O uso do laser de alta e baixa intensidade para o tratamento de hipersensibilidade dentinária: uma revisão integrativa

Objetivo: Determinar as evidências científicas sobre a influência do uso de lasers de baixa e alta intensidade no tratamento da hipersensibilidade da dentina. Revisão de literatura: Foram realizadas buscas na Biblioteca Virtual em Saúde (BVS), incluindo as bases de dados: Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS); Bibliografia Brasileira de Odontologia (BBO); e National Library of Medicine (MEDLINE). A maioria dos estudos destacam a eficácia dos lasers na redução da HD, com o laser Nd:YAG mostrando-se eficaz na obliteração dos túbulos dentinários e proporcionando alívio a longo prazo. Apesar dos benefícios, alguns estudos alertam para possíveis danos à polpa dentária, especialmente com lasers de alta potência. Considerações finais: Embora os lasers tenham se mostrado eficazes na redução da HD, a escolha do laser deve ser personalizada para cada paciente, destacando a necessidade de aprimorar os protocolos clínicos e adquirir experiência relevante por parte dos profissionais especialistas.

Objective: To determine the scientific evidence on the influence of the use of low and high intensity lasers in the treatment of dentin hypersensitivity. Literature review: Searches were carried out in the Virtual Health Library (VHL), including the databases: Latin American and Caribbean Literature in Health Sciences (LILACS); Brazilian Bibliography of Dentistry (BBO); and National Library of Medicine (MEDLINE). Most studies highlight the effectiveness of lasers in reducing HD, with the Nd:YAG laser proving effective in obliterating dentinal tubules and providing long-term relief. Despite the benefits, some studies warn of possible damage to the dental pulp, especially with high-power lasers. Final considerations: Although lasers have been shown to be effective in reducing HD, the choice of laser must be personalized for each patient, highlighting the need to improve clinical protocols and acquire relevant experience on the part of specialist professionals.

Effect of simulated brushing on surface roughness and wear of bis-acryl-based materials submitted to different polishing protocols.

BACKGROUND: Provisional materials must have enough strength to withstand masticatory loads without suffering deformation or fracture, and their surfaces must have good finishing and polishing characteristics to reduce biofilm accumulation. Thus, the purpose of this study was to investigate the best polishing protocol for different bis-acryl composite resins in comparison with a conventional resin composite and a self-curing acrylic resin aiming to obtain a smooth restoration surface and resistance to wear. MATERIAL AND METHODS: One hundred and four samples (15 mm length x 5 mm width x 4 mm depth) were prepared and divided into four groups according to the material tested: Protemp 4 and Structur 3 bis-acryl composite resins, Dencor self-curing acrylic resin, Filtek Z350XT conventional composite resin. The polishing procedures were performed with Sof-Lex Pop-On discs or Sof-Lex spirals and abrasion procedures were performed on a brushing machine. The surface roughness was analyzed at three periods (initial, post-polishing and post-brushing) and the wear was evaluated after simulated brushing. The results were submitted to ANOVA followed by the Tukey (α = 0.05). RESULTS: Filtek Z350XT groups showed the lowest values of initial surface roughness followed by Structur 3, Protemp 4 and Dencor groups. After polishing and simulated brushing, Filtek Z350XT groups also presented the lowest roughness values, followed by bis-acryl groups (Structur 3 and Protemp 4) and Dencor groups demonstrated the highest surface roughness. Sof-Lex Pop-On discs system exhibited lower roughness values for all groups. CONCLUSIONS: Sof-Lex Pop-On discs system promoted the best polishing for all groups. Overall, Filtek Z350XT groups presented lower results for both roughness and wear for all periods evaluated, followed by Protemp 4 and Structur 3, meanwhile Dencor groups presented the highest roughness and wear values for all periods. Key words:Acrylic resin, bis-acryl, brushing, composite resin, polishing, roughness, wear.

Doenças ocupacionais e princípios ergonômicos voltados à formação de profissionais da Odontologia / Occupational diseases and ergonomic principles aimed at training dentistry professionals

Introdução: a alta demanda diária para desempenhar os serviços, aliada ao descuido com o bem-estar laboral, acaba causando uma má postura na hora dos atendimentos, acarretando problemas osteomusculares, dor e, consequentemente, doenças ocupacionais. Objetivo: avaliar o conhecimento dos acadêmicos nos diferentes semestres do curso de Odontologia de uma instituição de ensino superior situada na cidade de Vitória da Conquista ­ Bahia, acerca dos princípios ergonômicos aplicados à prática clínica, além de investigar sintomas associados às doenças ocupacionais. Metodologia: foram selecionados, de forma aleatória, 186 alunos matriculados nas clínicas da faculdade, os quais foram convidados a responder a dois questionários contendo perguntas relacionadas ao conceito de ergonomia e a doenças ocupacionais na Odontologia. Foi aplicado o teste qui-quadradro de Pearson; nos casos em que a frequência esperada foi menor que cinco (n < 5), foi utilizado o teste exato de Fisher (p<0,05). Resultados: cerca de 69% dos graduandos demonstraram total insciênciasobre a ergonomia, 87% apresentaram pouco conhecimento a respeito das doenças ocupacionais da Odontologia, 75% consideraram insatisfatório o conhecimento sobre ergonomia na faculdade e cerca de 76% queixaram-se de dores osteomusculares em pelo menos um local anatômico do seu corpo. Conclusão: o presente estudo demonstrou o pouco conhecimento dos estudantes Oe odontologia a respeito dessa temática e o possível desenvolvimento de doenças osteomusculares ainda na graduação.

