A rare case of suicide by bleach fatal ingestion: a case report and a literature overview.

Background: Nowadays it is estimated that worldwide more than 700 000 people die by suicide every year and a greater amount attempt this practice. Suicide is the fourth cause of death among 15-29 years old people. Sodium Hypochlorite (NaOCl) is used in household and com-mercial bleaches and due to its easy availability, accidental exposure to or intentional ingestion of NaOCl occurs frequently. In most cases health effects are only transient but if the subject ingests a large amount of this substance, this can generate severe consequences as oesophageal or stomach lesions and electrolytic imbalance. In the present study we analyse a rare case of suicide by fatal ingestion of bleach. Case Report: Case of a caucasic 47 years old woman with a background of several suicide attempts by exogenous substance ingestion that was found death alone in her apartment. The purpose of our investigation was identifying the cause of death. A rigorous and multidisciplinary methodological approach was adopted, including an accurate judicial inspection of the environment, an anamnestic collection, an autoptic procedure completed by macro and microscopic examinations of internal organs and a toxicological examination of biological fluids. Furthermore, a literature overview of similar cases was carried out. The resulting evidence demonstrates that woman's death occurred after a massive bleach ingestion. Conclusions: This case report highlights the importance of forensic methodology in investigating the ingestion of exogenous substances. Crime scene investigation, a detailed post-mortem examination, toxicology and a complete histopathological study are mandatory to solve the enigma.

Occurrence, migration and health risks of fluorescent whitening agents and phthalates in bottled water.

The occurrence and health risks of fluorescent whitening agents (FWAs) in bottled water were reported for the first time. FWA184 and FWA393 were the most frequently detected FWAs, with mean concentrations of 3.99-17.00 ng L-1. Phthalates (PAEs) such as dibutyl phthalate (DBP), di-iso-butyl phthalate (DiBP), and diethylhexyl phthalate (DEHP) were prevalent in bottled water, with mean levels of 40.89-716.66 ng L-1, and their concentrations in bottled water were much higher than those of FWAs. FWAs and PAEs in bottles and caps were extracted using organic solvent, and the correlation analysis showed that FWA393 and DEHP most likely originated from bottles, while bottle caps were the main sources of DBP and DiBP. The calculated risk quotients (RQs) of target substances and all age groups were considerably lower than the threshold of 0.1, indicating that consuming bottled water containing these plastic additives was unlikely to pose health risks for people of all ages. However, RQ values for underage people were several times higher than those for adults and hence cannot be neglected; therefore, special attention should be paid to understand the potential risks posed by the exposure to these plastic additives during early life stages, especially the infant stage.

Bleach suit for atopic dermatitis.

Bleach baths are an important adjunct in the management of atopic dermatitis. However, many homes do not have bath tubs. We tried to overcome this by soaking a cotton pajama suit or Indian kurta pajama in dilute bleach solution and then having the child wear it for ten minutes. This is done two to three times a week, as in standard bleach tub baths. We have tried this technique in eleven patients with satisfactory outcomes and no adverse effects.

Changes in physical properties of universal composites and CAD/CAM materials after bleaching and antioxidant applications: Scanning electron microscope and atomic force microscope evaluation.

To evaluate the effects of vital bleaching agents and the subsequent application of ascorbic acid (AA) to universal composites and resin-based CAD/CAM blocks on the physical properties of materials. In the study; G-enial A'chord (GCA), Filtek Ultimate (FU), Clearfil Majesty (CM) composites, and LAVA Ultimate (LU), Cerasmart (GCC) CAD/CAM blocks were used. The materials were divided into two subgroups based on the applied bleaching type (n = 30/group): office bleaching (OB) and home bleaching (HB). After bleaching, AA was applied to the samples. Surface roughness, microhardness, and color change values of all samples were measured at three stages: initial (I), post-bleaching (B), and post-bleaching+AA application (BA). Statistical analysis was performed using 3-way Mixed ANOVA with Bonferroni correction (p < .05). The BA of the HB group of CM; the B of the HB group of LU; the B roughness values of both the OB and HB groups of GCC were significantly lower than I. The microhardness values of all the materials examined decreased significantly after both bleaching (p < .05). With regard to the AA application, it significantly decreased Ra values in the HB group of CM. In addition, it significantly increased the microhardness values in the HB groups of CM and GCC. Also, the ΔE001 and ΔE002 values for the FU and GCC HB groups were significantly higher than in the OB groups (p < .05). Bleaching and AA application affected the physical properties of the materials. The physical properties of the materials either remained unchanged or improved with the application of AA after bleaching. RESEARCH HIGHLIGHTS: This article presents in vitro results of a new approach that has not been studied before. Ascorbic acid, used to increase the bond strength between the material-tooth after bleaching, was used to eliminate the adverse effects of bleaching on the physical properties of aesthetic restorative materials. Additionally, the effects of all procedures on the materials were examined using scanning electron microscopy (SEM) and atomic force microscopy (AFM). As a result of the study, it was concluded that the application of ascorbic acid after bleaching improved the physical properties of some of the materials.

