Tooth color change and tolerability evaluation of a hydrogen peroxide whitening strip compared to a strip, paste, and rinse regimen containing plant-based oils and Dead Sea salt.

PURPOSE: To assess tooth color changes and tolerability with use of a hydrogen peroxide whitening strip compared to a regimen of a strip, rinse and paste for tooth whitening. METHODS: This was a single-center, parallel-group, double-blind, randomized controlled clinical trial. Qualified generally healthy adult participants were assigned to one of two treatment groups. The test group included peroxide-free strips, a fluoride-free whitening toothpaste, and a whitening mouthwash (all Lumineux Oral Essentials); all test products contain plant-based oils (coconut, sage, and lemon peel) and Dead Sea salt. The control group included hydrogen peroxide whitening strips (Crest 3DWhitestrips Classic White) and a sodium fluoride non-whitening toothpaste (Crest). Both groups used a soft manual toothbrush (Oral-B). Strips (for both groups) and rinse (for test group) were used once daily. Changes in tooth color were assessed objectively and quantitatively by digital image analysis after 7, 10 and 14 treatments. RESULTS: 50 participants were enrolled and randomized to treatment and 48 completed the trial. Participants had an average age of 40.8 years (range 18 to 62 years) and 64% were female. At the end of treatment, the test group did not provide statistically significant changes in yellowness (b*) or lightness (L*) from baseline (P≥ 0.411), whereas the control group demonstrated a statistically significant mean yellowness reduction (SD) of 1.55 (0.703) and a mean lightness improvement (SD) of 1.57 (1.141) compared to baseline (P< 0.001 for both). The control group also provided statistically significantly greater mean yellowness reductions and mean lightness improvements compared to the test group at all time points (P< 0.002). Products in both groups were well tolerated, with minor oral irritation and tooth sensitivity representing the most common findings during treatment. CLINICAL SIGNIFICANCE: The Crest Whitestrips control whitening strip provided significant tooth whitening efficacy, whereas the Lumineux Oral Essentials test regimen containing plant-based oils and Dead Sea salt did not. This evidence is important for dental professionals to consider when making recommendations for patients seeking at-home whitening treatments.

Management of Multifactorial Stained Enamel Defects on Anterior Dentition Using a Combination Treatment of Whitening, Microabrasion, Resin Infiltration and Resin-based Composite Restoration.

OBJECTIVES: This case report describes a combination treatment composed of tooth whitening, microabrasion, resin infiltration, and resin-based composite restoration to manage multifactorial stained enamel lesions on anterior teeth. CLINICAL CONSIDERATIONS: The patient's primary concern was to improve the esthetics of their smile after about a decade of extensive orthodontic and orthognathic procedures. After clinical evaluation and history taking, the authors determined that the enamel defects were the result of carious and developmental factors. In-office tooth whitening took place in one visit, followed by micro abrasion and resin infiltration in another visit. Thirteen months later, a follow-up visit showed that the results were stable and that the patient was satisfied with the overall outcome. A small resin composite restoration was added at the follow up visit to repair a previous restoration and to reestablish the facial contours of the central incisor. CONCLUSIONS: A combination treatment protocol composed of tooth whitening, microabrasion, and resin infiltration can improve patient satisfaction and avoid unnecessary invasive treatment.

Microabrasion in the management of enamel discolorations in paediatric dentistry: a systematic review.

Structural abnormalities of the anterior teeth could be aesthetically compromising in young patients. The dentist must provide solutions while preserving dental tissue. Microabrasion approach can be a solution. We conducted a systematic literature review to evaluate whether microbrasion treatment in paediatric dentistry can improve aesthetic in cases of pre- or post-eruptive discolorations on tooth enamel. 741 articles published up to September 2021 were selected from 3 databases using the key word "microabrasion". 11 prospective studies including 6 randomized were relevant to the inclusion criteria. Microabrasion appears to be an effective and reliable technique for the management of pre and post enamel discoloration in paediatric dentistry, especially in fluorosis. More high-powered, well-conducted randomized studies with complete evaluation criteria are needed for other types of spots. Standardization of criteria for assessing treatment success and of the protocol required should be explored.