Introduction: The high daily demand to perform the services allied to the carelessness with the job well-being lead to a bad posture at the appointments, causing musculoskeletal problems, pain, and, consequently, occupational diseases. Objective: to evaluate the knowledge of students in the different semesters of the Dentistry course of a Higher Education Institution located in the city of Vitória da Conquista - Bahia, on the ergonomic principles applied to clinical practice, and investigate the symptoms associated with occupational diseases. Methodology: 186 students enrolled in the college clinics were randomly selected and invited to answer two questionnaires, containing questions related to the concept of ergonomics and occupational diseases in dentistry. Pearson's chi-square test was applied; in cases that the expected frequency was less than five (n<5), Fisher´s exact test was used (p<0.05). Results: around 69% of the undergraduates demonstrated total unawareness about ergonomics, 87% had little knowledge about occupational diseases in Dentistry, 75% consider the knowledge about ergonomics in college unsatisfactory, and about 76% complained of musculoskeletal pain in at least one anatomical site of their body. Conclusion: the presente study demonstrated Dentistry students have little knowledge about this theme and the possible development of musculoskeletal diseases while still in the undergraduate course.

Efeitos do clareamento dental em consultório para dentes polpados: uma revisão da literatura / Efeitos do clareamento dental em consultório para dentes polpados: uma revisão da literatura

Introdução: A busca por um padrão de dentes mais brancos tem estimulado o consumo de agentes clareadores e, apesar de ser um tratamento estético conservador, possíveis danos à estrutura oral podem ocorrer com o uso excessivo desses produtos. Objetivo: Discorrer sobre as principais implicações do clareamento dental em consultó rio realizado em dentes vitais, ressaltando os efeitos locais causados tanto nos tecidos moles, quanto nos duros. Metodologia: Trata-se de uma revisão de literatura, realizada nas bases de dados online: Pubmed, Lilacs e Scielo, incluindo artigos originais e de revisão. Utilizando os seguintes descritores: "Esmalte Dentário", "Clareamento Dental", "Clareadores" e "Sensibilidade da dentina". Conclusão: Observou-se que dentre os efeitos adversos, a sensibilidade dentária durante e após o clareamento de dentes vitais ocorre mais frequentemente, seguido da irritação gengival e das alterações da superfície do esmalte.

Introduction: the search for whiter teeth pattern has encouraged the consumption of bleaching agents and, despite being a conservative aesthetic treatment, possible damages to the oral structure can occur with excessive use of bleaching products. Objective: to describe the main implications of the vital tooth bleaching in-office, emphasizing the local effects in the soft and hard tissues. Methods: this is a literature review that used electronic databases: PubMED/ Medline, Lilacs and Scielo, including original and review articles. The following descriptors were used: "Dental Enamel", "Tooth Bleaching", "Bleaching Agents" and "Dentin Sensitivity". Conclusion: It was observed that among the adverse effects tooth sensitivity during and after vital tooth bleaching occur more often, followed the gingival irritation and alteration of the enamel surface.

Relación entre mordida cruzada posterior unilateral y hábitos bucales deletéreos en preescolares de un municipio del sudoeste del Bahía / Relação entre mordida cruzada posterior unilateral e hábitos bucais deletérios em pré-escolares de um município do sudoeste da Bahia / Relationship between unilateral posterior crossbite and deleterious oral habits in preschool children from a municipality in southwestern Bahia

Objetivo: El objetivo de esta investigación fue verificar la prevalencia de maloclusión en niños preescolares de un municipio del suroeste de Bahía, evaluando la presencia de mordida cruzada posterior unilateral y su relación con hábitos bucales deletéreos. Materiales y Métodos: La investigación fue realizada en niños matriculados en guarderías públicas y convenidas del municipio de Vitória da Conquista, BA, Brasil; después del cálculo muestral, la muestra incluyó 440 niños con edades de Original3 a 5 años. La presencia de maloclusión fue evaluada clínicamente y un cuestionario para evaluar la relación con los hábitos fue respondido por los representantes. Resultados: Se encontró un porcentaje de 94,28 % de los casos con mordida cruzada posterior unilateral relacionada a hábitos bucales. Conclusiones: Se hace evidente que los hábitos de succión no nutritiva pueden ser un factor etiológico para la mordida cruzada posterior unilateral.

Objetivo: O objetivo da pesquisa foi verificar a prevalência da má oclusão em crianças pré-escolares de um município do sudoeste baiano, enfocando a presença de mordida cruzada posterior unilateral e sua relação com hábitos bucais deletérios. Materiais e métodos: A pesquisa foi realizada em crianças matriculadas em creches públicas e conveniadas do município de Vitória da Conquista, BA, Brasil; após cálculo amostral, a amostra contemplou 440 crianças com idades entre os 3 e os 5 anos. A presença de má oclusão foi avaliada clinicamente e um critério para avaliar a relação com os hábitos foi respondido pelos responsáveis. Resultados: Encontrou-se uma porcentagem de 94,28% dos casos com mordida cruzada posterior unilateral relacionada aos hábitos bucais. Conclusão: Nota-se que os hábitos de sucção não nutritivo podem ser um fator etiológico para a mordida cruzada unilateral posterior.

