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1.
Am J Dent ; 33(1): 17-24, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32056410

RESUMO

PURPOSE: To review and assess the literature on in vitro studies evaluating tooth bleaching efficacy considering the use of a negative control, type of tooth substrate, storage medium, color evaluation methods, and evaluation time points. METHODS: The following databases were searched: PubMed (MEDLINE), Web of Science. Search used Medical Subject Headings (MeSH) in PubMed in addition to free text. The following limits were applied: English, articles published between January 1989 and October 2017. Additional free text key terms included: in vitro, tooth bleaching, placebo, negative control, overall CIELAB color change (ΔE*ab), change in shade guide units (ΔSGU), tooth color stabilization, evaluation time points, bovine teeth, and staining. Search was repeated in Web of Science but no additional articles were identified. A total of 11 studies were included for qualitative and quantitative analysis. RESULTS: The meta-analysis of nine included studies that reported ΔE*ab values, revealed that the NC statistically exceeded the perceptibility threshold (PT) of 1.2 (P< 0.05). The estimate was 2.872 with lower and upper bounds of 1.955 and 3.790, respectively. CLINICAL SIGNIFICANCE: Randomized controlled trials are gold standards to evaluate bleaching efficacy of different materials. However, in vitro studies offer a way to screen for potential bleaching efficacy. It is vital to determine an appropriate cut-off value for determining bleaching efficacy in vitro and further apply for clinical relevance.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Dente , Animais , Bovinos , Cor , Peróxido de Hidrogênio
2.
J Esthet Restor Dent ; 31(2): 124-131, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30478984

RESUMO

OBJECTIVES: To assess two professional tooth bleaching products: Philips Zoom WhiteSpeed (PZW) and Ultradent Opalescence Boost PF (UOB); and to assess bleaching maintenance after use of Philips Sonicare power toothbrush (SDC) or manual toothbrush (MTB). METHODS: There was a randomized, parallel clinical trial. Eligible subjects were 18-75 years, with VITA Classical shade (VCS) of A3 on anterior teeth. Subjects were randomized to bleaching with PZW or UOB. Tooth color and shade were assessed using VITA EasyShade (VES), VCS, and VITA Bleachedguide (VBG). Subjects returned on Days 7 and 30. On Day 30, participants were dispensed either SDC or MTB for home use until Day 90. RESULTS: A total of 135 subjects completed the study. For the primary endpoint, ΔE at Day 7, a significantly larger reduction was observed for PZW than UOB (P value = .0059). Significant differences in shade were also observed at Day 7 for VCS (P value = 0.0106), and VBG (P value = .0489). On Day 90, the SDC was statistically superior to MTB in maintaining shade per VBG and VCS, but not ΔE. CONCLUSIONS: At Day 7, PZW showed statistically greater change in overall color and shade than UOB. The SDC maintained tooth shade significantly better than MTB. Both bleaching regimens were safe. CLINICAL SIGNIFICANCE: The outcomes confirm the bleaching efficacy advantage of a lower H2 O2 dose-LED accelerated professional tooth bleaching system, compared to a higher-dose H2 O2 approach. The safety assessments via clinical intraoral exam and daily logged use of subjects' desensitizing agents, and the incidence and severity of reported sensitivity, provide evidence that both professional products are safe for use. Finally, powered tooth brushing may confer an advantage to manual tooth brushing in maintaining tooth shade-change results following professional whitening.


Assuntos
Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Humanos , Peróxido de Hidrogênio , Resultado do Tratamento
3.
J Dent Hyg ; 92(2): 31-37, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29739845

RESUMO

Purpose: The purpose of this study was to evaluate whether current educational strategies at a dental institution in the United States made a difference in dental hygiene (DNHY) and dental students' (D3) learning outcomes in the four domains of evidence-based practice (EBP), knowledge, attitude, accessing evidence, and confidence (KACE), following a 12-week research design course.Methods: All participants DNHY (n=19) and D3 (n=96) enrolled in the research design course at Loma Linda University completed a paper KACE survey distributed on the first day of class. Students completed the KACE survey once more at the end of the 12-week course. Pre- and post-survey results were compared both within and between the DNHY and D3 student groups to identify the learning outcomes in the four domains of EBP; knowledge, attitude, accessing evidence, and confidence in EBP. Descriptive statistics were conducted to profile all variables in the study; the level of significance was set at α=0.05.Results: All DNHY students (n=19) completed the pre and post KACE surveys; of the D3 (n=96) students enrolled in the course 82% (n=79) competed the post-survey. Comparison of the survey results showed that both DNHY and D3 students demonstrated statistically significant increases in their level of knowledge and attitude (p < 0.05) towards EBP. In the attitude domain, DNHY students indicated more positive attitudes towards EBP (p < 0.001) than their D3 student cohorts. Neither group demonstrated significant changes in confidence in applying EBP (p > 0.05).Conclusion: DNHY and D3 students increased their knowledge and developed more positive attitudes towards EBP following a 12-week research design course. Study results identify improvement areas for EBP knowledge acquisition including determining levels of evidence, analysis of study results, and evaluating the appropriateness of research study designs through the use of validated EBP survey instrument.


