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1.
Oper Dent ; 45(3): 265-275, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32396502

RESUMO

OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate a high concentration of hydrogen peroxide (35%) regarding tooth sensitivity and color change in tooth bleaching in comparison to low concentrations (6% to 20%). METHODS AND MATERIALS: This review was conducted using the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and is registered on the Prospective Register of Systematic Reviews (CRD42017064493). The PICO question was "Does a concentration of hydrogen peroxide ≥35% using in-office bleaching procedure contribute to greater tooth sensitivity?" A search was made in PubMed/MEDLINE, Scopus, and the Cochrane Library. RESULTS: Fourteen studies were selected for the qualitative analysis and seven for quantitative analysis. A total of 649 patients were evaluated (mean age: 36.32 years; range: 13.9 to 31 years), and the follow-up period ranged from one week to 12 months. The meta-analysis demonstrated that tooth sensitivity was higher in the patients submitted to treatment involving a high concentration of hydrogen peroxide (0.67; 95% confidence interval [CI]: 0.44 to 1.03; p=0.04; I 2 : 56%), and a significant difference was found regarding objective color ΔE (1.53; 95% CI: 2.99 to 0.08; p<0.0001; I 2 : 82%) but no significant difference was found regarding subjective color ΔSGU (0.24; CI: 0.75 to 1.23; p<0.00001; I 2 : 89%). CONCLUSIONS: This study indicated that a lower concentration of hydrogen peroxide causes less tooth sensitivity and better effectiveness in objective color change (ΔE); however, there is no difference between them related to subjective color (ΔSGU).


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Pré-Escolar , Cor , Humanos , Peróxido de Hidrogênio , Lactente , Resultado do Tratamento
2.
J Appl Oral Sci ; 28: e20190720, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32428059

RESUMO

Objective This study evaluated the clinical effect of violet LED light on in-office bleaching used alone or combined with 37% carbamide peroxide (CP) or 35% hydrogen peroxide (HP). Methodology A total of 100 patients were divided into five groups (n=20): LED, LED/CP, CP, LED/HP and HP. Colorimetric evaluation was performed using a spectrophotometer (ΔE, ΔL, Δa, Δb) and a visual shade guide (ΔSGU). Calcium (Ca)/phosphorous (P) ratio was quantified in the enamel microbiopsies. Measurements were performed at baseline (T 0 ), after bleaching (T B ) and in the 14-day follow-up (T 14 ). At each bleaching session, a visual scale determined the absolute risk (AR) and intensity of tooth sensitivity (TS). Data were evaluated by one-way (ΔE, Δa, ΔL, Δb), two-way repeated measures ANOVA (Ca/P ratio), and Tukey post-hoc tests. ΔSGU and TS were evaluated by Kruskal-Wallis and Mann-Whitney, and AR by Chi-Squared tests (a=5%). Results LED produced the lowest ΔE (p<0.05), but LED/HP promoted greater ΔE, ΔSGU and Δb (T 14 ) than HP (p<0.05). No differences were observed in ΔE and ΔSGU for LED/CP and HP groups (p>0.05). ΔL and Δa were not influenced by LED activation. After bleaching, LED/CP exhibited greater Δb than CP (p>0.05), but no differences were found between these groups at T 14 (p>0.05). LED treatment promoted the lowest risk of TS (16%), while HP promoted the highest (94.4%) (p<0.05). No statistical differences of risk of TS were found for CP (44%), LED/CP (61%) and LED/HP (88%) groups (p>0.05). No differences were found in enamel Ca/P ratio among treatments, regardless of evaluation times. Conclusions Violet LED alone produced the lowest bleaching effect, but enhanced HP bleaching results. Patients treated with LED/CP reached the same efficacy of HP, with reduced risk and intensity of tooth sensitivity and none of the bleaching protocols adversely affected enamel mineral content.


