Evaluation of the effectiveness in teeth whitening of a single session with 6% hydrogen peroxide Laser/LED system.

BACKGROUND: Due to the current importance of dental whitening, multiple studies have been carried out in order to achieve an efficient, effective, and innocuous procedure. This study aimed to compare the effectiveness and sensitivity of in-office dental bleaching with one versus two applications of 6% hydrogen peroxide (HP) gel with nitrogen titanium dioxide (TiO2) nanoparticles activated by LED/Laser lamp in a single-session. METHODS: This RCT with a split-mouth design was performed in twenty-seven volunteers. The in-office dental bleaching technique was performed using 6% HP with nitrogen TiO2 nanoparticles. In each patient, groups were randomized by hemiarch: Group 1 received one application of 72 minutes and Group 2 received two applications of 36 minutes, both groups in a single-session. RESULTS: There were no significant differences in the effectiveness of a single-session with one or two applications of 6% HP with nitrogen TiO2 nanoparticles between both groups(p>0.05). A positive and increase of ∆E value was observed in both groups. Group 1 showed an increase of 4.45 in the immediate measurement, remaining at 4.41 until the one-week control, to increase up to an ∆E of 4.99 at one-month control. Group 2 showed a sustained increase of 4.02 units in the immediate control until reaching the maximum value of 5.46 units of ∆E at one-month control. CONCLUSION: One session single application protocol of 6% Hydrogen Peroxide gel with nanoparticulate TiO2 activated by LED/Laser is effective and efficient for dental bleaching.

Riesgo biológico del blanqueamiento dental interno / Biological risk posed by internal tooth whitening

Introducción: El blanqueamiento dental interno forma parte de la práctica odontológica desde hace varias décadas, pero se han descrito riesgos biológicos de los cuales no existe mucha evidencia. Objetivo: Describir los riesgos biológicos provocados por el blanqueamiento dental interno en dientes no vitales. Métodos: Se realizó una revisión sistemática exploratoria en la base de datos bibliográfica PubMed empleando operadores booleanos y palabras clave que aparecen recogidas en los Descriptores en Ciencias de la Salud. Las variables estudiadas fueron: autor principal, título, año de publicación, tipo de artículo, revista donde se publicaron los artículos y riesgo biológico del blanqueamiento interno descrito. Se filtraron y procesaron los resultados en una base de datos y se analizaron los textos completos para evaluar su calidad y que estos cumplieran los criterios de inclusión y exclusión. Resultados: Fueron incluidos en el estudio 14 artículos, todos por investigaciones originales o revisiones sistemáticas. El 64,3 por ciento de los artículos proyectaba los hallazgos hacia la presencia de reabsorciones cervicales externas posterior al blanqueamiento dental interno. El resto no aportó evidencia alguna de riesgos biológicos luego del tratamiento descrito. Conclusiones: Más de la mitad de los artículos incluidos en el estudio concluyeron que la reabsorción cervical externa es el principal riesgo biológico que trae consigo el tratamiento blanqueador interno de dientes no vitales, apoyados por un factor desencadenante de historial de traumatismos dentarios que propician la aparición de estas afectaciones(AU)

Introduction: Internal tooth whitening has been a component of dental practice for several decades, but biological risks have been described about which not much evidence is available. Objective: Describe the biological risks posed by internal tooth whitening in nonvital teeth. Methods: An exploratory systematic review was conducted in the bibliographic database PubMed using Boolean operators and key words obtained from Health Sciences Descriptors. The variables analyzed were main author, title, year of publication, article type, journal where the articles were published and biological risk of the internal tooth whitening procedure described. Results were filtered and processed in a database and full texts were analyzed for quality and compliance with the inclusion and exclusion criteria. Results: A total 14 articles were included in the study, all of which were either original studies or systematic reviews. In 64.3 percent of the articles, findings had to do with the presence of external cervical resorption after internal tooth whitening. The remaining articles did not contribute any evidence of biological risks after the treatment described. Conclusions: More than half of the articles included in the study concluded that external cervical resorption is the main biological risk posed by internal whitening of nonvital teeth, supported by the triggering factor of a history of dental trauma leading to the occurrence of these disorders(AU)

Percepción de estudiantes respecto al recambio de restauraciones / Students' perception regarding the replacement of restorations

Introducción: El reemplazo de restauraciones defectuosas representa la mayor parte de la práctica del odontólogo, lo que lleva a una perdida mayor del remanente dentario ante cada reemplazo. Objetivo: Determinar si existe variación del criterio clínico en alumnos frente a la decisión de recambio en restauraciones de resina compuesta previo y posterior al reacondicionamiento. Material y Métodos: Estudio analítico transversal. Se contó con una muestra de 40 estudiantes de quinto año de un universo de 72. Se utilizó un set fotográfico, que contaba con restauraciones defectuosas, en uno o más parámetros según los criterios RYGE/USPHS, las cuales posteriormente se reacondicionaron, por lo que se contaba con las fotografías del antes y del después del tratamiento conservador. Se realizó una encuesta a partir de las fotografías mostradas en la cual debían indicar la elección de tratamiento. Resultados: Se observó que hay una gran variación de elección de tratamiento previo a ser reparadas con tratamientos conservadores: 38 por ciento y no conservador de 62 por ciento y frente a la misma restauración de resina posterior a haber sido intervenida la elección de tratamiento conservador fue de 83 por ciento y no conservador 17 por ciento. Mediante el Test de McNemar se obtuvo un p<0.0001 entre elección de tratamiento conservador por sobre el no conservador posterior a haber sido realizada el reacondicionamiento de la restauración. Conclusiones: Existe un cambio en la percepción sobre la indicación de tratamiento de restauraciones defectuosas, a favor de una alternativa conservadora, después de que han sido intervenidas con procedimientos mínimamente invasivos(AU)