Assuntos
Atitude do Pessoal de Saúde , Higienistas Dentários/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Estudantes de Odontologia/psicologia , Competência Clínica , Currículo , Odontologia Baseada em Evidências , Humanos , Autoimagem
4.
J Esthet Restor Dent ; 28(5): 313-320, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27513289

RESUMO

PURPOSE: To evaluate the whitening efficacy of a new two-layer technology in-office system compared to a conventional gel-type system and determine hydrogen peroxide penetration (HPP) into the pulp cavity. MATERIALS AND METHODS: Extracted molars (n = 60) were assigned to group NC: glycerol gel; group QPRO: 20% HP varnish (Zoom Quick Pro, Philips Oral Healthcare); group ZOOM_NL: 25% HP gel (Zoom Chairside Whitening); and group ZOOM_WL: 25% HP gel (Zoom Chairside Whitening) with light-activation. HPP levels were estimated with leucocrystal-violet and horseradish-peroxidase. Instrumental color measurements were performed at baseline (T0 ), 1-day post first whitening (T1 ), 1-day post second whitening (T2 ), 1-day post third whitening (T3 ), and 1-month post whitening (T4 ). One-way analysis of variance followed by post hoc Tukey's HSD test was performed to detect difference in ΔE* and HP penetration levels (α = 0.05). RESULTS: ΔE* of NC was lower than other groups, whereas ΔE* of ZOOM_WL was greater than the other three groups, at T3 and T4 . Mean HPP level obtained from ZOOM_WL (1.568 ± 0.753 µg/mL) was significantly greater than those obtained from the other groups, whereas the mean HPP level observed in NC group (-0.131 ± 0.003 µg/mL) was significantly lower than the other groups. CONCLUSIONS: Tooth whitening efficacy and HPP levels vary based on whitening systems used. CLINICAL SIGNIFICANCE: The two-layer technology in-office varnish system may be an alternative whitening option to reduce chair time in the office. (J Esthet Restor Dent 28:313-320, 2016).


Assuntos
Peróxido de Hidrogênio/farmacologia , Clareadores Dentários/farmacologia , Clareamento Dental , Cor
5.
J Esthet Restor Dent ; 28 Suppl 1: S14-22, 2016 03.
Artigo em Inglês | MEDLINE | ID: mdl-27079767

RESUMO

OBJECTIVES: To establish time-course of potassium nitrate (PN) penetration into the pulp cavity, and determine whether PN pretreatment would affect whitening efficacy. MATERIALS AND METHODS: Extracted teeth (n = 100) were randomized into five groups of 20 specimens each. Relief ACP (Philips Oral Healthcare, Los Angeles, CA, USA) was applied for 0, 5, 15, 30, and 60 minutes for groups 15, respectively. A nitrate/nitrite assay kit was used for colorimetric detection of nitrate. Whitening was performed using a Zoom White Speed system (Philips Oral Healthcare) for 60 minutes. Tooth color was measured with a spectrophotometer at baseline (T0 ), 1-day post PN application (T1 ), 1-day post-whitening (T2 ), and 1-month post-whitening (T3 ). Kruskal-Wallis test was used to assess group differences in PN penetration and tooth color change. RESULTS: PN penetration differed among all groups except 2 and 3. There were no differences among groups for any baseline color parameters (p > 0.30). At T2 there was no change relative to baseline for individual components L*, a*, and b*. At T3 and T4 there was significant change relative to baseline for ΔL*, Δb*, and ΔE*, for all groups. CONCLUSIONS: PN penetration is time dependent and pretreatment with PN does not affect whitening efficacy. CLINICAL SIGNIFICANCE: Postassium nitrate penetration into the pulp cavity occurred as early as 5 minutes after application, and pretreatment with potassium nitrate containing desensitizers did not adversely affect tooth whitening efficacy. (J Esthet Restor Dent 28:S14-S22, 2016).


