Efficacy of mouth rinses and toothpaste on tooth whitening.

OBJECTIVES: People increasingly desire tooth whitening. Considering the wide range of whitening products on the market, this study evaluated the efficacy of whitening toothpastes and mouth rinses compared with the 10% carbamide peroxide (CP) whitening gel. METHODS: We obtained 120 cylindrical specimens from bovine teeth, which were darkened for 24 hours in a coffee solution. The color measurement was performed by a spectrophotometer using the CIE L*a*b* system, and specimens were divided into six groups according to the use of the following agents: group 1, conventional fluoridated toothpaste; group 2, Close Up White Now; group 3, Listerine Whitening; group 4, Colgate Plax Whitening; group 5, experimental mouth rinse with Plasdone; and group 6, 10% CP Whiteness Perfect. After the simulation of 12 weeks of treatment for groups 1 to 5 and 14 days of treatment for group 6, the specimens were subjected to a new color reading. RESULTS: Data were subjected to one-way analysis of variance (α=0.05), which showed significant differences among groups after 12 weeks for ΔE (p=0.001). Results of the Tukey test revealed that groups 3, 4, and 6 presented significantly higher color alteration than groups 1, 2, and 5. CONCLUSIONS: The whitening toothpaste Close Up White Now and the experimental mouth rinse with Plasdone showed similar color alteration as conventional toothpaste after a 12-week treatment simulation. These groups presented significantly lower color alteration compared with whitening mouth rinses Listerine and Colgate Plax Whitening, which showed similar results to those observed after 14 days of bleaching with 10% CP treatment.

Bond Stability of a Universal Adhesive System to Eroded/Abraded Dentin After Deproteinization.

OBJECTIVE: Erosive/abrasive challenges can potentially compromise bonding to dentin. Aiming to improve the quality and stability of bonding to this substrate, this study investigated the combined effect of erosion and toothbrush abrasion on the microtensile bond strength (µTBS) stability to dentin using a universal adhesive system in total and self-etching modes, associated or not associated with deproteinization. METHODS: Bovine dentin specimens were divided into five groups according to the organic matrix condition (n=20): control (C); erosion (E); erosion + abrasion (EA); erosion + sodium hypochlorite (EH); erosion + abrasion + sodium hypochlorite (EAH). The groups were further divided (n=10) according to the mode of application (total or self-etching) of a universal adhesive. After the bonding procedure, composite blocks were built up, and the samples were cut to obtain sticks for µTBS testing. For each specimen, one-half of the sticks was immediately tested, and the other one-half was tested after artificial aging (5000 thermocycles, 5°C and 55°C). RESULTS: Three-way analysis of variance (α=5%) showed a significant difference for the triple interaction ( p=0.0007). Higher µTBS means were obtained for the EH and EAH groups compared with the E and EA groups. The control group showed immediate µTBS values similar to that of the E and EA groups for both bond strategies. CONCLUSIONS: Erosion and erosion/abrasion did not significantly influence the immediate µTBS to dentin. Artificial aging reduced µTBS values for the groups C, E, and EA using the total-etching mode. Deproteinization maintained the bond stability to artificially aged eroded and eroded/abraded dentin.

Effect of hydrogen peroxide concentration on enamel color and microhardness.

OBJECTIVES: The aim of this study was to investigate the effect of hydrogen peroxide gels with different concentrations (20%, 25%, 30%, and 35%) on enamel Knoop microhardness (KNH) as well as on changes in dental color (C). METHODS: Cylindrical specimens of enamel/dentin (3-mm diameter and 2-mm thickness) were obtained from bovine incisors and randomly divided into six groups (n=20), according to the concentration of the whitening gel (20%, 25%, 30%, 35%, control, thickener). After polishing, initial values of KNH0 and color measurement, assessed by spectrophotometry using the CIE L*a*b* system, were taken from the enamel surface. The gels were applied on the enamel surface for 30 minutes, and immediate values of KNHi were taken. After seven days of being stored in artificial saliva, new measures of KNH7 and color (L7* a7* b7*, for calculating ΔE, ΔL, and Δb) were made. Data were submitted to statistical analysis of variance, followed by Tukey test (p<0.05). RESULTS: Differences in gel concentration and time did not influence the microhardness (p=0.54 and p=0.29, respectively). In relation to color changes, ΔE data showed that the 35% gel presented a higher color alteration than the 20% gel did (p=0.006). CONCLUSION: Bleaching with 35% hydrogen peroxide gel was more effective than with the 20% gel, without promoting significant adverse effects on enamel surface microhardness.