Management of Discolored Anterior Teeth with Pulp Canal Obliteration.

The purpose of this article is to present the effect and follow-up results of combined single-tooth vital bleaching when discoloration is due to pulp canal obliteration. In these cases, discoloration was managed successfully via home bleaching with a customized single-tooth tray and in-office bleaching without root canal treatment.

Enamel Developmental Defect Masking on Central Incisor with Infiltrant Resin.

The aim of this paper is to present a case of masking of a hypoplastic lesion using the infiltrating resin technique, without use of drilling or any loss of tooth structure. A 22-year-old female patient complained of a noncarious white spot on the buccal surface of the upper right central incisor which affected the esthetics of her smile. Despite the tooth discoloration, the tooth structure was intact, with no depressions, cracks, or grooves. During the anamnesis, she reported that the white spot had been present since childhood. On the basis of the information provided by the patient and collected during intraoral clinical examination, it was determined that the stain was suggestive of enamel hypoplasia. The treatment proposed to the patient was the application of infiltrating resin to mask the hypoplasia on the surface of the tooth enamel without any loss of tooth structure. In this case, Icon infiltrating resin proved to be efficient in masking the hypoplastic lesion. The final appearance of the treated tooth was satisfactory, with homogeneity and gloss on the surface, which minimized the characteristics of an unpleasant smile.

Fast Cross-Linked Hydrogel as a Green Light-Activated Photocatalyst for Localized Biofilm Disruption and Brush-Free Tooth Whitening.

Biofilm-driven caries and tooth discoloration are two major problems in oral health care. The current methods have the disadvantages of insufficient biofilm targeting and irreversible enamel damage. Herein, an injectable sodium alginate hydrogel membrane doped with bismuth oxychloride (Bi12O17Cl2) and cubic cuprous oxide (Cu2O) nanoparticles was designed to simultaneously achieve local tooth whitening and biofilm removal through a photodynamic dental therapy process. This fast cross-linked hydrogel could form a biofilm removal coating on the target tooth surface precisely. Afterward, reactive oxygen species was effectively released on demand under green light, which could not only eradicate the biofilm but also whiten the tooth non-destructively in a facile manner without significant damage to both the enamel and biological cells. After the usage, the removal of this hydrogel can also enhance the effect of biofilm destruction and caries prevention.

Newer Technique of Extra-Coronal Bleaching with Sodium Perborate on Non-Pitted Fluorosis Stains in Permanent Anterior Teeth.

Variety of treatment approaches have been proposed for esthetic management of dental fluorosis. Microabrasion, bleaching using hydrogen peroxide, and etch bleach seal are commonly used methods. Bleaching using sodium perborate has been used for intracoronal bleaching. Till now, no study has used sodium perborate for extracoronal bleaching of discolored stained teeth. OBJECTIVES: To evaluate the esthetic improvement of non-pitted fluorosis stains using sodium perborate and compare with etch bleach seal, microabrasion and in-office bleaching with 30% H2O2 on visual assessment scale VAS (primary objective) and to assess any untoward effects including staining, sensitivity, gingival problems within the course of study (secondary objectives). STUDY DESIGN: A randomized control trial with 6 months follow up. Methodology- Twenty children aged 8 to 12 years with non-pitted fluorosis in upper anterior teeth were divided into 4 groups with 5 patients in each group. RESULTS AND DISCUSSION: All of the techniques showed improvement in esthetics with VAS. However, microabrasion and bleaching using sodium perborate had significantly better results than other 2 techniques. CONCLUSION: Sodium perborate showed excellent results in extracoronal bleaching of fluorosed teeth. However a randomized study with large sample size is required to draw a definitive conclusion regarding superiority of one technique over others.

Clinical efficacy of a novel radiofrequency toothbrush for tooth stain reduction and tooth whitening: A randomized controlled trial.