Introduction: The replacement of defective restorations, which leads to a greater loss of the dental remnant before each replacement, represents the large majority of the dentist's practice. Objective: To determine if there is any variation in students´ clinical criterion in relation to the decision of replacement of composite resin restorations prior to and following reconditioning. Material and Methods: A cross-sectional analytical study was conducted. The sample was composed of 40 fifth-year students in a universe of 72. A set of photographs showing defective restorations in one or more parameters evaluated according to RYGE / USPHS criteria was used. They were later reconditioned, so there were photographs prior to and following conservative treatment. Based on the photographs shown, a survey in which they had to indicate the choice of treatment was performed. Results: We observed that there is a great variation in the choice of treatment prior to the repair with conservative treatments (38 percent) and non-conservative ones (62 percent), compared to the same resin restoration after the choice of conservative treatment (83 percent) and non-conservative one (17 percent). Using the McNemar Test, p<0.0001 was obtained between the choice of conservative treatment over the non-conservative one after the restoration reconditioning had been performed. Conclusions: There is a change in perception of the indication of treatment to repair defective restorations towards a conservative alternative after they have undergone minimally invasive procedures(AU)

Regresión de la luminosidad del color posblanqueamiento dental casero en pacientes fumadores y no fumadores / Color luminosity regression after home tooth whitening in smoking and nonsmoking patients

Introducción: Existen muchos estudios de efectividad del blanqueamiento dental; sin embargo, son muy pocos los que hablan de regresión de color (fenómeno que se produce posterior a un blanqueamiento dental), lo mismo ocurre en relación a pacientes fumadores. Objetivo Determinar la regresión de la luminosidad del color en pacientes sometidos a blanqueamiento dental casero con peróxido de carbamida al 10 por ciento, en pacientes fumadores y no fumadores. Métodos: Estudio descriptivo, transversal, en 43 pacientes de un grupo de 60 previamente tratados de forma casera durante 3 semanas con peróxido de carbamida al 10 por ciento. Fueron divididos en un grupo experimental (pacientes fumadores GE) y grupo control (no fumadores GC). Se midió la variación del color con el espectrofotómetro Vita Easyshade® a la semana, mes, 6 meses y 9 meses posblanqueamiento. Los datos obtenidos mediante la medición con el espectrofotómetro fueron analizados por el test de Shapiro Wilk y Kolmogorov-Smirnov para evaluar normalidad de la distribución y, posteriormente, sometidos al test Mann-Whitney U y Wilcoxon W (#945; = 0,05). Resultados: El delta L* fue: 2,3 (GE) y 3,66 (GC); deltas calculados con datos de los 9 meses vs. semana posblanqueamiento. No hubo diferencias estadísticamente significativas entre ambos grupos. Conclusiones: No existen diferencias estadísticamente significativas en la regresión del color posteriores al blanqueamiento casero con peróxido de carbamida al 10 por ciento en pacientes fumadores y no fumadores(AU)

Introduction: Many studies have been conducted about the effectiveness of tooth whitening, but few refer to color regression (a phenomenon occurring after tooth whitening) or to smoking patients. Objective: Determine color luminosity regression in smoking and nonsmoking patients undergoing home tooth whitening with 10 percent carbamide peroxide. Methods: A descriptive cross-sectional study was conducted of 43 patients from a group of 60 previously undergoing home treatment with 10 percent carbamide peroxide for 3 weeks. The patients were divided into an experimental group (EG, smoking patients) and a control group (CG, nonsmoking patients). A Vita Easyshade® spectrophotometer was used to measure color variation one week, one month, 6 months and 9 months after whitening. The data obtained by spectrophotometry were analyzed with the Shapiro-Wilk and the Kolmogorov-Smirnov tests to evaluate the normality of the distribution, and then they were subjected to the Mann-Whitney-Wilcoxon U test (α = 0,05). Results: Delta L* was 2,3 (EG) and 3,66 (CG); delta values were estimated from data obtained 9 months vs. one week after whitening. No statistically significant differences were found between the groups. Conclusions: No statistically significant color regression differences are found in either smoking or nonsmoking patients after home whitening with 10 percent carbamide peroxide(AU)

Evaluación de la autopercepción de estética dental en pacientes tratados con dos modalidades distintas de blanqueamiento dental / Evaluation of dental esthetics self-perception in patients treated with two different types of tooth whitening