Objective: The objective of the study was to verify the prevalence of malocclusion in pre-school children in a municipality in southwest Bahia, focusing on the presence of unilateral posterior crossbite and its relation with deleterious oral habits. Materials and methods: The research was carried out in children enrolled in public day care centers and in the city of Vitória da Conquista, BA, Brasil. After sample calculation, the sample consisted of 440 children aged 3 to 5 years. The presence of malocclusion was clinically evaluated and a questionnarie for evaluating the relationship with habits was answered by those represented. Results: We found that 94.28% of the cases with unilateral posterior crossbite were related to oral habits. Conclusions: It was found that nutritional sucking habits may be an etiological factor for posterior unilateral crossbite.

Marginal adaptation in proximal cavities restored with composites and other materials / Adaptação marginal em cavidades proximais com compósitos e outros materiais

Objective: To evaluate the marginal adaptation, in enamel (E) and dentin (D), of composite resin (CR) associated with flowable resin composite (flow), bulk fill flowable base (bulk) and resin modified glass ionomer cement (RMGIC) in slot cavities. Material and Methods: The study was conducted after approval (Protocol No. 21148413.4.0000.5417) from Ethics Committee. Forty extracted human molar teeth were randomly assigned in eight experimental groups: E-CR, E-BULK, E-FLOW, E-RMGIC, D-CR, D-BULK, D-FLOW, D-RMGIC. The occlusal surface was planned, two slot cavities with standard sizes (depth: 2.0 mm, height: 2.5 mm, width: 2.0 mm) were created on a machine for making cavities. The teeth were restored and after 24h subjected to 2000 cyclic loading and sectioned for analysis of marginal adaptation by scanning electron microscopy (SEM). The micrographs were analyzed with the Image J program to measure the size of marginal gaps. The data were transformed into percentages (%GAPS = LG ÷ LM × 100) and analyzed by 2-way ANOVA followed by the post hoc Tukey test (α=0.05). Results: There was a significant difference between different treatments (p0.05). Conclusions: It was concluded that restorations with flowable composite resin and bulk fill liners exhibit the same behavior, but the RMGIC liner increased marginal gap (AU)

Objetivo: Avaliar a adaptação marginal, em esmalte (E) e dentina (D), de restaurações com resina composta (RC) associada a resina composta fluida (flow), resina bulk fill (bulk) e cimento de ionômero modificado por resina (CIVMR) em cavidades tipo slot. Materiais e Métodos: O estudo foi realizado após aprovação no Comitê de Ética e Pesquisa (Protocolo no. 21148413.4.0000.5417). Quarenta molares humanos foram aleatoriamente distribuídos em oito grupos experimentais: E-RC, E-BULK, E-FLOW, E-CIVMR, D-RC, D-BULK, D-FLOW, D-CIVMR. A superfície oclusal foi planificada e duas cavidades tipo slot com tamanhos padronizados (profundidade: 2,0 mm, altura: 2,5 mm, largura: 2,0 mm) foram realizadas em uma máquina para confecção de cavidades. Os dentes foram restaurados e, após 24h, submetidos a 2000 ciclos mecânicos e foram seccionados para análise da adaptação marginal em microscopia eletrônica de varredura (MEV). As micrografias foram analisadas através do programa Image J para medir as fendas marginais. Os dados foram transformados em porcentagens (%fendas = largura da fenda / largura da margem x 100) e analisados através do teste ANOVA-2 critérios seguido do teste de Tukey (α=0,05). Resultados: Houve diferença significante entre os diferentes tratamentos (p0,05). Conclusões: Concluiu-se que as restaurações com base de resina flow e bulk fill exibiram o mesmo comportamento, mas a base de CIVMR aumentou a fenda marginal. (AU)

Alterações morfológicas e químicas do esmalte humano após o clareamento dental: avaliação in situ / Morphological and chemical changes of human enamel after tooth bleaching: in situ evaluation

