In vivo assessment of periodontal structures and measurement of gingival sulcus with Optical Coherence Tomography: a pilot study.

There has been increasing interest on the development of clinically acceptable, more sensitive and specific methods for non-invasive diagnosis in Periodontics. In this pilot study, the performance of an Optical Coherence Tomography (OCT) system in imaging periodontal structures in humans was evaluated. Gingival sulcus depth measurements were obtained and compared with traditional probes. In total, 445 sites of 23 periodontally healthy individuals were measured by 3 instruments: North Carolina manual probe, Florida automated probe and OCT at 1325 nm. To obtain quantitative measurements from OCT images, the gingival refractive index was also determined. Discomfort/pain perception and the duration of examinations were compared among the instruments. The analysis of OCT images allowed the identification of relevant anatomic dental and periodontal regions. The average sulcus depth measured by OCT, 0.85 ± 0.27 mm and 0.87 ± 0.28 mm, was lower than the values obtained by manual and automated probing. Discomfort/pain were prevalent for traditional probes, which are invasive methods, than for the non-invasive OCT technique. OCT has the potential to be a reliable tool for in vivo periodontal tissues evaluation and for reproducible sulcus depth measurements in healthy sites. Further technological advances are required to reduce the procedure time and promote evaluation of posterior oral regions. Photonic assessment of periodontal tissue with OCT (top) in a clinical environment, showing tooth/gingiva features (bottom).

Effect of pH values of two bleaching gels on enamel microhardness.

This study evaluated the influence of bleaching gel pH and the effect of remineralizing gels after bleaching in different time intervals. Sixty bovine incisors were divided into 2 groups (n = 30). Group 1 was bleached with a 35% hydrogen peroxide (HP) acid gel and Group 2 was bleached with a 35% HP neutral gel. Each group was then divided into 3 subgroups (n = 10) according to the post-bleaching treatment used: storage in artificial saliva, application of a fluoride gel, or application of a gel consisting of fluoride, potassium nitrate, and nanostructured calcium phosphate. Specimens were stored in artificial saliva, and enamel microhardness was evaluated at 24 hours and 15 days postbleaching. Vickers microhardness data were analyzed by means of 2-way ANOVA, with repeated measurements and Bonferroni's post-hoc test. Twenty-four hours after bleaching, no significant differences were found between the bleaching gels. At 15 days postbleaching, Group 2 samples demonstrated a significant reduction in microhardness. No significant differences were found between the remineralizing gels, though all of the postbleaching treatments after the use of 35% neutral gel were able to re-establish baseline microhardness. It was concluded that neutral bleaching gel significantly reduced enamel microhardness 15 days after bleaching and that the use of remineralizing gels did not significantly enhance the microhardness of bleached enamel. However, in clinical situations, the acquired enamel pellicle protects tooth surfaces, and postbleaching, decalcified enamel would undergo recalcification. This study indicates that it is important to consider the bleaching agent's pH and composition when treating patients with reduced salivary secretion.

Impact of remineralizing agents on enamel microhardness recovery after in-office tooth bleaching therapies.

OBJECTIVE: It has been shown that bleaching with 35/38% hydrogen peroxides may alter both enamel morphology and mineral content. This study aimed to analyze the morphology and microhardness of enamel bleached with in-office hydrogen peroxides and exposed toremineralizing agents. MATERIALS AND METHODS: After recording initial enamel morphology and microhardness, 60 bovine incisors were bleached using either a calcium-containing 35% hydrogen peroxide (Whiteness HP Blue) or a calcium-free 35% hydrogen peroxide (Whitegold Office) (n = 30). Then, the teeth were subjected to one of three post-bleaching remineralizing treatments (n = 10): storage in artificial saliva only, application of a sodium fluoride gel or application of a nanohydroxyapatite-based agent (Nano-P). After 24 h and 14 days of post-bleaching treatments, the enamel morphology and microhardness were re-evaluated. The microhardness data were analyzed by means of two-way ANOVA with repeated measurements and Tukey tests (p < 0.05), while the enamel morphology was analyzed descriptively. RESULTS: Samples exposed to Nano-P presented statistically the highest microhardness 24 h after its application in comparison with other remineralizing agents. The microhardness recovery did not occur in any of the groups 14 days after treatment. The morphology of all samples 14 days after the application of all remineralizing agents presented a higher number of irregularities. CONCLUSION: Although some remineralizing products provided microhardness recovery and a positive effect on enamel morphology at 24 h post-bleaching, none of them were able to maintain microhardness and enamel morphology at 14 days post-bleaching.