Assuntos
Cavidade Pulpar , Nitratos , Compostos de Potássio , Clareamento Dental , Cor , Cavidade Pulpar/química , Peróxido de Hidrogênio , Nitratos/farmacocinética , Compostos de Potássio/farmacocinética , Distribuição Aleatória
6.
J Dent Educ ; 80(1): 91-9, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26729689

RESUMO

The aim of this study was to evaluate the effect of digital tooth preparation imaging and evaluation technology on dental students' technical abilities, self-evaluation skills, and the assessment of their simulated clinical work. A total of 80 second-year students at one U.S. dental school were assigned to one of three groups: control (n=40), E4D Compare (n=20), and Sirona prepCheck (n=20). Students in the control group were taught by traditional teaching methodologies, and the technology-assisted groups received both traditional training and supplementary feedback from the corresponding digital system. Three outcomes were measured: faculty technical score, self-evaluation score, and E4D Compare scores at 0.30 mm tolerance. Correlations were determined between the groups' scores from visual assessment and self-evaluation and between the visual assessment and digital scores. The results showed that the visual assessment and self-evaluation scores did not differ among groups (p>0.05). Overall, correlations between visual and digital assessment scores were modest though statistically significant (5% level of significance). These results suggest that the use of digital tooth preparation evaluation technology did not impact the students' prosthodontic technical and self-evaluation skills. Visual scores given by faculty and digital assessment scores correlated moderately in only two instances.


Assuntos
Desenho Assistido por Computador , Educação em Odontologia , Avaliação Educacional/métodos , Tecnologia Educacional/métodos , Prostodontia/educação , Preparo Prostodôntico do Dente/métodos , Adulto , Lista de Checagem , Competência Clínica , Instrução por Computador , Docentes de Odontologia , Retroalimentação , Feminino , Humanos , Masculino , Programas de Autoavaliação , Ensino/métodos , Tecnologia Odontológica/métodos , Adulto Jovem
7.
J Dent Educ ; 79(9): 1093-100, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26329034

RESUMO

The aim of this study was to evaluate the impact of computer-assisted learning on first-year dental students' waxing abilities and self-evaluation skills. Additionally, this study sought to determine how well digital evaluation software performed compared to faculty grading with respect to students' technical scores on a practical competency examination. First-year students at one U.S. dental school were assigned to one of three groups: control (n=40), E4D Compare (n=20), and Sirona prepCheck (n=19). Students in the control group were taught by traditional teaching methodologies, and the technology-assisted groups received both traditional training and supplementary feedback from the corresponding digital system. Five outcomes were measured: visual assessment score, self-evaluation score, and digital assessment scores at 0.25 mm, 0.30 mm, and 0.35 mm tolerance. The scores from visual assessment and self-evaluation were examined for differences among groups using the Kruskal-Wallis test. Correlation between the visual assessment and digital scores was measured using Pearson and Spearman rank correlation coefficients. At completion of the course, students were asked to complete a survey on the use of these digital technologies. All 79 students in the first-year class participated in the study, for a 100% response rate. The results showed that the visual assessment and self-evaluation scores did not differ among groups (p>0.05). Overall correlations between visual and digital assessment scores were modest though statistically significant (5% level of significance). Analysis of survey responses completed by students in the technology groups showed that profiles for the two groups were similar and not favorable towards digital technology. The study concluded that technology-assisted training did not affect these students' waxing performance or self-evaluation skills and that visual scores given by faculty and digital assessment scores correlated moderately.


Assuntos
Anatomia/educação , Instrução por Computador , Educação em Odontologia , Aprendizagem , Modelos Anatômicos , Adulto , Avaliação Educacional/métodos , Tecnologia Educacional , Docentes de Odontologia , Retroalimentação , Feminino , Humanos , Masculino , Destreza Motora , Programas de Autoavaliação , Software , Ensino/métodos , Adulto Jovem
8.
J Contemp Dent Pract ; 16(5): 366-71, 2015 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-26162255

RESUMO

AIM: The E4D Compare software is an innovative tool that provides immediate feedback to students' projects and competencies. It should provide consistent scores even when different scanners are used which may have inherent subtle differences in calibration. This study aimed to evaluate potential discrepancies in evaluation using the E4D Compare software based on four different NEVO scanners in dental anatomy projects. Additionally, correlation between digital and visual scores was evaluated. MATERIALS AND METHODS: Thirty-five projects of maxillary left central incisors were evaluated. Among these, thirty wax-ups were performed by four operators and five consisted of standard dentoform teeth. Five scores were obtained for each project: one from an instructor that visually graded the project and from four different NEVO scanners. A faculty involved in teaching the dental anatomy course blindly scored the 35 projects. One operator scanned all projects to four NEVO scanners (D4D Technologies, Richardson, TX, USA). The images were aligned to the gold standard, and tolerance set at 0.3 mm to generate a score. The score reflected percentage match between the project and the gold standard. One-way ANOVA with repeated measures was used to determine whether there was a significant difference in scores among the four NEVO scanners. Paired-sample t-test was used to detect any difference between visual scores and the average scores of the four NEVO scanners. Pearson's correlation test was used to assess the relationship between visual and average scores of NEVO scanners. RESULTS: There was no significant difference in mean scores among four different NEVO scanners [F(3, 102) = 2.27, p = 0.0852 one-way ANOVA with repeated measures]. Moreover, the data provided strong evidence that a significant difference existed between visual and digital scores (p = 0.0217; a paired - sample t-test). Mean visual scores were significantly lower than digital scores (72.4 vs 75.1). Pearson's correlation coefficient of 0.85 indicated a strong correlation between visual and digital scores (p < 0.0001). CONCLUSION: The E4D Compare software provides consistent scores even when different scanners are used and correlates well with visual scores. CLINICAL SIGNIFICANCE: The use of innovative digital assessment tools in dental education is promising with the E4D Compare software correlating well with visual scores and providing consistent scores even when different scanners are used.