BACKGROUND: The authors aimed to evaluate the effect of a novel radiofrequency (RF) toothbrush on tooth stains and shades compared with a sonic vibrating toothbrush (CVS Health SmileSonic Pro Advanced Clean Sonic Toothbrush, Ranir) that earned the American Dental Association Seal of Acceptance. METHODS: The authors conducted a single-blind prospective study over 6 weeks. Participants were randomized to 1 of 2 study groups to receive either an RF toothbrush (ToothWave, Home Skinovations [test]) or a sonic vibrating toothbrush (SmileSonic powered toothbrush, Ranir [control]) and performed twice-daily toothbrushing with fluoridated toothpaste (Crest Cavity Protection, Procter & Gamble) for 6 weeks. Tooth stains and shades were assessed using the Lobene Stain Index and VITA Bleachedguide 3D-MASTER shade guide (VITA North America) at baseline and after 4 and 6 weeks of toothbrushing. In addition, the VITA Easyshade Advance 4.0 spectrophotometer (VITA North America) was used for shade evaluation. Safety was evaluated by means of oral soft-tissue examinations at each visit. Percentage reduction from baseline was compared between the groups. Statistical analyses were conducted using Mann-Whitney nonparametric model. RESULTS: Eighty-six participants (43 in each group) completed the study with fully evaluable data. At baseline, the groups did not differ significantly in mean measurement scores. Percentage reductions of the measured scores were significantly greater (more extrinsic stain removal and whitening) in the test group than in the control group (P < .001). Both toothbrushes were well-tolerated, and no device-related adverse events were reported during the study. CONCLUSIONS: The RF toothbrush produced substantial benefits in the reduction of tooth stains and whitening of tooth shade compared with a powered toothbrush (CVS Health SmileSonic Pro Advanced Clean Sonic Toothbrush, Ranir) that earned the American Dental Association Seal of Acceptance. PRACTICAL IMPLICATIONS: The novel RF toothbrush is a safe and effective tool for stain removal and tooth whitening and can serve as an alternative to other whitening agents. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT03885609.

The Thickness and Opacity of Aesthetic Materials Influence the Restoration of Discolored Teeth.

OBJECTIVES: This study aimed to evaluate the influence of thickness and opacity on the ability of composite resin and ceramic veneer restorations to mask discolored teeth. METHODS: Ninety veneers were made of lithium disilicate ceramic, shades BL1 and 0 (IPS e.max Press, Ivoclar Vivadent), and 60 were made of composite resin, shade BL-L (IPS Empress Direct, Ivoclar Vivadent). The veneers measured 4 mm in width x 4 mm in length and had a thickness of 0.7, 1.0, or 1.2 mm. One hundred and fifty human premolars were selected to obtain 150 dental fragments with the following dimensions: 4 mm x 4 mm x 3 mm (width x length x thickness). The fragments were discolored, submitted to color measurement and randomly assigned to 15 groups (n=10) according to the type and opacity of the restorative material (IPS e.max Press: high translucency [HT], low translucency [LT], and medium opacity [MO]; IPS Empress Direct: dentin and enamel) and thickness of the veneers (0.7, 1.0, and 1.2 mm). After cementation of the ceramic or composite resin veneers using a translucent resin cement (RelyX veneer, 3M), a final color measurement was taken from each specimen and the total color variation (ΔE) was calculated by subtracting the initial and the final color measurement. The final lightness (L*) of the restored dental fragments was also calculated. RESULTS: The highest ΔE values were observed for the LT and MO ceramic groups, followed by dentin composite resin. Regarding the different thicknesses of ceramic veneers, every 1.2-mm-thick group had higher values of ΔE, considering their respective opacities (p<0.05). The highest lightness values were found for the LT and MO ceramic veneers (thickness of 1.2 mm). Dentin-shade composite resins showed similar lightness values in all groups. CONCLUSION: The best thickness/opacity combinations for masking discolored dental substrates were LT and MO ceramic veneers with 1.2-mm thickness. Dentin-shade composite resin veneers with a thickness of 0.7-1.0 mm showed good ability to mask discolored dental substrates.

Clinical evaluation of a novel radiofrequency-based toothbrush for teeth whitening and reduction of teeth stains: A pilot study.

