONCLUSIONS: SLS-containing toothpastes showed more toxicity on HGF-1 cells. Toothpaste containing hydroxyapatite did not show toxic effects on HGF-1 cells. SLS, sodium lauryl sarcosinate and hydrogen peroxide in toothpastes increase antimicrobial effects.

In vitro evaluation of the tooth bleaching efficacy and safety of high-concentration hydrogen peroxide with cold atmospheric plasma.

BACKGROUND: Using hydrogen peroxide (HP) for tooth bleaching may induce various side effects. Cold atmospheric plasma (CAP) is a promising solution. We aimed to evaluate and compare the efficacy and safety of tooth bleaching using high-concentration HP with CAP with conventional in-office bleaching. METHODS: Fifty-one discolored extracted human teeth were assigned to three groups: Group 1 (light-emitting diode with 35 % HP), Group 2 (CAP with 35 % HP), and Group 3 (only CAP). Bleaching was conducted over three sessions for a total of 20 min. The bleaching effect was evaluated based on the changes in color (ΔE00 and WID) and lightness (ΔL⁎ and ΔG). Safety was assessed by examining the dark areas on the enamel and monitoring the pulp chamber temperature. The study analyzed how different bleaching methods and durations affected ΔE00 and ΔWID using repeated-measures analysis of variance (ANOVA). The Kruskal-Wallis and Mann-Whitney tests were used for ΔL⁎ and dark areas, and one-way ANOVA for ΔG after 20 min of bleaching. RESULTS: The ΔE00 and WID demonstrated an interaction based on the bleaching method and time, with Group 1 exhibiting the highest ΔE00 and WID at all treatment times (p < 0.001). ΔL⁎ and ΔG did not differ significantly between Groups 1 and 2 (p = 0.056 and 0.062, respectively) and were lowest in Group 3 (p < 0.001). Group 1 exhibited the darkest areas and highest pulp chamber temperatures (p < 0.001). Group 1 exhibited statistically significant color changes. Group 2 demonstrated similar effects, but with enhanced safety profiles. CONCLUSIONS: Group 2, although displaying a slightly less pronounced color change compared with Group 1, achieved a color alteration readily discernible to the naked eye. This suggests that CAP with 35 % HP could be an interesting area for further investigation as an alternative to traditional in-office bleaching methods.

An experimental teeth bleaching agent containing casein phosphopeptide-amorphous calcium phosphate.

OBJECTIVES: This study was aimed to obtain an experimental bleaching agent by adding casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in order to eliminate the mineral loss on the tooth surface after bleaching and to evaluate the bleaching effectiveness. MATERIALS AND METHODS: In this study, experimental bleaching agents containing 1%, 3% CPP-ACP and without CPP-ACP were obtained. Bleaching effectiveness (color change), the effect of bleaching agents on mineral content (energy dispersive x-ray spectroscopy), surface morphology (scanning electron microscope), and surface hardness of enamel (Vicker's microhardness) before and after bleaching were evaluated. The obtained data were statistically analyzed. RESULTS: When the bleaching levels of the groups were compared, no statistically significant difference was observed between the control and 1% CPP-ACP groups (p > 0.05) while the addition of 3% CPP-ACP decreased significantly the effectiveness of the bleaching agent (p < 0.05). When the effects of experimental bleaching agents on surface hardness were examined, while the enamel surface hardness decreased statistically significantly after application in the control group (p < 0.05), no statistically significant change was observed in surface hardness after the application of 1% CPP-ACP containing bleaching agent (p > 0.05). However, a statistically significant increase was observed in surface hardness after the application of 3% CPP-ACP containing bleaching agent (p < 0.05). When the Ca and P ratio of the groups were compared, no statistically significant difference was observed between the control and 1% CPP-ACP groups (p > 0.05), while they increased significantly in 3% CPP-ACP group (p < 0.05). CONCLUSIONS: The addition of 1% CPP-ACP to the bleaching agent had positive effects on the mineral content and surface hardness of the enamel, and did not negatively affect the whitening effectiveness. CLINICAL SIGNIFICANCE: Adding CPP-ACP to the bleaching agent at appropriate concentrations can eliminate possible negative effects without compromising the effectiveness of the bleaching agent.