Assuntos
Peróxido de Carbamida/administração & dosagem , Peróxido de Hidrogênio/administração & dosagem , Luz , Fototerapia/métodos , Clareadores Dentários/administração & dosagem , Clareamento Dental/métodos , Adolescente , Adulto , Análise de Variância , Colorimetria , Terapia Combinada , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/efeitos da radiação , Sensibilidade da Dentina/induzido quimicamente , Feminino , Humanos , Masculino , Valores de Referência , Fatores de Risco , Espectrofotometria , Estatísticas não Paramétricas , Propriedades de Superfície/efeitos dos fármacos , Propriedades de Superfície/efeitos da radiação , Resultado do Tratamento , Adulto Jovem
3.
J Appl Oral Sci ; 28: e20190163, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32236351

RESUMO

OBJECTIVE: This in vitro study evaluated the effect of commercial whitening dentifrices on erosive tooth wear (ETW) of bovine enamel samples, in comparison with commercial regular dentifrices. METHODOLOGY: Sixty bovine crowns were embedded in acrylic resin, polished and then had their baseline profile determined. They were randomly assigned to 5 groups (n=12/group), according to the type of commercial dentifrice to be tested: GI - Crest Anti-cavity Regular; GII - Crest 3D White; GIII - Colgate Total 12 Clean Mint; GIV - Colgate Optic White; GV - Placebo (negative control, fluoride-free dentifrice). The samples were submitted to daily erosive and abrasive challenges for 3 days. The erosive challenges were performed 3 times a day by immersing the specimens in 0.1% citric acid solution (pH 2.5) for 90 s. Each day after the first and last erosive challenges, the specimens were subjected to the abrasive challenge for 15 s, using a toothbrushing machine (Biopdi, São Carlos, SP, Brazil), soft toothbrushes and slurry (1:3 g/ml) of the tested toothpastes (1.5 N). The specimens were kept in artificial saliva between the challenges. The final profile was obtained and the ETW (µm) was calculated. Data were analyzed by Kruskal-Wallis and Dunn's tests (p<0.05). RESULTS: All dentifrices tested significantly reduced the enamel wear in comparison with the Placebo, except GIII. The median (95% CI) ETW was 1.35 (1.25-1.46)bc for GI, 1.17 (1.01-1.34)cd for GII, 1.36 (1.28-1.45)ab for GIII, 1.08 (1.04-1.14)d for GIV and 2.28 (2.18-2.39)a for GV. CONCLUSION: When dentifrices from the same manufacturer were compared, the whitening dentifrices led to similar or less wear than the regular ones.


Assuntos
Esmalte Dentário/efeitos dos fármacos , Clareadores Dentários/efeitos adversos , Erosão Dentária/induzido quimicamente , Cremes Dentais/efeitos adversos , Animais , Bovinos , Esmalte Dentário/química , Teste de Materiais , Estatísticas não Paramétricas , Propriedades de Superfície , Fatores de Tempo , Clareadores Dentários/química , Escovação Dentária/efeitos adversos , Cremes Dentais/química
4.
Am J Dent ; 33(2): 79-82, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32259412

RESUMO

PURPOSE: To evaluate the bleaching efficacy of laser application with chemical treatment compared to chemical treatment alone. METHODS: This was a randomized controlled trial (RCT), single blind (evaluator), in 24 patients randomized into two groups: Laser and chemical intervention (12) or chemical intervention alone without laser (12). The commercial products used were Whiteness HP 35% hydrogen peroxide gel and the Whitening Laser II of DCM equipment. The color was measured with a spectrophotometer before, immediately and 3 days after the bleaching procedure. The trial outcome measures were obtained using the Vita EasyShade spectrophotometer and the International CIELCh system. To establish differences before vs. after treatments and between groups, the T test and chi² tests were applied. The data was statistically analyzed with Student's T-test (P ≤ 0.05). RESULTS: After applying the delta formula to measure the change in color, both groups gave clinically significant results before vs. after bleaching procedures ( P ≤ 0.05). The deltas for luminosity, chroma, and hue all showed significant improvements for baseline to 15 minutes post treatment (P ≤ 0.05), baseline to 3 days post treatment (P ≤ 0.05), but not for 15 minutes to 3 days post treatment (P ≥ 0.05). When comparing between groups applying T-test, no statistically significant differences were found (P ≥ 0.05) for all three deltas. When comparing sensitivity after bleaching, no differences were found between groups (P ≥ 0.05). CLINICAL SIGNIFICANCE: The use of laser during bleaching treatment did not improve the results compared to not using laser.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Cor , Humanos , Peróxido de Hidrogênio , Resultado do Tratamento
5.
Am J Dent ; 33(2): 89-94, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32259414

