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

RESUMO

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


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Dente , Animais , Bovinos , Cor , Peróxido de Hidrogênio
2.
Oral Health Prev Dent ; 18(2): 161-164, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32099975

RESUMO

PURPOSE: This randomised controlled study evaluated the effectiveness of an oral probiotic, Streptococcus salivarius M18 (SsM18), in children with black stains (BSs) in order to counteract their reformation. MATERIALS AND METHODS: Fifty-eight children (aged 4-10 years) presenting with BSs were enrolled. They were randomly divided into two groups: group A (n = 29) included children who were given the test product containing SsM18 once a day for 3 months; group B (n = 29) included children who did not receive any treatment. Before beginning the study, all the children underwent professional removal of BSs. The assessment of BSs was done after 3 months (T1) and after 6 months (T2). RESULTS: Four patients (1 belonging to group A and 3 to group B) were excluded from the study because they started antibiotic therapy. After 3 months (T1), BSs were detected in 6 of the 28 children (21.2%) from group A and in 13 out of the 26 (50%) children from group B (p < 0.05). After 6 months (T2), BSs were detected in 9 out of the 28 (32.1%) children from group A and in 14 of the 26 (53.8%) children from group B (p > 0.05). CONCLUSIONS: BSs formation in children could be prevented by administering S. salivarius M18.


Assuntos
Probióticos , Streptococcus salivarius , Descoloração de Dente , Antibacterianos , Criança , Pré-Escolar , Humanos
3.
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
4.
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
5.
Int J Dent Hyg ; 18(1): 27-43, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31054209

RESUMO

OBJECTIVES: To investigate whether chlorhexidine mouthwash (CHX-MW), with an anti-discoloration system(ADS), is effective in preventing extrinsic tooth surface discoloration. Additionally, this paper seeks to evaluate whether CHX combined with an ADS maintains its efficacy with respect to reducing plaque and gingivitis scores. MATERIAL AND METHODS: MEDLINE-PubMed and Cochrane-Central were searched up to October 2018 to identify eligible studies. Papers evaluating the effect of CHX-MW+ADS compared to CHX without an ADS were included. A descriptive analysis and when feasible a meta-analysis was performed. RESULTS: Screening resulted in 13 eligible publications, presenting 16 comparisons. Six of these evaluated the MW in a non-brushing model and ten as an adjunct to toothbrushing. A descriptive analysis demonstrated that the majority showed no differences in bleeding, gingivitis and plaque scores. This was confirmed by the meta-analysis. In non-brushing experiments, the difference-of-means (DiffM) for plaque scores was 0.10 (P = 0.45, 95%CI: [-0.15; 0.34]) and for the gingival index 0.04 (P = 0.15,95%CI: [-0.02; 0.11]). The DiffM in brushing studies for plaque scores was 0.01 (P = 0.29, 95%CI: [-0.01; 0.02]) and for the gingival index 0.00 (P = 0.87,95%CI: [-0.05; 0.06]). With respect to staining scores, the meta-analysis revealed that in non-brushing studies, the standardized mean difference was 3.19 (P = 0.0005,95%CI: [-3.98; -1.41]) while in brushing studies, the DiffM was 0.12 (P = 0.95,95%CI: [-3.32; 3.55]). CONCLUSION: There is moderate quality evidence from non-brushing studies that the addition of an ADS to CHX-MW reduces tooth surface discoloration and does not appear to affect its properties with respect to gingival inflammation and plaque scores. In brushing studies, there is also moderate quality evidence that ADS does not affect the anti-plaque and anti-gingivitis efficacy of CHX. The majority of comparisons and the meta-analysis including these indicate no significant effect of ADS on tooth staining in situations where the mouthwash is used in addition to toothbrushing.