In-office Bleaching Activated With Violet LED: Effect on Pulpal and Tooth Temperature and Pulp Viability.

OBJECTIVES: This study evaluated the influence of hydrogen peroxide (HP) with or without titanium dioxide nanotubes (TiO2) associated with violet LED (VL) regarding: a) the temperature change in the pulp chamber and facial surface; b) the decomposition of HP; and c) the cytotoxicity of the gels on pulp cells. METHODS AND MATERIALS: The experimental groups were: HP35 (35% HP/Whiteness HP, FGM); HP35+VL; HP35T (HP35+TiO2); HP35T+VL; HP7 (7.5% HP/White Class 7.5%, FGM); HP7+VL; HP7T (HP7+TiO2); and HP7T+VL. TiO2 was incorporated into the bleaching gels at 1%. Eighty bovine incisors were evaluated to determine temperature change in 8 experimental groups (n=10/group). A k-type thermocouple was used to evaluate the temperatures of the facial surface and in the pulp chamber, achieved by enabling endodontic access to the palatal surface, throughout the 30-minute session. HP decomposition (n=3) of gels was evaluated by using an automatic potentiometric titrator at the initial and 30-minute time points. Trans-enamel and trans-dentinal cell viability were assessed with a pulp chamber device as well as enamel and dentin discs (n=6), and the treatment extracts (culture medium + diffused components) were collected and applied to MDPC-23 odontoblast cells to evaluate cell viability according to the MTT test. RESULTS: A temperature increase in the pulp chamber was observed in the presence of VL at 30 minutes (p<0.05) (Mann-Whitney test). Also at 30 minutes, HP35 showed greater decomposition in the presence of VL rather than in its absence (p<0.05) (mixed linear models and the Tukey-Kramer test). HP7 provided greater cell viability than the groups treated with HP35 (p<0.05) (generalized linear models test). Cell viability was significantly lower for HP7 in the presence of VL (p<0.05). CONCLUSION: Pulpal temperature increased with VL (maximum of 1.9°C), but did not exceed the critical limit to cause pulp damage. Less concentrated HP resulted in higher cell viability, even when associated with VL.

Influence of coating dental enamel with a TiF4-loaded polymeric primer on the adverse effects caused by a bleaching gel with 35% H2O2.

OBJECTIVE: To evaluate whether coating enamel with a polymeric primer (PPol) containing titanium tetrafluoride (TiF4) before applying a bleaching gel with 35% H2O2 (35% BG) increases esthetic efficacy, prevents changes in morphology and hardness of enamel, as well as reduces the cytotoxicity from conventional in-office bleaching. MATERIALS AND METHODS: Standardized enamel/dentin discs were stained and bleached for 45 min (one session) with 35% BG. Groups 2TiF4, 6TiF4, and 10TiF4 received the gel on the enamel previously coated with PPol containing 2 mg/mL, 6 mg/mL, or 10 mg/mL, respectively. No treatment or application of 35% BG directly on enamel were used as negative control (NC), and positive control (PC), respectively. UV-reflectance spectrophotometry (CIE L*a*b* system, ΔE00, and ΔWI, n = 8) determined the bleaching efficacy of treatments. Enamel microhardness (Knoop, n = 8), morphology, and composition (SEM/EDS, n = 4) were also evaluated. Enamel/dentin discs adapted to artificial pulp chambers (n = 8) were used for trans-amelodentinal cytotoxicity tests. Following the treatments, the extracts (culture medium + bleaching gel components diffused through the discs) were collected and applied to odontoblast-like MDPC-23 cells, which were assessed concerning their viability (alamarBlue, n = 8; Live/Dead, n = 4), oxidative stress (n = 8), and morphology (SEM). The amount of H2O2 in the extracts was also determined (leuco crystal violet/peroxidase, n = 8). The numerical data underwent one-criterion variance analysis (one-way ANOVA), followed by Tukey's test, at a 5% significance level. RESULTS: Regarding the ΔE00, no difference was observed among groups 2TiF4, 6TiF4, and PC (p > 0.05). The ΔWI was similar between groups 2TiF4 and PC (p > 0.05). The ΔWI of group 6TiF4 was superior to PC (p < 0.05), and group 10TiF4 achieved the highest ΔE00 and ΔWI values (p < 0.05). Besides limiting enamel microstructural changes compared to PC, group 10TiF4 significantly increased the hardness of this mineralized dental tissue. The highest cellular viability occurred in 10TiF4 compared to the other bleached groups (p < 0.05). Trans-amelodentinal H2O2 diffusion decreased in groups 2TiF4, 6TiF4, and 10TiF4 in comparison with PC (p < 0.05). CONCLUSION: Coating enamel with a PPol containing TiF4 before applying a 35% BG may increase enamel microhardness and esthetic efficacy and reduce the trans-amelodentinal cytotoxicity of conventional in-office tooth bleaching. The PPol containing 10 mg/mL of TiF4 promoted the best outcomes.