RESUMO

PURPOSE: This crossover study evaluated the hydrogen (HP) and carbamide (CP) peroxide degradation of bleaching gels in prefilled (PT) and customized trays (CT). METHODS: Volunteers were randomly allocated to treatments (n=10) : PT-HP/OGO (Opalescence GO-10%); CT-HP/WTC (White Class-10%) or CT-CP/OPF (Opalescence PF-10%). Gel samples were collected from the upper and lower trays in each period (baseline, 15, 30, 50 and 120 minutes). HP concentration was determined with the potassium permanganate titration method. Degradation was calculated based on initial concentration of gels. Repeated measures two-way ANOVA and Tukey's test (5%) were applied. RESULTS: Bleaching gels exhibited exponential degradation over time. In 30 minutes, no significant differences in degradation among them were detected (P= 0.13). After 2 hours, lower degradation of CT-CP/OPF (61.85±10.65), compared with hydrogen peroxide in PT and CT (71.55±8.24 and 78.69±9.33, respectively) was observed. The gels showed higher degradation rate in lower trays than in upper trays in all evaluated times. In general, the bleaching gels in lower trays degraded more than in upper trays. The carbamide peroxide gel presented lower degradation than hydrogen peroxide after 2 hours. The degradation of the 10% hydrogen peroxide gel used in prefilled trays was higher than the one in customized trays after 30 minutes, but after 120 minutes, the degradation rate was similar for both. CLINICAL SIGNIFICANCE: Bleaching gels degraded faster in lower arches than in upper arches. The degradation process was faster in the first 15 minutes of use and depended on the gel's composition, time of use, and tray position in the dental arches.


Assuntos
Clareadores Dentários , Clareamento Dental , Estudos Cross-Over , Humanos , Peróxido de Hidrogênio , Peróxidos , Ureia
6.
Stomatologiia (Mosk) ; 99(1): 7-11, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32125295

RESUMO

PURPOSE: To determine the effect of whitening toothpastes on the color of a nanocomposite material using a spectrophotometer. MATERIAL AND METHODS: The study involved 50 samples from nanocomposite restoration material which were exposed under laboratory conditions to brushing with one of 4 types of toothpastes (control with no bleaching agents, peroxide paste with carbamide, abrasive and enzyme-based pastes). Using the parameters a, b and L obtained by spectrophotometry, delta E (ΔE) value was calculated. To determine the maximum and minimum A posteriori comparisons by the Scheffe method were used to influence the delta E parameter after exposure to the pastes. Oxygen-containing paste (OZPP) had a maximum effect on the increase of the ΔE parameter, ΔE=1.03 comparing to ΔE=0.20 in control toothpaste. The isolated effect of a toothbrush resulted in a large change in the parameter ΔE, compared to the effect of a controls. However, the ΔE does not indicate the clarification of the material, but only a change in color relative to the initial measurement. As a result of spectrophotometry and statistical data processing, it was found that all pastes had a sufficient effect on the color change for the device to determine, but this change was not noticeable to the human eye.


Assuntos
Nanocompostos , Clareadores Dentários , Clareamento Dental , Humanos , Espectrofotometria , Cremes Dentais
7.
Quintessence Int ; 51(5): 364-371, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32159531

RESUMO

The most commonly used bleaching agents contain different concentrations of hydrogen peroxide and carbamide peroxide. In the present case, the bleaching procedure was performed using an induced field of cold atmospheric plasma, obtained from dielectric barrier discharge. The therapeutic effect of the device used in the clinical procedure is based on floating electrode dielectric barrier discharge, in which the glass electrode functions as the primary electrode, while the therapeutic area, which in this case is the tooth, represents the secondary electrode. A periodontal (PA) probe is a glass tube filled with a noble gas, which generates an electrical discharge in the gap between the tip of the electrode surface and the therapeutic area, thus producing reactive oxygen species. Bleaching with only the cold atmospheric plasma bleaching technique, without any conventional bleaching agents, was performed successfully for an endodontically treated tooth. The cold atmospheric plasma bleaching technique, which could be a novel approach for the bleaching of non-vital teeth, provides good clinical results and is safe for clinical use.