Assuntos
Anatomia/educação , Instrução por Computador/métodos , Educação em Odontologia , Lista de Checagem , Competência Clínica , Dentística Operatória/educação , Humanos , Imageamento Tridimensional/métodos , Incisivo/anatomia & histologia , Lasers , Imagem Óptica/instrumentação , Desempenho Psicomotor/fisiologia , Software , Ensino , Interface Usuário-Computador
9.
J Contemp Dent Pract ; 16(5): 383-8, 2015 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-26162258

RESUMO

AIM: This study aimed to determine the efficacy of trays made with and without reservoirs, in conjunction with time and cost evaluations, by measuring color change with home whitening procedures. MATERIALS AND METHODS: Extracted human maxillary teeth (central incisors n = 20; canines n = 20; molars n = 20) and 60 artificial teeth (lateral n = 20; premolar n = 40) were mounted into ten typodonts. Tray fabrication was completed such that a block-out resin reservoir was placed on half of the buccal surface of the tray, while the other half remained without a reservoir. Whitening with custom fabricated trays was performed based on two different whitening regimens, where each regimen was assigned to five typodonts: Night-time: Opalescence PF 10% carbamide peroxide for 8 hours daily and Day-time: Philips DayWhite 9.5% hydrogen peroxide for 30 minutes, twice daily. Both systems were applied for 1 week. To evaluate tooth shade, the VITA Easyshade® Advance 4.0 spectrophotometer was used. Color measurements were obtained at baseline (T1), 1-day post-whitening (T2), and 1 month post-whitening (T3). One-way ANOVA, followed by post-hoc Tukey's HSD test, was used to detect significant difference in the overall color change (ΔE*) among the four groups at T2 and T3. Additionally, paired-sample t-test was used to assess difference in ΔE* between T2 and T3 treatment within each of four techniques of tray fabrication. RESULTS: No significant difference in ΔE* was found among the four groups at T2 and T3 (p > 0.05 in each instance). There were significant differences in mean ΔE* between T2 and T3 treatment for the day white treatment groups without reservoir (6.96 vs 10.19 respectively; p = 0.0026) and with reservoirs (6.23 vs 9.79 respectively; p = 0.0031). CONCLUSION: The use of reservoirs does not have a significant effect on whitening efficacy, regardless of type of whitening material and regimen. CLINICAL SIGNIFICANCE: The use of custom fabricated trays with or without reservoirs were equally effective in whitening teeth.


Assuntos
Autocuidado , Clareamento Dental/instrumentação , Peróxido de Carbamida , Cor , Desenho de Equipamento , Humanos , Peróxido de Hidrogênio/administração & dosagem , Técnicas In Vitro , Teste de Materiais , Peróxidos/administração & dosagem , Distribuição Aleatória , Espectrofotometria/instrumentação , Fatores de Tempo , Dente/efeitos dos fármacos , Clareamento Dental/economia , Clareadores Dentários/administração & dosagem , Dente Artificial , Resultado do Tratamento , Ureia/administração & dosagem , Ureia/análogos & derivados
10.
J Esthet Restor Dent ; 27(5): 240-57, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25969131

