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1.
Braz Oral Res ; 35: e113, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34816901

RESUMO

The ultrastructural and mechanical properties of enamel surface were evaluated after prolonged bleaching treatments with 10% carbamide peroxide in the presence or absence of orange juice (erosive challenge) and toothbrushing (abrasive challenge). In total, 145 incisor bovine teeth were used in this study. Twenty-five samples were prepared for the ultrastructural evaluations, and 120 samples were prepared for microhardness and roughness tests. These 120 samples were divided into eight experimental groups (n = 15): G1- artificial saliva; G2- abrasion; G3- erosion; G4- dental bleaching; G5- erosion + abrasion; G6- bleaching + abrasion; G7- bleaching + erosion; and G8- bleaching + erosion + abrasion. All groups were tested at T0 (before treatment), T1 (14 days), T2 (21 days), and T3 (28 days). Two-way analysis of variance for repeated measures and the post hoc Sidak tests (p ≤ 0.05) were used. The roughness evaluation demonstrated an increase in damage for all experimental groups with an increase in the time period. For microhardness, the groups exposed to artificial saliva (AS) and abrasive challenge did not show any differences at any time points, while the other groups showed a decrease in microhardness from T0 to T3. Ultrastructural evaluation showed different surface alterations in response to the treatments. Despite prolonged bleaching periods, the procedure caused lesser enamel surface alterations than exposure to orange juice alone or in combination with brushing.


Assuntos
Clareamento Dental , Animais , Peróxido de Carbamida , Bovinos , Esmalte Dentário , Hábitos , Clareamento Dental/efeitos adversos , Escovação Dentária
2.
Am J Dent ; 34(5): 281-285, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34689453

RESUMO

PURPOSE: To evaluate the bleaching sensitivity and the bleaching effectiveness of in-office bleaching, following a protocol of complete cervical third protection with gingival dam in comparison with a traditional manner of applying gingival dam (used only in the gingival sulcus area). METHODS: 35 participants were selected for this double-blind split-mouth randomized clinical trial. The control group received the gingival barrier in the traditional manner, and in the experimental group the barrier was extended by about 3 mm to include the cervical region. The bleaching agent was applied in two sessions. The risk and intensity of bleaching sensitivity were assessed using two scales. The bleaching effectiveness was evaluated with a digital spectrophotometer with the tip placed in the cervical area. The absolute risk of bleaching sensitivity was compared by the McNemar's test and bleaching effectiveness (ΔEab, ΔE00 and ΔWi) and intensity of bleaching sensitivity was evaluated by Wilcoxon-paired test (α= 0.05). RESULTS: No significant difference at risk (P= 1.0) and intensity of bleaching sensitivity (P> 0.45) was seen between groups. After 30 days, bleaching effectiveness had no statistical difference between the groups (P> 0.09). CLINICAL SIGNIFICANCE: Extending the barrier in the cervical region of teeth did not reduce the risk and intensity of bleaching sensitivity, nor jeopardize the bleaching effectiveness.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Sensibilidade da Dentina/prevenção & controle , Humanos , Peróxido de Hidrogênio , Boca , Ensaios Clínicos Controlados Aleatórios como Assunto , Clareamento Dental/efeitos adversos , Clareadores Dentários/efeitos adversos , Resultado do Tratamento
3.
Sci Rep ; 11(1): 17418, 2021 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-34465829

RESUMO

Hyperalgesia has become a major problem restricting the clinical application of tooth bleaching. We hypothesized that transient receptor potential ankyrin 1 (TRPA1), a pain conduction tunnel, plays a role in tooth hyperalgesia and inflammation after bleaching. Dental pulp stem cells were seeded on the dentin side of the disc, which was cut from the premolar buccal tissue, with 15% (90 min) or 40% (3 × 15 min) bleaching gel applied on the enamel side, and treated with or without a TRPA1 inhibitor. The bleaching gel stimulated intracellular reactive oxygen species, Ca2+, ATP, and extracellular ATP in a dose-dependent manner, and increased the mRNA and protein levels of hyperalgesia (TRPA1 and PANX1) and inflammation (TNFα and IL6) factors. This increment was adversely affected by TRPA1 inhibitor. In animal study, the protein levels of TRPA1 (P = 0.0006), PANX1 (P < 0.0001), and proliferation factors [PCNA (P < 0.0001) and Caspase 3 (P = 0.0066)] increased significantly after treated rat incisors with 15% and 40% bleaching gels as detected by immunohistochemistry. These results show that TRPA1 plays a critical role in sensitivity and inflammation after tooth bleaching, providing a solid foundation for further research on reducing the complications of tooth bleaching.