Assuntos
Anti-Infecciosos Locais , Placa Dentária , Gengivite , Descoloração de Dente , Clorexidina , Humanos , Antissépticos Bucais
6.
Int J Prosthodont ; 33(1): 105-110, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31860920

RESUMO

Enamel hypoplasia occurs because of a defect in formation of the organic matrix during the development of tooth enamel. Minimally invasive procedures of the slightly altered enamel contribute to a greater longevity of teeth and prevent them from relapsing into the repetitive restorative cycle. This case history report aimed to show a sequential technique of minimally invasive procedures for esthetic resolution in anterior teeth. Prior to microabrasion, anterior teeth were bleached in office with 37% hydrogen peroxide. Afterwards, hypoplastic spots on the buccal incisal thirds of the maxillary central incisors were treated with two sessions of microabrasion using phosphoric acid and pumice stone and one session using resin infiltrant. Besides a slight remaining white spot on tooth 21, the masking of spots was done with this sequence of treatments, re-establishing color harmony. Spot depth, diagnosis, and the most relevant treatment choice determined the clinical success.


Assuntos
Hipoplasia do Esmalte Dentário , Clareamento Dental , Descoloração de Dente , Esmalte Dentário , Microabrasão do Esmalte , Estética Dentária , Humanos
7.
Braz. dent. sci ; 23(1): 1-7, 2020. ilus, tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1049566

RESUMO

Objective: This retrospective observational study evaluated the clinical performance of intracoronal whitening and correlated the main factors that interfere with its stability and patient satisfaction. Material and Methods: The paper was designed following the STROBE statement. Patients from the Institute of Science and Technology - ICT/UNESP database who underwent nonvital tooth whitening from August 2010 to July 2015 were selected. Data collection was performed by researching the institution records, patients interview, clinical and radiographic examination. Data were analyzed using MannWhitney test and Spearman's correlation (p < 0.05). Results: The initial search on 1275 records resulted in 43 patients, of whom 18 were selected according to eligibility criteria. There was positive correlation only between the degree of patient's satisfaction and the perception of color difference after whitening treatment (p < 0.05). Color relapse was observed in all conditions, independently of the period of followup (p > 0.05). There was no case of external cervical root resorption. Conclusion: Color changes after whitening influenced patient's satisfaction. There was no correlation among the color relapse and height of gutta-percha, return interval or cause of darkening (AU)


Objetivo: Este estudo observacional retrospectivo avaliou o desempenho clínico do clareamento interno e correlacionou os principais fatores que interferem em sua estabilidade e satisfação do paciente. Material e Métodos: O artigo foi elaborado seguindo o STROBE. Pacientes do banco de dados do Instituto de Ciência e Tecnologia ­ ICT/UNESP que foram submetidos ao clareamento dental em dentes desvitalizados entre agosto de 2010 e julho de 2015 foram selecionados. A coleta de dados foi realizada por meio de pesquisa em prontuários da instituição, entrevista com os pacientes, exames clínico e radiográfico. Os dados foram analisados usando o teste de Mann-Whitney e correlação de Spearman (p < 0,05). Resultados: A pesquisa inicial em 1275 registros resultou em 43 pacientes, dos quais 18 foram selecionados de acordo com os critérios de elegibilidade. Houve correlação positiva apenas entre o grau de satisfação do paciente e a percepção da diferença de cor após o tratamento clareador (p < 0,05). A recidiva da cor foi observada em todas as condições, independentemente do tempo de acompanhamento (p > 0,05). Não houve nenhum caso de reabsorção cervical externa. Conclusão: As mudanças de cor após o clareamento influenciaram a satisfação do paciente. Não houve correlação entre a recidiva da cor e a altura do guta-percha, o intervalo de retorno ou a causa do escurecimento. (AU)


Assuntos
Clareamento Dental , Descoloração de Dente , Dente não Vital
8.
J Contemp Dent Pract ; 20(10): 1141-1145, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31883247