RESUMO

PURPOSE: This review integrated the current literature on diffusion of whitening agents, their interactions with stain molecules, and changes to the surface, with the aim of establishing a better understanding of the mechanism underlying tooth whitening. MATERIALS AND METHODS: An electronic PubMed database search, with combinations of the following terms was performed: Tooth Bleaching, Tooth Bleaching Agent, Hydrogen Peroxide, Pharmacokinetics, Tooth Permeability, Oxidation-Reduction, Tooth Demineralization, and Color. RESULTS: Tooth whitening is a dynamic process that involves diffusion of the whitening material to interact with stain molecules and also involves micromorphologic alterations on the surface and changes within the tooth that affect its optical properties. The interaction seems not to be limited to stain molecules, but rather an affinity-based interaction process that also accompanies effects on sound enamel and dentin structures. CONCLUSIONS: This review underlines that supervision by dental health professionals as recommended by the American Dental Association (ADA) Council on Scientific Affairs is critical to achieving a successful and safe whitening outcome. CLINICAL SIGNIFICANCE: The mechanism that underlies tooth whitening with the use of peroxide-based materials is a complex phenomenon encompassing diffusion, interaction, and surfaces changes within the tooth. Therefore, supervision by dental health professionals as recommended by the ADA Council on Scientific Affairs is imperative to achieve a successful and safe whitening outcome.


Assuntos
Clareamento Dental , Humanos
11.
J Esthet Restor Dent ; 27 Suppl 1: S10-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25913537

RESUMO

PURPOSE: There is still controversy as to the efficacy of light activation used in tooth whitening. The purpose of this study was to evaluate the effect of light activation on tooth color change relative to the artificial dye color. MATERIALS AND METHODS: Extracted human third molars (160) were randomly distributed into eight groups of 20 specimens each based on artificial staining and use of light activation. All groups received three 45-minute sessions of in-office whitening at 3-day intervals. Color measurements were performed with an intraoral spectrophotometer at baseline prior to staining (T0), after artificial staining (T1), 1-day--(T2), and 1-week--(T3) post-whitening. Color differences were calculated relative to after artificial staining color parameters (L*1, a*1, b*1) with the use of a software analysis program enabling synchronization of two images. RESULTS: Within the same staining groups, the light-activated samples exhibited a greater color change than their nonlight-activated counterparts. However, only in the case of the yellow-stained samples at 1-day post-whitening was there a significant difference between the nonlight-activated and light-activated groups (Tukey's post hoc multiple comparison test for pairwise comparisons, p < 0.05). CONCLUSIONS: Light activation is a valid method for enhancing the efficacy of tooth whitening with respect to overall color change and works best with yellow stains. CLINICAL SIGNIFICANCE: Light activation is a valid method for enhancing the efficacy of tooth whitening with respect to overall color change and works best with yellow stains.


Assuntos
Cor , Luz , Clareamento Dental , Descoloração de Dente/terapia , Adulto , Feminino , Humanos
12.
J Contemp Dent Pract ; 16(12): 933-8, 2015 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-27018026

RESUMO

AIM: This study aimed to evaluate the repeatability of color measurements of an intraoral spectrophotometer with the use of three different methods by two operators. MATERIALS AND METHODS: A total of 60 teeth were obtained, comprising 30 human maxillary teeth [central incisors (n = 10); canines (n = 10); molars (n = 10)] and 30 artificial teeth [lateral incisors (n = 10); premolar (n = 20)]. Multiple repeated color measurements were obtained from each tooth using three measuring methods by each of the two operators. Five typodonts with alternating artificial and human teeth were made. Measurements were taken by two operators with the Vita EasyShade spectrophotometer using the custom tray (CT), custom jig (CJ) and free hand (FH) method, twice, at an interval of 2 to 7 days. Friedman test was used to detect difference among the three color measuring methods. Post hoc Wilcoxon signed-rank test with Bonferroni correction applied was used for pair-wise comparison of color measurements among the three methods. Additionally, a paired-sample t-test was used to assess a significant difference between the two duplicated measurements made on the same tooth by the same operator for each color parameter and measuring method. RESULTS: For operator A, mean (SD) overall color change-ΔE* (SD) perceived for FH, CT and CJ were 2.21(2.00), 2.39 (1.58) and 2.86 (1.92), respectively. There was statistically significant difference in perceived ΔE* in FH vs CJ (p = 0.0107). However, there were no significant differences between FH and CT (p = 0.2829) or between CT and CJ (p = 0.1159). For operator B mean ΔE* (SD) for FH, CT and CJ were 3.24 (3.46), 1.95 (1.19) and 2.45 (1.56), respectively. There was a significant difference between FH and CT (p = 0.0031). However, there were no statistically significant differences in ΔE* in FH vs CJ (p = 0.3696) or CT vs CJ (p = 0.0809). CONCLUSION: The repeatability of color measurements was different among the three measuring methods by operators. Overall, the CT method worked well for both operators. CLINICAL SIGNIFICANCE: The use of a custom tray with apertures can improve the repeatability of color measurements of an intraoral spectrophotometer.