Assuntos
Polpa Dentária/patologia , Hiperalgesia/patologia , Inflamação/patologia , Espécies Reativas de Oxigênio/metabolismo , Células-Tronco/patologia , Clareadores Dentários/efeitos adversos , Clareamento Dental/efeitos adversos , Animais , Cálcio/metabolismo , Polpa Dentária/efeitos dos fármacos , Polpa Dentária/metabolismo , Géis/efeitos adversos , Hiperalgesia/induzido quimicamente , Hiperalgesia/metabolismo , Inflamação/induzido quimicamente , Inflamação/metabolismo , Ratos , Ratos Sprague-Dawley , Células-Tronco/efeitos dos fármacos , Células-Tronco/metabolismo , Fator de Necrose Tumoral alfa/metabolismo
4.
Sci Rep ; 11(1): 13177, 2021 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-34162984

RESUMO

This systematic review assessed the effectiveness of ozone (O3) in the color change of in-office tooth bleaching in vital teeth (TB) and the sensitivity control. Only randomized controlled clinical trials were included. Seven databases were used as primary search sources, and three additional sources were searched to capture the "grey literature" partially. The JBI tool was used to assess the risk of bias. TB was assessed using the ΔELab color change metric comparing tooth color pre- and post-bleaching. We meta-analyzed the ΔELab estimates per method and calculated the absolute standardized mean difference using random-effect models. The GRADE approach assessed the certainty of the evidence. The ΔELab estimates ranged from 1.28 when the O3 was used alone to 6.93 when combined with hydrogen peroxide (HP). Two studies compared O3 and HP alone, but their TB was similar (SMD = - 0.02; 95%CI: - 0.54; 0.49). The bleaching effectiveness for the combination of O3 + HP compared to HP was similar (SMD = 0.38; 95%CI: - 0.04; 0.81). Thus, based on the available literature, our findings suggest that O3 is not superior to the conventional technique using HP on the change of tooth color. The O3 did not present sensitivity when used alone. When O3 was used in combination with HP, patients reported hypersensitivity only when O3 was applied before HP, i.e., no sensitivity was perceived when O3 was applied after HP.


Assuntos
Sensibilidade da Dentina/induzido quimicamente , Ozônio/farmacologia , Clareadores Dentários/farmacologia , Clareamento Dental/métodos , Colorimetria , Interações Medicamentosas , Humanos , Peróxido de Hidrogênio/administração & dosagem , Peróxido de Hidrogênio/efeitos adversos , Peróxido de Hidrogênio/farmacologia , Ozônio/administração & dosagem , Ozônio/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Clareamento Dental/efeitos adversos , Clareadores Dentários/administração & dosagem , Clareadores Dentários/efeitos adversos
5.
Eur Arch Paediatr Dent ; 22(4): 759-763, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33666898

RESUMO

PURPOSE: The aim of this study was to determine whether carbamide peroxide is effective in bleaching vital permanent teeth in children. METHODS: A literature search was conducted using all keywords relevant to the research subject. The outcome measures were identified as colour change, tooth sensitivity, oral irritation and patient satisfaction. The certainty of evidence for each outcome was assessed using the current GRADE guidelines. RESULTS: Of 115 potentially relevant articles, 112 were excluded, as they did not exclusively involve children, intervention involved additional treatment such as microabrasion or restorative work, or case studies. Patient satisfaction was not assessed in the three articles so no analysis could be made with regards to this outcome. The GRADE assessment showed that all of the three articles demonstrated very low certainty of evidence for the other assessed outcomes. The overall findings from the studies suggest that a 10% carbamide peroxide overnight tray system is effective at bleaching vital permanent teeth in children and associated tooth sensitivity and oral irritation are found to be in a similar range compared to those reported in adult studies. However, due to the very low certainty of the evidence, it is not possible to draw these conclusions. CONCLUSION: Better quality randomised controlled trials are needed to investigate the indication, short and long term effectiveness and side effects of carbamide teeth in vital permanent teeth in children.


