Influence of Bleaching Agent Containing Bioactive Glass on Color and Microhardness of Bovine Enamel

To try to reduce the deleterious effects of tooth whitening, bioactive materials have been used. Forty enamel/dentin blocks were stained on dark tea and randomly assigned into four groups (n=10): control group (unbleached), HP35 % (35 % hydrogen peroxide), BG45S5 (Bioglass 45S5® incorporated into HP35 %), and BIO (Biosilicate® incorporated into HP35 %). Colorimetric analysis and microhardness evaluation was performed at baseline, 24 hours and 7 days after the final whitening session. Two-way ANOVA for repeated measures and Bonferroni test was used at a significance level of 5 %. All the coordinates (ΔL*, Δa*, Δb*, ΔE00 and WID) showed a difference between the control group and the experimental ones (p0.05), which suggest a color stability over a week. In contrast, after 7 days, the WID showed that control and PH35 % were different than the other groups (p 0.05). The microhardness did not change over time (p>0.05), except for 35 % HP. In conclusion Bioglass 45S5® and Biosilicate® prevented enamel damage without negatively affect the whitening efficacy.

Para intentar reducir los efectos nocivos del aclaramiento dental, se han usado materiales bioactivos. Cuarenta bloques de esmalte/dentina se tiñeron con té oscuro y se asignaron al azar en cuatro grupos (n=10): grupo de control (sin blanquear), HP35% (peróxido de hidrógeno al 35 %), BG45S5 (Bioglass 45S5® incorporado en HP35%) y BIO (Biosilicato® incorporado a HP35%). El análisis colorimétrico y la evaluación de la microdureza se realizaron al inicio del estudio, 24 horas y 7 días después de la última sesión de blanqueamiento. Se utilizó ANOVA de dos vías para medidas repetidas y la prueba de Bonferroni a un nivel de significancia del 5 %. Todas las coordenadas (ΔL*, Δa*, Δb*, ΔE00 y WID) mostraron diferencia entre el grupo control y el experimental (p0.05), lo que sugiere una estabilidad del color durante una semana. En cambio, a los 7 días, el WID mostró que el control y el PH35 % eran diferentes a los demás grupos (p 0.05). La microdureza no cambió con el tiempo (p>0.05), excepto para 35 % HP. En conclusión Bioglass 45S5® y Biosilicate® previnieron el daño del esmalte sin afectar negativamente la eficacia del blanqueamiento.

The influence of hydrogen peroxide concentration on the chemical kinetics of photo-accelerated tooth whitening.

BACKGROUND: The bleaching procedure consists of chemical principles of free radical release that react with chromophores, which results in an amount of energy released in this process. However, the evaluation of the electrical potential generated in these protocols has not yet been thoroughly investigated in the literature. Thus, this study aimed to examine variations in pH, mV, and temperature of different concentrations of hydrogen peroxide in the presence or absence of an intermittent LED/LASER photo acceleration system. METHODS: The study was divided into six groups (n = 9) according to the concentration of hydrogen peroxide (6%, 15%, and 35%), associated or not with the photo acceleration system LED/LASER. We followed the variation of pH, mV, and temperature at 1, 5, 10, 15, and 30 min after gel manipulation. Data were evaluated by two-way ANOVA of repeated measures (α =0.05). RESULTS: pH, mV, and temperature of the groups showed statistical differences both in the light and bleach and in the interaction between the two factors (p < 0.0001), where pH and mV were more influenced by the bleach and light factor, while the temperature was influenced by the bleach factor associated with light. HP15 presented the most significant change in pH, mV, and temperature. CONCLUSION: The use of LED/laser increased the temperature of the gels and altered the pH and mV kinetics of HP6 and HP15, which did not occur in HP35, possibly due to the high ionic potential linked to the concentration.

Assessment of the temporal variation of electrical potential and pH of different bleaching agents.

