Dental aesthetic perception of patients submitted to activated charcoal-based bleaching agents: A randomized clinical trial.

OBJECTIVE: To evaluate the effects of activated charcoal-based products used in two presentation forms (powder or toothpaste), compared to 10 % carbamide peroxide and conventional toothpaste on aesthetic perception and psychosocial impact before and after treatment. METHODS: Fifty-six participants were divided into 4 experimental groups (n = 14). Activated charcoal-based powder (PW); Activated charcoal-based dentifrice (AC); Conventional fluoride toothpaste (CD) and 10 % carbamide peroxide (CP). All products were used for 14 days. Psychosocial impact on dental esthetics (PIDAQ), oral health impact profile (OHIP- Esthetics) and orofacial esthetics scale (OES) questionnaires were applied before and after treatment. Descriptive and exploratory data analyses were performed and analyzed using linear mixed models for repeated measures over time considering significance level of α = 0.05. RESULTS: For PIDAQ, the CP group showed significant decrease in psychological impact, aesthetic perception domains and overall score, while in the PW group, there was only a significant decrease in the psychological impact domain. Decrease in OHIP was observed for the functional limitation domain scores for treatments with CP and PW, in the psychological discomfort domain, decrease was observed for all groups, while for the OES questionnaire, significant increase in the color domain was observed for the CP group. CONCLUSION: Activated charcoal-based products showed lower scores in all questionnaires when compared with carbamide peroxide; thus, charcoal-based products promoted lower impact on quality of life and aesthetic perception. CLINICAL RELEVANCE: In this randomized clinical trial, charcoal-based OTC products had inferior quality of life and aesthetic perception results compared to conventional carbamide peroxide bleaching.

Color stability and surface roughness of composite resins submitted to brushing with bleaching toothpastes: An in situ study.

OBJECTIVE: To evaluate, in situ, the color stability (CS) and surface roughness (SR) of composite resins after toothbrushing with whitening toothpaste. MATERIALS AND METHODS: Specimens (6 × 2 mm/) of composite resin (Tetric N-Ceram, Z250 and Z350) were randomly fixed on thirty participants' upper molars (buccal surface). For an initial standardization (7 days), participants used a soft toothbrush and nonwhitening toothpaste (SDB - Sorrisos Dentes Brancos). Initial CS (Easyshade) and SR (Surfcorder RS) measurements were performed. For SR, impressions of specimens were taken (Express, 3 M ESPE) to produce replicas in polyurethane resin (Axon F16, Abcol). Participants were randomly separated into three groups (n = 10) regarding used toothpaste (SDB; Close up White Now - CWN; Colgate Luminous White - CLW). After 90 days, CS and SR measurements were obtained, and data were analyzed (2-way ANOVA, repeated measures, Bonferroni, P < .05). RESULTS: Z250 showed higher (P < .05) color change than Z350. Tetric N-Ceram presented an intermediary value for ΔE, however, it also demonstrated higher SR (P < .05) after brushing with CLW, compared with SDB and CWN. CONCLUSIONS: The SR change of composite resin after toothbrushing with a whitening toothpaste is material dependent, but the toothpaste abrasiveness does not change the CS. CLINICAL SIGNIFICANCE: Whitening toothpaste do not change the color stability of composites; however, it can alter the restorative composite surface roughness.

Whitening toothpaste containing activated charcoal, blue covarine, hydrogen peroxide or microbeads: which one is the most effective?

Abstract The efficacy of whitening toothpastes is questionable and controversial. Clinicians, patients and researchers have expressed concern with whitening toothpastes due to the risk of wearing the dental structure and the potential for disappointment if the advertised cosmetic results are not achieved. Objective: This study compared the whitening performance of toothpastes with different whitening technologies after initial and continued use. Material and Methods: Ninety bovine incisors were stained using a concentrated solution of black tea. They were randomly distributed into 6 groups, according to the toothpaste whitening technology: activated charcoal (B&W), blue covarine (WAD), hydrogen peroxide (LWA), microbeads (Oral B 3D White Perfection - 3DW) and optimized abrasives (XW4D). They were compared to a traditional toothpaste without a whitening agent (TA - control). Specimens underwent a brushing machine with controlled pressure, time and temperature. A calibrated examiner measured the color using a VITA-Classical scale before the first brushing cycle (T0), after the first brushing cycle (TI), and after a brushing cycle that simulates continuous use (TCU). Whitening performance was evaluated by the difference of shades (ΔSGU) between T0-TI and T0-TCU timepoints, using the Kruskal-Wallis and Dunn's non-parametric test. The Wilcoxon test was used to evaluate the cumulative effect (α=0.05). Results: Statistically significant differences were observed between toothpastes in both TI and TCU (p<0.05). The time of use also had a significant effect (p<0.05). Conclusion: Only WAD and 3DW showed whitening performance after the first use (TI). The greatest whitening performance after continuous use was obtained by WAD, followed by LWA and 3DW. The use of conventional toothpaste (TA) promotes no tooth whitening. Clinical relevance: Microbead abrasives (3DW) and blue covarine (WAD) were the active technology tested that presented the best global tooth whitening performance.