OBJECTIVES: To evaluate the effect of a novel radiofrequency (RF)-utilizing toothbrush on reduction of stains and improvement of teeth shade. MATERIALS AND METHODS: This was an open label, prospective study, including six clinical visits that were conducted over a period of 8 weeks. Subjects performed twice daily brushing using a novel RF-utilizing toothbrush, used manually with no mechanical vibration. Teeth shade and stains were assessed using Vita Easyshade advanced 4.0 device and a visual assessment of standardized digital photographs, before, and following 4 and 8 weeks of treatment. RESULTS: Twelve subjects completed the study with fully evaluable data. A notable shade improvement (whitening) was observed between the visits according to the average scores of teeth whitening index per subject. Statistical analysis conducted by the unstructured mix model confirmed a significant reduction in the average score of whitening index between baseline and visit 5 (p < 0.001) as well as between baseline and visit 6 (p < 0.001). No significant difference was found between the average teeth shade in visit 5 as compared to visit 6 (p = 0.918). No significant difference was found in teeth shade between females and males; however, subjects age was significantly correlated with teeth shade (p < 0.001). Digital photographs indicated a notable reduction in visible dark stains. The toothbrush was well tolerated and no device-related adverse events were reported during the study. CONCLUSIONS: The novel RF-utilizing toothbrush produced significant benefits relating to teeth whitening and stains reduction, following one and 8 weeks of brushing.

Efectividad de la terapia láser combinada con la técnica convencional en pacientes con discromías dentales / Effectiveness of laser therapy combined with the conventional technique in patients with dental dischromya

Introducción: La discromía dental es una afectación estética, de causa multifactorial, caracterizada por el cambio de coloración de uno o varios dientes. Objetivo: Evaluar la efectividad de la terapia láser como fuente de luz y calor en pacientes con discromías dentales. Método: Se realizó un estudio cuasi experimental, de intervención terapéutica, en 24 pacientes con discromías dentales atendidos en la Clínica Estomatológica Provincial DocenteMártires del Moncada de Santiago de Cuba, desde julio de 2017 hasta julio de 2018. Los integrantes del estudio se asignaron de forma aleatoria a 2 grupos de tratamiento:a los pares (grupo de estudio) se les aplicó láser combinado con la técnica convencional de peróxido de hidrógeno;a los impares (grupo control), tratamiento convencional solamente.Se utilizaron las frecuencias absoluta y relativa como medidas de resumen, así como la prueba de X 2 de homogeneidad para la validación estadística, con un nivel de significación de 0,05. Resultados: Para los pacientes del grupo de estudio, la segunda y tercera sesiones fueron más efectivas. Al culminar el tratamiento, ambos resultaron efectivos, pero los que recibieron láser evolucionaron más rápidamente que los tratados solo con peróxido de hidrógeno. Conclusiones: El uso de la terapia láser y peróxido de hidrógeno fue efectivo en pacientes con discromías dentales y demostró que no provoca efectos adversos en los dientes tratados.

Introduction: The dental dischromya is an esthetic disorder, of multifactorial cause, characterized by the change of coloration of one or several teeth. Objective: To evaluate the effectiveness of laser therapy as a source of light and heat in patients with dental dischromya. Method: A quasi-experiment, of therapeutic intervention study, was carried out in 24 patients with dental dischromya assisted in Mártires del Moncada Teaching Provincial Stomatological Clinic in Santiago de Cuba, from July, 2017 to March, 2018. The members of the study were assigned at random with 2 treatment groups: a study group (pairs) to whom laser combined with the conventional technique of peroxide of hydrogen was applied; to odd number patients (control group), conventional treatment only. The absolute and relative frequencies were used as summary measures, as well as the chi-square test of homogeneity for the statistical validation, with a level of significance of 0.05. Results: For the patients of the study group, the second and third sessions were more effective. When culminating the treatment, both were effective, but those that received laser evolved more quickly than those treated with peroxide of hydrogen. Conclusions: The use of the laser therapy and peroxide of hydrogen was effective in patients with dental dischromya and it was demonstrated that doesn't cause adverse effects in the treated teeth.

Clinical Performance of Enamel Microabrasion for Esthetic Management of Stained Dental Fluorosis Teeth.

CLINICAL RELEVANCE: Enamel microabrasion is an effective first-line esthetic treatment for the removal of tooth stains due to fluorosis, with an improvement in the appearance of teeth that is associated with a high level of patient acceptance.

