Adhesion and sealing of different universal adhesive systems associated with bulk-fill resins after using endodontic irrigation solutions: An in vitro study.

This study aimed to evaluate the interface of universal adhesive (UA) with bulk-fill resin (BF) and dentin, after endodontic irrigation. The pulp chamber of 96 molars was irrigated with chlorhexidine 2% (CHX) or sodium hypochlorite 5.25% (NaOCl) and restored according to three restorative protocols. Microtensile bond strength (µTBS) and nanoleakage tests were performed after 24 h of thermocycling. Kruskal Wallis, Mann-Whitney and Wilcoxon were performed (p < 0.05). Comparing restorative systems, a difference was found only when irrigated with CHX after 24 h. CHX provided higher µTBS than NaOCl after 24 h for two restorative protocols; after thermocycling, NaOCl provided the greatest µTBS than CHX for one group. Decreased µTBS was observed for all restorative systems when CHX was used after thermocycling. NaOCl demonstrated the highest nanoleakage. The composition of UA influenced the immediate adhesion and sealing to BF when CHX was used; ageing has a deteriorating effect on adhesion and sealing for all restorative systems.

Influence of daily usage times on patients' compliance during at-home bleaching: a randomized clinical trial.

The effectiveness of at-home dental bleaching treatments depends on the time that bleaching products are in contact with the teeth surface and, consequently, on the adequate use of associated custom acetate trays. OBJECTIVE: This randomized single-blinded trial aimed to analyze if the daily usage time of these products influences the patient's compliance behavior when submitted to monitored at-home dental bleaching. Secondary outcomes were color change and tooth sensitivity. METHODOLOGY: Sixty-six volunteers were randomly distributed into three groups (n=22): patients were instructed to use the trays for 2 (G2), 4 (G4), and 8 (G8) hours daily. The daily dental bleaching compliance behavior was measured using a microsensor inserted into the trays. Subjective and objective color evaluation assessments were adopted at baseline (T0), one (T1), two (T2), and three weeks (T3) after the beginning of the bleaching treatment, as well as two weeks after the treatment (T4). Tooth sensitivity was analyzed using the VAS scale, ranging from T1 to T4. RESULTS: G2 showed a greater degree of cooperation than G8 and cooperation was inversely proportional to the recommended usage time. Significantly higher color change was observed in the upper arch for G8 when compared to G2 in subjective analysis, from T1 to T4. There were no statistical differences between the groups in objective analysis. CONCLUSION: Shorter recommended usage time of the bleaching product may improve the patient's compliance with at-home dental bleaching treatments. However, increased daily usage time may promote better subjective color change. Bleaching sensitivity was more significant in the first week for a longer time of use.

Influence of daily usage times on patients' compliance during at-home bleaching: a randomized clinical trial

Abstract The effectiveness of at-home dental bleaching treatments depends on the time that bleaching products are in contact with the teeth surface and, consequently, on the adequate use of associated custom acetate trays. Objective This randomized single-blinded trial aimed to analyze if the daily usage time of these products influences the patient's compliance behavior when submitted to monitored at-home dental bleaching. Secondary outcomes were color change and tooth sensitivity. Methodology Sixty-six volunteers were randomly distributed into three groups (n=22): patients were instructed to use the trays for 2 (G2), 4 (G4), and 8 (G8) hours daily. The daily dental bleaching compliance behavior was measured using a microsensor inserted into the trays. Subjective and objective color evaluation assessments were adopted at baseline (T0), one (T1), two (T2), and three weeks (T3) after the beginning of the bleaching treatment, as well as two weeks after the treatment (T4). Tooth sensitivity was analyzed using the VAS scale, ranging from T1 to T4. Results G2 showed a greater degree of cooperation than G8 and cooperation was inversely proportional to the recommended usage time. Significantly higher color change was observed in the upper arch for G8 when compared to G2 in subjective analysis, from T1 to T4. There were no statistical differences between the groups in objective analysis. Conclusion Shorter recommended usage time of the bleaching product may improve the patient's compliance with at-home dental bleaching treatments. However, increased daily usage time may promote better subjective color change. Bleaching sensitivity was more significant in the first week for a longer time of use.