Assessment of color changes and adverse effects of over-the-counter bleaching protocols: a systematic review and network meta-analysis.

OBJECTIVES: To assess color change efficacy and the adverse effects of varied over-the-counter (OTC) bleaching protocols. METHODOLOGY: The study included randomized clinical trials evaluating color changes from OTC bleaching agents. Nine databases were searched, including the partial capture of the grey literature. The RoB2 tool analyzed the individual risk of bias in the studies. Frequentist network meta-analyses compared treatments through common comparators (∆Eab* and ∆SGU color changes, and tooth sensitivity), integrating direct and indirect estimates and using the mean and risk differences as effect measures with respective 95% confidence intervals. The GRADE approach assessed the certainty of the evidence. RESULTS: Overall, 37 remaining studies constituted the qualitative analysis, and ten composed the meta-analyses. The total sample included 1,932 individuals. ∆Eab* was significantly higher in groups 6% hydrogen peroxide (HP) strips (≥ 14 h). ∆SGU was significantly higher in groups at-home 10% carbamide peroxide (CP) (≥ 14 h), followed by 6% HP strips (≥ 14 h) and 3% HP strips (≥ 14 h). At-home 10% CP (7-13 h) and placebo showed lower risks of tooth sensitivity without significant differences between these treatments. CONCLUSION: Considering the low level of evidence, OTC products presented satisfactory short-term effects on tooth bleaching compared to the placebo, with little to no impact on dentin hypersensitivity and gingival irritation. CLINICAL RELEVANCE: OTC products are proving to be practical alternatives for tooth whitening. However, patients should be advised about the possible risks of carrying out such procedures without professional supervision.

Effect of carbamide peroxide on biomechanical properties of vacuum-formed retainers: A split-mouth randomized controlled trial.

OBJECTIVE: To investigate the effect of tooth whitening on biomechanical properties of vacuum-formed retainers (VFRs). METHODS: Using a split-mouth, randomised controlled trial design, thirty participants were randomly allocated to receive whitening on either the upper or the lower arch, using 10 % carbamide peroxide for two weeks. Biomechanical properties such as hardness, tensile strength, and surface roughness were assessed two weeks after whitening was completed. RESULTS: Tensile strength of the whitening arch (mean ± SD: 40.93 ± 3.96 MPa) was significantly lower than that of the control (47.40 ± 5.03 MPa) (difference 6.47 MPa, 95 % CI 4.51 - 8.42, p < 0.001). Hardness and internal roughness of the whitening arch (VHN = 14.63 ± 2.29 N/mm2 and Ra = 1.33 ± 0.35 µm, respectively) were significantly greater than those of the control (12.22 ± 1.86 N/mm2 and 0.96 ± 0.29 µm, respectively) (differences 2.41 N/mm2, 95 % CI 1.56 - 3.25, p < 0.001 and 0.37 µm, 95 % CI 0.23 - 0.51, p < 0.001, respectively). The whitening arch showed greater tooth colour change (ΔE = 6.00 ± 3.32) than the control (ΔE = 2.50 ± 1.70) (difference = 3.50, 95 % CI 2.43 - 4.56, p < 0.001). CONCLUSIONS: Based on this short-term study, marked tooth colour change was achieved by whitening with VFRs as the whitening trays, but this changed the VFRs' biomechanical properties, including a decrease in tensile strength and an increase in hardness and internal roughness. CLINICAL SIGNIFICANCE: The application of carbamide peroxide in VFRs may compromise their mechanical properties.