Longitudinal Evaluation of Bond Strength to Enamel of Dental Adhesive Systems Associated with Nd:YAG Laser.

OBJECTIVES: This study evaluated the durability of bond strength to enamel using total-etch (Single Bond/SB) and self-etch (Clearfil SE Bond/CSEB) adhesives associated with neodymium:yttrium-aluminu-garnet (Nd:YAG) laser irradiation through the uncured adhesives. METHODS: Bovine incisors were worn to expose an area of enamel and were divided into four groups: group 1 (control) SB + polymerization; group 2 (control) CSEB + polymerization; group 3 (laser) - SB + Nd:YAG laser (174.16 J/cm(2)) + polymerization; and group 4 (laser) CSEB + Nd:YAG (174.16 J/cm(2)) + polymerization. Blocks of composite were fabricated and stored for 24 hours or 12 months, sectioned into beams, and submitted to microtensile tests. Results were analyzed by three-way analysis of variance (ANOVA) (adhesive, technique, and storage time) and Tukey tests. RESULTS: ANOVA revealed significant differences for adhesive × technique and technique × storage time (p<0.05). The mean values (MPa) for interaction adhesive × technique (standard deviation) were as follows: SB/control = 35.78 (6.04)a; SB/laser = 26.40 (7.25)b, CSEB/control = 26.32 (5.71)b, CSEB/laser = 23.90 (7.49)b. For interaction technique × storage time the mean values were as follows: control/24 hours = 32.58 (6.49)a; control/12 months = 29.52 (8.38)a; laser/24 hours = 29.37 (5.71)a; laser/12 months = 20.92 (6.5)b. Groups with the same letters showed no statistically significant differences. CONCLUSION: Scanning electron microscope analysis showed evident areas of micromorphological alterations in lased samples after 12 months of water storage. Nd:YAG laser irradiation of enamel through unpolymerized total-etch adhesive significantly reduced bond strength compared with the control. Bond strength decreased when enamel samples irradiated with Nd:YAG laser through unpolymerized adhesives were stored in water for 12 months.

Influence of pH on the effectiveness of hydrogen peroxide whitening.

OBJECTIVE: To evaluate the influence of pH on the bleaching effect of hydrogen peroxide on chromogen agents. METHOD: Hydrogen peroxide 50% was mixed with red wine or with an alcoholic solution of tobacco in glass cuvettes, resulting in final peroxide concentrations of 16.97% and 21.12%, respectively. The pH of this mixture was measured and adjusted with 3.3 M HCl solution or 2.5 M NaOH solution to obtain the final pH values of 3.0, 4.0, 5.0, 6.0, 7.0, 8.0, and 9.0. After mixing, the color of these solutions was evaluated in a reflectance spectrophotometer; readings were repeated after 10 minutes for the wine solution and 20 minutes for the tobacco solution. Ten samples were prepared for each solution at each pH. Color changes (Delta E) were calculated. The data were statistically analyzed using analysis of variance one-way and Tukey tests, with a significance level of 5%. RESULTS: There were significant differences among the different pH values for the wine and tobacco solutions (p=0.0001). The Tukey test showed that for both solutions, pH 9.0 resulted in a significantly greater bleaching effect than the other values tested. CONCLUSION: The efficacy of hydrogen peroxide bleaching is directly proportional to the increase in its pH.

Influence of different surface treatments on bond strength of resin composite using the intrinsic characterization technique.