Color and surface roughness alterations of bulk-fill resin composites submitted to simulated toothbrushing with whitening dentifrices

Aim: To evaluate the surface roughness and color stability of bulk-fill resin composites after simulated toothbrushing with whitening dentifrices. The radioactive/relative dentin abrasion (RDA) and radioactive/relative enamel abrasion (REA) of dentifrices were also assessed. Methods: Specimens (n=10) of Tetric N Ceram Bulk Fill (TNCB), Filtek One Bulk Fill (FOB) resin composites, and Z100(Control) were prepared using a cylindrical Teflon matrix. Surface roughness (Ra, µm) was assessed by a roughness meter and the color evaluations (ΔEab , ΔE00 , WID ) were performed using a digital spectrophotometer based on the CIELAB system. Three measurements were performed per sample, before and after simulated toothbrushing with 3D Oral-B White Perfection (3DW) and Black is White (BW) dentifrices. The abrasivity (REA and RDA values) of the used dentifrices was also determined by the Hefferren abrasivity test. Results: The Ra values increased significantly in all resin composites after 3DW and BW toothbrushing. The acceptable threshold color varied among resin composites, and TNCB and Z100 presented the highest ΔEab and ΔE00 for BW dentifrice. The 3DW dentifrice was significantly more abrasive than BW dentifrice on enamel and dentin. Conclusions: simulated toothbrushing with tested whitening dentifrices increased the surface roughness at acceptable levels. The Tetric N Ceram Bulk-fill and Z100 composite showed the highest color alteration in BW. 3D White Perfection dentifrice was more abrasive on dentin and enamel than Black is White.

Intracoronal tooth bleaching - A review and treatment guidelines.

Intracoronal bleaching is a minimally invasive procedure that was introduced into dentistry in the 19th century. The role of that procedure in enhancing the colour of teeth subjected to internal discolouration while being conservative made it extremely popular amongst dental professionals. Different materials and techniques have been utilized over the years attempting to obtain predictable long-term results while minimizing any associated risks. Contemporarily, bleaching agents are mainly based on peroxide-releasing compounds in different formulations and delivery systems. Different theories have been formulated on the bleaching mechanism of such agents, but the exact mechanism is yet to be proven. The effect of hydrogen peroxide-based bleaching agents on the organic structure of enamel and dentine has been extensively investigated to address the effects of bonding of resin-based restorative materials to hard tooth structure. Multiple case reports raised a concern about the contribution of intracoronal bleaching in developing invasive root resorption. Modification of intracoronal bleaching techniques was thus necessary to address such concerns. This review will provide a summary of the important aspects of intracoronal bleaching, focusing on how it applies to the contemporary clinical setting. © 2023 Australian Dental Association.

Dental aesthetic perception of patients submitted to activated charcoal-based bleaching agents: A randomized clinical trial.

