ABSTRACT
PURPOSE: To investigate if tooth whitening had any effect on the shade of occlusal pit and fissure stains and whether reservoirs in bleaching trays affected bleaching of occlusal pit and fissure stains. METHODS: 96 extracted molars were randomly divided into three paired groups for whitening using a 10% carbamide peroxide solution (Opalescence) or a 22% carbamide peroxide solution (Nite White Excel 3), or tap water for a control. One of each pair utilized reservoirs in their custom bleaching trays. Three dentists evaluated the shade of a specified occlusal area of pit and fissure stain twice before bleaching and twice after bleaching. RESULTS: Pit and fissure stain showed significant lightening of shade for either of the bleaching systems (P < 0.0005) but not the control (P = 0.816). There was no significant difference in pit and fissure stain shade lightening following treatment between those groups utilizing reservoirs in the custom trays and those without reservoirs (P = 0.658).
Subject(s)
Dental Fissures/pathology , Tooth Bleaching/methods , Tooth Discoloration/drug therapy , Carbamide Peroxide , Color , Dental Enamel/drug effects , Dental Enamel/pathology , Drug Combinations , Equipment Design , Humans , Molar/drug effects , Molar/pathology , Oxidants/administration & dosage , Oxidants/therapeutic use , Peroxides/administration & dosage , Peroxides/therapeutic use , Tooth Bleaching/instrumentation , Urea/administration & dosage , Urea/analogs & derivatives , Urea/therapeutic useABSTRACT
In this clinical study, DIAGNOdent (KaVo) was used to assess previously diagnosed carious lesions in the pits and fissures of first and second molars. The measurements from this device were correlated with the depth and volume of the cavity preparations that resulted from minimal intervention to remove occlusal carious lesions. Twenty-five patients, 18 years of age and older, who were previously scheduled for an occlusal restoration due to caries, were recruited and enrolled in this clinical study. These patients had 48 qualifying teeth without previous restorations, sealants or other carious lesions. The occlusal surface of each study tooth was cleaned utilizing ProphyFlex2 (KaVo). Two dentists separately traced the pit and fissure system of each tooth using DIAGNOdent for two 15-second periods each. The peak reading of each of the four measurements was recorded. An impression of the occlusal surface of each tooth was recorded with a polyvinyl siloxane bite registration material. The carious lesions were removed with an air abrasion unit employing a 0.015-inch nozzle opening utilizing minimal operative intervention. A low viscosity polyvinyl siloxane was used to take an impression of the cavity preparation impression, using the bite registration impression to form the occlusal surface of the preparation impression. The preparation impression volume was calculated from its weight, using the known density of the impression material. The greatest depth of the preparation was measured. The Pearson correlation coefficient was used to investigate any relationship between depth or volume of the preparation impression and the DIAGNOdent measurements. The correlation for preparation volume and maximum DIAGNOdent measurement was 0.191 (p = 0.189). Other logical subsets of cases also did not result in any statistically significant correlations between the DIAGNOdent readings and the depth or volume of the final cavity preparations.
Subject(s)
Dental Cavity Preparation/methods , Dental Enamel/pathology , Dental Fissures/therapy , Lasers , Adolescent , Adult , Air Abrasion, Dental/instrumentation , Air Abrasion, Dental/methods , Dental Cavity Preparation/instrumentation , Dental Fissures/diagnosis , Dental Impression Materials , Dental Impression Technique , Dental Prophylaxis , Fluorescence , Humans , Molar/pathology , Polyvinyls , SiloxanesABSTRACT
BACKGROUND: The purpose of this study was to quantify conservation of tooth structure and evaluate the efficacy of early treatment of questionable carious lesions in pits and fissures of posterior teeth using air abrasion followed by placement of preventive resin restorations. METHODS: Ninety-three patients with 223 questionably carious teeth, mainly with darkly stained pits and fissures, were recruited from general dentistry clinics. After baseline evaluation, each tooth was randomly assigned to either an early treatment or control group. The authors used air abrasion to investigate the pits and fissures of teeth in the early treatment group. The teeth were sealed and restored with a flowable resin-based composite. All teeth in both groups were examined at six-month intervals to clinically evaluate the quality of the restorations and the caries status of the control teeth. RESULTS: After two years, two of the 113 restorations in the early treatment group required further treatment because of penetrating stain at a margin. In the control group, 14 teeth required treatment because of caries. The mean weight of the impression material--a surrogate measure of volume of removed tooth structure--in preparations that extended into dentin in the early treatment group was 0.0260 grams compared with 0.0281 g in the control group. There was no statistically significant difference between the impression weights (P = .390). CONCLUSION: After two years of a proposed five-year study, the authors concluded that conservation of tooth structure was not substantiated by early treatment. CLINICAL IMPLICATIONS: Treating questionable carious lesions early may not conserve tooth structure.