RESUMEN Objetivo: Determinar la influencia en la variación de la autopercepción estética dental, al someterse a dos modalidades distintas de blanqueamiento dental. Métodos: Investigación descriptiva transversal con 48 pacientes que fueron tratados con dos sistemas de blanqueamiento. Se aplicó la encuesta "Perfil de impacto de salud oral", versión en español (OHIP-e, por sus siglas en inglés), con el fin de medir la autopercepción estética previamente al tratamiento de blanqueamiento. Estos pacientes fueron asignados a uno de los dos grupos de tratamiento, grupo de blanqueamiento "ambulatorio" o grupo de blanqueamiento "clínico". La encuesta OHIP-e volvió a ser aplicada una semana luego del término de la intervención. Se analizaron los puntajes obtenidos en la escala de autopercepción de estética bucal, antes y después de la intervención, en ambos grupos de estudio. Se realizó la prueba Z de Kolmogórov-Smirnov para determinar la normalidad de los puntajes promedio de OHIP-e. Se realizó una prueba t de Student, que evaluó el cambio de la autopercepción de estética dental antes y después al blanqueamiento. Los análisis estadísticos se realizaron aceptando una probabilidad de error tipo I de 0,05 (p< 0,05). Resultados: Los puntajes de OHIP-e inicialmente fueron distintos en ambos grupos y mejoraron (disminuyeron no significativamente con la aplicación de los tratamientos de blanqueamiento en ambos grupos, p< 0,05), excepto en la dimensión dolor físico en el grupo "clínico" (p= 0,03). Conclusiones: El blanqueamiento dental "ambulatorio" y "clínico", presentan un cambio en la autopercepción estética dental similar, luego de una semana de realizado el tratamiento. Ambos tratamientos presentaron un impacto positivo en la autopercepción estética dental de los pacientes(AU)

ABSTRACT Objective: Determine the effect of two different types of tooth whitening on dental esthetics self-perception. Methods: A descriptive cross-sectional study was conducted of 48 patients treated with two whitening systems. The Spanish version of the Oral Health Impact Profile (OHIP-e) was used to measure esthetic self-perception before the whitening treatment. The patients were assigned to one of two treatment groups: ambulatory whitening group and clinical whitening group. The OHIP-e survey was applied again one week after completion of the intervention. The scores obtained by both groups were analyzed with the oral esthetics self-perception scale before and after the intervention. The Kolmogorov-Smirnov Z test was applied to determine the normality of mean OHIP-e scores. Student's t test was used to evaluate the change in dental esthetics self-perception before and after whitening. The statistical analyses performed accepted a type I error probability of 0.05 (p< 0.05). Results: OHIP-e scores were initially different in the two groups and improved in both (decreased non-significantly with the application of the whitening treatments, p< 0.05), except for the physical pain dimension in the clinical group (p= 0.03). Conclusions: Ambulatory and clinical tooth whitening bring about a similar change in dental esthetics self-perception a week after completion of the treatment. Both treatments had a positive impact on the patients' dental esthetics self-perception(AU)

Inflammatory markers IL-1ß and RANK-L assessment after non-vital bleaching: A 3-month follow-up.

OBJECTIVE: This study assessed IL-1ß and RANK-L levels in vivo and color stability of non-vital teeth bleached using hydrogen (35%) and carbamide (37%) peroxides 3 months after treatment. MATERIALS AND METHODS: Fifty teeth were randomly divided into two groups(n = 25):35% hydrogen peroxide (HP) or 37% carbamide peroxide (CP). Four sessions of intracoronal walking-bleach procedure were performed. IL-1ß and RANK-L levels were assessed from gingival crevicular fluid samples (from three vestibular and three palatines sites) at eight different time-points: at the beginning of the study (baseline), after four sessions of intracanal bleaching, and at 1 week, 1 month, and 3 months posttreatment. The color variations were visually detected using Vita bleach shade guide (ΔSGU). RESULTS: Significant increases of IL-1ß and RANK-L levels were detected at all time-points (all P < .05) when comparing each time-point to baseline, and a high correlation (>0.8-Spearman) between variables. According the ΔSGU values, a color change of five for HP and four for CP were detected. CONCLUSIONS: Non-vital walking bleach technique promotes an increase in IL-1ß and RANKL levels in periodontal tissues and also, it is maintained until the third-month posttreatment. CLINICAL SIGNIFICANCE: The internal whitening of teeth increases the levels of cytokines associated with inflammation and bone resorption 3 months after the whitening procedure is finished; this should warn of possible harmful effects of this whitening technique.