Esthetic recovery of teeth presenting fluorotic enamel stains using enamel microabrasion and home-monitored dental bleaching.

This clinical report describes the enamel microabrasion technique for removing maxillary and mandibular hard fluorotic enamel stains followed by home-monitored home dental bleaching. The removal of fluorotic enamel stains utilized macroabrasion with a water-cooled, fine-tapered 3195 FF diamond bur followed microabrasion with the application of Prema Compound (Premier Dental Products Co, Norristown, PA, USA). Home-monitored dental bleaching was performed 14 days after enamel microabrasion using a 10% carbamide peroxide gel for 2 h/day. The wearing time of the acetate tray/dental bleaching was quantified by a microsensor from TheraMon microelectronic system (Sales Agency Gschladt, Hargelsberg, Austria) that was completely embedded in the acetate trays. The teeth were bleached effectively during 23 days. The mean wearing time of the acetate trays/dental bleaching product was 1.54 h/day, for the upper and lower arches. The patient reported satisfaction with the treatment. The association of enamel microabrasion and home dental bleaching was an excellent clinical treatment for teeth affected with enamel fluorosis.

Dental bleaching on teeth submitted to enamel microabrasion 30 years ago-a case report of patients' compliance during bleaching treatment.

OBJECTIVES: The present dental bleaching case report describes a new method that precisely quantifies the daily wearing-times of the bleaching product by inserting a microsensor in the acetate custom tray. The bleaching efficacy was also discussed since the patient was previously submitted to enamel microabrasion. METHODS: The patient was submitted to enamel microabrasion in 1987, and bleaching treatment was performed in 2005. In 2017, re-bleaching was executed using 10% peroxide carbamide. The electronic microsensor, TheraMon (TheraMon® microelectronic system; Sales Agency Gschladt, Hargelsberg, Austria), was embedded in the labial region of the upper and lower acetate trays to evaluate the wearing-times of the acetate trays/bleaching product. The patient was instructed to wear the tray for 6 to 8 h/day while sleeping. After 24 days of bleaching treatment, the data obtained from the TheraMon electronic devices was collected and interpreted. RESULTS: The patient did not entirely follow the bleaching treatment as recommended, as there was no evidence of use of the upper and lower trays for some days; additionally, the bleaching product was used for shorter and longer periods than was instructed. CONCLUSIONS: The TheraMon microeletronic device precisely measured the wearing-times of the acetate tray/bleaching product during the bleaching treatment. Teeth submitted to enamel microabrasion presented with a healthy clinical appearance after 30 years. CLINICAL SIGNIFICANCE: Measuring the length and frequency of use of an acetate tray/bleaching product can be important to clinicians and patients for obtaining a controlled and adequate bleaching treatment.

Avaliação clínica prospectiva randomizada do monitoramento digital de pacientes submetidos ao clareamento caseiro: efeito do tempo de uso do produto clareador nos graus de colaboração e satisfação do paciente, na efetividade e ocorrência de sensibilidade / Clinical prospective randomized evaluation of the digital monitoring of patients submitted to home bleaching: effect of the wear time of the bleaching product on the levels of collaboration and patient satisfaction, on the effectiveness and occurrence of sensitivity