Assuntos
Sensibilidade da Dentina , Clareamento Dental , Adolescente , Adulto , Peróxido de Carbamida , Criança , Sensibilidade da Dentina/induzido quimicamente , Combinação de Medicamentos , Europa (Continente) , Humanos , Peróxidos/efeitos adversos , Clareamento Dental/efeitos adversos
6.
Quintessence Int ; 52(7): 596-605, 2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-33749220

RESUMO

OBJECTIVE: Bleaching sensitivity (BS) is the most common adverse effect of tooth bleaching treatments. This study evaluated the effect of adding 1% sodium hexametaphosphate (SHMP) on BS and the whitening effectiveness of a bleaching gel. METHOD AND MATERIALS: Two maxillary quadrants from 26 patients were randomly assigned to the experimental and control groups in a split-mouth design. In the control group the at-home bleaching gel containing 3% hydrogen peroxide, and in the experimental quadrant the same gel with 1% SHMP, were applied in individual trays for 6 hours per night for 2 weeks. The patients' sensitivity to cold and touch as well as spontaneous sensitivity were recorded based on a visual analog scale (VAS). Changes in shade guide units (ΔSGU) and ΔE were measured using a spectrophotometer. Data were analyzed using the Kolmogorov-Smirnov, Mann-Whitney U, Wilcoxon signed-rank test, and independent sample t test. RESULTS: Twenty-four patients completed the study. After 2 weeks, the sensitivity to cold and touch was significantly lower in the intervention group compared to the control (P = .015 and P = .039, respectively). The spontaneous sensitivity revealed no significant alteration between these two groups and during the bleaching period in each group (P > .050). Regarding both color measurements, the bleaching effectiveness in both groups was comparable, with no noticeable difference (P > .050). CONCLUSION: The application of 1% SHMP was able to reduce the BS with no detrimental effect on the at-home bleaching effectiveness. (Quintessence Int 2021;52:596-605; doi: 10.3290/j.qi.b1098303).


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Sensibilidade da Dentina/induzido quimicamente , Sensibilidade da Dentina/prevenção & controle , Humanos , Peróxido de Hidrogênio , Fosfatos , Clareamento Dental/efeitos adversos , Clareadores Dentários/efeitos adversos , Resultado do Tratamento
7.
Photobiomodul Photomed Laser Surg ; 39(6): 403-410, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33567218

RESUMO

Objective: This in vivo study compared two bleaching techniques with regard to the degree of tooth sensitivity (TS), color change, and treatment stability for a 6-month follow-up period. Materials and methods: Sixty volunteers were selected according to inclusion and exclusion criteria and submitted to in-office bleaching. For group 1, we performed one bleaching session with a 35% hydrogen peroxide gel and a second bleaching session after 7 days; for group 2, we performed two bleaching sessions with two applications per session, each session with a 7-day interval, using a light-emitting diodes (LEDs) device emitting violet light (405-410 nm) without employing peroxide-containing bleaching gel. TS was recorded immediately before and immediately after each bleaching session using the Variance Analogic Scale. The color of upper central incisors and upper canines at baseline was recorded immediately after each bleaching session, after 15, 30, and 180 days, with a value-oriented shade guide used by two well-trained observers. Results: The two whitening protocols results were similar regarding the immediate effectiveness and 6-month stability of tooth whitening. Dental bleaching with violet LED did not promote postoperative pain sensitivity at any of the evaluated times. However, dental bleaching performed with 35% hydrogen peroxide promoted higher postoperative pain sensitivity. Conclusions: The violet light alone provided dental bleaching and had the clinical advantage of promoting less immediate postoperative sensitivity; however, an unwanted repigmentation occurred after dental bleaching with light alone.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Sensibilidade da Dentina/induzido quimicamente , Seguimentos , Humanos , Peróxido de Hidrogênio/efeitos adversos , Clareamento Dental/efeitos adversos , Clareadores Dentários/efeitos adversos
8.
Evid Based Dent ; 21(4): 130-131, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33339972

RESUMO

Data sources The authors searched Medline via PubMed, Scopus, Web of Science, the Cochrane Library and ClinicalTrials.gov for published and unpublished clinical trials. Only randomised clinical trials, with either a parallel or crossover design, reporting the tooth sensitivity of participants undergoing in-office dental bleaching and comparing pain frequency and severity with oral premedication of a non-steroidal or other anti-inflammatory drug compared with a placebo were used in the review. Studies that evaluated the topical administration of drugs or desensitising agents were not reviewed.Study selection In total,5,050 randomised clinical studies were screened and 11 studies were included in the various meta-analyses. Nine studies examined the effect of pre-emptive analgesics on the risk of sensitivity and ten studies evaluated the effect of drugs on the severity of sensitivity; seven of these studies were assessed as having a low risk of bias.Data extraction and synthesis This systematic review and meta-analysis was conducted a priori and registered at the International Prospective Register of Systematic Reviews. There were two reviewers who extracted data from the study tables and independently performed quality assessments of the selected trials using the Office of Health Assessment and Translation risk of bias rating tool for human and animal studies. Risk ratios were calculated for the dichotomous sensitivity risk data and mean difference for measures of sensitivity intensity.Results The authors found no effect of the drugs on the risk of sensitivity. Using a visual analogue scale, the authors identified a small but clinically insignificant reduction in the level of sensitivity in the drug-treated group evaluated up to one hour after bleaching. This was not observed when a numerical rating scale was used to measure pain intensity. For the 24-hour pain data, the authors did not find any significant intensity difference between groups. Mean pain intensity scores were generally low in both experimental groups in all randomised controlled trials reviewed. Based on a visual inspection of the funnel plots of all outcomes, the authors concluded that there was no publication bias.Conclusions The data did not support the pre-emptive use of anti-inflammatory drugs in preventing or reducing the intensity of pain caused by in-office tooth bleaching.