Microabrasión del esmalte. Indicaciones, limitaciones y alcance clínico / Enamel micro-abrasion. Indications, limitations and clinical scope

Existen muchas patologías pigmentarias que alteran la estética del color dentario; algunas de ellas pueden circunscribirse a la superficie externa del esmalte y por ende ser tratadas con una técnica microabrasiva para su eliminación. La indicación de un tratamiento más agresivo en relación al blanqueamiento convencional, dependerá no solo de la ubicación de la lesión, sino también de la severidad de la misma, de la calidad de la estructura del tejido adamantino y de la anatomía dentaria entre muchas otras variables (AU)

ere are many pigment pathologies that alter the aesthetics of tooth color; Some of them can be confined to the outer surface of the enamel and therefore be treated with a microabrasive technique for their removal. e indication of a more aggressive treatment in relation to conventional whitening will depend not only on the location of the lesion, but also on its severity, the quality of the structure of the adamantine tissue and the dental anatomy among many other variables (AU)

[Study of masking ability of laminate veneers for discolored teeth].

OBJECTIVE: To select the most effective method among different masking treatments, such as different thickness and transparence, tissue surface's opaque coating, and opaque resin cement to restore discolored teeth esthetically by porcelain veneer. METHODS: Four extracted intact maxillary central incisors were prepared for porcelain veneer restoration and each three heat pressed porcelain veneers from three thicknesses (0.8 mm, 1.0 mm, 1.2 mm) and two transparency(high transparence, HT and low transparence, LT))in Vita shade A2 were fabricated for each tooth, in total of 72 pieces. The surfaces of three prepared teeth were then painted to mimic situations of severe dental fluorosis, severe tetracycline teeth, and necrotic teeth. Each of the veneers was temporarily cemented to the corresponding tooth surface using try-in cements with three different colors (transparent, opaque, and yellow), then used the shade guide (3D master) and electronic colorimeter (easy shade) to record the shade of each porcelain veneer through hue, lightness, and chroma reading. After that, high-transparence porcelain veneers in thickness of 0.8 mm was fused with a layer of opaque porcelain in tissue surface, and were shade matched again after cementation. Statistic treatments were performed to analyze the difference in each masking method. RESULTS: For each 0.2 mm increase in the veneer thickness of porcelain, the average lightness was reduced by 1 unit, while the chroma was not changed which was independent of the type of the resin cements. When the thickness of the porcelain veneer was decreased to 0.8 mm, the opacity effect was not remarkable even if a low-transparence porcelain veneer was used. Transparent and yellow resin cements had poor opaque performance, while opaque resin cement could reduce the lightness by 2 units and the chroma was also reduced. The opaque layer of the tissue surface could be applied uniformly, and the lightness and chroma could be reduced to Vita 2M1 to 2M1.5 levels regardless of the color of resin cements, which suggested a stable opacity effect for different discolored teeth in this study. CONCLUSION: For porcelain veneer restoration of discolored teeth, thickened veneers are the most effective means to display a natural transmittance and color. Tissue surface's opacity coatings and opaque resin cements can also be used to reduce grayscale and increase lightness.

Conservative esthetic management of severe dental fluorosis with in-office power bleaching.

Fluorosis is an endemic disease, prevailing in about 25 countries globally. Dental fluorosis is an acquired defect of enamel due to the exposure of an individual to excessive fluoride levels during tooth development. It could result in mild-to-severe discoloration of teeth, which might necessitate esthetic correction. Bleaching is one of the common treatment modalities used in the esthetic correction of such cases. In-office power bleaching is one of the techniques of tooth bleaching that involves clinical application and activation of the bleaching agent with light to accelerate the bleaching process. This case report describes the esthetic correction of severe dental fluorosis by power bleaching, without any need for invasive treatment. This report suggests that in-office power bleaching is an effective and conservative method for esthetic correction of tooth discoloration in severe dental fluorosis.

