Color Change of Resin-based Composites After In Vitro Bleaching Protocols: A Systematic Review and Meta-analysis.

OBJECTIVES: To systematically review the literature on color stability of resin-based composites (RBC) after in vitro bleaching protocols and to assess the influence of bleaching protocols by meta-regression analysis on RBC color stability, and the association with clinical and experimental characteristics. METHODS: The electronic search was conducted in MEDLINE/PubMed, Scopus, and Web of Science databases and included English language studies that evaluated and reported color differences (CIELAB values) of RBC after in vitro bleaching procedures using hydrogen peroxide and/or carbamide peroxide. RESULTS: Database search for color change of RBC after bleaching retrieved 1335 eligible papers after removing duplicates. After initial screening, 66 articles were assessed for full-text reading with final inclusion of 23 published papers. A meta-regression analysis showed that storage time (p≤0.01), color measuring device (p≤0.01), and background color (p≤0.01) had influenced on color changes of RBC. The bleaching protocol (bleaching agent and time of application) did not influence on color changes of RBC (p>0.01). CONCLUSIONS: There is evidence that RBC change color after bleaching, but the change is not clinically significant.

Nutritional control of pregnant women on chronic hemodialysis.

The authors describe their experience in the follow-up of four patients with chronic renal failure who became pregnant while being treated with chronic hemodialysis. The outcomes were successful and each gave birth to healthy babies. The adequate nutritional condition previous to the pregnancies added more safety to their management. Special dedication to the nutritional control enabled a good outcome of their pregnancies. It stressed the importance of the intervention of the nutritionist-dietitian in the follow-up of nephrologic patients and the integration of a multidisciplinary staff.