Introdução: A alteração de cor dos dentes apresenta-se como um dos fatores que mais concorrem para o desequilíbrio do sorriso, sendo o clareamento dental amplamente difundido e solicitado pelos pacientes. Objetivo: Este estudo in situ teve como objetivo avaliar as mudanças morfológicas e químicas do esmalte quando submetido a três agentes clareadores à base de peróxido de hidrogênio ativados com fonte de luz híbrida e um agente placebo (gel sem peróxido de hidrogênio), por meio do uso da espectrometria de energia dispersiva de raios-X (EDS). Metodologia: Fragmentos de terceiros molares humanos foram divididos em quatro grupos (n=12), para a realização de uma sessão de clareamento com cinco aplicações de oito minutos dos géis clareadores: Placebo (Plac); Lase Peroxide Flex 35% e 15% (DMC) (LPF35LH e LPF15LH); Gel experimental a 10% (DMC) (EXP10LHV), e foram fotocatalizados com luz híbrida: LED azul/laser de diodo (LH) (Whitening Lase II, DMC) ou LED violeta/laser de diodo (LHV) (luz experimental, DMC). Após o clareamento, os espécimes foram fixados a dispositivos intraorais usados pelos participantes durante 15 dias. A composição inorgânica e topografia da superfície de esmalte foram analisadas antes e após o clareamento, e depois de 3, 7 e 15 dias de exposição à saliva. Os valores elementares da composição foram analisados por ANOVA a um critério de medidas repetidas e teste de Tukey. Para a topografia os escores foram determinados por três examinadores previamente calibrados pelo teste Kappa e foi aplicado o teste estatístico de Friedman e Kruskal-Wallis, e as comparações individuais foram realizadas pelo teste de Dunn ( = 0,05). Resultados: De maneira geral, não houve alterações significativas na porcentagem elementar do esmalte nos diferentes períodos estudados. Ao analisar os dois principais elementos, o grupo LPF35HL obteve o menor valor de cálcio (Ca), possuindo diferença estatisticamente significante quando comparado com o grupo EXP10LHV, enquanto os valores de fosfato (P) permaneceram constantes. Morfologicamente somente o grupo EXP10LHV demostrou maior planificação da superfície quando comparado o período de 7 dias com 15 dias. Conclusão: Os diferentes protocolos clareadores empregados, demonstraram alterações pontuais na variação dos elementos químicos e na morfologia do esmalte dental ao longo do período de avaliação.(AU)

Introduction: The tooth color change is one of the factors that contributes most to the smile imbalance, and dental bleaching is widely diffused and requested by the patients. Objective: The aimed of this in situ study is to evaluate the morphological and chemical changes of the enamel when submitted to three activated hydrogen peroxide bleaching agents with hybrid light source and a placebo agent (gel without hydrogen peroxide), using energy-dispersive X-ray spectroscopy (EDS). Methodology: Fragments of human third molars were divided into four groups (n = 12) to perform a bleaching session with five eight minute applications of bleaching gels: Placebo (Plac); Lase Peroxide Flex 35% and 15% (DMC) (LPF35LH and LPF15LH); 10% experimental gel (DMC) (EXP10LHV), and photocatalyzed with hybrid light: blue LED / diode laser (LH) (Whitening Lase II, DMC) or violet LED / diode laser (LHV). After bleaching, the specimens were fixed to intraoral devices used by participants for 15 days. The inorganic composition and topography of the enamel surface were analyzed before and after bleaching, and after 3, 7 and 15 days of exposure to saliva. The elementary values of the composition were analyzed by one-way ANOVA at a repeated measures and Tukey's test. For the topography the scores were determined by three examiners previously calibrated by the Kappa test and the Friedman and Kruskal-Wallis statistical test were applied, and the individual comparisons were performed by the Dunn test ( = 0.05). Results: In general, there were no significant changes in the elemental percentage of enamel in the different periods studied. When analyzing the two main elements, the LPF35HL group had the lowest calcium (Ca) value, which had a statistically significant difference when compared to the EXP10LHV group, while the phosphate (P) values remained constant. Morphologically, only the EXP10LHV group showed greater surface planning when compared to the period of 7 days with 15 days. Conclusion: The different bleaching protocols employed showed specific alterations in the variation of the chemical elements and the morphology of the dental enamel during the evaluation period.(AU)

Effect of Two Antioxidants Agents on Microtensile Bond Strength to Bleached Enamel.

This in vitro study evaluated the effect of sodium bicarbonate and sodium ascorbate on the microtensile bond strength of an etch-and-rinse system to bleached bovine enamel. Sixty bovine enamel blocks (4x4 mm) were flattened and randomly allocated into 5 groups: G1 (negative control): without treatment; G2 (positive control): bleached with 35% hydrogen peroxide (HP); G3: bleached and stored for 7 days in artificial saliva before restorative procedures; G4: bleached and treated with 10% sodium bicarbonate solution for 5 min; G5: bleached and treated with 10% sodium ascorbate hydrogel for 15 min. HP gel was applied twice (20 min each, except in G1) and the adhesive restorations were performed. After 24 h, the specimens were sectioned into sticks and submitted to microtensile bond strength testing with a crosshead speed of 0.5 mm/min (n=12). As a complementary visual observation, the enamel surfaces of the G1 and G2 specimens were evaluated with scanning electron microscopy. Data were analyzed by one-way ANOVA (p<0.05). The means (standard deviation) were: G1: 24.22±7.74; G2: 18.29±5.88; G3: 40.88±7.95; G4: 19.95±5.67 and G5: 24.43±6.43. Adhesive failures were predominant in all groups. The comparison between the treatments indicates that waiting 7 days after bleaching is still the most effective approach. When this waiting period is not possible, application of sodium ascorbate or sodium bicarbonate seems to be a good alternative. Therefore, the practicality of obtaining sodium bicarbonate in the bleaching kits and its higher stability enables its clinical use.