OBJECTIVE: To evaluate the effects of activated charcoal-based products used in two presentation forms (powder or toothpaste), compared to 10 % carbamide peroxide and conventional toothpaste on aesthetic perception and psychosocial impact before and after treatment. METHODS: Fifty-six participants were divided into 4 experimental groups (n = 14). Activated charcoal-based powder (PW); Activated charcoal-based dentifrice (AC); Conventional fluoride toothpaste (CD) and 10 % carbamide peroxide (CP). All products were used for 14 days. Psychosocial impact on dental esthetics (PIDAQ), oral health impact profile (OHIP- Esthetics) and orofacial esthetics scale (OES) questionnaires were applied before and after treatment. Descriptive and exploratory data analyses were performed and analyzed using linear mixed models for repeated measures over time considering significance level of α = 0.05. RESULTS: For PIDAQ, the CP group showed significant decrease in psychological impact, aesthetic perception domains and overall score, while in the PW group, there was only a significant decrease in the psychological impact domain. Decrease in OHIP was observed for the functional limitation domain scores for treatments with CP and PW, in the psychological discomfort domain, decrease was observed for all groups, while for the OES questionnaire, significant increase in the color domain was observed for the CP group. CONCLUSION: Activated charcoal-based products showed lower scores in all questionnaires when compared with carbamide peroxide; thus, charcoal-based products promoted lower impact on quality of life and aesthetic perception. CLINICAL RELEVANCE: In this randomized clinical trial, charcoal-based OTC products had inferior quality of life and aesthetic perception results compared to conventional carbamide peroxide bleaching.

The effect of in-office bleaching agents on the Vickers hardness and surface topography of polished and unpolished CAD/CAM composite materials.

In-office bleaching, using hydrogen peroxide, is effective to remove dental enamel stains. However, bleaching agents can deteriorate surface properties of CAD-CAM materials. This in vitro study aimed to investigate the effect of in-office bleaching agents on Vickers hardness and surface topography of polished and unpolished dental CAD-CAM composite materials (Grandio blocs, Lava Ultimate, BRILLIANT Crios, Cerasmart), and a polymer-infiltrated ceramic network block (Vita Enamic). The specimens were randomly divided into two groups: unpolished or polished. The micro-hardness and surface topography of each group were measured before bleaching, after a 60 min bleaching period, and 24-h and one-month post-bleaching. In-office bleaching significantly influenced the Vickers hardness of both the polished and unpolished CAD/CAM composite blocks, with Vita Enamic exhibiting the least hardness stability among all groups. Furthermore, in-office bleaching significantly influenced the surface roughness of unpolished CAD/CAM composite blocks. There was a significant difference in hardness reduction between the polished and unpolished specimens for most of the investigated materials at different time points. The bleaching did not influence the surface roughness of the investigated polished group, except for Vita Enamic and Lava Ultimate. However, it did influence the surface roughness of the investigated materials in the unpolished group.

Anti-Melanogenic and Antioxidant Activity of Bifidobacterium longum Strain ZJ1 Extracts, Isolated from a Chinese Centenarian.

Melanin produced by melanocytes protects our skin against ultraviolet (UV) radiation-induced cell damage and oxidative stress. Melanin overproduction by hyperactivated melanocytes is the direct cause of skin hyperpigmentary disorders, such as freckles and melasma. Exploring natural whitening agents without the concern of toxicity has been highly desired. In this study, we focused on a Bifidobacterium longum strain, ZJ1, isolated from a Chinese centenarian, and we evaluated the anti-melanogenic activity of the distinctive extracts of ZJ1. Our results demonstrated that whole lysate (WL) and bacterial lysate (BL) of ZJ1 ferments efficiently reduce α-melanocyte-stimulating hormone (α-MSH)-induced melanin production in B16-F10 cells as well as the melanin content in zebrafish embryos. BL and WL downregulate melanogenesis-related gene expression and indirectly inhibit intracellular tyrosinase activity. Furthermore, they both showed antioxidant activity in a menadione-induced zebrafish embryo model. Our results suggest that ZJ1 fermentation lysates have application potential as therapeutic reagents for hyperpigmentary disorders and whitening agents for cosmetics.

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.

Effect of in-office bleaching agent on the surface roughness and microhardness of nanofilled and nanohybrid composite resins.