Assuntos
Pigmentação em Prótese , Espectrofotometria , Cor , Humanos , Dente , Dente Artificial
13.
J Contemp Dent Pract ; 16(11): 921-5, 2015 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-26718302

RESUMO

AIMS: Tooth whitening is a widely utilized esthetic treatment in dentistry. With increased access to over-the-counter (OTC) systems concerns have been raised as to potential adverse effects associated with overuse of whitening materials. Therefore, this study aimed to evaluate enamel erosion due to different whitening regimens when used in excess of recommended guidelines. MATERIALS AND METHODS: Extracted human teeth (n = 66) were randomly divided into 11 groups (n = 6/group). Specimens were exposed to OTC products: Crest Whitestrips and 5-minute natural white and a do-it-yourself (DIY) strawberry whitening recipe. Within each regimen, groups were further divided per exposure time: specimens receiving the recommended product dosage; 5 times the recommended dosage; and 10 times the recommended dosage. Negative and positive controls were treated with grade 3 water and 1.0% citric acid, respectively. Specimens were nail-varnished to limit application to a 1 × 4 mm window. Following treatment, specimens were sectioned and erosion (drop in µm) measured using polarized light microscopy. Two-sample t-test was used to detect difference in amount of enamel erosion between negative and positive groups, while one-way analysis of variance (ANOVA), followed by post hoc Dunnett's test was used to detect difference between set of treatment groups and negative control groups or among all experimental groups. RESULTS: There was significant difference in mean amount of enamel erosion (p < 0.0001). Mean enamel erosion for positive control group was significantly greater than that for negative control group (23.50 vs 2.65 µm). There was significant effect for type of treatments on enamel erosion [F(9,50) = 25.19; p < 0.0001]. There was no significant difference between the negative control and each of treatment groups (p > 0.05 for all instances), except for Natural White_10 times treatment group (p < 0.0001) that was significantly greater than the negative control group (14.82 vs 2.65 µm). CONCLUSION: Caution is advised when using certain over-the-counter products beyond recommended guidelines as there is potential for enamel erosion. CLINICAL SIGNIFICANCE: Enamel erosion due to the overuse of whitening products varies for different modalities and products. Therefore, caution is advised when using certain over-the-counter products beyond recommended guidelines, as there is potential for enamel erosion.


Assuntos
Esmalte Dentário , Microscopia de Polarização , Clareadores Dentários/efeitos adversos , Clareamento Dental , Erosão Dentária/induzido quimicamente , Humanos , Fluoreto de Sódio/uso terapêutico
14.
Odontology ; 103(3): 274-9, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24972882

RESUMO

The purpose of this study was to evaluate the effect of four whitening modalities on surface enamel as assessed with microhardness tester, profilometer, and scanning electron microscopy (SEM). Whitening was performed according to manufacturer's directions for over-the-counter (OTC), dentist dispensed for home use (HW) and in-office (OW) whitening. Do-it-yourself (DIY) whitening consisted of a strawberry and baking soda mix. Additionally, negative and positive controls were used. A total of 120 enamel specimens were used for microhardness testing at baseline and post-whitening. Following microhardness testing specimens were prepared for SEM observations. A total of 120 enamel specimens were used for surface roughness testing at baseline and post-whitening (n = 20 per group). Rank-based Analysis of Covariance was performed to compare microhardness and surface roughness changes. Tests of hypotheses were two-sided with α = 0.05. There was a significant difference in Knoop hardness changes (ΔKHN) among the groups (Kruskal-Wallis test, p < 0.0001). Significant hardness reduction was observed in the positive control and DIY group (p < 0.0001). Mean surface roughness changes (ΔRa) were significantly different among the groups (Kruskal-Wallis test, p < 0.0001). Surface roughness increased in the OTC group (p = 0.03) and in the positive control (p < 0.0001). The four whitening modalities-DIY, OTC, HW and OW induced minimal surface morphology changes when observed with SEM. It can be concluded that none of the four whitening modalities adversely affected enamel surface morphology. However, caution should be advised when using a DIY regimen as it may affect enamel microhardness and an OTC product as it has the potential to increase surface roughness.


Assuntos
Esmalte Dentário/efeitos dos fármacos , Clareadores Dentários/química , Clareamento Dental/métodos , Dureza , Humanos , Técnicas In Vitro , Microscopia Eletrônica de Varredura , Propriedades de Superfície
15.
J Esthet Restor Dent ; 26(5): 353-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25493305

RESUMO

In-office bleaching is an effective method for whitening teeth.Tooth sensitivity associated with in-office whitening is reversible and may range from mild to considerable. The incidence and severity of tooth sensitivity can be reduced by pretreatment with a desensitizer such as potassium nitrate. Histologic studies and clinical studies on long-term pulpal effects are lacking to definitively support the safety of in-office tooth whitening. Future studies on the etiology of tooth sensitivity related to whitening might greatly improve the means of preventing and managing this side effect.