RESUMO

AIM: To determine the knowledge and attitude of dental practitioners (DPs) for internal bleaching technique (IBT) in Kingdom of Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was developed based on a convenient sampling of dental practitioners and specialists working in Kingdom of Saudi Arabia. DPs responded to a structured, self-administered questionnaire for evaluation of their knowledge and attitude toward IBT. The questionnaire had two components: (i) the characteristics of the study participants; and (ii) the items related to the internal bleaching technique (IBT). Data analysis was conducted using SPSS (version 25.0), with descriptive statistics and a bivariate analysis. RESULTS: A total of 532 dental practitioners (61.3% males and 38.7% females) participated in this study. The response rate of participation was estimated at 92.5%. Almost 37% participants considered the sodium perborate as the most commonly used dental material for internal bleaching. Almost 70% participants reported that superficial enamel discoloration was a contraindication for internal bleaching in endodontically treated teeth. CONCLUSION: DPs have good knowledge and attitude on use of IBT for discolored teeth. In general, there is a need to improve knowledge and attitude of dental professionals about the IBT by attending continuing dental educational programs. CLINICAL SIGNIFICANCE: Saving of the remaining tooth structure is a main principle of the different types of dental treatments. So the IBT should be known for all dental practitioners to use it before going to more aggressive dental treatment options such as full crowns. How to cite this article: Doumani M, Alotaibi AN, Al Hussain F, et al. Internal Bleaching of Endodontically Treated Teeth: A Dental Practitioner's Perspective from Kingdom of Saudi Arabia. J Contemp Dent Pract 2019;20(10):1141-1145.


Assuntos
Clareamento Dental , Descoloração de Dente , Dente não Vital , Boratos , Estudos Transversais , Feminino , Humanos , Peróxido de Hidrogênio , Masculino , Arábia Saudita
9.
J Endod ; 45(12S): S49-S51, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31623905

RESUMO

Dark coronal discoloration is a common outcome of traumatic dental injuries in primary incisors. However, there are only a few research studies on the mechanism that causes dark discoloration, the condition of the pulp, and the preferred treatment of such teeth. This article is a summary of the author's research studies and personal experience regarding dark coronal discoloration of traumatized primary incisors.


Assuntos
Necrose da Polpa Dentária , Polpa Dentária , Incisivo , Descoloração de Dente , Humanos , Incisivo/lesões , Dente Decíduo
10.
Clin Ter ; 170(5): e373-e381, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31612196

RESUMO

Among the various pathologies of the oral cavity, the formation of "unsightly black spots" on the surface of the tooth, universally known as Black Stain (BS) has recently been acquiring more interest. Usually BS is typically found in individuals in prepubertal age, even though it has been identified in adults associated with microbial exchange and / or with iron metabolism disorders. Microbial exchange concerns the possible exchange of bacteria between family members which can take place directly, through effusions, or indirectly, through brushes, cutlery or glasses. For this reason, it is recommended that toothbrushes of family members not be left damp and in contact with each other. The bathroom, being a warm-humid environment, is in fact an optimal habitat for microbial proliferation. Of specific importance in BS is the accumulation of iron in tissues and secretions which, together with chromogenic bacteria, are the primary cause of this pathology. In fact, among the metabolic products synthesized by bacteria in the oral cavity, hydrogen sulfide is of considerable interest, since upon reacting with iron available in saliva, in pathological conditions (iron metabolism disorders), it forms black precipitates consisting of ferric sulfide. These precipitates bind to the surface of the teeth, tending to form a stria that usually follows the contour of the gingiva, with an unsightly and variable chromatic intensity. In physiological situations, iron homeostasis is defined as the state of equilibrium between iron present in tissues and in secretions and that which is present in the circulation. Instead, in pathological conditions, defined as iron metabolism disorders, there is an accumulation of iron in tissues and secretions and a lack of it in the circulation. It is also important to remember that subjects affected by BS are more protected from carious processes than healthy subjects, probably due to a significant predominance of chromogenic bacteria compared to those responsible for caries. It should also be remembered that in young subjects BS tends to regress with pubertal development and the transition to adult life. In any case, using common professional hygiene procedures, it is possible to remove BS as well as plaque and tartar deposits. In particular, with ultrasonic scalers, polishing pastes and powders carried by air and water jets, the surfaces of the teeth can be restored to their natural healthy state. All the techniques for removing the precipitates, are not enough however, to fix and permanently eradicate their appearance, as these precipitates last only for short periods and recur very frequently. Due to the frequent recurrences, new oral microbiota control therapies are emerging; among these the use of lactoferrin (Lf) in the dental field and particularly in the treatment of BS appears to be very promising. Taken togheter, here the effect of Lf in subjects affected by BS has been investigated.