OBJECTIVE: This study evaluated the influence of different surface treatments on the resin bond strength/light-cured characterizing materials (LCCMs), using the intrinsic characterization technique. The intrinsic technique is characterized by the use of LCCMs between the increments of resin composite (resin/thin film of LCCM/external layer of resin covering the LCCM). MATERIALS AND METHODS: Using a silicone matrix, 240 blocks of composite (Z350/3M ESPE) were fabricated. The surfaces received different surface treatments, totaling four groups (n=60): Group C (control group), no surface treatment was used; Group PA, 37% phosphoric acid for one minute and washing the surface for two minutes; Group RD, roughening with diamond tip; and Group AO, aluminum oxide. Each group was divided into four subgroups (n=15), according to the LCCMs used: Subgroup WT, White Tetric Color pigment (Ivoclar/Vivadent) LCCM; Subgroup BT, Black Tetric Color pigment (Ivoclar/Vivadent) LCCM; Subgroup WK, White Kolor Plus pigment (Kerr) LCCM; Subgroup BK, Brown Kolor Plus pigment (Kerr) LCCM. All materials were used according to the manufacturer's instructions. After this, block composites were fabricated over the LCCMs. Specimens were sectioned and submitted to microtensile testing to evaluate the bond strength at the interface. Data were submitted to two-way analysis of variance (ANOVA) (surface treatment and LCCMs) and Tukey tests. RESULTS: ANOVA presented a value of p<0.05. The mean values (±SD) for the factor surface treatment were as follows: Group C, 30.05 MPa (±5.88)a; Group PA, 23.46 MPa (±5.45)b; Group RD, 21.39 MPa (±6.36)b; Group AO, 15.05 MPa (±4.57)c. Groups followed by the same letters do not present significant statistical differences. The control group presented significantly higher bond strength values than the other groups. The group that received surface treatment with aluminum oxide presented significantly lower bond strength values than the other groups. CONCLUSION: Surface treatments of composite with phosphoric acid, diamond tip, and aluminum oxide significantly diminished the bond strength between composite and the LCCMs.

Effect of biomimetic remineralization on the dynamic nanomechanical properties of dentin hybrid layers.

The mineral and organic phases of mineralized dentin contribute co-operatively to its strength and toughness. This study tested the null hypothesis that there is no difference in nano-dynamic mechanical behavior (complex modulus-E*; loss modulus-E''; storage modulus-E'; in GPa) of dentin hybrid layers (baseline: E*, 3.86 ± 0.24; E'', 0.23 ± 0.05; E', 3.85 ± 0.24) created by an etch-and-rinse adhesive in the presence or absence of biomimetic remineralization after in vitro aging. Using scanning probe microscopy and nano-dynamic mechanical analysis, we demonstrated that biomimetic remineralization restored the nano-dynamic mechanical behavior of heavily remineralized, resin-sparse regions of dentin hybrid layers (E*, 19.73 ± 3.85; E'', 8.75 ± 3.97; E', 16.02 ± 2.58) to those of the mineralized dentin base (E*, 19.20 ± 2.42; E'', 6.57 ± 1.96; E', 17.39 ± 2.0) [p > 0.05]. Conversely, those resin-sparse, water-rich regions degraded in the absence of biomimetic remineralization, with significant decline [p < 0.05] in their complex and storage moduli (E*, 0.83 ± 0.35; E'', 0.88 ± 0.24; E', 0.62 ± 0.32). Intrafibrillar apatite deposition preserves the integrity of resin-sparse regions of hybrid layers by restoring their nanomechanical properties to those exhibited by mineralized dentin.

The critical barrier to progress in dentine bonding with the etch-and-rinse technique.

OBJECTIVES: The lack of durability in resin-dentine bonds led to the use of chlorhexidine as MMP-inhibitor to prevent the degradation of hybrid layers. Biomimetic remineralisation is a concept-proven approach in preventing the degradation of resin-dentine bonds. The purpose of this study is to examine the integrity of aged resin-dentine interfaces created with a nanofiller-containing etch-and-rinse adhesive after the application of these two approaches. METHODS: The more established MMP-inhibition approach was examined using a parallel in vivo and in vitro ageing design to facilitate comparison with the biomimetic remineralisation approach using an in vitro ageing design. Specimens bonded without chlorhexidine exhibited extensive degradation of the hybrid layer after 12 months of in vivo ageing. RESULTS: Dissolution of nanofillers could be seen within a water-rich zone within the adhesive layer. Although specimens bonded with chlorhexidine exhibited intact hybrid layers, water-rich regions remained in those hybrid layers and degradation of nanofillers occurred within the adhesive layer. Specimens subjected to in vitro biomimetic remineralisation followed by in vitro ageing demonstrated intrafibrillar collagen remineralisation within hybrid layers and deposition of mineral nanocrystals in nanovoids within the adhesive. CONCLUSIONS: The impact was realized by understanding the lack of an inherent mechanism to remove water from resin-dentine interfaces as the critical barrier to progress in bonding with the etch-and-rinse technique. The experimental biomimetic remineralisation strategy offers a creative solution for incorporating a progressive hydration mechanism to achieve this goal, which warrants its translation into a clinically applicable technique.