Assuntos
Gases em Plasma , Clareadores Dentários , Clareamento Dental , Dente não Vital , Peróxido de Carbamida , Humanos , Peróxido de Hidrogênio , Peróxidos , Ureia
8.
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
9.
Int J Esthet Dent ; 15(1): 44-54, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31994535

RESUMO

OBJECTIVE: The present study was undertaken to determine the tooth whitening effectiveness of trays with no reservoirs (Invisalign aligners or Vivera retainers used as bleaching trays), initially with a finite element analysis (FEA) and subsequently with a clinical study using spectrophotometry. MATERIALS AND METHODS: The FEA technique was used to determine the ideal distribution of bleaching gel between teeth and aligners in vitro. Three sample areas of gel application on the maxillary central incisors (the incisal edge, the middle part, and the gingival edge) were analyzed. Spectrophotometry was used to ascertain the clinical effectiveness of the bleaching gel as it related to the results of the FEA. More specifically, the chromatic variation obtained by the bleaching gel on teeth 41 and 32 (control teeth, with reservoirs) was compared with that on teeth 31 and 42 (study teeth, without reservoirs). RESULTS: The FEA results showed that the optimal gel distribution is reached when 2 mm3 of gel is applied to the center of the vestibular face of the tooth in the tray. As regards the clinical study, there were no relevant differences of whitening effectiveness between the teeth with reservoirs and those without. In both cases, the whitening was effective and the patients were completely satisfied with the results. CONCLUSIONS: The advantages for patients to receive dental bleaching during orthodontic treatment with aligners are evident. The procedure is not time consuming and requires less financial expense. Further clinical studies are required to assess the effectiveness of the procedure.


Assuntos
Clareadores Dentários , Clareamento Dental , Peróxido de Carbamida , Humanos , Peróxido de Hidrogênio , Peróxidos , Resultado do Tratamento , Ureia
10.
Oper Dent ; 45(1): E1-E10, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31891544

RESUMO

OBJECTIVES: This study aimed to evaluate the desensitizing effect of a prefilled disposable tray containing potassium nitrate and fluoride on the self-reported tooth sensitivity (TS) and the bleaching efficacy of 40% hydrogen peroxide bleaching agent used for in-office bleaching in comparison with potassium nitrate and fluoride gel applied in a conventional-delivered tray system in an equivalence clinical trial. METHODS AND MATERIALS: Seventy-eight patients, with a right maxillary canine darker than A3, were selected for this single-blind (evaluators), randomized clinical trial. Teeth were bleached in two sessions with a one-week interval in between. Before in-office bleaching, the prefilled disposable tray or conventional tray containing potassium nitrate and fluoride was used for 15 minutes. Subsequently, the bleaching agent was applied in two 20-minute applications (per the manufacturer's directions) in each session. The color change was evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easyshade Advance Spectrophotometer) methods at baseline and 30 days after the first bleaching session. TS was recorded for up to 48 hours using a 0-10 visual analog scale. The absolute risk was evaluated by chi-square test, while the intensity of TS was evaluated by McNemar test (α=0.05). Color change in shade guide units and ΔE was analyzed by Student t-test for independent samples (α=0.05). RESULTS: Significant whitening was observed in both groups after 30 days of clinical evaluation. The use of different methods of desensitizer in a tray did not influence the absolute risk and intensity of TS (p>0.05), although a tendency of lower risk of TS with the prefilled disposable tray containing potassium nitrate and fluoride was observed. CONCLUSION: The use of a prefilled disposable tray containing potassium nitrate and fluoride before the application of the in-office bleaching product did not affect the whitening degree and decreased self-reported TS when compared with a conventional-delivered tray system.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Humanos , Peróxido de Hidrogênio , Método Simples-Cego , Resultado do Tratamento
11.
Clin Oral Investig ; 24(1): 385-394, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31104111