INTRODUCTION: Tooth whitening procedures are under continuous investigation to improve esthetic outcomes and reduce bleaching sensitivity (BS) precipitating from treatments. During the dental bleaching process it is known that the release of free radicals degrades the organic pigment molecules of the tooth and with this an amount of energy is released. Nonetheless, previous studies have never investigated the temporal correlation between of pH and electric potential (EP) generated in this treatment. OBJECTIVES: Therefore, the objective of the present study was to investigate temporal variations of pH and EP associated with three different commercially available bleaching gels and the correlation levels between parameters of interest to provide relevant information regarding the kinetics of oxidation reactions in dental bleaching procedures. METHODS: The study was divided into 3 groups (n = 9) in function of hydrogen peroxide concentration (either 6%, 15% and 35%). The temporal evolution of pH and EP values were determined using a highly-accurate and previously calibrated pH meter at specific time-points (5, 10, 15 and 30 min). RESULTS: Data obtained were submitted to one-way ANOVA of repeated measures with Bonferroni post-test (α = 0.05). The results of the study showed difference in the factor gel concentration (p < 0,0001), time (p < 0,0001) and interaction (gel/time) (p = 0.002) while throughout the intervals evaluated the groups remained relatively stable and without significant difference in the intragroup variation of pH (p < 0.05) and in EDP only with significant difference in the 5 min interval of the 35% concentration. A 2nd order polynomial relationship test showed high correlation levels. CONCLUSION: It can thus be concluded that there is a negative relationship between EP and pH variation in the different gel concentrations. CLINICAL SIGNIFICANCE: The findings of the present study suggest that bleaching gels of higher concentration may provoke BS that are more intense and durable due to significant electric depolarization of neuronal extensions of pulpal tissues.

Fiber-reinforced fixed dental prosthesis to replace missing anterior teeth: case reports.

The direct fiber-reinforced fixed dental prosthesis (FRFDP) is a minimally invasive approach to replacing missing anterior teeth, offering good survival rates and sound mechanical properties. This report describes the placement and 12-month follow-up results of FRFDPs used to replace missing anterior teeth in 2 patients. In the first case, the extraction of the maxillary right central incisor was related to trauma. In the second case, severe periodontal disease necessitated the extraction of the mandibular left central incisor. Based on the biological and financial considerations of the patients and the need to obtain clinical resolution in a short time, placement of an FRFDP was proposed in each case. Each patient was informed of the benefits and limitations of an FRFDP and accepted the treatment plan. In each case, an FRFDP was placed immediately after the surgical extraction of the incisor, using the extracted tooth as a pontic. The results observed at the 12-month follow-up examinations of the patients suggest that the FRFDP is a viable, esthetic, and functional option to replace missing anterior teeth.

Association of microabrasion and tooth whitening with LED/laser system in the treatment of incisor hypomineralization: 3-year follow-up.

The hypomineralization of enamel is characterized as a defect in the quality of the enamel during the maturation process. This presents with clinical consequence as a whitish and rough appearance that effects the aesthetics of the dental elements. In recent years there has been a significant increase in this pathology, which has led to a great demand from professionals in the search for knowledge and appropriate technique to treat cases. Minimally invasive therapy may be sufficient for the aesthetic return of the altered enamel. Thus, the present clinical case aimed to present an aesthetic treatment of enamel hypomineralization in the upper incisors with a minimally invasive approach of association of microabrasion with low concentration tooth whitening photoaccelerated by violet LED and infrared laser. The follow-up of the case was performed for 3 years and the association of the techniques proved effective in returning the aesthetics and well-being of the patient, appearing as a good conservative alternative for the treatment of enamel hypomineralization.

Physiological and Behavioral Manifestations of Children and Teenagers with Down Syndrome During the Dental Appointment: A Comparative Cross-Sectional Study

Abstract Objective: To measure the heart rate (HR) and the behavior of children and teenagers with Down Syndrome (DS) during the dental appointment. Material and Methods: Two groups (n = 52), of both genders, aged 2-14 years, matched by age group were formed: study group (SG) - individuals with DS and control group (CG) - normotypical school children. The participants were submitted to clinical examination and prophylaxis. An oximeter was used to measure the HR at five moments of the dental consultation: before entering the practice room (T0), when sitting in the dental chair (T1), during the clinical examination (T2), during prophylaxis (T3) and immediately after prophylaxis (T4). Behavior, classified according to the Frankl Scale, was observed at T3. Mann Whitney, Kruskal-Wallis, Dunn and Pearson's Chi-square tests were used to analyze and compare variables (significance level at 5%). Results: In SG, a significant difference in HR was observed according to the moment of dental appointment (p<0.001 SG; 0.3385 CG). The highest HR value in SG was observed at T3 (median 110.00; IIQ 96.00-124.00), the only moment significantly different (p<0.001) from HR values for CG. A difference in behavior between groups (p<0.001) was also observed. Conclusion: HR of individuals with DS varied throughout the dental appointment, and they also had a higher prevalence of uncooperative behavior.

The Quality of Toothbrushing in Children with Intellectual Disabilities Enrolled in an Oral Health Promotion Programme: A Paired Study.