Efecto de la aplicación activa con aplicadores mejorados de un adhesivo universal / Effect of the active application of a universal adhesive with improved applicators

RESUMEN Introducción: La permeabilidad dentinaria es conocida como el paso de fluidos, iones, partículas, moléculas y bacterias a través de la dentina bajo ciertas condiciones. Objetivo: Determinar la influencia de la aplicación activa con un aplicador mejorado de un adhesivo dentinario sobre la conductancia hidráulica dentinaria humana, in vitro. Métodos: Estudio experimental in vitro en 40 terceros molares libres de caries, con indicación de exodoncia, provenientes de pacientes sanos entre 15 y 30 años, previo consentimiento informado. Posteriormente se limpiaron, desinfectaron y conservaron para ser incluidos en bloques de resina epóxica. Luego se realizaron cortes transversales y se obtuvieron discos dentinarios de 1,5 mm de espesor y 25 mm de diámetro. Se dividieron en dos grupos de 20 unidades cada uno, se sometieron a grabado con ácido ortofosfórico al 37 por ciento, y se lavaron y secaron. Sobre una balanza de precisión se les aplicó adhesivo dentinario fotopolimerizable, registrando la fuerza ejercida. En el grupo 1 se usó un microbrush en la aplicación y en el grupo 2 un aplicador mejorado diseñado especialmente. Posteriormente cada muestra fue sometida a una cámara de difusión para obtener la tasa de flujo y luego calcular la conductancia hidráulica, la cual otorga información acerca de la permeabilidad de la dentina. Resultados: los resultados obtenidos fueron levemente menores en el grupo 2, sin embargo, experimentaron una distribución normal. Conclusiones: no existen diferencias significativas, al ser analizados estadísticamente bajo diversas pruebas, en los valores de conductancia hidráulica. Tampoco se pudo establecer una relación inversa entre la fuerza de aplicación de un adhesivo en forma activa con un aplicador mejorado y la conductancia hidráulica, por lo cual no se aconseja el uso de dicho instrumento(AU)

ABSTRACT Introduction: Dentin permeability is defined as the passage of fluids, ions, particles, molecules and bacteria through the dentin under certain conditions. Objective: Determine the effect of the active application of a dentin adhesive with an improved applicator on human dentin hydraulic conductance in vitro. Methods: An in vitro experimental study was conducted of 40 caries-free third molars with an indication of exodontia from healthy patients aged 15-30 years, prior informed consent. The molars were cleaned, disinfected and preserved to be included in epoxy resin blocks. Cross-sectional cuts were then made to obtain dentin discs 1.5 mm thick and 25 mm in diameter. These were divided into two 20-unit groups, were subjected to etching with 37 percent orthophosphoric acid, and were washed and dried. On a precision scale photopolymerizable dentin adhesive was applied, recording the force exerted. Application was performed with a Microbrush applicator in Group 1 and with an improved dedicated applicator in Group 2. The samples were then placed in a diffusion chamber to determine flow rate and subsequently estimate hydraulic conductance, thus obtaining information about dentin permeability. Results: Results were slightly lower in Group 2, but they displayed normal distribution. Conclusions: Statistical analysis with various tests did not find any significant differences in hydraulic conductance values, nor could an inverse relation be established between the force of active application of an adhesive with an improved applicator and hydraulic conductance. Therefore, use of that instrument is not advised(AU)

One-year bleaching efficacy using two HP products with different pH: A double-blind randomized clinical trial.

OBJECTIVES: This split-mouth, double-blind, randomized clinical trial evaluated the 1-year bleaching efficacy produced by two hydrogen peroxide gels with different pHs. MATERIALS AND METHODS: Twenty-eight patients were divided into two groups corresponding to two different products: Pola Office (pH = 2.0/SDI) and Pola Office Plus (pH = 7.0/SDI). The treatment was assessed during and after the bleaching procedure up to 12 months post-treatment. The assessment consisted of two bleaching scales shade guide units (ΔSGU) and spectrophotometric device (ΔE, ΔE00, and Whiteness Index) of both maxillary quadrants. Results for ΔSGUs in both scales and ΔE00 and Whiteness Index were compared using Mann Whitney test and ΔE measurements through the t-Student test for paired samples in each evaluation time. The color rebound (1- vs 12-month postbleaching data) was evaluated with Wilcoxon test (alpha = .05). RESULTS: During the different times of evaluation, the color variation was similar for both products (P > .05), both for subjective (ΔSGUs) and objective assessments (ΔE, ΔE00, and Whiteness Index). Also, both products showed a slight rebound after 12-month postbleaching (P > .05). CONCLUSIONS: Concerning the stability of color, in-office dental whitening with two hydrogen peroxide gels of different pHs produced similar results, with no significant of regression, for 12 months postwhitening. CLINICAL SIGNIFICANCE: Bleaching using a neutral (pH = 7.0) in-office gel demonstrated similar stability and rebound effect than an acidic one (pH = 2.0).

Teeth whitening with 6% hydrogen peroxide and its impact on quality of life: 2 years of follow-up.

This study aimed to evaluate color longevity after 2 years of whitening gel (6% hydrogen peroxide (HP), blue LED/infrared laser activation system) in comparison to a control 35% concentration in a split-mouth study and investigate the long-term effect on quality of life (QOL).Thirty-one patients were treated. Whitening using 6% or 35% HP gel was performed on half of the upper jaw in each patient. The color was measured at baseline and 1 week, 1 month, 1 and 2 years after treatment using the Easyshade Vita spectrophotometer and the Vita Bleached and Vita Classical Shade Guides organized by value. During 2 years of follow-up, color was evaluated before and after dental prophylaxis. Oral Health of Impact Profile (OHIP 14) and Psychosocial Impact Dental Aesthetics Questionnaire (PIDAQ) surveys measured QOL. Nineteen patients were evaluated at the 2-year follow-up. Significant differences in ΔE were measured between the two groups at all time points (p < 0.05). No significant differences in ΔSGU were observed at any time point (p > 0.05). The positive effect of bleaching on QOL was maintained in patients treated with a low concentration of the whitening gel. The two compounds remained effective after 2 years. An objective color difference was found between the groups, but no difference was observed in subjective reports. The positive effect on QOL remained after 2 years of follow-up in this cohort of patients.ClinicalTrials.gov identifier NCT02353611.