Résumé La fluorose est une maladie endémique, qui prévaut dans environ 25 pays dans le monde. La fluorose dentaire est un défaut acquis des l'émail dû à l'exposition d'un individu à des niveaux excessifs de fluor pendant de développement des dents. Cela pourrait aboutir à une décoloration légère à sévère des dents, qui nécessite une correction esthétique. Le blanchiment est l'une des modalités de traitement courantes utilisées dans la correction esthétique de ces cas. "In-office power" le blanchiment est l'une des techniques de blanchiment des dents qui implique l'application clinique et l'activation de l'agent de blanchiment avec de la lumière pour accélérer le processus de blanchiment. Ce rapport de cas décrit la correction esthétique de la fluorose dentaire sévère par blanchiment "power", sans aucun besoin pour d'un traitement invasif. Ce rapport suggère que le blanchiment "In-office power" est une méthode efficace et conservatrice pour la correction esthétique de la décoloration dentaire dans la fluorose dentaire sévère.

Conservative esthetic management of post orthodontic treatment discolored tooth with calcified canal: a case report.

A case of pulp canal obliteration (PCO) two years after the completion of orthodontic treatment is presented. Post orthodontic treatment PCO is a rare finding. A 23 years old female presented with the discoloration of clinical crown of maxillary right central incisor. Radiographic examination revealed the calcified canal and diffused periapical radiolucency. Vitality tests were negative. A decision was made to do root canal treatment followed by the walking bleaching. After the successful completion of the root canal treatment the internal bleaching was performed. The discolored tooth showed significant improvement in color. Internal bleaching is a viable conservative treatment for improving esthetics in single non vital discolored tooth.

Study of masking ability of laminate veneers for discolored teeth / 北京大学学报(医学版)

OBJECTIVE@#To select the most effective method among different masking treatments, such as different thickness and transparence, tissue surface's opaque coating, and opaque resin cement to restore discolored teeth esthetically by porcelain veneer.@*METHODS@#Four extracted intact maxillary central incisors were prepared for porcelain veneer restoration and each three heat pressed porcelain veneers from three thicknesses (0.8 mm, 1.0 mm, 1.2 mm) and two transparency(high transparence, HT and low transparence, LT))in Vita shade A2 were fabricated for each tooth, in total of 72 pieces. The surfaces of three prepared teeth were then painted to mimic situations of severe dental fluorosis, severe tetracycline teeth, and necrotic teeth. Each of the veneers was temporarily cemented to the corresponding tooth surface using try-in cements with three different colors (transparent, opaque, and yellow), then used the shade guide (3D master) and electronic colorimeter (easy shade) to record the shade of each porcelain veneer through hue, lightness, and chroma reading. After that, high-transparence porcelain veneers in thickness of 0.8 mm was fused with a layer of opaque porcelain in tissue surface, and were shade matched again after cementation. Statistic treatments were performed to analyze the difference in each masking method.@*RESULTS@#For each 0.2 mm increase in the veneer thickness of porcelain, the average lightness was reduced by 1 unit, while the chroma was not changed which was independent of the type of the resin cements. When the thickness of the porcelain veneer was decreased to 0.8 mm, the opacity effect was not remarkable even if a low-transparence porcelain veneer was used. Transparent and yellow resin cements had poor opaque performance, while opaque resin cement could reduce the lightness by 2 units and the chroma was also reduced. The opaque layer of the tissue surface could be applied uniformly, and the lightness and chroma could be reduced to Vita 2M1 to 2M1.5 levels regardless of the color of resin cements, which suggested a stable opacity effect for different discolored teeth in this study.@*CONCLUSION@#For porcelain veneer restoration of discolored teeth, thickened veneers are the most effective means to display a natural transmittance and color. Tissue surface's opacity coatings and opaque resin cements can also be used to reduce grayscale and increase lightness.

Effect of pH conditioners on tooth bleaching.