Assuntos
Polpa Dentária/efeitos dos fármacos , Dessensibilizantes Dentinários/administração & dosagem , Sensibilidade da Dentina/prevenção & controle , Peróxido de Hidrogênio/uso terapêutico , Neurotransmissores/análise , Nitratos/administração & dosagem , Oxidantes/uso terapêutico , Satisfação do Paciente , Compostos de Potássio/administração & dosagem , Fluoreto de Sódio/administração & dosagem , Substância P/efeitos dos fármacos , Clareamento Dental/efeitos adversos , Clareamento Dental/métodos , Ureia/análogos & derivados , Humanos
16.
J Dent Educ ; 78(12): 1655-62, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25480281

RESUMO

Conventional grading of dental students' projects in preclinical courses has mainly relied on visual evaluation by experienced instructors. The purpose of this study was to compare conventional visual grading in a dental anatomy course at one U.S. dental school to a novel digital assessment technique. A total of sixty samples comprised of two sets of faculty wax-ups (n=30), student wax-ups (n=15), and dentoform teeth of tooth #14 (n=15) were used for this study. Two additional faculty members visually graded the samples according to a checklist and then repeated the grading after one week. The sample wax-up with the highest score based on the visual grading was selected as the master model for the digital grading, which was also performed twice with an interim period of one week. Descriptive statistics and signed rank tests for systematic bias were used for intra- and interrater comparisons. The intraclass correlation (ICC) was used as a measure of intra- and interrater reliability. None of the faculty members achieved the minimum acceptable intrarater agreement of 0.8. Interrater agreement was substantially less than intrarater agreement for the visual grading, whereas all measures of intrarater agreement were greater than 0.9 and considered excellent for the digital assessment technique. These results suggest that visual grading is limited by modest intrarater reliability and low interrater agreement. Digital grading is a promising evaluation method showing excellent intrarater reliability and correlation. Correlation for visual and digital grading was consistently modest, partly supporting the potential use of digital technology in dental anatomy grading.


Assuntos
Anatomia/educação , Educação em Odontologia , Avaliação Educacional/métodos , Viés , Calibragem , Lista de Checagem , Modelos Dentários , Avaliação Educacional/normas , Tecnologia Educacional , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Lasers , Microcomputadores , Dente Molar/anatomia & histologia , Variações Dependentes do Observador , Reprodutibilidade dos Testes
18.
J Contemp Dent Pract ; 14(6): 1060-4, 2013 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-24858751

RESUMO

AIM: To directly determine the mass of dye retained in teeth following exposure to aqueous solutions of Rhodamine B and to correlate tooth color modifications. MATERIALS AND METHODS: Extracted third molars (25) were selected and sectioned at the cementoenamel junction for coronal staining. Pulp tissue was removed and teeth sonicated to remove debris. Teeth were kept in deionized water for 12 hours and subsequently weighed. They were then stained for 4 hours in 5 ml of Rhodamine B dye at two different concentrations. The samples were then subjected to two 8 hours rinses in deionized water. The tooth shade was recorded with a commercially available intraoral spectrophotometer (Vita Easyshade Compact, Vita Zahnfabrik, Bad Säckingen, Germany) at baseline (T1), after dye immersion (T2), and after water rinsing (T3). A standard absorption curve was then used to calculate the dye mass in the rinse solutions as well as the post- treatment stain solutions. All solution optical absorption curves were recorded using a laboratory research spectrophotometer (Cary 300, Agilent, USA). The mass of dye in each solution was then calculated from the standard curve relating optical absorption to aqueous dye concentration. RESULTS: An average change in the CIE (a) values of 8.0 ± 0.3 were observed for concentrations of Rhodamine B similar to the optical appearance of wine or other darkly colored juices while an increase of 10× in concentration gave values too high to measure using a standard intraoral spectrophotometer. By measuring the optical absorbance of the staining solutions before and after the staining process, we were able to measure dye retention of 54 ± 26 micrograms per gram of tooth. CONCLUSION: While no significant correlation could be found between the amount of stain retention in the dentition and the tooth shade due to the high uncertainties in the spectroscopic measurements, we were able to show that this method should admit such comparisons for future research. CLINICAL SIGNIFICANCE: The development of a reliable chromophore infiltration model may provide standardized and reproducible results in evaluating tooth whitening efficacy.