Effect of Two Antioxidants Agents on Microtensile Bond Strength to Bleached Enamel

Abstract This in vitro study evaluated the effect of sodium bicarbonate and sodium ascorbate on the microtensile bond strength of an etch-and-rinse system to bleached bovine enamel. Sixty bovine enamel blocks (4x4 mm) were flattened and randomly allocated into 5 groups: G1 (negative control): without treatment; G2 (positive control): bleached with 35% hydrogen peroxide (HP); G3: bleached and stored for 7 days in artificial saliva before restorative procedures; G4: bleached and treated with 10% sodium bicarbonate solution for 5 min; G5: bleached and treated with 10% sodium ascorbate hydrogel for 15 min. HP gel was applied twice (20 min each, except in G1) and the adhesive restorations were performed. After 24 h, the specimens were sectioned into sticks and submitted to microtensile bond strength testing with a crosshead speed of 0.5 mm/min (n=12). As a complementary visual observation, the enamel surfaces of the G1 and G2 specimens were evaluated with scanning electron microscopy. Data were analyzed by one-way ANOVA (p<0.05). The means (standard deviation) were: G1: 24.22±7.74; G2: 18.29±5.88; G3: 40.88±7.95; G4: 19.95±5.67 and G5: 24.43±6.43. Adhesive failures were predominant in all groups. The comparison between the treatments indicates that waiting 7 days after bleaching is still the most effective approach. When this waiting period is not possible, application of sodium ascorbate or sodium bicarbonate seems to be a good alternative. Therefore, the practicality of obtaining sodium bicarbonate in the bleaching kits and its higher stability enables its clinical use.

Resumo Este estudo in vitro avaliou o efeito do bicarbonato de sódio e do ascorbato de sódio na resistência de união de um sistema adesivo convencional unido ao esmalte bovino clareado. Sessenta blocos de esmalte bovino (4x4 mm) foram planificados e distribuídos aleatoriamente em 5 grupos: G1: (controle negativo); G2 (controle positivo): clareamento com peróxido de hidrogênio 35% (HP); G3: clareamento com HP seguido de armazenamento por 7 dias em saliva artificial antes do procedimento restaurador; G4: clareamento com HP seguido de tratamento com a solução de bicarbonato de sódio 10% por 5 min; G5: clareamento com HP seguido de tratamento com hidrogel de ascorbato de sódio 10% por 15 min. O HP foi aplicado duas vezes (20 min cada, com exceção do grupo G1) e então as restaurações adesivas foram realizadas. Após 24 h, os espécimes foram seccionados em palitos e submetidos ao teste de resistência de união a uma velocidade de 0,5 mm/min (n=12). As superfícies de esmalte de G1 e G2 foram avaliadas com microscopia eletrônica de varredura para fins de análise visual complementar. Os dados foram analisados por ANOVA a um critério (p<0,05). As medias (desvio-padrão) foram: G1: 24,22±7,74; G2: 18,29±5,88; G3: 40,88±7,95; G4: 19,95±5,67 e G5: 24,43±6,43. Falhas adesivas foram predominantes em todos os grupos. A comparação entre os diferentes tratamentos indica que esperar 7 dias após o clareamento é ainda a abordagem mais eficaz. Nos casos em que este período de espera não é possível, a aplicação do ascorbato de sódio e do bicarbonate de sódio parecem ser boas alternativas. Entretanto, a praticidade na obtenção da solução de bicarbonato de sódio nos kits de clareamento e sua maior estabilidade favorecem o seu uso clínico.

Evaluation of temperature increase during in-office bleaching.

The use of light sources in the bleaching process reduces the time required and promotes satisfactory results. However, these light sources can cause an increase in the pulp temperature. Objective The purpose of the present study was to measure the increase in intrapulpal temperature induced by different light-activated bleaching procedures with and without the use of a bleaching gel. Material and Methods A human maxillary central incisor was sectioned 2 mm below the cementoenamel junction. A K-type thermocouple probe was introduced into the pulp chamber. A 35% hydrogen peroxide bleaching gel was applied to the vestibular tooth surface. The light units used were a conventional halogen, a hybrid light (only LED and LED/Laser), a high intensity LED, and a green LED light. Temperature increase values were compared by two-way ANOVA and Tukey´s tests (p<0.05). Results There were statistically significant differences in temperature increases between the different light sources used and between the same light sources with and without the use of a bleaching gel. The presence of a bleaching gel generated an increase in intra-pulpal temperature in groups activated with halogen light, hybrid light, and high intensity LED. Compared to the other light sources, the conventional halogen lamp applied over the bleaching gel induced a significant increase in temperature (3.83±0.41°C). The green LED unit with and without gel application did not produce any significant intrapulpal temperature variations. Conclusion In the present study, the conventional halogen lamp caused the highest increase in intrapulpal temperature, and the green LED caused the least. There was an increase in temperature with all lights tested and the maximum temperature remained below the critical level (5.5°C). The addition of a bleaching gel led to a higher increase in intrapulpal temperatures.

Direct Composite Restorations to Mask Intrinsic Staining: An Eighteen-Year Follow-Up.

In this case example, the use of direct composite resin allowed for a relatively simple, conservative treatment that provided excellent function and aesthetics, while preserving healthy dental tissue. The importance of continued follow-up and a periodic maintenance and minor repair process will ensure longevity of the restorations, as aesthetics, and the occlusion.