The purpose of this study was to evaluate the effect of pH conditioners on tooth bleaching using hematoporphirin-stained paper and artificially discolored bovine tooth model. Experimental bleaching gels containing 23% hydrogen peroxide, adjusting pH 7.0 by different pH conditioners (NaOH, NaHCO3, Na2CO3, KOH, KHCO3, and K2CO3), were prepared. Each bleaching gel was applied on a hematoporphirin-stained paper, and the light was exposed for 5 min. Before and after bleaching, color was measured and color difference was calculated. Artificially discolored bovine tooth samples were prepared and bleached by four experimental bleaching gels containing NaOH, NaHCO3, Na2CO3, or KHCO3. The bleaching time was 10 min with light exposure, and bleaching was repeated 10 times. The color of bleached surface was measured at each bleaching period, and color difference was calculated. In the experiment using hematoporphirin-stained paper, degrees of color difference were KHCO3 > NaHCO3 > KOH > NaOH > Na2CO3 ≥ K2CO3. In the experiment using bovine teeth, degrees of color difference were KHCO3 > NaHCO3 > NaOH > Na2CO3. It was concluded that the bleaching materials with same pH and different pH conditioners showed different bleaching effects and that both cation and anion in the pH conditioners affected bleaching effect.

Influence of ultrasonic agitation on bond strength, marginal adaptation, and tooth discoloration provided by three coronary barrier endodontic materials.

OBJECTIVES: The effect of ultrasonic agitation (UA) on bond strength and adaptation of cervical plugs prepared with MTA Angelus (MTA), MTA Repair HP (MTAHP), and Biodentine (BIO) was evaluated. Dentin discoloration caused by the materials/treatment was also assessed. MATERIALS AND METHODS: Seventy-two single rooted teeth were divided into six groups depending on the materials/treatment. After cervical plug preparation, dentin discs were excised for the push-out test; additional discs were analyzed under the confocal microscope to determine adaptation (gaps occurrence). For dentin discoloration analysis (ΔE), blocks of bovine incisors had cavities prepared and filled with the materials/treatment (from 7 to 180 days). RESULTS: Both bond strength and adaptation were positively influenced by UA (P < 0.05). Comparison between materials showed an advantage for BIO when compared to MTAHP (P < 0.05). The best and worst results were provided by BIO/UA (12.66 MPa and 1.87%) and MTAHP (2.54 MPa and 28.58%), respectively. For ΔE, significant differences were observed throughout the periods. Just the MTA without UA exhibited noticeable discoloration at 180 days (P < 0.05). CONCLUSIONS: UA favored a better adaptation of the materials to the dentin root, resulting in higher bond strength and adaptation of the materials to the root canal walls. Moreover, UA reduced MTA discoloration, keeping it imperceptible over the period evaluated. CLINICAL RELEVANCE: The better adaptation and higher bond strength provided by UA can be considered clinically relevant due to the importance of maintaining blood clot integrity and the possible esthetic compromise provided by reparative materials when used as coronary barrier in regenerative procedures.

Odontología estética mínimamente invasiva / Minimally invasive esthetic dentistry

La odontología de mínima invasión se ha convertido en la filosofía de tratamiento dental más aceptada en la actualidad. La posibilidad de incorporarla se ha debido en gran medida a la aparición de nuevos materiales dentales que se adhieren a la estructura dental, a técnicas más conservadoras de estructura dental sana y sobre todo a una nueva forma de pensar tanto de clínicos como de los mismos pacientes. La odontología estética contemporánea se ha visto infl uenciada por este nuevo paradigma. El tratamiento de pigmentaciones dentales también se ha visto benefi ciado por esta nueva tendencia y nuevos materiales han aparecido recientemente que conservan la mayor cantidad de tejido dental sano sin necesidad de preparaciones no conservadoras. Lo más importante al incorporar estas nuevas tecnologías es la realización de un diagnóstico adecuado entendiendo la causa que origina esta condición y así poder implementar el mejor tratamiento posible (AU)

Minimally invasive dentistry has become the standard of care most widely accepted today. This trend has been posible in great extent to the advent of new dental materials that adhere to dental structure, more conservative techniques of healthy dental tissue but mainly from clinicians and patients with a new way of thinking. Contemporary esthetic dentistry has been influenced by this new paradigm. Treatment of dental stainings has also been infl uenced by this new trend and new materials have recently surfaced that keep healthy dental tissue without the need of non conservative preparations. The most important aspect in order to incorporate this new technologies is a correct diagnosis understanding the cause that originated this condition in order to implement the best posible treatment (AU)