Assuntos
Anti-Infecciosos/administração & dosagem , Cárie Dentária/dietoterapia , Distúrbios do Metabolismo do Ferro/tratamento farmacológico , Lactoferrina/administração & dosagem , Descoloração de Dente/diagnóstico , Adulto , Criança , Cárie Dentária/diagnóstico , Placa Dentária/diagnóstico , Feminino , Humanos , Distúrbios do Metabolismo do Ferro/diagnóstico , Masculino , Gravidez , Saliva/metabolismo , Descoloração de Dente/tratamento farmacológico
11.
J Forensic Leg Med ; 68: 101869, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31557628

RESUMO

The cadaveric alterations that derive from the decomposition of the human body are often investigated and examined in medical autopsies together with any other evidence of thanatological interest. This study aimed to systematically review case-specific characteristics of dental autopsies that reported the pink tooth phenomenon (PTP). The review was performed in October/2018 and followed PRISMA and Cochrane guidelines. Seven databases were searched as primary study sources (PubMed, Scopus, LILACS, SciELO, Web of Science, Science Direct and Embase) and three (OATD, Open Grey and Open Thesis) were searched for "grey literature". Only descriptive studies were collected, namely case reports and case series. The risk of bias among the studies was assessed with The Joanna Briggs Institute Critical Appraisal tool. From each case, the sex and age of the victims were registered, together with the place of body recovery, time of death, cadaveric status, cause of death, and number and position of pink teeth. Additionally, a supplemental quantitative analysis was conducted within a sampled subgroup. Poisson regression with robust variance was used to analyze relative risks of presenting pink teeth according to age and tooth position. Eleven studies out of 1004 were eligible. In total 71 cases of cadavers with pink teeth were reported. Two (2.81%) victims had unknown sex, while 17 (23.95%) were females and 52 (73.24%) were males. The victims were aged between 4 and 85 years (mean age 31.13 ±â€¯13.32). Dental autopsies registered 331 pink teeth (163 anterior, 87 premolars and 81 molars). The age did not influence on presenting an additional pink tooth, regardless of tooth position (p > 0.05). Forensic dentists must be aware of pink teeth in dental autopsies. This is an unspecific phenomenon and must not be misinterpreted in medico-legal investigations.


Assuntos
Mudanças Depois da Morte , Descoloração de Dente/patologia , Afogamento/patologia , Humanos
12.
Quintessence Int ; 50(10): 802-807, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31559399

RESUMO

Over the past decades, the walking bleach technique using sodium perborate was considered a safe and effective method to bleach nonvital discolored teeth. However, sodium perborate has been classified as carcinogenic, mutagenic, and toxic for reproduction by European Union legislation. Its use is therefore prohibited since April 2015. The initially described inside/outside bleaching technique, combining internal and external application of 10% carbamide peroxide, is an alternative to the walking bleach technique using sodium perborate. While good esthetic results and low risks of external cervical resorptions have been associated with this technique, its main drawback is that the access cavity is left open. To overcome this disadvantage, the present authors propose to seal the bleaching agent in the access cavity instead of leaving the latter open. Through a clinical case, this paper presents and discusses several aspects of this protocol, including the clinical steps, the design of the bleaching tray, and the treatment of potential recurrences. The present authors believe that the protocol proposed in this article is easier to use for the patient. Moreover, it prevents the accumulation of food debris in the access cavity and avoids the colonization of coronary dentin by bacteria.


