Randomized clinical trial on the efficacy and safety of four professional at-home tooth whitening gels.

OBJECTIVE: This randomized clinical trial evaluated the efficacy and safety of four gels of differing concentrations used for at-home vital bleaching. MATERIALS AND METHODS: Ninety-six volunteers participated in the study and were divided into four groups of 24 individuals. A gel of differing concentration was used for each group: 10% and 15% carbamide peroxide and 7.5% and 9.5% hydrogen peroxide. The patients used the whitening agent in a tray without reservoirs for one hour per day for two weeks. The measurement of the change in tooth color was made by two observers in the maxillary right central incisor and with a colorimeter in both upper central incisors and canines, using the CIE L*a*b* and CIE L*C*h* values. Sensitivity was evaluated by the participants on a scale with values as follows: 0 = absent, 1 = minor, 2 = moderate, 3 = considerable, 4 = severe. RESULTS: At the baseline, the observers noted darker colors than the colorimeter (p<0.01), and there were differences between incisors and canines in all the CIE L*a*b* and CIE L*C*h* values (p<0.001). In all of the groups and for all of the CIE L*a*b* and CIE L*C*h* parameters, there were color changes in the assessments made in the four maxillary teeth after treatment (p<0.001). There were no differences in ΔL* and ΔE* between the groups. The number of patients who experienced sensitivity and the intensity of the sensitivity were not significant. CONCLUSIONS: There were no differences in the degree of whitening among the different products. With all of the products there was an increase in L*, a decrease in chromatic intensity (C*), and an increase in the value (tone) or hue (h*).

Epidemiology, mortality rate and survival in a homogeneous population of hypopituitary patients.

INTRODUCTION: Hypopituitarism is associated with higher prevalence of cardiovascular risk factors and premature death. Furthermore, some clinical and therapeutic features of hypopituitarism have been associated with a worse prognosis. OBJECTIVE: We reviewed, retrospectively, a large series of adult patients with hypopituitarism using stringent epidemiological criteria. Prevalence, association with cardiovascular risk factors, mortality and survival have been analysed. DESIGN AND METHODS: Two hundred and nine adult hypopituitary patients (56·9% females) from a population of 405 218 inhabitants, followed for 10 years. RESULTS: Prevalence of hypopituitarism at the end of the study was 37·5 cases/100 000 inhabitants. Incidence of hypopituitarism was 2·07 cases/100 000 inhabitants and year. Thirty-two patients died during the period of the study. Standardized mortality rate (SMR) was 8·05, higher in males (8·92 vs 7·34) and in younger patients (84·93 vs 5·26). Diagnosis of acromegaly (P = 0·033), previous radiotherapy (P = 0·02), higher BMI (P = 0·04), diabetes mellitus (P = 0·03) and cancer (P < 0·0001) were associated with mortality. A lower survival was associated with older age at diagnosis, nontumoural causes, previous radiotherapy, diabetes mellitus with poor metabolic control and malignant disease. CONCLUSIONS: Prevalence of hypopituitarism was 37·5 cases/100 000 inhabitants, and annual incidence was 2·07 cases/100 000 inhabitants. SMR was 8 times higher in hypopituitarism than in general population and was also higher in males and younger patients. Reduced survival was significantly related to cancer, nontumoural causes of hypopituitarism, older age at diagnosis, previous radiotherapy and diabetes mellitus with poor metabolic control.

Repeatability and accuracy of a paralleling technique for radiographic evaluation of distal bone healing after impacted third molar surgery.

OBJECTIVES: The purpose of this study was to investigate the repeatability and radiographic accuracy of an intraoral paralleling technique to evaluate periodontal bone healing on the distal surface of the second mandibular molar (2 Mm) after impacted third mandibular molar (3 Mm) surgical extraction. METHODS: In order to estimate the variation in different radiographs, three replicas were made, each from 2 Mm, totalling 69 radiographic radicular longitude (RRL) recordings. One operator performed the periapical radiographs in a standard manner, utilizing a modified posterior film holder for the radiographic technique of parallelism, applied on the posterior region with the X-ray beam focused on the centre of 2 Mm. These radiographic recordings of the same region were obtained on three different and separate occasions, over a 12 month evaluation period after surgical extraction of the impacted 3 Mm. The RRL variable was measured and recorded three times by the same operator, with side-by-side comparison of three posterior periapical radiographs, irrespective of when the assessments were performed. RESULTS: There were no statistically significant differences between the three replica recordings (p = 0.969). The correlations between the three sets of measurements were evaluated and found to be highly associated (intraclass correlation reliability coefficient = 0.90) and statistically significant (p≤0.05). The median and mean error of the radiographic technique evaluated was ±0.257 mm and ±0.347 mm, respectively. CONCLUSIONS: The radiographic technique described permits standardization in periapical radiographs with a high repeatability and accuracy in posterior radiographic records (distal surface of 2 Mm) over a postoperative evaluation period of 12 months.