Assuntos
Sensibilidade da Dentina , Preparações Farmacêuticas , Clareamento Dental , Analgésicos , Anti-Inflamatórios , Sensibilidade da Dentina/induzido quimicamente , Sensibilidade da Dentina/prevenção & controle , Humanos , Clareamento Dental/efeitos adversos
9.
Rev. cuba. estomatol ; 57(4): e3376, Oct.-Dec. 2020. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1144452

RESUMO

RESUMEN Introducción: El blanqueamiento intracoronal es una alternativa mínimamente invasiva que permite devolver el color a dientes no vitales tincionados. La estabilidad del color logrado es fundamental para evaluar la predictibilidad de este tipo de tratamiento. Objetivo: Evaluar la estabilidad del color 3 años después del blanqueamiento intracameral con peróxido de hidrógeno y carbamida a diferentes concentraciones. Métodos: Se utilizaron 44 premolares extraídos por indicación ortodóncica, los cuales fueron tratados endodónticamente y pigmentados artificialmente con cromógenos sanguíneos. Las muestras fueron divididas aleatoriamente en 4 grupos de estudio (n = 11) siendo: grupo A: peróxido de carbamida 37 por ciento, grupo B: peróxido de hidrógeno 35 por ciento, grupo C: peróxido de carbamida 100 por ciento y grupo D: control; para luego realizar 4 aplicaciones de agente blanqueador con un intervalo de 4 días entre cada aplicación. El registro del color se realizó mediante espectrofotometría, lo que permitió obtener los valores CIE L*a*b* para calcular la variación total de color entre los parámetros iniciales y finales del tratamiento, así como el control a los 3 años. Resultados: Los resultados fueron analizados mediante las pruebas de Shapiro-Wilks, ANOVA y Mann-Whitney, sin registrar diferencias significativas en la variación total de color al control de los 3 años (p > 0,05). Conclusión: Los resultados del blanqueamiento intracoronal, independiente del tipo y concentración del agente utilizado en este estudio son estables en el tiempo y cualquier variación regresiva de color debe ser atribuida a factores extrínsecos(AU)


ABSTRACT Introduction: Intracoronal whitening is a minimally invasive procedure to restore natural color to stained non-vital teeth. The color stability achieved is fundamental to evaluate the predictability of this type of treatment. Objective: Evaluate color stability 3 years after intracameral whitening with carbamide and hydrogen peroxide at various concentrations. Methods: A total 44 premolars were used which had been extracted by orthodontic indication. The premolars were treated endodontically and artificially pigmented with blood chromogenes. The samples were randomly divided into 4 study groups (n = 11): Group A: 37 percent carbamide peroxide, Group B: 35 percent hydrogen peroxide, Group C: 100 percent carbamide peroxide and Group D: control. Four applications were then made of the whitening agent with a 4-days' separation between them. Color was recorded by spectrophotometry, obtaining the values CIE L*a*b* to estimate total color variation between the initial and final parameters of the treatment, as well as control at 3 years. Results: The results were analyzed with Shapiro-Wilk, ANOVA and Mann-Whitney tests, not finding any significant differences in total color variation with respect to the 3 years' control (p > 0.05). Conclusion: The results of the intracoronal whitening studied are stable throughout time, regardless of the type and concentration of the agent used, and any regressive color variation should be attributed to extrinsic factors(AU)


Assuntos
Humanos , Espectrofotometria/métodos , Clareamento Dental/efeitos adversos , Dente não Vital/tratamento farmacológico , Peróxido de Carbamida/uso terapêutico , Peróxido de Hidrogênio/uso terapêutico
10.
J Dent ; 103: 103499, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33068711