Evaluation of temperature increase during in-office bleaching

ABSTRACT The use of light sources in the bleaching process reduces the time required and promotes satisfactory results. However, these light sources can cause an increase in the pulp temperature. Objective The purpose of the present study was to measure the increase in intrapulpal temperature induced by different light-activated bleaching procedures with and without the use of a bleaching gel. Material and Methods A human maxillary central incisor was sectioned 2 mm below the cementoenamel junction. A K-type thermocouple probe was introduced into the pulp chamber. A 35% hydrogen peroxide bleaching gel was applied to the vestibular tooth surface. The light units used were a conventional halogen, a hybrid light (only LED and LED/Laser), a high intensity LED, and a green LED light. Temperature increase values were compared by two-way ANOVA and Tukey´s tests (p<0.05). Results There were statistically significant differences in temperature increases between the different light sources used and between the same light sources with and without the use of a bleaching gel. The presence of a bleaching gel generated an increase in intra-pulpal temperature in groups activated with halogen light, hybrid light, and high intensity LED. Compared to the other light sources, the conventional halogen lamp applied over the bleaching gel induced a significant increase in temperature (3.83±0.41°C). The green LED unit with and without gel application did not produce any significant intrapulpal temperature variations. Conclusion In the present study, the conventional halogen lamp caused the highest increase in intrapulpal temperature, and the green LED caused the least. There was an increase in temperature with all lights tested and the maximum temperature remained below the critical level (5.5°C). The addition of a bleaching gel led to a higher increase in intrapulpal temperatures.

Influence of pH, bleaching agents, and acid etching on surface wear of bovine enamel.

UNLABELLED: Development of new materials for tooth bleaching justifies the need for studies to evaluate the changes in the enamel surface caused by different bleaching protocols. OBJECTIVE: The aim of this study was to evaluate the bovine dental enamel wear in function of different bleaching gel protocols, acid etching and pH variation. MATERIAL AND METHODS: Sixty fragments of bovine teeth were cut, obtaining a control and test areas. In the test area, one half received etching followed by a bleaching gel application, and the other half, only the bleaching gel. The fragments were randomly divided into six groups (n=10), each one received one bleaching session with five hydrogen peroxide gel applications of 8 min, activated with hybrid light, diode laser/blue LED (HL) or diode laser/violet LED (VHL) (experimental): Control (C); 35% Total Blanc Office (TBO35HL); 35% Lase Peroxide Sensy (LPS35HL); 25% Lase Peroxide Sensy II (LPS25HL); 15% Lase Peroxide Lite (LPL15HL); and 10% hydrogen peroxide (experimental) (EXP10VHL). pH values were determined by a pHmeter at the initial and final time periods. Specimens were stored, subjected to simulated brushing cycles, and the superficial wear was determined (µm). ANOVA and Tukey´s tests were applied (α=0.05). RESULTS: The pH showed a slight decrease, except for Group LPL15HL. Group LPS25HL showed the highest degree of wear, with and without etching. CONCLUSION: There was a decrease from the initial to the final pH. Different bleaching gels were able to increase the surface wear values after simulated brushing. Acid etching before bleaching increased surface wear values in all groups.

Influence of pH, bleaching agents, and acid etching on surface wear of bovine enamel

ABSTRACT Development of new materials for tooth bleaching justifies the need for studies to evaluate the changes in the enamel surface caused by different bleaching protocols. Objective The aim of this study was to evaluate the bovine dental enamel wear in function of different bleaching gel protocols, acid etching and pH variation. Material and Methods Sixty fragments of bovine teeth were cut, obtaining a control and test areas. In the test area, one half received etching followed by a bleaching gel application, and the other half, only the bleaching gel. The fragments were randomly divided into six groups (n=10), each one received one bleaching session with five hydrogen peroxide gel applications of 8 min, activated with hybrid light, diode laser/blue LED (HL) or diode laser/violet LED (VHL) (experimental): Control (C); 35% Total Blanc Office (TBO35HL); 35% Lase Peroxide Sensy (LPS35HL); 25% Lase Peroxide Sensy II (LPS25HL); 15% Lase Peroxide Lite (LPL15HL); and 10% hydrogen peroxide (experimental) (EXP10VHL). pH values were determined by a pHmeter at the initial and final time periods. Specimens were stored, subjected to simulated brushing cycles, and the superficial wear was determined (μm). ANOVA and Tukey´s tests were applied (α=0.05). Results The pH showed a slight decrease, except for Group LPL15HL. Group LPS25HL showed the highest degree of wear, with and without etching. Conclusion There was a decrease from the initial to the final pH. Different bleaching gels were able to increase the surface wear values after simulated brushing. Acid etching before bleaching increased surface wear values in all groups.

Evaluation of pH Levels and Surface Roughness After Bleaching and Abrasion Tests of Eight Commercial Products.