Assuntos
Clareamento Dental , Descoloração de Dente , Dente não Vital , Peróxido de Carbamida , Humanos , Peróxido de Hidrogênio , Peróxidos , Ureia
14.
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
15.
Gen Dent ; 67(5): 40-44, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31454321

RESUMO

In general, patients' dissatisfaction with the appearance of their smile is mainly influenced by the color of their teeth. Darkening of a single anterior tooth negatively impacts the appearance of the smile. Tooth bleaching is considered a conservative treatment option for darkened nonvital teeth, and, whenever possible, must be considered the first choice of treatment. This article describes the successful use of the internal-external home bleaching technique in 2 patients, each of whom had a single darkened nonvital tooth. In this technique, the bleaching agent is applied simultaneously to both the internal and external surfaces of the tooth. The bleaching agent of choice is 10% carbamide peroxide. This technique is simple, low cost, and conservative and provides excellent esthetic results.


Assuntos
Clareamento Dental , Descoloração de Dente , Dente não Vital , Estética Dentária , Humanos , Peróxido de Hidrogênio , Peróxidos , Ureia
16.
J Oral Sci ; 61(3): 379-385, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31378754

RESUMO

There is some evidence of tooth discoloration after regenerative endodontic procedures. The aim of this review is to determine which materials used in regenerative procedures induce tooth discoloration. The authors searched six digital databases in February 2018: PubMed, Google Scholar, the Cochrane Library, Scopus, Web of Science, and Lilacs. As a result, 353 studies were found. Eleven studies that met the established criteria were selected. Analysis of the selected studies showed that most materials used in regenerative endodontic procedures have the potential to stain tooth tissues. To decrease tooth discoloration, sealing dentin with a dentin-bonding agent before the placement of a disinfectant paste and barrier materials should be considered. Only a small number of in vitro studies have been performed; therefore, further studies on this topic are warranted.


Assuntos
Materiais Restauradores do Canal Radicular , Descoloração de Dente , Compostos de Cálcio , Humanos , Endodontia Regenerativa , Silicatos
17.
J Contemp Dent Pract ; 20(5): 587-592, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31316023

RESUMO

AIM: The aim of this study is to evaluate and compare the amount of radicular peroxide penetration when various concentrations of carbamide peroxide (CP) bleaching gels (10, 15, and 35%) and a mixture of 30% hydrogen peroxide (HP) with sodium perborate are used for intracoronal bleaching. MATERIALS AND METHODS: Fifty extracted single-rooted premolars from young adults were used. The specimens were then divided into five groups such that teeth with varying sizes were equally distributed in all groups. Group I-distilled water (control group), group II-10% CP, group III-15% CP, group IV-35% CP, and group V-30% HP with sodium perborate. Intermediate restorative material (IRM) was used to seal access cavities and left for a week at 37 °C in an incubator. Following the bleaching process, suspended teeth from plastic tubes containing distilled water were removed and the water was used to determine the amount of peroxide levels. A UV-visible spectrophotometer at a wavelength of 480 nm was used to determine the quantity of peroxide based on the optical density. RESULTS: Results showed the highest peroxide leakage in group V, followed by group IV, and then group III, whereas the least peroxide penetration was found in group II, and the control group or group I showed no penetration. The Kruskal-Wallis test showed a significant difference between the various groups tested. The Mann-Whitney test was done to find in which pair of groups there exists a significant difference. It was found that all the groups when compared among themselves showed a significant difference. CONCLUSION: The present study concluded that lower concentrations of CP 10 and 15% produced lower peroxide leakage. Hence, it could be tried as an alternate to traditional agents in cases with compromised tooth which shows cervical tooth defects where the risk of external root resorption is higher. CLINICAL SIGNIFICANCE: The management of discolored teeth involves different techniques; among various techniques, bleaching is considered to be a safe, effective, and relatively noninvasive technique to lighten discolored teeth and it also conserves dental hard tissue.