RESUMO

OBJECTIVES: This randomized triple-blind clinical trial, split-mouth design, evaluated the application effect of the desensitizing gel before and after in-office bleaching on tooth sensitivity. MATERIALS AND METHODS: In one group, the desensitizing gel was applied for 10 min before the bleaching with 35% hydrogen peroxide, and then application of placebo gel after (n = 90). In the other group, the desensitizing gel was applied before and after the bleaching procedure for 10 min (n = 90). The primary outcome was pain intensity assessed with a numeric rating scale and a visual analog scale. Color was evaluated by means of a digital spectrophotometer and a shade guides. RESULTS: The proportion of patients that experienced pain in the side of before application was 90% (95% CI 82 to 94.6%), while the side of before and after was 93% (95% CI 86.2 to 96.9%), without significant difference between groups (OR = 0.25; 95% CI 0.005 to 2.52; p = 0.37). Pain was correlated in both groups, for the NRS scale (p < 0.0001) and the VAS scale (p < 0.0001) in all assessment periods. Significant whitening was detected, and no significant difference of color change was observed between groups (p > 0.45). CONCLUSIONS: The application of the desensitizing agent did not influence the effectiveness of bleaching, but it was not efficient in reducing the sensitivity, when applied before the procedure, or before and after. CLINICAL RELEVANCE: The use of a desensitizing gel before or after in-office bleaching does not reduce incidence or intensity of tooth sensitivity.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Sensibilidade da Dentina/etiologia , Sensibilidade da Dentina/prevenção & controle , Feminino , Humanos , Peróxido de Hidrogênio , Clareamento Dental/efeitos adversos , Resultado do Tratamento
12.
Odontology ; 108(1): 143-151, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31289971

RESUMO

The purpose of this paper is to investigate which elements of tooth colour are most influenced by whitening and to identify the short-term changes in satisfaction with smile aesthetics and quality of life induced by tooth whitening and the role of global self-esteem. Sixty participants were randomly assigned to a treated or a placebo group (each group N = 30). Their anterior teeth were bleached with a photo-activated whitening gel, or subjected to a placebo. Lightness, chroma and the translucency of teeth were assessed before and 1 week after the procedure using a spectrophotometer. The Self-Esteem Scale, Psychosocial Impact of Dental Aesthetics Questionnaire, the Orofacial Aesthetic Scale and the Oral Health Impact Profile were administered to subjects. Changes in colour and chroma were greater in the treated than the placebo group (3.8 ± 1.5 vs. 1.7 ± 1.5 and - 3.2 ± 1.5 vs. 0.0 ± 1.1; p < 0.001). The treated group reported increased satisfaction with appearance and a decrease in psychological and social impacts (p < 0.05). In the placebo group there was no objective change in colour but the subjects reported an increase in satisfaction and dental self-confidence, as well as a decrease in psychological impact (p < 0.05). Self-esteem did not have a moderation nor a mediation effect. In conclusion, patients are not able to accurately detect the colour change induced by tooth whitening after 1 week, but they are also largely suggestible when evaluating the changes in quality of life. Changes in quality of life induced by tooth whitening are not influenced by global self-esteem.ClinicalTrials.gov Identifier NCT03380702.


Assuntos
Clareadores Dentários , Clareamento Dental , Método Duplo-Cego , Estética Dentária , Humanos , Peróxido de Hidrogênio , Qualidade de Vida
13.
Braz Dent J ; 30(5): 498-504, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31664303