Background: To compare the surface roughness and microhardness of Ceram.x® SphereTEC™ one and Filtek Z350 XT after in-office bleaching with Pola office. Methods: Twenty samples each of (10 mm diameter and 2 mm height) Ceram.x® SphereTEC™ one and Filtek Z350 XT were prepared. The samples were subjected to three bleaching sessions with 35% hydrogen peroxide (Pola office) with a seven-day interval between each session. Surface roughness and microhardness of the prepared samples prior to and after the bleaching regimen were measured using a profilometer and Vickers hardness tester, respectively. Results: A significant reduction (p <0.001) in the surface hardness of Filtek Z350 XT from 27.67 ± 2.10 to 17.83 ± 1.36 Vickers hardness number (VHN) was observed after the bleaching whereas no significant reduction in surface hardness was observed with Ceram.x® SphereTEC™ one. The adjusted mean (estimated marginal mean) microhardness after bleaching for Ceram.x ® SphereTEC™ one (35.79 ± 1.45) was significantly higher than Filtek Z350 XT (19.54 ± 1.45) (p < 0.001). However, in-office bleaching of these materials did not significantly alter their surface roughness. Conclusions: In office-bleaching with 35% hydrogen peroxide can reduce the microhardness of nanofilled composite. However, the surface roughness was not influenced by the bleaching procedure in both nanohybrid and nanofilled composite resin materials.

Quantitative analysis of the degree of demineralization for bleached enamel by optical coherence tomography.

BACKGROUND: Tooth bleaching imparts whitening effects along with adverse effects such as increased tooth sensitivity and enamel surface changes. Herein, we employed optical coherence tomography (OCT), a nondestructive optical detection technique, for evaluation of tooth enamel after treatment with peroxide-based bleaching agents. METHODS: Fifteen enamel samples were bleached using 38% acidic hydrogen peroxide-based bleach, subjected to OCT scanning, and then cross-sectioned and imaged under polarized light microscopy (PLM) and transverse microradiography (TMR). OCT cross-sectional images were compared with PLM and TMR. The depth and severity of demineralization produced in the bleached enamel were measured by OCT, PLM, and TMR. Comparison between the three techniques was performed using Kruskal-Wallis H non-parametric test and Pearson correlation. RESULTS: In comparison with PLM and TMR, OCT clearly detected the changes in the enamel surface after hydrogen peroxide bleaching. Significant correlations (p<0.05) were observed in lesion depth between OCT and PLM (r=0.820), OCT and TMR (r=0.822), and TMR and PLM (r=0.861). There was no statistically significant difference in demineralization depth values measured by OCT, PLM, and TMR (p>0.05). CONCLUSION: OCT can allow real-time, non-invasive imaging of artificially bleached tooth models and automatically measure the early changes in the enamel lesion structure upon exposure to hydrogen peroxide-based bleaching agents.

Effects of Dental Bleaching Agents on the Surface Roughness of Dental Restoration Materials.

Background and Objectives: This study aimed to evaluate the surface roughness evolution of several finished and polished composites when bleaching materials are applied. The research was conducted on four microhybrid or nanofilled composites that are used in dental restorations. Materials and Methods: For each composite type, 5 samples were selected for control, 5 samples were subjected to the bleaching protocol "office bleach" with 40% hydrogen peroxide, and 5 other samples were subjected to the "home bleach" protocol with 16% carbamide peroxide, resulting in a total number of 60 samples. The surfaces of all the samples were tested for roughness, and the values of the most relevant parameter (Ra), were collected. Comparisons between composites and samples were performed using one-way ANOVA (in Statistical Package for Social Sciences). Results: After the bleaching protocol with 40% hydrogen peroxide gel, it was found that the roughness of the group increased considerably compared to the control group, so the highest roughness was found at GC Gradia direct anterior group, and the lowest value was registered for the 3M ESPE Valux Plus group. Following the bleaching protocol with 16% carbamide peroxide (home bleach), it was noted that the sample surfaces were not as affected. In this case, the lowest roughness was found at 3M ESPE Valux Plus group, and the highest roughness was registered for the GC G-aenial anterior group. Following the interpretation of the results, all four types of dental composites tested showed significant surface roughness differences between the groups subjected to bleaching protocols and those kept as control (p < 0.05). Conclusions: The surfaces of the samples were affected by the bleaching protocols by increasing the roughness compared to the control samples.

Prognosis in home dental bleaching: a systematic review.

