Randomized clinical trial of the effect of NovaMin and CPP-ACPF in combination with dental bleaching.

OBJECTIVE: This randomized, controlled, double-blind clinical study evaluated the effect of calcium sodium phosphosilicate (NovaMin) and casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) on the prevention of post-operative sensitivity and on the effects of clinical bleaching treatment. MATERIAL AND METHODS: Sixty volunteers were selected according to inclusion and exclusion criteria and were randomly assigned into three groups (n=20): CG (control group) patients, who were treated with 35% hydrogen peroxide; NOVAG (NovaMin group) patients, who were treated with 35% hydrogen peroxide followed by the application of NovaMin; and CPPG (CPP group) patients, who were treated with 35% hydrogen peroxide followed by the application of CPP-ACPF. Both bioactive agents were applied for five minutes. An evaporative stimulus associated with a modified visual scale was used to analyze sensitivity 24 hours after each bleaching session. The color evaluation was performed on the maxillary central incisors using a spectrophotometer. Associations between the intervention group, bleaching session, and reported sensitivity were tested using Chi-square partitioning. RESULTS: Color change values (ΔE) were analyzed using analysis of variance (ANOVA). The significance level used for both tests was 5%. In the intragroup assessment, the Friedman test showed that only the CPP-ACPF group showed no statistically significant difference (p<0.05) between baseline and first bleaching session. In the intergroup assessment, the Kruskal-Wallis test showed that the CPPG had less postoperative sensitivity after the first session, when compared to the other groups (p<0.05). Color change analysis (ΔE) showed a significant difference between the means obtained in the different bleaching sessions in all groups (p<0.05). CONCLUSIONS: This study showed that the combination of CPP-ACPF with 35% hydrogen peroxide significantly reduced post-operative sensitivity in the first session, compared with the other evaluated treatments. The association of CPP-ACPF and NovaMin did not affect the color change induced by tooth bleaching.

Randomized clinical trial of the effect of NovaMin and CPP-ACPF in combination with dental bleaching

Abstract Objective This randomized, controlled, double-blind clinical study evaluated the effect of calcium sodium phosphosilicate (NovaMin) and casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) on the prevention of post-operative sensitivity and on the effects of clinical bleaching treatment. Material and Methods Sixty volunteers were selected according to inclusion and exclusion criteria and were randomly assigned into three groups (n=20): CG (control group) patients, who were treated with 35% hydrogen peroxide; NOVAG (NovaMin group) patients, who were treated with 35% hydrogen peroxide followed by the application of NovaMin; and CPPG (CPP group) patients, who were treated with 35% hydrogen peroxide followed by the application of CPP-ACPF. Both bioactive agents were applied for five minutes. An evaporative stimulus associated with a modified visual scale was used to analyze sensitivity 24 hours after each bleaching session. The color evaluation was performed on the maxillary central incisors using a spectrophotometer. Associations between the intervention group, bleaching session, and reported sensitivity were tested using Chi-square partitioning. Results Color change values (ΔE) were analyzed using analysis of variance (ANOVA). The significance level used for both tests was 5%. In the intragroup assessment, the Friedman test showed that only the CPP-ACPF group showed no statistically significant difference (p<0.05) between baseline and first bleaching session. In the intergroup assessment, the Kruskal-Wallis test showed that the CPPG had less postoperative sensitivity after the first session, when compared to the other groups (p<0.05). Color change analysis (ΔE) showed a significant difference between the means obtained in the different bleaching sessions in all groups (p<0.05). Conclusions This study showed that the combination of CPP-ACPF with 35% hydrogen peroxide significantly reduced post-operative sensitivity in the first session, compared with the other evaluated treatments. The association of CPP-ACPF and NovaMin did not affect the color change induced by tooth bleaching.

An in situ Evaluation of Bioactives on the Morphology of Bleached Enamel.

AIM: The aim of this study was to use surface rugosity analysis (Ra) and scanning electron microscopy (SEM) comparing effects of nano-hydroxyapatite (NANO), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and NovaMin (NOVA) on enamel's human morphology bleached with 37.5% hydrogen peroxide. MATERIALS AND METHODS: Forty specimens (3 × 3 × 3 mm) were obtained from fully included third molars and four specimens were attached in the first molars of the volunteers. The POLA-positive control has only been bleached. Three experimental groups were bleached and treated with respective bioactive: NANO, CPP-ACP, and NovaMin. The Ra analyses were performed before and after the treatment using a rugosimeter. The obtained photomicrographs were analyzed using SEM (n = 3) by three examiners, and the study was double blind. RESULTS: The Ra results were analyzed by one-way analysis of variance and Tukey's post hoc test (p < 0.05). All experimental groups showed significant differences of the others; however, the experimental groups were not significantly different from each other. CONCLUSION: The enamel morphology of the bioactive-treated groups had more regular surfaces, than the others.

Influence of fluoride concentration and pH Value of 35% hydrogen peroxide on the hardness, roughness and morphology of bovine enamel.

AIM: The aim of this in vitro study was to evaluate the effects of different sodium fuoride (NaF) concentrations and pH values on the Knoop hardness (KHN), surface roughness (SR), and morphology of bovine incisors bleached with 35% hydrogen peroxide (HP). MATERIALS AND METHODS: Sixty-five bovine incisors were fragmented (5 mm(2) × 2 mm) and distributed in 5 groups: Control (unbleached), Low NaF/Acidic (35% HP + 1.3% NaF, pH 5.5), Low NaF/Neutral (35% HP + 1.3% NaF, pH 7.0), High NaF/ Acidic (35% HP + 2% NaF, pH 5.5), and High NaF/Neutral (35% HP + 2% NaF, pH 7.0). KHN analysis was performed with a microhardness tester under a load of 25 gf for 5 seconds. The average SR was obtained with a rugosimeter. KHN and SR were analyzed before and after treatments. For morphological analysis, specimens were dehydrated and gold-sputtered, and scanning electron micrographs were obtained and analyzed by 3 examiners with a double-blinded technique. KHN and SR results were analyzed by one-way ANOVA and Tukey's test (p < 0.05). RESULTS: Only the Low NaF/Acidic and Low NaF/Neutral groups showed significant differences between the initial and final KHN values. All bleached groups presented significant differences between the initial and final SR values. Among the bleached groups, the least and most morphological changes were shown by the High NaF/Neutral and the Low NaF/Acidic group, respectively. CONCLUSION: Treatment with 35% HP and 2% NaF at pH 7.0 promoted the least changes in morphology, hardness and roughness among the bleached groups. CLINICAL SIGNIFICANCE: In-office bleaching with high-concentration HP and 2% NaF at neutral pH promoted the least changes in enamel hardness, SR, and morphology compared to other treatments.