At-home bleaching with carbamide peroxide with concentrations below 10%: bleaching efficacy and permeability in the pulp chamber.

OBJECTIVES: To evaluate the bleaching efficacy and permeability of hydrogen peroxide (HP) in the pulp chamber of human teeth bleached with lower concentrations of carbamide peroxide gel (4%, 5% and 7% CP). MATERIALS AND METHODS: Bleaching gels with lower concentrations were formulated and a commercial standard gel, 10% CP, was used as a reference. Fifty-six human premolars were randomly divided into four groups. Applications of the bleaching gel were made for 3 h for 21 days. The bleaching efficacy was evaluated by digital spectrophotometry on 1, 7, 14 and 21 days, with analysis in the ∆Eab, ∆E00 and WID color spaces. The concentration of HP in the pulp chamber was measured in the same periods by UV-Vis spectrophotometry (µg/mL). Two-way repeated analysis of variance (ANOVA) examined bleaching efficacy and HP permeability, followed by Tukey's post-hoc test (α = 0.05). RESULTS: All groups showed significant color changes, with no statistical differences after the second and third week of bleaching (p > 0.05). The 'time' factor was statistically different (p < 0.05), increasing the bleaching efficacy throughout the treatment. The 4% CP group had lower HP levels in the pulp chamber (p < 0.05). CONCLUSIONS: The results seem promising, revealing that low concentration gels are as effective as 10% CP with the benefit of reducing the amount of HP in the pulp chamber. CLINICAL RELEVANCE: Low concentration 4% PC and 5% PC maintains bleaching efficacy, reduces the penetration of HP peroxide into the pulp chamber, and may reduce tooth sensitivity.

Effect of Calcium Hydroxide and Antioxidant Agents Filling the Pulp Chamber after Internal Bleaching.

To evaluate the effect of calcium hydroxide (CH), sodium ascorbate (SA) and sodium thiosulfate (ST) filling the pulp chamber on color stability and longevity of teeth after internal bleaching. Crowns of bovine incisors were submitted to internal bleaching and divided into groups according the material used in the pulp chamber: Control, CH, SA, ST. Each group was divided into two subgroups according to the time to perform restorative procedures (7 or 15 days). Color measurement was performed with a spectrophotometer at nine periods. The darkening (ΔE) values were calculated. The Mann-Whitney test was used to statistically analyze the data (p ⟨ 0.05). After bleaching, ΔE values were higher than 3.5, showing that the procedure was effective. After 24 hours, no difference was observed between groups. After 7 days, SA showed higher ΔE than the control group (p ⟨ 0.05). CH and TS did not differ from the control group. In restorations performed after 7/15 days, SA group showed higher values of darkening after 1 and 4 months than the control group (p ⟨ 0.05). SA induced perceptible darkening after bleaching and should not be used to fill the pulp chamber. ST and CH show color stability and longevity after 12 months.

In vitro evaluation of the effect of different bleaching varnishes: Hydrogen peroxide penetration into the pulp chamber and color change.

OBJECTIVE: To evaluate the penetration of hydrogen peroxide (HP) into the pulp chamber and the color change of different bleaching varnishes in low concentrations used for at-home bleaching. MATERIALS AND METHODS: Ninety healthy premolars were used, randomly distributed into nine groups (n = 10) according to bleaching varnish (PL, PolaLuminate; VS, VivaStyle Paint On Plus; CA, Cavex Bite&White whitening pen and; AW AlignerWhite) and time (10 and 30 min), and a control group (no bleaching). The penetration of HP was evaluated by UV-Vis spectroscopy. To evaluate the color change (ΔEab , ΔE00 , ΔWID ) a digital spectrophotometer was used (α = 0.05). RESULTS: The AW group in 10 min and the control group showed similar and lower HP penetration in the pulp chamber when compared to the other groups (p = 0.003). Increasing the application time to 30 minutes elevated the amount of HP inside the pulp chamber for all groups (p = 0.003), except for PL (p > 0.05). When applied for 30 min all bleaching varnishes showed higher color change (ΔWID ) when compared to 10 min (p = 0.04). CONCLUSIONS: For all bleaching varnishes evaluated, PolaLuminate applied for 30 min showed lower penetration into the pulp chamber and higher bleaching effects. CLINICAL SIGNIFICANCE: The use of bleaching varnishes seems promising for teeth bleaching, but it varies according to user product and protocol.