RESUMO

This clinical trial evaluated the effect of preemptive use of the non-steroidal anti-inflammatory drug piroxicam in a single dose 30 min prior to in-office bleaching on the prevention of tooth sensitivity (TS) reported by patients. Fifty patients were submitted to two sessions of in-office tooth bleaching with 35% hydrogen peroxide used for 2 sessions, each consisting of a single 45-min application, with an interval of 7 days between session. Thirty minutes prior to the procedure, the patient randomly received a single dose of piroxicam (200 mg) or placebo in a double-blind, randomized, crossover design. The TS was evaluated using verbal rate (VRS) and visual analog (VAS) scales during the bleaching procedure and at 24 h after each session. The color changes were assessed by the Vita Bleachedguide scale 1 week after each bleaching session. Risk of TS was calculated from the VRS and analyzed by the McNemar test, while the level of TS was analyzed by the Mann-Whitney test. For the VAS, t-tests were used to compare data from the treatments at each assessment time. Data regarding color changes were subjected to Wilcoxon and Mann-Whitney tests (α=0.05). The preemptive administration of piroxicam did not affect the risk and level of TS compared to placebo, irrespective of the assessment time. The treatment sequence did not affect bleaching effectiveness. In conclusion, the administration of a single dose of piroxicam prior to in-office tooth bleaching was unable to significantly reduce the risk and level of TS.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Método Duplo-Cego , Humanos , Peróxido de Hidrogênio , Piroxicam
14.
J Am Dent Assoc ; 150(10): e145-e157, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31561766

RESUMO

BACKGROUND: The authors' aim was to evaluate the effectiveness of anti-inflammatory drugs on tooth sensitivity (TS) during and after in-office dental bleaching procedures. TYPES OF STUDIES REVIEWED: The authors selected randomized controlled trials in which the investigators compared anti-inflammatory drugs with a placebo to evaluate in-office dental bleaching TS. The authors performed an electronic search by using PubMed, ScienceDirect, and Embase. In addition, the authors searched other Web sites, such as ClinicalTrials.gov, to identify ongoing studies. RESULTS: The authors included 7 randomized controlled trials (324 adults) in the review. According to the extracted data, the authors performed the meta-analysis by using risk ratios and their 95% confidence intervals or by using the mean difference with a 95% confidence interval. The authors used the Cochrane Collaboration's tool to assess study quality. After the evaluation, the authors considered 6 studies to be high quality and a single study to be low quality. The overall results of the evaluation process revealed the absence of a clinically significant effect of anti-inflammatory drugs. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The results of this analytic process indicated that anti-inflammatory drugs have no clinically significant effect on the TS that occurs due to in-office bleaching. Readers must analyze these results carefully given the limitations of this review, such as the small samples size and the heterogeneity among the studies in some stages of the evaluation process. The results of this analytical study highlight the need for more clinical studies to reach a significant conclusion because TS is one of the most important reasons for the cessation of bleaching treatment.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Dente , Adulto , Anti-Inflamatórios , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
15.
Indian J Dent Res ; 30(3): 393-398, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31397414

RESUMO

Background: The objectives were to evaluate the effect of surface treatments and waiting time before contact with dye on bleached enamel staining and surface treatments on roughness. Methods: One hundred bleached teeth were randomly assigned to G1 artificial saliva, G2 2% sodium fluoride (Flugel, Nova DFL), G3 casein phosphopeptide-amorphous calcium phosphate fluoride paste (MI Paste Plus, GC America), G4 rinse for bleached color maintenance (Keep White Rinse, DMC), and G5 polishing with impregnated disks (SuperBuff Disk, Shofu). Fifty specimens were immersed in coffee immediately after treatment; the others 1 h after. Color difference (ΔE) was evaluated with a spectrophotometer (Vita EasyShade) and roughness (Ra, Rq) with an optical profilometer (NewView 7300). Effects were analyzed with two-way ANOVA, Friedman, and Kruskal-Wallis test (P < 0.05). Results: Surface treatments (P = 0.878), waiting time (P = 0.105), and interaction (P = 0.145) were not significant to bleached color maintenance. Roughness was different among the evaluation time points (2nd evaluation >1st evaluation >3rd evaluation) (P < 0.001); not among surface treatments (G1, G2, G3, G4, G5) (P > 0.05). Conclusions: Surface treatments were similar to saliva for bleached enamel color maintenance. Immediate or 1-h postponed contact with coffee did not affect bleached enamel color. Bleaching increased enamel roughness; surface treatments and artificial saliva decreased it.