Effects of Sealing Marginal Occlusal Defects of Composite Restorations with a Nanofiller-Reinforced Flowable Resin Composite: A Double-Blind, Randomised Clinical Trial with One-Year Follow-Up.

PURPOSE: To evaluate the 6-and 12-month performance of microrepairs of marginal occlusal microdefects of resin composite restorations in a group of patients with high caries risk. MATERIALS AND METHODS: Thirty-five patients with at least three resin composite restorations with marginal occlusal defects were randomly distributed into three treatment groups: (1) sealed with flowable resin composite; (2) sealed with resin-based sealant; or (3) control. Restorations in all groups were assessed using World Dental Federation (FDI) criteria at three time points: baseline, and at 6 and 12 months after sealing. RESULTS: After 1 year, 32 patients were examined. Of all the repaired restorations, those of the flowable resin composite (RC) group maintained an FDI value of 1 for marginal occlusal adaptation for 81.3% of the restorations at 6 and 78.1% at 12 months. The resin-based sealant group kept a value of 1 for the same parameter on 65.6% of restorations at 6 and 50% at 12 months with a statistically significant difference (p= 0.024) between the two time periods. There was a statistically significant difference between the two groups at the 12-month comparison (p = 0.015). CONCLUSIONS: Occlusal RC restorations that were sealed using either a resin-based sealant or a nanofilled flowable RC benefited from improved clinical status after 12 months. Use of the latter presented the better clinical performance of the two by providing a higher rate of total retention of sealing materials.

The effects of at-home whitening on patients' oral health, psychology, and aesthetic perception.

BACKGROUND: The aesthetic self-perception and psychosocial impact of whitening is poorly explored in the literature; it is even less clear whether the effect of whitening may influence the psychology or social relations of patients. Therefore, the aim of this trial is to evaluate the impact of an at-home whitening procedure on patients' quality of life. Also, this study's secondary objective is the adaptation and validation of the Spanish version of the OES questionnaire (OES-SP). METHODS: Fifty eight patients underwent whitening with 10% carbamide peroxide (CP) gel for 1 h daily for 3 weeks. For these participants, the OHIP-Esthetics, PIDAQ, and OES surveys were applied before, one week after, and one month after the whitening procedure. Oral health-related quality of life was measured using the OHIP-Esthetics survey and the psychosocial impact using the PIDAQ survey. The orofacial aesthetics was measured by OES and validated for the Spanish Chilean context. The treatment efficacy (ΔE and ΔSGU) and data from the OHIP-Esthetics PIDAQ and OES surveys were compared using the Wilcoxon Signed-Rank test. RESULTS: The whitening procedure was effective (ΔE = 5.9 ± 1.8). The OHIP-Esthetics results were significant when comparing the initial baseline survey prior to the treatment and one week after whitening (p < 0.001) and when comparing the baseline and one-month results (p < 0.001). The overall score on the PIDAQ, after one week post-whitening, was separated into factors and all factors were statistically significant (p < 0.03); the factors for the one-month results were also all statistically significant (p < 0.001), except the social impact factor. The OES questionnaire had statistically significantly increased scores both one week and one month post-treatment (p < 0.0001). The reliability, validity, and responsiveness of the OES-SP were satisfactory. CONCLUSION: The at-home whitening procedure with carbamide peroxide 10% had a positive effect on patients' oral health-related quality of life, psychology, and aesthetic perception after one month post-whitening. The Chilean Spanish version of the OES showed satisfactory psychometric characteristics to evaluate dental whitening. TRIAL REGISTRATION: NCT02605239 . Date that the study was retrospectively registered: 11-11-2015.

Quality of life and stability of tooth color change at three months after dental bleaching.

PURPOSE: Intracoronary bleaching is a minimally invasive, alternative treatment that addresses aesthetic concerns related to non-vital teeth discoloration. However, to the best of our knowledge, no studies have assessed the psychosocial impacts of such procedures on patients' aesthetic perceptions. The aim of this study was to evaluate aesthetic perceptions and the psychosocial impact of patients up to 3 months after their teeth had been bleached with hydrogen peroxide (35%) and carbamide peroxide (37%) using the walking bleach technique. METHODS: The patients were randomly divided into two groups according to the bleaching agent used: G1 = hydrogen peroxide 35% (n = 25) and G2 = carbamide peroxide 37% (n = 25). Non-vital bleaching was performed in four sessions. Color was objectively (ΔE) and subjectively (ΔSGU) evaluated. Aesthetic perception and psychosocial factors were evaluated before, 1 week and 1 month after the bleaching using the Oral Health Impact Profile (OHIP) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) questionnaires. RESULTS: The color change (ΔE) values at 1 month were G1 = 16.80 ± 6.07 and G2 = 14.09 ± 4.83. These values remained stable until the third month after treatment (p > 0.05). There was a decrease in the values of OHIP-aesthetics and PIDAQ after treatment versus baseline (p < 0.05). This status was maintained through the third month after treatment. CONCLUSIONS: Both agents were highly effective and had a positive impact on the aesthetic perception and psychosocial impact of patients, values that also remained stable over time. Non-vital bleaching yields positive and stable impacts on aesthetic perception and psychosocial factors. ClinicalTrials.gov identifier NCT02718183.