OBJECTIVE: This in vitro study evaluated the effect of different bleaching protocols and the variation of pH levels of bleaching gels regarding roughness and wear of bovine enamel, after in-office bleaching protocols and brushing. MATERIALS AND METHODS: Ninety fragments were randomly divided into nine groups: C, control; WHP15, 35% hydrogen peroxide (HP) (Whiteness HP, FGM) three gel applications of 15 min each, three sessions with 1 week intervals; WHP45, 35% HP (Whiteness HP) one application/45 min, three sessions with 1 week intervals; LPS, 35% HP (Lase Peroxide, DMC) plus hybrid light (HL) [light-emitting diode (LED)/diode laser], four applications/7 min 30 sec (6 min of HL activation), one session; LPSII, 25% HP (Lase Peroxide II, DMC) plus HL, four applications/7 min 30 sec (6 min of HL activation), one session; LPL, 15% HP (Lase Peroxide Light, DMC) four applications/7 min 30 sec (6 min of HL activation), one session; WO, 35% HP (Whitegold Office, Dentsply) three applications/15 min, three sessions with 1 week intervals; WBC40, 35% HP (Whiteness HP Blue Calcium, FGM) one application/40 min, three sessions with 1 week intervals; and WBC50, 20% HP (Whiteness HP Blue Calcium) one application/50 min, three sessions with 1 week intervals. The median pH values were determined utilizing a pH meter during the initial and final gel applications. A rugosimeter was utilized to evaluate the surface roughness (Ra) before and after bleaching and brushing (100,000 strokes), and the surface wear after brushing. RESULTS: For the results of the pH values, there was a decrease in the pH levels from the initial to the final bleaching time, except for the WBC50. The WO and WBC40 groups exhibited higher pH values. For the results of roughness and wear, there was an increase in surface roughness and wear among the groups. CONCLUSIONS: The pH values tended to decrease from the initial to the final bleaching. After tooth brushing, bleaching procedures with lower pH products provided a significant increase in enamel wear and surface roughness.

Whitening gel and light source influence on pulp chamber temperature

Introduction: The chemical injury caused to the pulp by the penetration of the whitening gel is already known, but another possible cause may be the heat generated by the irradiation of the whitening gel with light sources to accelerate the whitening reaction. Objective: To evaluate in vitro the temperature increasing in the pulp chamber during in-office bleaching with different gel concentrations and light sources. Material and methods: A maxillary human central incisor was used in the 6 groups evaluated. The specimen was sectioned 3 mm apical to the cementoenamel junction. The root canal and pulp chamber were cleaned and widened with a diamond bur to receive the sensor of a thermocouple thermometer. The following hydrogen peroxide gel concentrations were evaluated: 35%, 25%, 15%, and 10%; and the following light sources were applied: blue hybrid LED/laser and violet hybrid LED/laser. The specimen bleaching was repeated 6 times per group. As a control, the temperature was measured with the application of light, without applying any gel. Results were evaluated with one-way ANOVA and Tukey's test (α = 5%). Results: Significant differences between groups were observed (p < 0.05). The blue LED without the gel induced the smallest heat (37.5 ± 0.2) and the blue LED with 15% gel caused the highest heat (38.2 ± 0.3). The combination of violet LED with the 10% gel caused no significant increase in temperature compared to the control in which light was used without gel (p> 0.05). Conclusion: No increase in pulp chamber temperature was higher than 2°C.

Avaliação da temperatura dental in vitro em procedimentos de clareamento dental de consultório / Evaluation of the dental temperature in vitro in tooth whitening procedures at the dental office

Este trabalho teve por objetivo avaliar a variação de temperatura na face vestibular e intra câmara pulpar gerada por diferentes protocolos de clareamento em consultório. Um canino superior humano foi seccionado abaixo da junção amelocementária e teve o interior de sua câmara pulpar ampliado para receber uma pasta condutora térmica e o sensor do termômetro digital termopar tipo K. A aferição da temperatura na face vestibular foi realizada com termômetro digital infravermelho com Mira Laser. Os protocolos de clareamento no dente selecionado foram distribuídos em doze grupos experimentais, variando-se a luz de ativação: luz híbrida LED e laser diodo (UltraBlue© IV–DMC), luz halógena (Spectrum Curing Light©, Dentsply Caulk) e ultravioleta (Zoom! Lamp© – Discus Dental), e os tratamentos: sem gel clareador, Lase Peroxide© (DMC), Whiteness HP Maxx© (FGM) e Whiteness HP© (FGM). Os resultados foram submetidos … análise de variância a 2 critérios (ANOVA) e teste de tukey (p≤0,05). As maiores elevações de temperatura (5øC) no interior da câmara pulpar foram observadas nos grupos ativados com a lâmpada ultravioleta sem a utilização de gel e comWhiteness HP Maxx. A luz híbrida apresentou menor aumento de temperatura (de 1,7 a 2øC). Em relação à temperatura externa, a Zoom! Lamp também induziu o maior aumento, estatisticamente significante em relação aos demais. Tanto o gel clareador quanto a ativação por luz foram relevantes para o aumento de temperatura no interior da câmara pulpar. Na face vestibular o aumento de temperatura deu-se pela ativação por luz, independente do gel utilizado.