RESUMO

OBJECTIVE: To answer the following research question: "Dolow/medium hydrogen peroxide (HP) concentrations used for in-office bleaching in patients with permanent dentition have similar color change and bleaching sensitivity (BS) to high HP concentrations?" DATA: Randomized controlled trials that compared low/medium vs. high concentrate HP were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. Meta-analyses were conducted for color change (ΔE*ab, ΔSGU/SGU), risk, and intensity of BS, using the random-effects model. Heterogeneity was assessed with the Cochrane Q test, I2 statistics, and prediction interval. The GRADE assessed the certainty of the evidence. SOURCES: Search was performed in PubMed, Cochrane Library, BBO, LILACS, Scopus, Web of Science and grey literature on 15th September 2018 (updated on 13th May 2020). STUDY SELECTION: 25 studies remained. Five were at low RoB; thirteen were at unclear RoB, and seven were at high RoB. The risk of having BS was, on average, 33 % lower (RR = 0.67; 95 % CI 0.51 to 0.86) for low/medium concentrate HP than high HP. No significant difference in color change was detected among groups, except from the subgroup low vs. high HP for the immediate color change, but this difference is not clinically relevant. The certainty of evidence for color change was low and very low, and moderate for the BS. CONCLUSIONS: Low and medium hydrogen peroxide concentrate products for in-office bleaching have lower risk and intensity of bleaching sensitivity than the high concentrate hydrogen peroxide group, with no difference in color change efficacy. CLINICAL SIGNIFICANCE: The use of low concentrate hydrogen peroxide products may produce the same color change efficacy with the bonus of having lower risk and intensity of bleaching sensitivity. However, the ideal concentration at which this occurs is yet unknown and deserves further investigations. No funding. PROSPERO CRD42018108266.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Cor , Humanos , Peróxido de Hidrogênio/efeitos adversos , Ácido Hipocloroso , Clareamento Dental/efeitos adversos , Clareadores Dentários/efeitos adversos
11.
Int J Esthet Dent ; 15(4): 490-502, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33089262

RESUMO

AIM: This study assessed the changes in color and translucency of dentin and enamel after staining and bleaching procedures as well as the contribution of the tissues to color change (CTCC). MATERIALS AND METHODS: Fifty enamel-dentin specimens were obtained from bovine incisors and grouped into 10 blocks based on the similarity of the baseline color. One specimen in each block was used as the control, and the others were intrinsically (blood) or extrinsically (coffee) stained. One stained specimen for each pigment was bleached with 35% hydrogen peroxide. The enamel was separated from the dentin, and the tooth color and translucency parameter (TP) were measured individually and after recombining these substrates. Changes in color (ΔE00), whitening index (WI), and TP caused by the staining and bleaching procedures were estimated through assessing the color differences compared with the controls. CTCC was also calculated by recombining the enamel and dentin tissues from different treatments. The data were analyzed using the paired t test or the two-way repeated measures ANOVA (α = 0.05). RESULTS: Extrinsic staining procedures produced higher color changes than intrinsic ones, except in dentin. The highest bleaching effect was observed in the dentin of specimens that were extrinsically stained. Similar CTCC values were observed for the dentin and enamel for both the staining and bleaching procedures. Except for the specimens that were treated with intrinsic staining and became more translucent after the bleaching procedure, the other treatments resulted in non-significant TP changes. CONCLUSIONS: Staining the specimens extrinsically resulted in higher color change than staining them intrinsically, and these specimens were more affected by the bleaching procedure. Enamel and dentin demonstrated similar CTCC values.


Assuntos
Clareamento Dental , Animais , Bovinos , Esmalte Dentário , Dentina , Peróxido de Hidrogênio , Coloração e Rotulagem , Clareamento Dental/efeitos adversos
12.
J Dent ; 103: 103508, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33121984

RESUMO

OBJECTIVES: This randomized double-blinded clinical trial evaluated the bleaching efficacy and incidence of contact hypersensitivity of three kinds of bleaching toothpaste. METHODS: Forty-nine participants above A2 shade on the maxillary central incisor (#11) and canine (#13) were randomized into three groups: TW group (n = 15), 0.75 % HP-containing toothpaste (Toothwhole white); VL group (n = 15), 0.75 % HP-containing toothpaste (Vussen 7); and VH group (n = 17), 2.8 % of HP-containing toothpaste (Vussen 28). Participants were instructed to manually brush their teeth for 3 min, 3 times per day for 12 weeks. They were followed-up after 4 and 12 weeks. Shade measurements were performed using a spectrophotometer (SP), and data were calculated with CIELab (ΔEab*) and CIEDE2000 (ΔE00) formula. Additionally, visual inspection (VI) using the Vitapan classical shade guide was also performed, and the correlation between the two measurements was analyzed by comparing the CIELab (ΔEab*) values. The incidence of contact hypersensitivity at each follow-up was recorded. A mixed-effect model was performed to assess shade changes and chi-square tests for the incidence of contact hypersensitivity, respectively. RESULTS: At 12 week follow-up, all groups showed ΔEab* above 3.46, and ΔE00 above 2.25 for tooth #11. For tooth #13, the ΔEab* and ΔE00 of VH and TW groups only were above those thresholds. Shade change varied according to toothpaste and follow-up points. SP and VI showed a moderate positive correlation for L*, a*, and b*, respectively (P < 0.05). Contact hypersensitivity was not significantly different among the groups (P > 0.05). CONCLUSIONS: Bleaching toothpaste with higher HP yields a better shade change than other toothpaste after 12 weeks. CLINICAL SIGNIFICANCE: The use of bleaching toothpaste with a higher HP concentration results in a better shade improvement.