Color stability, psychosocial impact, and effect on self-perception of esthetics of tooth whitening using low-concentration (6%) hydrogen peroxide.

OBJECTIVE: The aim of this study was to assess the bleaching efficacy and impact on psychosocial and esthetics self-perception of a low-concentration (6%) hydrogen peroxide (H2O2) gel compared with a conventional (37.5%) H2O2 gel when used as an in-office treatment. METHOD AND MATERIALS: In total, 35 participants received two sessions of three 12-minute applications of treatment with 37.5% H2O2 on one side of the mouth and 6% H2O2 on the other. Color changes were measured objectively using total variation in color (ΔE) and subjectively using Vita Classical scale (ΔSGU). The Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ) and Oral Health Impact Profile (OHIP-14) esthetic questionnaires were administered to measure self-perception and the psychosocial impact of the whitening procedure. RESULTS: Both gels produced significant changes in tooth color at 1 and 3 months post-whitening. The objective efficacy (ΔE) of 37.5% H2O2 (9.06 ± 2.96) was significantly higher than that of 6% H2O2 (5.69 ± 3.06). The results of the subjective assessment were not statistically different. There was a positive impact on esthetic auto perception (OHIP-14, P < .05) and psychosocial impact (PIDAQ, P < .05) at the 3-month time point. CONCLUSION: Low concentration of H2O2 (6%) achieved effective bleaching (ΔE > 5 units) with good stability at 3 months accompanied by a positive psychosocial impact and enhanced self-perception. However, the traditional 35% concentration was objectively more effective.

Effect of gender of the operator and application mode of adhesives on dentin hydraulic conductance in an in vitro model

ABSTRACT: Aim: To compare the hydraulic conductance of human dentin disks which have been treated with an adhesive by operators of different genders and by active or passive modes of application. 60 third molars of healthy adults were included in resin blocks. These were cut to obtain 60 dentin disks of 1mm +/- 0.1 mm thick. Group 1 and 2, the adhesive was applied by 15 male operators passively (group 1) and vigorously (group 2). Groups 3 and 4, the adhesive was applied by 15 female operators passively (group 3) and vigorously (group 4). The flow rate was measured with a diffusion chamber and the hydraulic conductance of the disks was determined. Results: Mean for hydraulic conductance of each group was: 1 (0.01752), 2 (0.00355), 3 (0.01215), 4 (0.00877) in μl/minxcm2. There was statistically significant difference in the hydraulic conductance between experimental and control groups. There was no difference in dentin hydraulic conductance between genders. There was statistically significant difference in hydraulic conductance between the different modes of application. There was a moderate association between the pressure exerted when applying the adhesive and the values of dentin hydraulic conductance in vitro.

Effectiveness and effect of non-vital bleaching on the quality of life of patients up to 6 months post-treatment: a randomized clinical trial.

OBJECTIVES: The aim of this study was to evaluate the esthetic perception of patients at 6 months after bleaching of non-vital teeth with 35% of hydrogen peroxide and 37% of carbamide peroxide using a walking bleach technique. We also assessed psychosocial impacts as well as the clinical effectiveness and stability of the color change. MATERIALS AND METHODS: The teeth bleaching treatment was randomly assigned to two groups according to the bleaching agent used: G1 HP = 35% of hydrogen peroxide (n = 25) and G2 CP = 37% of carbamide peroxide (n = 25). The non-vital bleaching was performed in four sessions using the walking bleach technique. The color was objectively (ΔE) and subjectively (ΔSGU) evaluated. The esthetic perception and psychosocial factors were evaluated before treatment as well as one and 6 months post-treatment using Oral Health Impact Profile (OHIP) esthetics and Psychosocial Impact of Dental Esthetics Questionnaire (PIDAQ). RESULTS: The color change (ΔE) at 6 months (G1 = 14.53 ± 5.07 and G2 = 14.09 ± 6.61) for both color groups remained stable until the 6-month post-treatment (p > 0.05). There was a decrease in the values of OHIP esthetics and PIDAQ after treatment compared to the baseline (p < 0.05), and this effect was maintained 6 months post-treatment. CONCLUSIONS: Both agents were highly effective and maintained the color stability at 6 months; this positively affected the esthetic perception and psychosocial impact of patients who also remained stable over time. CLINICAL RELEVANCE: Non-vital bleaching produces a positive and stable impact on the esthetic perception and psychosocial factors at medium-term follow-ups.