This study aimed to evaluate the temperature variation in the vestibular surface of teeth and inside their pulp chamber generated by different protocols in office whitening. A human upper canine was sectioned below the enamel-cement junction and had the interior of its chamber enlarged to receive a thermally conductive paste and the sensor of type K digital thermometer. The temperature measurement was performed on the vestibular surface with infrared digital thermometer with laser-sights. The protocols in tooth whitening selected were distributed in twelve experimental groups, varying the light activation: light hybrid LED and laser diode (UltraBlue IV© - DMC), halogen light (Spectrum Curing Light©, Dentsply Caulk) and ultraviolet (Zoom! Lamp© - Discus Dental), and treatments: no bleaching gel, Lase Peroxide© (DMC), Whiteness HP Maxx© (FGM), and Whiteness HP© (FGM). Results were subjected to variance analysis 2 way (ANOVA) and Tukey test (p≤0.05). The highest elevations of temperature (5øC) inside the pulp chamber were observed in the groups activated with ultraviolet light without the use of gel and Whiteness HP Maxx©. The light hybrid showed a smaller increase in temperature (from 1.7 to 2øC). On the facial surface, the Zoom! Lamp also induced the largest increase statistically significant in relation to others. Both the bleaching gel and light activation were relevant to the temperature increase inside the pulp chamber. In vestibular surface temperature increase occurred by light activation, regardless the used gel.

Comprometimento do esmalte bovino após escovação em função do condicionamento ácido, clareamento ativado com luz híbrida, concentração e pH dos géis clareadores / Commitment of bovine enamel after brushing in the function of acid etching,whitening activated with hybrid light, and pH concentration of the bleaching gels

Este estudo in vitro avaliou a influência do clareamento ativado com luz híbrida, em função da variação do pH e concentração de géis clareadores, e do condicionamento ácido prévio do esmalte bovino na alteração da rugosidade e desgaste após escovação simulada. Fragmentos de esmalte (1,5cm x 0,5cm x 0,4cm) foram divididos em duas partes, ficando uma metade como controle e a outra como área teste. Esta última foi subdividida em duas metades, sendo que uma recebeu o condicionamento ácido somado ao gel clareador e a outra somente o gel clareador. Os espécimes foram divididos aleatoriamente em seis grupos (n=10): C = controle; TBO35LH = Total Blanc Office 35% 1 sessão (5x8) + ativação com luz híbrida LED/Laser; LPS35LH= Lase Peroxide Sense 35% - 1 sessão (5x8) + ativação com luz híbrida LED/Laser; LPS25LH = Lase Peroxide Sense 25% - 1 sessão (5x8) + ativação com luz híbrida LED/Laser; LPL15LH = Lase Peroxide Lite 15% - 1 sessão (5x8) + ativação com luz híbrida LED/Laser; LPL10LHV = Lase Peroxide Lite 10% - 1 sessão (5x8) + ativação com luz híbrida LED/Laser violeta. A rugosidade aritmética (Ra) inicial, após clareamento e após escovação, foi determinada pela média (μm) de três leituras (em cada área sem e com ácido totalizando seis leituras por espécimes) com o rugosímetro Hommel Tester T 1000. Os valores médios do pH foram determinados pelo peagômetro digital Sentron Model 1001 nos tempos inicial e final. Os espécimes foram armazenados em saliva artificial por sete dias, submetidos a 100.000 ciclos de escovação simulada. Após 24 horas o desgaste superficial foi determinado (μm) empregando o mesmo rugosímetro. Em relação ao desgaste e a alteração de rugosidade superficial, os resultados foram submetidos à Anova a dois critérios e a dois critérios de medidas repetidas e posteriormente ao teste de Tukey. Os dados obtidos das leituras de pH foram submetidos à ANOVA a um critério e a dois critérios de medidas repetidas e ao teste de Kruskal Wallis e Tukey...

This in vitro study evaluated the influence of whitening activated with hybrid light on the function variations of the pH level and concentration of bleaching gels and prior acid etching of bovine enamel and the change in roughness and wear after simulated tooth brushing. Fragments of enamel (1.5 cm x 0.5 cm x 0.4 cm) were divided into two parts, one half as the control and the other as the test area. The latter was divided into two halves, one of which received the etching added to the whitening gel and the other with only the whitening gel. The specimens were randomly divided into six groups (n = 10): C = control; TBO35LH = 35% Total Blanc Office 1x session (5x8') + activation with hybrid light LED/Laser; LPS35LH = 35% Lase Peroxide Sense - 1x session (5x8') + activation with hybrid light LED/Laser; LPS25LH = 25% Sense Lase Peroxide - 1x session (5x8') + activation with hybrid light LED/Laser; LPL15LH = 15% Lase Peroxide Lite - 1x session (5x8 ') + activation with hybrid light LED/Laser; LPL10LHV = 10% Lase Peroxide Lite - 1x session (5x8') + activation with violet hybrid light LED/Laser. The arithmetic roughness (Ra) started after bleaching and after brushing was determined by averaging (μm) the three readings (in each area - with and without acid for a total of six readings per specimen) with a Rugosimeter Hommel Tester T 1000. The mean pH values were determined by the Sentron Model 1001 digital pH meter at the start and end times. The specimens were stored in artificial saliva for seven days, and subjected to 100,000 cycles of simulated brushing. After 24 hours, the surface wear was determined (μm) employing the same roughness meter. In relation to the change in wear and surface roughness, the results were evaluated by two way ANOVA testing for repeated measures and later, a Tukey's test. The data obtained from the pH readings were submitted to two way ANOVA testing for repeated measures and the Kruskal Wallis and Tukey tests...