Assuntos
Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Humanos , Peróxido de Hidrogênio , Clareamento Dental/efeitos adversos , Clareadores Dentários/uso terapêutico , Cremes Dentais/uso terapêutico , Resultado do Tratamento
13.
Ann Afr Med ; 19(3): 211-214, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32820736

RESUMO

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.


Assuntos
Fluorose Dentária/terapia , Clareamento Dental/métodos , Descoloração de Dente/etiologia , Adolescente , Estética , Fluorose Dentária/complicações , Humanos , Masculino , Clareamento Dental/efeitos adversos , Descoloração de Dente/terapia , Resultado do Tratamento
14.
J Dent ; 100: 103423, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32615235

RESUMO

OBJECTIVES: To provide a narrative review on vital dental whitening chemistry, toxicity and safety, vital dental whitening techniques, whitening systems, potential side effects of whitening and cyclic whitening using products with a range of concentrations and pH values. In addition, new developments and recommendations in the field of vital dental whitening will be presented to help clinicians understand the whitening process, its advantages, limitations, and the impact of whitening concentration and pH on enamel providing guidance in tailoring whitening treatments. DATA: Data were gathered using the following keywords: dental whitening, roughness, hardness, sensitivity, hydrogen peroxide, whitening pH, whitening concentration, whitening chemistry, colour, and toxicity. SOURCES: An electronic search was performed using PubMed and Scopus databases. Bibliographic material from papers reviewed was then used to find other relevant publications. CONCLUSIONS: The effectiveness of vital dental whitening depends on many factors, such as the concentration/pH of the whitening agent, application duration, chemical additives, and re-mineralising agents used. Developing new whitening products and technologies such as nano-additives and alternative carrier systems is showing promising results, and might prove efficient in maximising whitening benefits by accelerating the whitening reaction and/or minimising expected reversible/irreversible enamel structural damage.


Assuntos
Clareamento Dental , Esmalte Dentário , Peróxido de Hidrogênio , Peróxidos/efeitos adversos , Clareamento Dental/efeitos adversos , Ureia
15.
J Appl Oral Sci ; 28: e20190384, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32520077

RESUMO

OBJECTIVES: This study evaluated if the use of a bioactive glass-ceramic-based gel, named Biosilicate (BS), before, after or mixed with bleaching gel, could influence the inflammation of the dental pulp tissue of rats' molars undergoing dental bleaching with hydrogen peroxide (H2O2). METHODOLOGY: The upper molars of Wistar rats (Rattus norvegicus, albinus) were divided into Ble: bleached (35% H2O2, 30-min); Ble-BS: bleached and followed by BS-based gel application (20 min); BS-Ble: BS-based gel application and then bleaching; BS/7d-Ble: BS-based gel applications for 7 days and then bleaching; Ble+BS: blend of H2O2 with BS-based gel (1:1, 30-min); and control: placebo gel. After 2 and 30 days (n=10), the rats were euthanized for histological evaluation. The Kruskal-Wallis and Dunn statistical tests were performed (P<0.05). RESULTS: At 2 days, the Ble and Ble-BS groups had significant alterations in the pulp tissue, with an area of necrosis. The groups with the application of BS-based gel before H2O2 had moderate inflammation and partial disorganization in the occlusal third of the coronary pulp and were significantly different from the Ble in the middle and cervical thirds (P<0.05). The most favorable results were observed in the Ble+BS, which was similar to the control in all thirds of the coronary pulp (P>0.05). At 30 days, the pulp tissue was organized and the bleached groups presented tertiary dentin deposition. The Ble group had the highest deposition of tertiary dentin, followed by the Ble-BS, and both were different from control (P<0.05). CONCLUSION: A single BS-based gel application beforehand or BS-based gel blended with a bleaching gel minimize the pulp damage induced by dental bleaching.