Effect of Clinical Experience on Accuracy and Reliability of Radiographic Caries Detection / Efecto de la Experiencia Clínica en la Precisión y Concordancia de Detección de Caries en Radiografías

ABSTRACT: The purpose of this study was to investigate the accuracy and interobserver reliability of examiners with different levels of clinical experience, when diagnosing radiographic proximal caries lesions. Bitewing radiographs were selected from a patient attending Operative Dentistry Clinic, Universidad de Chile. Radiographic examination was performed by three different groups: A: third year dentistry students, B: fourth year dentistry students, and C: dentist recently graduated. Thirty-two proximal surfaces were scored as: 0, sound; 1: enamel caries; and 2: dentinal caries. The data were analysed and accuracy and interexaminer reliability were calculated. Accuracy values for enamel caries were: A (0.54), B (0.55) and C (0.58), and dentinal caries were: A (0.55), B (0.61) and C (0.63). Interexaminer reliability denoted marginal agreement for all groups, A (0.249), B (0.213) and C (0.282) for enamel caries and A (0.058), B (0.102), and C (0.344) for dentinal caries. The results of this study indicate that the accuracy and interexaminer reliability of bitewing radiographic examination were influenced by the clinical experience when detecting radiographic proximal caries, however low values of accuracy and interexaminer reliability were noted, reinforcing the necessity of improving education and training in radiographic caries detection.

RESUMEN:El objetivo de este trabajo fue evaluar la precisión y concordancia entre examinadores con distinto nivel de experiencia clínica, al diagnosticar lesiones de caries proximales en radiografías. Un set de radiografías bitewing fue seleccionado de un paciente que acudió a la Clínica de Operatoria de la Facultad de Odontología, Universidad de Chile. El examen radiográfico fue realizado por tres grupos distintos: A: estudiantes de Odontología de tercer año, B: estudiantes de Odontología de cuarto año, y C: dentistas recientemente graduados. Treinta y dos superficies proximales fueron analizadas y evaluadas como: 0, sana; 1: lesión de caries de esmalte, 2: lesión de caries dentinaria. Los datos obtenidos fueron analizados y la precisión y concordancia entre examinadores fueron calculadas. Los valores de precisión en lesiones de esmalte fueron: A (0,54), B (0,55) y C (0,58), y para lesiones dentinarias fueron: A (0,55), B (0,61) y C (0,63). La concordancia entre examinadores denotó ser marginal para todos los grupos, A (0,249), B (0,213) y C (0,282) en lesiones de esmalte y A (0,058), B (0,102), y C (0,344) en lesiones dentinarias. Los resultados de este estudio indican que la precisión y la concordancia entre examinadores está influenciada por la experiencia clínica, sin embargo los valores encontrados fueron bajos, lo que refuerza la necesidad de mejorar la educación y entrenamiento en detección de lesiones de caries en radiografías

Influence of the passive evaporation of adhesive on the conductance of dentin

ABSTRACT: Aim: Determine the influence of time of passive evaporation of the solvent in a universal adhesive on the hydraulic conductance and permeability of dentin in an ex vivo human model. Henceforth, 60 healthy non-occluding third molars, indicated for therapeutic extraction/removal, of informed and consented patients aged between 18 and 30 years, were used here in. First, extracted teeth were incorporated into epoxy resin blocks and then dentin disks (1mm +/- 0.1 mm thick) were prepared. Dentin was acid etched with 35% ortho-phosphoric acid for 15 seconds in order to remove the smear layer and obtain permeable dentin. Samples were then randomized and divided into 5 groups (n=12). A Single Bond Universal adhesive layer with different time of passive evaporation of the solvent was then applied: GC=10 seconds, G1=30 seconds, G2=60 seconds, G3=300 seconds and G4=50 minutes. Finally, the flow rate was measured using a diffusion chamber, a model previously proposed by Pashley et al. Results: The obtained hydraulic conductance averages were as follows: GC=0.00052, G1=0.00018, G2=0.00006, G3=0.00005, G4=0.00005 expressed in uL•cm-2•min-1cm•H2O-1. For comparisons between groups, ANOVA and post hoc Tukey (ρ<0.05) tests were applied, resulting in a statistically significant difference between the GC group and all experimental groups (ρ <0.05). An influence of solvent passive evaporation thereby reducing hydraulic conductance in the experimental groups, was detected.

Does refurbishing composites lead to short-term effects or long-lasting improvement?

PURPOSE: To evaluate the clinical performance of refurbished resin composite restorations compared to untreated (negative control) restorations over a period of 10 years. METHODS: 26 subjects (having a total of 52 composite restorations) were recruited. All restorations in the refurbished group showed clinical features rated bravo according to modified USPHS criteria. Untreated restorations were those that had been deemed acceptable (alpha or bravo rated); these were used as controls. Two examiners performed assessments at baseline and during the 5th and 10th years after the intervention. Wilcoxon tests were performed for within-group comparisons, Friedman tests were used for multiple within-group comparisons, and Mann Whitney tests were used for between-groups comparisons. Kaplan-Meier survival curves were calculated, and the Mantel-Cox test was used to compare curves. P < 0.05 was considered statistically significant. RESULTS: In both groups, 10-year scores were significantly different from baseline scores in all clinical parameters except secondary caries. There were no statistically significant differences in the survival analysis of groups (log-rank test, P = 0.376). Refurbishing treatment improved the anatomy, roughness, luster, and marginal adaptation of restorations with a short-term effect, with most properties rated acceptable after 10 years of clinical service. The clinical characteristics were similar for all groups at the 10th year.