Assuntos
Clareadores Dentários , Clareamento Dental , Esmalte Dentário , Saliva Artificial , Coloração e Rotulagem
16.
Clin Oral Investig ; 23(10): 3673-3689, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31468261

RESUMO

OBJECTIVES: A systematic review and meta-analysis were performed to answer this research question: "Does combined in-office (IO) and at-home (AH) bleaching produce improved color change and lower tooth sensitivity (TS) better than solely AH or IO bleaching in adults?" MATERIAL AND METHODS: Randomized controlled trials in adults that compared combined versus sole application bleaching were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. Meta-analyses were conducted for color change in shade guide units (∆SGU) and with a spectrophotometer (∆E*), risk, and intensity of TS, using the random effects model. Heterogeneity was assessed with Cochran's Q test and I2 statistics. GRADE assessed the quality of the evidence. PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, SIGLE, IADR abstracts, unpublished, ongoing trial registries, dissertations, and theses were searched on August 28, 2017 (updated on January 29, 2019). RESULTS: Twelve studies remained. Two were considered to have low RoB. For combined vs. IO bleaching, no significant difference for ∆E*, ∆SGU, and risk of TS were observed; data were not available to analyze the intensity of TS. For combined vs. AH bleaching, no significant difference for ∆E*, ∆SGU, but lower TS to risk (RR 1.40, 95% 1.10 to 1.80) and intensity (MD 1.40, 95% CI 0.18 to 2.63) were detected for AH bleaching. Quality of evidence was graded as low or very low in all meta-analyses. CONCLUSION: Lower risk and intensity of TS was observed for the solely AH group without jeopardizing color change. However, more studies are still encouraged due to the low quality of evidence for most of the outcomes. CLINICAL RELEVANCE: If clinicians are to choose between combined or sole AH bleaching, the solely AH may be preferable; combined bleaching may potentiate the risk of TS without benefits in color change. For combined or sole IO bleaching, no important clinical difference in color change and risk of TS were detected; however, intensity of TS could not be compared due to lack of data. Further studies should be conducted due to the low/very low quality of the evidence.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Dente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
Dent Mater J ; 38(5): 790-797, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31434830

RESUMO

The aim of this in vitro study was to evaluate the effects of desensitizer pre-treatment on in-office bleaching using an artificial discoloration tooth model. The stained specimens were divided into four groups (n=10); without application (Control group), Shield Force plus (SF group), UltraEz (UE group) and Teeth Mate AP paste (TM group) applied before bleaching. Each group was bleached by an in-office bleaching agent. The CIE L*a*b* values were measured by a colorimeter before and after ten consecutive bleaching treatments and the color difference (∆E) was calculated. There was no statistical difference among ∆E values of Control, UE, and TM groups (p>0.05). There was a significant difference between SF and Control groups (p<0.001). It was concluded that application of TM and UE did not affect the change of tooth shade while SF application impeded the bleaching effect.


Assuntos
Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Dente , Cor , Humanos , Peróxido de Hidrogênio
18.
J Appl Oral Sci ; 27: e20180453, 2019 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-31411261

RESUMO

OBJECTIVE: This study was designed for the chemical activation of a 35% hydrogen peroxide (H2O2) bleaching gel to increase its whitening effectiveness and reduce its toxicity. METHODOLOGY: First, the bleaching gel - associated or not with ferrous sulfate (FS), manganese chloride (MC), peroxidase (PR), or catalase (CT) - was applied (3x 15 min) to enamel/dentin discs adapted to artificial pulp chambers. Then, odontoblast-like MDPC-23 cells were exposed for 1 h to the extracts (culture medium + components released from the product), for the assessment of viability (MTT assay) and oxidative stress (H2DCFDA). Residual H2O2 and bleaching effectiveness (DE) were also evaluated. Data were analyzed with one-way ANOVA complemented with Tukey's test (n=8. p<0.05). RESULTS: All chemically activated groups minimized MDPC-23 oxidative stress generation; however, significantly higher cell viability was detected for MC, PR, and CT than for plain 35% H2O2 gel. Nevertheless, FS, MC, PR, and CT reduced the amount of residual H2O2 and increased bleaching effectiveness. CONCLUSION: Chemical activation of 35% H2O2 gel with MC, PR, and CT minimized residual H2O2 and pulp cell toxicity; but PR duplicated the whitening potential of the bleaching gel after a single 45-minute session.