Assuntos
Corantes Fluorescentes/farmacocinética , Dente Serotino/metabolismo , Rodaminas/farmacocinética , Descoloração de Dente/classificação , Absorção Fisico-Química , Cor , Corantes Fluorescentes/administração & dosagem , Corantes Fluorescentes/química , Humanos , Imersão , Rodaminas/administração & dosagem , Rodaminas/química , Espectrofotometria/instrumentação , Fatores de Tempo , Coroa do Dente/metabolismo , Descoloração de Dente/metabolismo , Água/química
19.
Am J Dent ; 26(6): 356-60, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24640442

RESUMO

PURPOSE: To evaluate the bleaching efficacy and erosion potential of various over-the-counter bleaching products following a test method specified in ISO 28399. METHODS: Specimens were prepared from bovine molars, stained in tea solution, embedded and randomly assigned to six groups of 10 enamel and dentin specimens each. Color was assessed at baseline, 1 day and 1 month post-bleaching with the Vita Bleachedguide 3D Master shade guide. Surface roughness changes (deltaRa), determined by baseline and post-treatment values were measured with a profilometer. The negative (NC) and positive control (PC) was treated with grade 3 water and 1.0% citric acid, respectively. Over-the-counter products were used according to manufacturer's instructions. Brite Teeth Pro (BT), Natural White 5-Minute Whitening (NW), Luster Premium White (LP), and Crest 3D Whitestrips (WS) represented a brush-on-paint system, tray system, light-activated system and adhesive-strip system, respectively. Kruskal-Wallis procedure was used to compare surface roughness changes among groups. Color change was assessed with Friedman-test and stratified by hard tissue type with alpha= 0.05. RESULTS: WS was the only group demonstrating color changes in enamel and dentin (P< 0.05). There were no differences in deltaRa for enamel and dentin among NC, BT, LP, and WS. NW showed increase in deltaRa in dentin (P< 0.05), while PC demonstrated an increase in deltaRa regardless of hard tissue type (P< 0.05).


Assuntos
Clareadores Dentários/uso terapêutico , Clareamento Dental/métodos , Erosão Dentária/etiologia , Animais , Bovinos , Ácido Cítrico/efeitos adversos , Cor , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/patologia , Dentina/efeitos dos fármacos , Dentina/patologia , Peróxido de Hidrogênio/efeitos adversos , Peróxido de Hidrogênio/uso terapêutico , Concentração de Íons de Hidrogênio , Medicamentos sem Prescrição/efeitos adversos , Medicamentos sem Prescrição/uso terapêutico , Distribuição Aleatória , Chá , Fatores de Tempo , Clareamento Dental/efeitos adversos , Clareamento Dental/instrumentação , Clareadores Dentários/efeitos adversos , Descoloração de Dente/tratamento farmacológico
20.
J Dent ; 41 Suppl 3: e39-45, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23261814

RESUMO

OBJECTIVES: To determine the effect of light activation on tooth whitening efficacy and hydrogen peroxide penetration into the pulp cavity and correlate tooth color change with penetration levels. METHODS: Extracted human canines (40) were randomized into four groups, Group A: placebo gel, Group B, placebo gel with light activation, Group C: 40% hydrogen peroxide gel, and Group D: 40% hydrogen peroxide gel with light activation. Treatment was performed three times, at 1-week intervals. Hydrogen peroxide penetration (HPP) was estimated spectrophotometrically and specimen color measured using the Vita Easy Shade Compact at baseline, after whitening, 1-h, 1-day, 1-, 4-, 8-, 12-, 16-, 20-, and 24-week post-whitening. Color change was measured per Commission Internationale de l'Eclairage methodology. ANCOVA was performed to compare color change and HPP level among the four groups. Partial nonparametric correlations between color change and HPP levels were performed with rank transformations. Tests of hypotheses were two-sided with alpha level of 0.05. RESULTS: Greater HPP was observed in Groups C and D compared to Groups A and B (p<0.001). Highest overall color change (ΔE*ab) values after treatment were observed in Group D and remained higher than Groups A-C (p<0.01). Changes in lightness and in the yellow-blue dimension (ΔL* and Δb*) were higher in Groups C and D compared to Groups A and B from post-whitening until 24 weeks (p<0.05). HPP levels were not correlated to color change (p>0.05). CONCLUSIONS: Light activation enhanced whitening efficacy without affecting hydrogen peroxide penetration levels.


Assuntos
Peróxido de Hidrogênio/uso terapêutico , Fototerapia/métodos , Clareadores Dentários/uso terapêutico , Clareamento Dental/métodos , Cor , Dente Canino/efeitos dos fármacos , Cavidade Pulpar/efeitos dos fármacos , Humanos , Umidade , Peróxido de Hidrogênio/farmacocinética , Peróxido de Hidrogênio/efeitos da radiação , Permeabilidade , Placebos , Espectrofotometria/métodos , Temperatura , Fatores de Tempo , Clareadores Dentários/farmacocinética , Clareadores Dentários/efeitos da radiação
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