OBJECTIVES: The aim of this systematic review was to evaluate the prognosis of at-home dental bleaching using low concentration bleaching products. MATERIALS AND METHODS: This review was conducted was performed following the recommendations of the 2020 PRISMA statement and was registered in the International Prospective Register of Systematic Reviews (PROSPERO-CRD42022360530). The PICO question was "What is the prognosis of home teeth whitening treatment?". An advanced electronic search was made in three databases: PubMed, Web of Science, and Embase. RESULTS: The database search led to the retrieval of 225 articles. After elimination of duplicate references, the titles and abstracts of the articles were analyzed with respect to the eligibility criteria, and 24 studies were included for the development of the systematic review. CONCLUSIONS: Most authors state that the color remains stable between 1 and 2.5 years regardless of the type of bleaching agent or the forms of administration, and color stability in cases of severe discolorations presents a higher degree of recurrence. CLINICAL RELEVANCE: Given the growing demand for dental cosmetic treatments, the following systematic review may aid the clinician's continuing education and evidence-based practice by providing knowledge on the field of at-home dental bleaching agents and their long-term effects.

Effect of the application of a hydrogen peroxide home bleaching agent on the cytotoxicity of different CAD-CAM restorative materials.

BACKGROUND: The information regarding the cytotoxicity of ceramic and resin-matrix ceramic materials subjected to over-the-counter bleaching agents is limited in the literature. OBJECTIVES: The aim of the present study was to investigate the cytotoxic effects of lithium disilicate ceramic (LDC), resin nano-ceramic (RNC) and nano-hybrid composite (NHC) computer-aided design/ computer-aided manufacturing (CAD-CAM) block materials subjected to a home bleaching agent and artificial saliva. MATERIAL AND METHODS: A total of 432 specimens were prepared from 3 different CAD-CAM materials. Each material group was divided into 4 groups according to the storage medium (phosphate-buffered saline (PBS) or artificial saliva), and whether the specimens were subjected to a bleaching agent or not. For the bleached groups, hydrogen peroxide (10%) was applied to the specimens for 30 min/day for 15 days, and the specimens were immersed in PBS or saliva after bleaching. The viability of epithelial cells was detected using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay at the end of the 5th, 10th and 15th day of the study. The data was statistically analyzed. RESULTS: Regardless of the storage medium and the time period, all restorative materials decreased the viability of cells. The highest cytotoxicity levels were determined on the 15th day of the study. The application of a bleaching agent increased the cytotoxicity of the LDC specimens stored in artificial saliva. The RNC material stored in PBS demonstrated significantly higher cell viability than the LDC and NHC groups. The LDC and RNC specimens stored in artificial saliva did not show any significant difference in cytotoxicity. When the materials were subjected to bleaching, NHC demonstrated the highest cytotoxicity during all periods. No significant difference was found between the LDC and RNC specimens subjected to both artificial saliva and bleaching in terms of cytotoxicity. CONCLUSIONS: The type of restorative material, the immersion medium, the application of a bleaching agent, and the application period affected the cytotoxicity of the materials. Over-the-counter home bleaching agents may induce cellular cytotoxicity due to the existing restorations, and patients should be informed about this potential biological response.

Effects of in-office bleaching agents on polished and unpolished nanofilled resin composite.

BACKGROUND: This study investigates the effects of in-office bleaching agents on the color change and surface roughness of nanofilled resin composite finished by various polishing procedures. METHODS: The authors made 108 specimens from nanofilled resin composite, and the finishing and polishing procedures were performed with either Sof-Lex (3M ESPE) or OneGloss (Shofu). The specimens were then immersed in tea or coffee solution for 1 week, after which in-office bleaching agents were applied (n = 9). After polishing and bleaching, the surface roughness was measured with a surface profilometer. The specimen color parameters were measured with the Commission Internationale de l'Eclairage L∗a∗b∗ system in 3 stages, namely after polishing, after staining, and at the end of the bleaching procedure. The total color changes (ΔEab∗) were calculated, and ΔEab∗ not exceeding 2.7 was considered a clinically acceptable threshold. RESULTS: The highest initial roughness value was observed on surfaces polished with OneGloss. In all groups, the surface roughness increased significantly after bleaching. For the Sof-Lex group specimens stained in both tea and coffee solutions, bleaching agent Opalescence Boost (Ultradent) reduced the color change value to 2.7 or less after bleaching. CONCLUSIONS: In-office bleaching agents increased surface roughness in all groups, especially on unpolished surfaces. However, surface roughness was at an acceptable threshold for the multistep polished group, Sof-Lex, after bleaching. Nanofilled resin composite staining can be partially reduced by in-office bleaching agents but not completely removed. PRACTICAL IMPLICATIONS: To reduce the increase in surface roughness of composite restorations due to bleaching, polishing should be applied before and after bleaching.