Effect of strontium fluorophosphate bioactive glass on color, microhardness and surface roughness of bleached enamel.

BACKGROUND: Undesirable effects of tooth bleaching can alter the biomechanical properties of enamel. OBJECTIVE: To determine the influence of strontium fluorophosphate bioactive glass (Sr-FPG) on color, microhardness and surface roughness of enamel bleached with 35% hydrogen peroxide. METHODS: The labial enamel of 36 extracted intact human anterior teeth were divided into 3 groups (n= 12), group 1 (HP): bleaching with 35% hydrogen peroxide only, group 2 (Sr-HP): bleaching with Sr-FPG incorporated 35% hydrogen peroxide and group 3 (HP-SrFPG): bleaching with 35% hydrogen peroxide followed by remineralization with Sr-FPG. Four consecutive eight-minute applications of the bleaching gel were done twice in all the groups. Color change (ΔE), microhardness and surface roughness were evaluated at baseline, post-bleaching and post-remineralization using spectrophotometer, Vickers hardness tester and profilometric analysis respectively. RESULTS: The mean ΔE among the groups was statistically similar (p> 0.05). Bleaching with HP significantly reduced microhardness (p< 0.05), whereas bleaching with Sr-HP and HP-SrFPG did not (p> 0.05). Post-bleaching microhardness in Sr-HP was significantly higher than HP-SrFPG (p< 0.05). An increased surface roughness was seen in Sr-HP bleached samples (p< 0.05). CONCLUSION: The addition of Sr-FPG to hydrogen peroxide significantly improved enamel microhardness than its use post-bleaching. An increase in surface roughness was seen post-bleaching with HP and Sr-HP.

Effects of enamel moistening and repositioning guide color on tooth whitening outcomes: A clinical trial.

This clinical trial investigated the effects of pre-application enamel moistening on the impact of a 37% carbamide peroxide whitener on tooth color changes and the influence of repositioning guide colors. Forty participants were randomly assigned to in-office tooth bleaching with either moistened enamel (experimental) or dry enamel (control). The whitener was applied for 45 min over two sessions. Tooth color was visually measured or assessed using a spectrophotometer with purple or green silicone guides. Tooth bleaching was assessed using CIE76 (ΔEab ) and CIEDE2000 (ΔE00 ) formulas and by whitening and bleaching index score changes. Moistening the enamel did not significantly affect tooth color. However, the guide color choice only impacted tooth color when measured instrumentally. At baseline, the green guide resulted in statistically significantly whiter teeth than the purple guide. Less pronounced differences in the b* coordinate between baseline and final measurements were found using the green guide. The green guide also produced lower ΔEab values and less change in indexes. In conclusion, moistening the enamel did not significantly impact tooth color changes. However, the repositioning guide color influenced the tooth bleaching measured instrumentally, except for ΔE00 .

Effect of antioxidant on tooth sensitivity after bleaching.

OBJECTIVES: This study aimed to investigate the effect of antioxidant (sodium ascorbate) on tooth sensitivity after two in-office bleaching techniques (light-activated and chemical bleaching). MATERIALS AND METHODS: Ten patients aged 18-25 were bleached in four groups according to bleaching materials and/or antioxidant used. Group A: Maxillary right quadrant received light-activated bleaching with antioxidant. Group B: Maxillary left quadrant received light-activated bleaching without antioxidant. Group C: Mandibular right quadrant received chemical bleaching without antioxidant. Group D: Mandibular left quadrant received chemical bleaching with antioxidant. The tooth sensitivity was recorded using Numerical Rating Scale (NRS) and Schiff Scale (SS) immediately after treatment, 1 day, 1 week, 2 weeks, and 1 month follow-up periods. RESULTS: Group B exhibited higher sensitivity values than Group A. This difference was statistically significant on the first day after treatment (p = 0.027* in NRS and p = 0.046* in SS). Furthermore, antioxidant incorporation in Group D led to a reduction in teeth sensitivity values compared to Group C. This disparity was highly significant on the first day after treatment (p = 0.001* in NRS and p < 0.001** in SS). CONCLUSIONS: The antioxidant (10% sodium ascorbate) reduces the intensity of tooth sensitivity at the different follow-up periods, especially after 1 day from bleaching. CLINICAL SIGNIFICANCE: Using 10% sodium ascorbate after bleaching is advisable to reduce post-operative tooth sensitivity.