Assuntos
Peróxido de Hidrogênio/química , Peróxido de Hidrogênio/toxicidade , Clareadores Dentários/química , Clareadores Dentários/toxicidade , Clareamento Dental/métodos , Análise de Variância , Catalase/química , Sobrevivência Celular , Células Cultivadas , Cloretos/química , Cor , Polpa Dentária/química , Polpa Dentária/diagnóstico por imagem , Dentina/química , Dentina/efeitos dos fármacos , Compostos Ferrosos/química , Compostos de Manganês/química , Odontoblastos/efeitos dos fármacos , Peroxidase/química , Valores de Referência , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de Tempo
19.
J Am Dent Assoc ; 150(10): 818-829.e4, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31446977

RESUMO

BACKGROUND: In-office dental bleaching results in a high risk of tooth sensitivity caused by the inflammatory process of the pulpal tissue. In this systematic review, the authors aimed to evaluate the effect of administering anti-inflammatory and analgesic drugs for the prevention of tooth sensitivity associated with in-office dental bleaching. TYPES OF STUDIES REVIEWED: The authors searched the databases MEDLINE via PubMed, Scopus, Web of Science, and Cochrane Library for clinical trials. They searched in ClinicalTrials.gov for unpublished trials. The authors included only randomized clinical trials comparing anti-inflammatory and analgesic drugs with a placebo and evaluating tooth sensitivity after in-office bleaching. They imposed no restrictions regarding publication dates or languages. RESULTS: The authors identified 5,050 studies after the removal of duplicates. They qualitatively and quantitatively analyzed the 11 studies remaining after the title and abstract screening. Nine studies showed a low risk of bias. The authors found no effect of the drugs on the risk (9 studies evaluated this outcome). Using a visual analog scale, the authors identified a similar level of sensitivity evaluated up to 1 hour (10 studies evaluated this outcome) and 24 hours (8 studies evaluated this outcome). They observed similar results using the numeric rate scale (8 and 6 studies used this tool, up to 1 hour and 24 hours respectively). The Grading of Recommendations Assessment, Development, and Evaluation approach showed a high level of evidence for all outcomes. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The high level of evidence available does not support the administration of anti-inflammatory and analgesic drugs to prevent tooth sensitivity caused by in-office dental bleaching.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Analgésicos , Anti-Inflamatórios , Humanos
20.
J Esthet Restor Dent ; 31(5): 431-440, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31448534

RESUMO

OBJECTIVE: The aim is to review the most important aspects about tooth whitening treatments, their side effects, and the new emerging approaches to overcome them. OVERVIEW: This review is focused on origin of tooth stains, the whitening systems and their chemistry, their side effects, and the new approaches. The search of bibliography of the period 1965-2018 has been analyzed. CONCLUSIONS: Tooth whitening has become one of the most requested dental treatments by the public. Tooth stains are classified according to their origin into two categories: intrinsic and extrinsic. The whitening systems are generally organized into two classes: in-office and at-home products. Most of the whitening systems use hydrogen peroxide as the active oxidative agent to degrade the organic compounds that cause stains. The concentration ranges depending on the treatment, and it may be applied directly or produced in a chemical reaction from carbamide peroxide that is more stable. Besides its popularity, tooth whitening still has some side effects being tooth hypersensitivity the most common. In order to decrease these side effects, new treatments are constantly in renewal processes. CLINICAL SIGNIFICANCE: Despite all the data and new strategies known about tooth whitening, there are many aspects that are not totally fully understood and methodologies that are not completely effective. Therefore, the development of effective, efficient, and long-lasting whitening treatments is still necessary.


Assuntos
Clareadores Dentários , Clareamento Dental , Combinação de Medicamentos , Peróxido de Hidrogênio , Peróxidos , Ureia
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