Whitening efficacy and tooth sensitivity in a combined in-office and at-home whitening protocol: A randomized controlled clinical trial.

OBJECTIVE: This controlled randomized clinical trial determined the whitening efficacy and the intensity and absolute risk of tooth sensitivity in dual whitening when prefilled at-home whitening trays were used between in-office whitening intervals. MATERIALS AND METHODS: An in-office whitening agent containing 35% hydrogen peroxide was used. A prefilled tray with a whitening agent containing 6% hydrogen peroxide was used for at-home whitening. Sixty-six subjects were randomly assigned to three groups. Group I: at-home whitening was performed 10 times between the in-office whitening treatments. Group II: at-home whitening was performed five times between the in-office whitening treatments. Group III: only in-office whitening was performed. The tooth color changes were evaluated using a spectrophotometer. A visual analog scale was used to express the pain intensity. RESULTS: All the groups showed increased ΔE*ab, ΔE00 , and ΔWID with increased whitening sessions. Group I at the 3rd whitening session showed significantly higher ΔE*ab, ΔE00 , and ΔWID than group III. Tooth sensitivity showed higher values up to 24 h after whitening. CONCLUSIONS: Although dual whitening with the prefilled tray and in-office whitening had higher whitening ability than in-office whitening alone, the intensity and absolute risk of tooth sensitivity was similar. CLINICAL RELEVANCE: The dual whitening might produce faster and stronger whitening effects than in-office whitening alone.

The effect of propolis on the bond strength of composite resin to enamel after intracoronal bleaching with different bleaching agents.

This study evaluated the effect of propolis as an antioxidant agent on bond strength to enamel after intracoronal bleaching. A total of 160 incisors were endodontically treated. Sixteen teeth were served as control, and the remaining teeth were randomly divided into three main groups according to the bleaching agent used; group 1: Sodium perborate (SP); group 2: Carbamide peroxide (CP); group 3: Hydrogen peroxide (HP). After bleaching, the samples were divided into three subgroups; subgroup A: no antioxidant agent application, subgroup B: sodium ascorbate (SA), subgroup C: propolis (PP). After the antioxidant agents application, the sample's surfaces were washed and dried. After adhesive application, composite resin cylinders were applied to enamel surfaces using tygon tubes and a shear bond strength test was performed. The use of PP significantly decreased the bond strength of composite resin to the enamel (p < 0.05). Using propolis as an antioxidant agent adversely affects the bond strength to enamel after intracoronal bleaching.

Impact of different intraorifice barriers on fracture resistance of non-vital bleached teeth.

Background and Aim: This study aimed to evaluate the effects of bleaching agents on the fracture resistance of endodontically treated teeth using different intraorifice barrier (IOB) materials. Materials and Methods: The endodontic treatment was performed for 160 mandibular premolars, and then, the teeth were divided into four groups according to the IOB: Ionoseal, Biodentine, ProRoot MTA, and TheraBase. Then, these teeth were subdivided into four subgroups (n = 10) based on the bleaching agents as distilled water (control), hydrogen peroxide 35% (HP), sodium perborate (SP), and carbamide peroxide 37% (CP). The access cavities were restored with composite resin after applying the bleaching agents for 7 days. The fracture resistance test was performed using a universal testing machine. Data were statistically analyzed, and the significance level was set at 5%. A scanning electron microscope was used to evaluate the effect of bleaching agents on the surfaces of IOBs. Results: The highest fracture resistance values were observed in Biodentine groups with significant differences compared to Ionoseal and ProRoot MTA (P <.05). The distilled water groups showed significantly the highest fracture resistance compared to SP and HP groups (P <.05). There was no significant difference between SP, HP, and CP groups (P >.05). It was demonstrated that the morphological surface of the intact IOBs (control) was different from the surface of IOBs treated with bleaching agents. Conclusion: The intracoronal bleaching procedures affected negatively the fracture resistance of the endodontically treated teeth.