Assuntos
Polpa Dentária/efeitos dos fármacos , Vidro/química , Peróxido de Hidrogênio/química , Pulpite/prevenção & controle , Clareadores Dentários/química , Clareamento Dental/métodos , Animais , Polpa Dentária/patologia , Peróxido de Hidrogênio/efeitos adversos , Masculino , Dente Molar , Pulpite/induzido quimicamente , Pulpite/patologia , Distribuição Aleatória , Ratos Wistar , Reprodutibilidade dos Testes , Fatores de Tempo , Clareamento Dental/efeitos adversos , Clareadores Dentários/efeitos adversos , Resultado do Tratamento
16.
Oper Dent ; 45(6): 632-642, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32516400

RESUMO

CLINICAL RELEVANCE: Pigments in tooth structures affect the diffusion of H2O2 through enamel and dentin. The bleaching methodology can be impacted. SUMMARY: Objective: The aim of this study was to evaluate the influence of the presence of pigments in tooth structures on the trans-enamel and trans-dentin diffusion of hydrogen peroxide (H2O2) and its cytotoxicity after carrying out an in-office bleaching therapy.Methods and Materials: A bleaching gel with 35% H2O2 was applied for 45 minutes (three times for 15 minutes) on enamel and dentin discs (n=6), either previously submitted to the intrinsic pigmentation protocol with a concentrated solution of black tea, or not, defining the following groups: G1, unbleached untreated discs (control 1); G2, unbleached pigmented discs (control 2); G3, bleached untreated discs; G4, bleached pigmented discs. The discs were adapted to artificial pulp chambers, which were placed in wells of 24-well plates containing 1 mL culture medium (Dulbecco's modified Eagle's medium [DMEM]). After applying the bleaching gel on enamel, the extracts (DMEM + components of bleaching gel that diffused through the discs) were collected and then applied on the cultured MDPC-23 odontoblast-like cells. Cell viability (methyl tetrazolium assay and Live & Dead, Calcein AM, and ethidium homodimer-1 [EthD-1] probes), the amount of H2O2 that diffused through enamel and dentin (leuco-crystal violet product), and the H2O2-mediated oxidative cell stress (SOx) and components of degradation were assessed (analysis of variance/Tukey; α=0.05).Results: There was no significant difference between the groups G1 and G2 for all the parameters tested (p>0.05). Reduction in the trans-enamel and trans-dentin diffusion of H2O2 occurred for G4 in comparison with G3. Significantly lower cell viability associated with greater oxidative stress was observed for G3 (p<0.05). Therefore, in-office tooth bleaching therapy performed in pigmented samples caused lower cytotoxic effects compared with untreated samples submitted to the same esthetic procedure (p<0.05).Conclusion: According to the methodology used in this investigation, the authors concluded that the presence of pigments in hard tooth structures decreases the trans-enamel and trans-dentin diffusion of H2O2 and the toxicity to pulp cells of an in-office bleaching gel with 35% H2O2.


Assuntos
Clareadores Dentários , Clareamento Dental , Dentina , Peróxido de Hidrogênio/toxicidade , Pigmentação , Clareamento Dental/efeitos adversos , Clareadores Dentários/toxicidade
17.
Oper Dent ; 45(6): 589-597, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32502260

RESUMO

CLINICAL RELEVANCE: The use of laser light during bleaching will not reduce the incidence or severity of sensitivity and will not increase the degree of color change compared with nonlaser light sources. SUMMARY: Objective: To evaluate whether the use of laser during in-office bleaching promotes a reduction in dental sensitivity after bleaching compared with other light sources.Methods: The present review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and is registered with PROSPERO (CDR42018096591). Searches were conducted in the PubMed/Medline, Web of Science, and Cochrane Library databases for relevant articles published up to August 2018. Only randomized clinical trials among adults that compared the use of laser during in-office whitening and other light sources were considered eligible.Results: After analysis of the texts retrieved during the database search, six articles met the eligibility criteria and were selected for the present review. For the outcome dental sensitivity, no significant difference was found favoring any type of light either for intensity (mean difference [MD]: -1.60; confidence interval [CI]: -3.42 to 0.22; p=0.09) or incidence (MD: 1.00; CI: 0.755 to 1.33; p=1.00). Regarding change in tooth color, no significant differences were found between the use of the laser and other light sources (MD: -2.22; CI: -6.36 to 1.93; p=0.29).Conclusions: Within the limitations of the present study, laser exerts no influence on tooth sensitivity compared with other light sources when used during in-office bleaching. The included studies demonstrated that laser use during in-office bleaching may have no influence on tooth color change.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Dente , Adulto , Humanos , Peróxido de Hidrogênio , Luz , Clareamento Dental/efeitos adversos
18.
Photobiomodul Photomed Laser Surg ; 38(10): 632-639, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32286911