Este estudo prospectivo, randomizado e paralelo analisou a alteração de cor, sensibilidade dental, grau de cooperação e satisfação de voluntários quando submetidos ao clareamento dental com peróxido de carbamida a 10%, empregado durante 21 dias por 2, 4 e 8 horas/dia. O tempo preciso do uso diário das moldeiras/produto clareador foi mensurado por meio de um microssensor TheraMon (Sales Agency Gschladt, Hargelsberhg, Áustria). Sessenta e seis voluntários, de ambos os gêneros, com idades entre 18 e 22 anos foram selecionados e distribuídos aleatoriamente em três grupos de estudo (n = 22), os quais receberam as informações sobre a presença do microssensor em suas moldeiras. O fator estudado foi o tempo de uso das moldeiras em três níveis: 2 (GI), 4 (GII) e 8 (GIII) hrs/dia. Para a análise clínica, as variáveis de resposta foram: grau de cooperação diária dos voluntários de acordo com o tempo de uso diário das moldeiras; grau de satisfação dos voluntários com o clareamento dental; eficácia do clareamento dental nos incisivos e caninos superiores e inferiores pelo método visual (Vita Classical) e digital (Vita Easyshade), assim como o grau de sensibilidade dental que foi avaliado com método analógico-visual. Os voluntários foram avaliados no período inicial (baseline), aos 7, 14 e 21 dias após o início do tratamento clareador e 14 dias após apenas para as observações da cor, sensibilidade e grau de satisfação. Os dados foram analisados com aplicação do teste ANOVA e pelo post teste de Tukey. Para o grau de cooperação diária dos voluntários, foram utilizadas observações dos tempos de uso das moldeiras (escores/dias) para cada arco e correspondentes a cada semana de tratamento. A análise digital apontou um mesmo nível de alteração de cor em todos os tempos de análise e de uso das moldeiras/produto clareador; exceção para o tempo de análise 7 dias do arco superior, que evidenciou uma maior alteração de cor para os maiores tempos de uso das moldeiras/produto clareador. A análise visual evidenciou que os maiores tempos de uso das moldeiras/produto clareador apresentou uma maior alteração de cor, após o tratamento clareador. A sensibilidade dental foi observada durante o tratamento clareador, mas postou-se praticamente ausente 14 dias após o clareamento. A maioria dos voluntários não seguiram as prescrições sugeridas do tempo de uso diário das moldeiras/produto clareador, sendo que os voluntários que as usaram pelo menor tempo apresentaram um maior grau de cooperação. A utilização das moldeiras/produto clareador por mais tempo foi capaz de proporcionar maior efetividade na alteração de cor e no grau de satisfação dos voluntários. Quanto mais prolongado o tempo de uso diário das moldeiras/produto clareador, maiores as chances de os voluntários não seguirem o protocolo recomendado(AU)

This prospective, randomized, parallel study analyzed the color change, tooth sensitivity, degrees of cooperation, and satisfaction of volunteers when submitted to at home dental bleaching with 10% carbamide peroxide (Opalescence - Ultradent Products, Inc. South Jordan, USA) for 21 consecutive days for 2, 4 and 8 hours/day. The wear time of acetate trays/dental bleaching was measured through a TheraMon microsensor (TheraMon® microelectronic system; Sales AgencyGschladt, Hargelsberhg, Austria). Sixty six volunteers, both sexes, with ages ranging from 18 to 22 years were selected and randonly distributed into 3 study groups (n=22). The volunters received information about presence of the microsensor in their trays. The fator studied was the wear time of the trays in three levels: during 2 (GI), 4 (GII) and 8 (GIII) hours/day. For the clinical analysis the response variables were: the degree of daily cooperation of the volunteers as the wear time/daily of the trays, microelectrically collected by micro sensor TheraMon®; the degree of satisfaction of volunteers with dental bleaching; the effectiveness of dental bleaching in the upper and lower incisors and canines teeth, by the visual method (Vita Classical) and digital (Vita Easyshade) and dental sensitivity was evaluated by the volunteers with a scale visual analog method on a scale of 0 to 10. The volunteers were evaluated at baseline period, at one, two and three weeks after the beginning of the bleaching treatment, and again two weeks after the bleaching treatment only for the observations of the color, sensitivity and degree of satisfaction. The data were analyzed using the ANOVA test and the Tukey post test. The digital analysis showed the same level of color change in all times of analysis and wear time of the trays; exception for the analysis time 7 days of the upper arch, which evidenced a greater color change for the longer time of wear time of the trays. The visual analysis evidenced that the greater wear time of the trays presented a greater color change, after the bleaching treatment. Dental sensitivity was observed throughout the bleaching treatment, but it was practically absent 14 days after treatment. Most of the volunteers did not follow the suggested prescriptions of the wear time daily of the trays, with those who used them for the shortest time presenting the highest degree of cooperation. The wear time of the trays/bleaching product for 8 hours/day, provided greater effectiveness of the color change in the visual and digital analysis, as well as greater degree of satisfaction of the volunteers. A discreet sensitivity was observed throughout the bleaching treatment, but it was practically absent 14 days after bleaching. It was observed that the volunteers did not follow correctly the prescriptions of the wear times of the trays/bleaching product, evidencing less the degree of collaboration of the volunteers for the greater wear times of the trays(AU)