EFFECTS OF PROFESSIONAL ORAL HYGIENE AND TEETH WHITENING ON THE MICROELEMENT COMPOSITION OF ENAMEL.

OBJECTIVE: Aim: The objective of this study is to investigate the impact of professional teeth cleaning and the substances used in modern dentistry for whitening on the microelement composition of tooth enamel. PATIENTS AND METHODS: Materials and Methods: To study the morphology and microelement composition of the enamel, scanning electron microscopy was performed using the MiraLM microscope equipped with a Schottky field emission electron gun from Tescan. RESULTS: Results: A comparative analysis between the areas subjected to mechanical cleaning and those where it was not applied revealed a significant difference in the research results, particularly in carbon, which changed from 25.16±1.04 to 32.02±1.8. An analysis of the enamel's chemical composition before and after whitening revealed a decrease in carbon from 45.91±1.20 to 42.46±1.74. The change in phosphorus content was determined to be from 9.77±0.39 to 9.56±0.75. A decrease in calcium from 15.96±0.64 to 15.21±1.22 and magnesium from 0.07±0.01 to 0.01±0.01 was also observed. CONCLUSION: Conclusions: Professional dental hygiene does not have a direct impact on the microelement composition of enamel, such as the levels of calcium, phosphorus, fluoride, and other microelements. However, it can have an indirect and temporary influence due to the use of abrasive materials that affect dental deposits, pellicle, and the surface layer of enamel. Teeth whitening can affect the microelement composition of enamel, but these changes are mostly temporary and associated with processes of demineralization/ remineralization and oxygenation.

Effects of the application of sodium ascorbate after in-office bleaching on the penetration of hydrogen peroxide, color change, and microtensile bond strength.

This study aimed to evaluate the effects of the application of 10% sodium ascorbate (SA) after in-office bleaching on the penetration of hydrogen peroxide (HP) into the pulp chamber, color change, and microtensile bond strength (µTBS) to the resin-enamel interface. Thirty premolars and thirty molars were randomly divided into three groups (n = 20 each). One group was exposed to deionized water (negative control). The other two groups were bleached with 35% HP in a single session for 3x15 minutes for each application. However, in only one of them, SA was applied for 10 minutes after bleaching. After, the concentration (µg/mL) of HP in each pulp chamber was evaluated by UV-Vis spectrophotometry. Color changes (ΔEab, ΔE00, and ΔWID) were evaluated with a digital spectrophotometer before and in the first week after bleaching. After treatment, molars were restored and sectioned to obtain resin-enamel interface sticks for µTBS at a crosshead speed of 1 mm/min until failure. The HP concentration and µTBS data were analyzed using one-way ANOVA and Tukey tests, and color changes were analyzed by t-tests (α = 0.05). SA application significantly improved the µTBS values and reduced the HP concentrations within the pulp chambers (p < 0.0001). The application of SA significantly interfered with the color changes after bleaching when compared to the control group (p < 0.05). Application of 10% SA after in-office bleaching successfully reduced the penetration of HP into the pulp chamber; however, it decreased color change.

The effect of tooth bleaching using violet LED (405-410 nm) on the properties of resin-based composites.