RESUMO

Objective: The aim of this study was to evaluate color longevity after different bleaching techniques. Background: Laser-activated bleaching methods are gaining popularity due to decreased chair time and increased patient compliance. However, the longevity of such methods has not been stated clearly. Methods: Sixty patients were divided into the following three groups (n = 20); group 1: chemical bleaching with 35% hydrogen peroxide (HP) gel, group 2: bleaching with 35% HP gel with diode laser activation, and group 3: bleaching with 35% HP gel with Er,Cr:YSGG laser activation. Color changes (ΔE*) were calculated by using two different formulas: (i) CIELAB (ΔEab) and (ii) CIEDE2000 (ΔE00) with a spectrophotometer before treatment, 24 h after treatment 3, 6, and 12 months after treatment. Evaluation of postoperative sensitivity was performed before and immediately after treatment, followed by re-evaluation 24 h and 1 week after treatment. Results: For ΔEab calculation, no significant difference was observed during both intra- and inter-group evaluations (p > 0.05). For ΔE00 calculation, no significant intergroup difference was observed (p > 0.05), whereas significant intragroup differences between the values of after treatment, 6-12 months. In the chemical bleaching group, increased postoperative sensitivity was observed after 24 h (p < 0.001). In the diode-laser-activated group, postoperative hypersensitivity was detected at 24 h and 1 week. No significant hypersensitivity was observed in the Er,Cr:YSGG-laser-activated group (p > 0.05). Conclusions: All three techniques provided efficient bleaching. Chemical and diode-activated bleaching methods resulted in slight sensitivity after application, whereas Er,Cr:YSGG-laser-activated bleaching did not cause sensitivity.


Assuntos
Lasers de Estado Sólido , Clareamento Dental , Seguimentos , Humanos , Peróxido de Hidrogênio/efeitos adversos , Lasers Semicondutores/uso terapêutico , Clareamento Dental/efeitos adversos
19.
Public Health Nurs ; 37(4): 626-627, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32058607

RESUMO

The demand for whiter teeth has been increasing, and home-based remedies are a popular way of whitening the teeth. These products may be prescribed by the dentist or purchased over the counter and comprise different modes to whiten the teeth and are administered in a range of ways by the person. This review found that the evidence was insufficient to draw reliable conclusions about the intervention, i.e., the use of these whitening products. The results indicated that people may experience side effects that irritate the mouth and gums. Therefore, nurses should direct people who are interested in teeth whitening to their dental professional for a discussion.


Assuntos
Autocuidado/métodos , Clareamento Dental/métodos , Adulto , Ensaios Clínicos como Assunto , Humanos , Medicamentos sem Prescrição , Clareamento Dental/efeitos adversos , Clareamento Dental/enfermagem
20.
Indian J Dent Res ; 31(6): 924-929, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33753666

RESUMO

Context: The side effects of bleaching products are still incompletely known. Aims: This work aims to evaluate the effects of bleaching regimens on colour variation, microstructure, roughness, composition and nanohardness of human dental enamel until 8 weeks. Settings and Design: : Twenty teeth were cross-sectioned to obtain eighty enamel fragments (50 × 50 mm) divided into four groups: CN (control Negative-artificial saliva), CP10 (10% carbamide peroxide), HP10 (10% hydrogen peroxide), and WS (whitening strips-10% hydrogen peroxide). Methods and Material: Roughness (atomic force microscopy-AFM and 3-D surface scanning), morphology (confocal laser scanning microscopy-CLSM and AFM), hardness and elastic modulus (nanoindentation), and composition (Raman microspectroscopy) were analysed before the therapy and after 4 and 8 weeks. Colour measures were performed weekly. Statistical Analysis Used: : Two-way ANOVA with repeated measures (P < 0.05). Results: Bleaching stabilizes after 3 weeks for HP10 and after 4 weeks for CP10 and WS. Roughness evaluation showed statistical difference for HP10 after 8 weeks for Sa and Sq, for HP10 and WS after 4 weeks and for CP10 after 8 weeks. The same occurred for hardness and elastic modulus. The morphological evaluation demonstrated the most significant effects after 8 weeks of treatment for HP10 and WS. Composition analysis revealed modifications in peaks related to the organic content spectra (protein) with an increase in detection after 4 weeks, followed by a decrease after 8 weeks. Conclusions: H2O2-based products caused morphological and compositional alterations on enamel.


Assuntos
Clareamento Dental , Peróxido de Carbamida , Esmalte Dentário , Dureza , Humanos , Peróxido de Hidrogênio , Peróxidos , Propriedades de Superfície , Clareamento Dental/efeitos adversos , Ureia
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