Comparación de la conductancia hidráulica dentinaria, de acuerdo al tiempo de aplicación de desensibilizantes con base de oxalatos / Comparison of dentinal hydraulic conductance according to the application time of oxalate-based desensitizers

Introdución: se utilizó un modelo in vitro, para medir la conductancia hidráulica en discos de dentina humana, tratados con ácido oxálico por 15, 30 o 60 s y la mantención del efecto oclusivo, medido a los 7 y 14 días post aplicación. Métodos: 45 discos dentinarios de 1mm de grosor fueron obtenidos de terceros molares humanos libres de caries, en inoclusión, de pacientes entre 16 a 30 años de edad. Los discos fueron divididos en tres grupos de estudio (n = 15), dependiendo del tiempo de aplicación de una solución comercial de desensibilizante dentinario (DD) a base de oxalato (BisBlock®), que contiene ˂ 5% ácido oxálico pH 1,5-1,8: grupo A aplicación del agente por 15 s, grupo B aplicación por 30 s y grupo C por 60 s. La conductancia hidráulica de cada disco fue calculada posterior al grabado ácido, lo que corresponde a la máxima permeabilidad de dicho disco (100%), inmediatamente tras la aplicación del ácido oxálico y tras siete y 14 días de mantención en suero fisiológico.El análisis estadístico se hizo mediante test de ANOVA y post hoc de Games-Howell. Resultados: 35,46 ± 23,41% para el grupo A, 36,34 ± 15,88% para el grupo B y 24,99 ± 14,99% para el grupo C, por lo que la utilización de DD por 15, 30 ó 60 s generó una disminución en la permeabilidad que fue estadísticamente significativa (p ˂ 0,05). Conclusiones: el DD fue eficaz en reducir la conductancia hidráulica independiente del tiempo de aplicación, siendo esta reducción sólo temporal, ya que tras siete días la permeabilidad retorna a valores cercanos a los iniciales.

Introduction: an in vitro model was used to measure the hydraulic conductance in human dentin discs treated with oxalic acid for 15, 30 or 60 s maintaining the occlusive effect and measuring 7 and 14 days after application. Methods: 45 dentin discs measuring 1 mm thick were obtained from human third molars which were free of caries and in no occlusion; the samples were obtained from patients aged 16 to 30 years. Discs were sorted out into three study groups (n = 15) depending on the time of application of a commercial solution of oxalate-based dentin desensitizer (DD) (BisBlock®) which contains ˂ 5% oxalic acid of 1.5-1.8 pH: in group A the agent was applied for 15 s, in group B it was applied for 30 s, and in group C for 60 s. The hydraulic conductance of each disc was calculated after acid etching, which corresponds to the maximum permeability of discs (100%) after immediate application of oxalic acid, as well as seven and fourteen days of storage in saline solution. The statistical analysis was done with ANOVA test and post-hoc Games-Howell test. Results: 35,46 ± 23.41% in Group A, 36.34 ± 15.88% in Group B and 24.99 ± 14.99% in Group C, showing that the use of DD for 15, 30 or 60 s decreased permeability in a statistically significant manner (p <0.05). Conclusions: DD was effective in reducing hydraulic conductance regardless of application time, but this reduction was temporary only, since after seven days permeability returns to values close to those of baseline.

Effectiveness of and tooth sensitivity with at-home bleaching in smokers: a multicenter clinical trial.

BACKGROUND: The authors conducted a 2-center controlled clinical study to show the equivalence of at-home bleaching in smokers and nonsmokers at 1 week and 1 month and evaluate tooth sensitivity (TS). METHODS: The authors selected 60 smokers and 60 nonsmokers with central incisors of shade A2 or darker. The participants performed bleaching with 10% carbamide peroxide for 3 hours daily for 3 weeks. The authors evaluated the color by using a shade guide and a spectrophotometer before, during, and after bleaching (1 week and 1 month). Patients recorded TS by using a 0-4 scale and a visual analog scale. The authors used multivariable regression analysis to test factors associated with color change and TS (α = .05). RESULTS: Smokers and nonsmokers showed significant color change statistically equivalent to within ± 2.0 units at 1 week after bleaching. Overall, color shade improved by 4.1 shade guide units (95% confidence interval [CI], 3.7-4.5) and 7.8 units of color change measured with the spectrophotometer (95% CI, 7.1-8.5) at 1 month. None of the factors affected the TS risk. TS absolute risk and intensity were similar between groups (P > .05), with an overall estimate of 47% (95% CI, 38-56%). CONCLUSIONS: The immediate effectiveness of whitening- and bleaching-related TS were not affected by smoking. PRACTICAL IMPLICATIONS: Smoking did not affect the immediate color change (1 week). Effective whitening was achieved regardless of whether the patient was a smoker. However, this equivalence was not apparent 1 month after bleaching, with smokers having slightly darker teeth.