PURPOSE: To assess the quality of toothbrushing of children with intellectual disability (ID). MATERIALS AND METHODS: One hundred thirty-six children, 68 with ID (SG = study group) and 68 non-ID (CG = control group), were paired. Their caregivers completed a questionnaire about socioeconomic and demographic characteristics and another about oral hygiene habits. The toothbrushing technique and position adopted were documented and the duration of the procedure was measured. A modification of the Simplified Oral Hygiene Index (SM-OHI) was used to classify the quality of brushing as: adequate, when all the teeth had SM-OHI 0 or 1; or inadequate, when at least one tooth had SM-OHI 2 or 3. The Kolmogorov-Smirnov test was used to assess the normality of data distribution for age, duration of brushing and SM-OHI. Fisher's exact test and the chi-squared test were applied to assess the association between ID and oral hygiene habits or characteristics of toothbrushing. To compare the duration of brushing groups, the Mann-Whitney test was applied. Student's t-test for independent samples was applied to compare mean MS-OHI. RESULTS: Mothers were the main persons performing children's toothbrushing in SG. They reported a higher daily brushing frequency, longer toothbrushing duration of children in the SG, SG children had lower SM-OHI scores and were thus rated as having adequate toothbrushing, in contrast to the CG (p < 0.001, p < 0.001; p = 0.012; p < 0.001; p < 0.001, respectively). CONCLUSION: Toothbrushing provided by caregivers for ID children was more effective than toothbrushing carried out by non-ID children of the same age and gender.

Saúde Bucal de Indivíduos com Transtorno do Espectro Autista / Oral Health of Individuals with Autistic Spectrum Disorder

Transtorno do Espectro Autista (TEA) é um espectro de transtornos do desenvolvimento neurológico que afeta o desenvolvimento e funcionamento do cérebro, por mecanismos ainda desconhecidos. A prevalência estimada para TEA é de um a dois para cada mil nascidos vivos e estes indivíduos apresentam limitações físicas e psicológicas que incluem atrasos no desenvolvimento da linguagem, dificuldades de comunicação e interação social, comportamentos restritos e repetitivos e muitos podem ter deficiência intelectual. Supõe-se que a saúde bucal de indivíduos com TEA é precária, em parte por suas limitações e pouca destreza manual para realização de cuidados em saúde, bem como pelo maior consumo de alimentos com adição de açúcar e retenção prolongada do bolo alimentar na cavidade bucal, que são observados nesta população. O objetivo deste artigo é apresentar uma revisão da literatura sobre as condições de saúde bucal de indivíduos autistas. Para o desenvolvimento da presente revisão de literatura foram realizadas buscas nas bases de dados MedLine/PubMed, Scopus e SciELO. Os artigos foram selecionados segundo descritores relacionados com saúde bucal e transtorno do espectro autista. Menor prevalência de cárie em indivíduos com TEA é relatada na maioria dos estudos, porém, observa-se a necessidade de estudos longitudinais que possam avaliar incidência e fatores associados com cárie dentária nesta população. Estudos sugerem que indivíduos autistas tenham pior condição periodontal, havendo uma lacuna sobre as condições associadas a essa maior prevalência. Embora com um número limitado de estudos, indivíduos autistas parecem não serem mais propensos a traumatismos dentários. (AU).

Autism Spectrum Disorder (ASD) is a spectrum of neurodevelopmental disorders that affect the brain development and functioning, by still unknown mechanisms. The estimated prevalence for ASD is one to two per thousand live births and these individuals present physical and psychological limitations that include delays in language development, difficulties in social interaction, communication and restricted and repetitive behaviors, and many may have intellectual disabilities. It is assumed that the oral health of ASD individuals is precarious, in part because of their limitations and little manual dexterity to perform health care, as well as the high consumption of foods with added sugar and prolonged retention of the food bolus in the oral cavity, which are observed in this population. The aim of this article is to present a review of the literature about the oral health conditions of autistic individuals. For the development of the present literature review, the MedLine / PubMed, Scopus and SciELO databases were searched. The articles were selected according to descriptors related to oral health and autism spectrum disorder. Lower caries prevalence in ASD individuals is reported in most of the studies, however, it is observed the need for longitudinal studies that can assess incidence and factors associated with dental caries in this population. Studies suggest that autistic individuals have worse periodontal conditions, and there is a lack of conditions associated with this higher prevalence. Despite the limited number of studies, autistic individuals do not appear to be more prone to dental trauma. (AU).