BACKGROUND: The objective of this study was to evaluate the effect of bleaching techniques, including or not the use of violet light (405-410 nm), on resin-based composites' color, surface roughness, nanohardness, and elastic modulus. METHODS: Ninety-six disk-shaped specimens (12 mm x 2 mm; n = 12) were prepared using Filtek Z350 XT (Z350) and IPS Empress Direct (ED) resin-based composites. After 24 h, specimens were stained in red wine for 28 days. After staining, specimens were divided into four experimental groups: 40 % Hydrogen Peroxide (HP); Violet Light (VL); 40 % Hydrogen Peroxide associated with Violet Light (HP+VL), and a control group - no treatment (NT). Specimens were evaluated at six experimental times: initial (24 h after light curing); after staining and after the 1st, 2nd, 3rd, and 4th bleaching sessions regarding the color change (ΔE00, L*, a*, b*, and WID); roughness (Ra), nanohardness and elastic modulus (GPa). Two-way analysis of variance for repeated measures was performed (α=0.05 %). RESULTS: There was a statistically significant difference between staining and the 1st bleaching session for all ED groups (p<0.05). After the last bleaching session, there were no differences between the experimental and the control groups of both resin-based composites. Bleaching using violet light did not change the roughness, nanohardness and elastic modulus of the tested resin-based composites (p>0.05). CONCLUSIONS: Although hydrogen peroxide and violet light remove pigments from resin-based composites without affecting their surface roughness, nanohardness, and elastic modulus, the color change was similar to the one obtained by immersion in distilled water.

Evaluation of Enamel Surfaces Treated with a Desensitizing Agent Containing CPP-ACP Before or After In-Office Bleaching.

PURPOSE: To evaluate the effects of desensitizing MI Varnish (GC America) applied before or after bleaching on the mineral component of enamel and surface topography. MATERIALS AND METHODS: The coronal portions of 10 freshly extracted bovine teeth were segmented for a total of 40 specimens. Enamel specimens obtained from each tooth were randomly divided into four groups (n = 10): Group A = no bleaching; Group B = bleaching with 40% hydrogen peroxide (HP); Group C = MI Varnish applied before bleaching; and Group D = MI Varnish applied after bleaching. The calcium (Ca) and phosphorus (P) levels of the specimens in each group were determined by energy dispersive spectroscopy (EDS). Morphologic changes were observed using scanning electron microscopy (SEM). One-way ANOVA and Tukey HSD tests were used for statistical analyses (α = .05). RESULTS: The mean Ca content of Group B was significantly lower than those of Groups A, C, and D (P < .05). The mean Ca content of Group C was significantly lower than that of Group A (P < .05). There was no significant difference in Ca content between the other groups (P > .05). The mean P content of Group A was significantly higher than those of Groups B to D (P < .05). There was no significant difference in P content between Groups B to D (P > .05). CONCLUSIONS: Application of MI Varnish before or after in-office bleaching was effective in reducing mineral loss. However, applying MI Varnish after bleaching was more effective.

Hybrid light applied with 37% carbamide peroxide bleaching agent with or without titanium dioxide potentializes color change effectiveness.

BACKGROUND: The effectiveness of dental color change was assessed by incorporating titanium dioxide (TiO2) into 37% carbamide peroxide bleaching agent associated with hybrid light. METHODOLOGY: Fifty bovine incisors were selected to receive the bleaching treatment, and separated into five groups (n = 10): 35% hydrogen peroxide (HP) (Whiteness HP, FGM/HP); 37% carbamide peroxide (CP) (Whiteness SuperEndo, FGM/CP); CP + hybrid light (HL) (CP HL); CP + 1% TiO2 (CP TiO2); CP TiO2 + hybrid light (CP TiO2 HL). The bleaching gels were applied to the dental surface for 30 min. Hybrid light (Whitening Plus, DMC/infrared laser diodes + blue LEDs +violet LEDs) was applied with 1 min of active light, alternating with 1 min of pause. A spectrophotometer (VITA Easyshade® Advance, Vita) was used to determine the color of the dental elements at baseline and time points after the 1st, 2nd and 3rd bleaching sessions. Color change effectiveness was evaluated using Vita Classical, CIEL*a*b*, WID and ΔEab, ΔE00 and ΔWID parameters. RESULTS: Generalized mixed linear models for repeated measures (α = 5%) showed significant decrease in Vita Classical scores and a* and b* values, as well as an increase in L* and ∆WID values for all the groups. Higher color change values for ΔEab were observed for CP HL and CP TiO2 HL, while those of ΔE00 and ΔWID were higher for CP TiO2 HL at the end of the bleaching treatment. CONCLUSION: Hybrid light applied with TiO2 incorporated into CP potentiated the effectiveness of the color change in the tooth structure.