Assuntos
Clareamento Dental , Descoloração de Dente , Boratos , Peróxido de Carbamida , Géis , Humanos , Peróxido de Hidrogênio , Peróxidos , Ureia , Adulto Jovem
18.
Int J Esthet Dent ; 14(3): 300-309, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31312815

RESUMO

BACKGROUND: The present study evaluated the coronal discoloration induced by different materials or blood as well as the effect of internal bleaching on discoloration. METHODS: After tooth color measurement at baseline with a sphere spectrophotometer (CIE L*a*b*), the root canals of molars were partially filled with white mineral trioxide aggregate (MTA), triple antibiotic paste (TAP), or a cotton pellet with bovine blood (control) was placed into the pulp chamber. The color changes were assessed at 30, 60, and 180 days after the procedure. Following the discoloration, internal bleaching was performed with a mixture of sodium perborate and hydrogen peroxide inserted into the pulp chamber, and this mixture was replaced weekly for 3 weeks. At baseline, after staining and after bleaching, the data of each color parameter were individually analyzed by one-way ANOVA, while differences in pooled color changes (∆E00) were assessed by two-way repeated measures ANOVA (α = 0.05). RESULTS: After the staining period, the TAP-stained specimens were darker and greener than the other specimens, and no difference was observed between the teeth stained with blood and those stained with MTA. The walking bleach technique resulted in an improved tooth color without a difference in the color changes among the different groups. CONCLUSION: The TAP-stained specimens had the greatest tooth discoloration, and the discoloration remained the highest after the walking bleach technique. PRACTICAL IMPLICATIONS: This in vitro study demonstrated that TAP yielded higher tooth discoloration, and this color might hinder a satisfactory tooth color from being obtained with the walking bleach technique.


Assuntos
Clareamento Dental , Descoloração de Dente , Dente , Animais , Bovinos , Endodontia Regenerativa
19.
Am J Dent ; 32(3): 124-132, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31295393

RESUMO

PURPOSE: To conduct a clinical evaluation of dental bleaching techniques using hydrogen peroxide (HP), regarding tooth sensitivity, gingival irritation, subject's perception of color change, and calcium (Ca) and phosphorous (P) concentrations in enamel. METHODS: 75 volunteers were distributed according to the bleaching technique (n=25): (a) at-home: 10%HP (Opalescence GO) for 15 days of continuous use (1 hour per day); (b) in-office: 40%HP (Opalescence Boost) in three clinical sessions (40 minutes each session); (c) combined: one initial session with 40%HP, and the rest with 10%HP for 15 days of continuous use. Clinical evaluations and Ca and P concentration collections were obtained before, during bleaching treatment, and 15 days after conclusion of treatment. The generalized linear models were used to evaluate the data for VITA Classical scale, CIELAB, tooth sensitivity, degree of acceptability of the technique, Ca and P concentrations and to determine the ΔE variables and color change perception. Gingival irritation was analyzed by Fisher's Exact test. The total frequencies for each time interval (regardless of bleaching technique) were compared at 50% by the chi-square test. RESULTS: The in-office technique presented the lowest tooth sensitivity, but all techniques caused an increase in sensitivity over time (P< 0.0001). All techniques resulted in lower Ca and P concentrations in enamel at each time point, compared with the baseline concentrations. Calcium concentrations did not differ significantly among the treatments (P= 0.9360). Phosphorus concentration at the 8th day was higher for the in-office technique group (P< 0.05). All the bleaching techniques were effective in altering color, with ΔE values higher than 3.3, without any significant differences (P= 0.3255). Higher occurrence of gingival irritation was observed for at-home and combined techniques. The combined technique seemed to promote a color change faster than the other techniques. CLINICAL SIGNIFICANCE: All the dental bleaching techniques proved equally effective in promoting tooth color change. These techniques may reduce calcium and phosphorous content in enamel. The at-home and the combined techniques may cause greater dental sensitivity than the in-office technique, and led to a higher prevalence of gingival irritation.


Assuntos
Peróxido de Hidrogênio , Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Esmalte Dentário , Humanos , Peróxido de Hidrogênio/uso terapêutico , Minerais , Clareamento Dental/métodos , Clareadores Dentários/uso terapêutico , Descoloração de Dente/tratamento farmacológico , Resultado do Tratamento
20.
Br Dent J ; 226(11): 839-849, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31203331

RESUMO

The single discoloured tooth poses an aesthetic dilemma. While several treatment approaches are available, bleaching offers a minimally invasive, aesthetic treatment modality. Predictability and success with bleaching stems from correct diagnosis, didactic treatment planning and the utilisation of appropriate techniques. This article aims to discuss the aetiologies of a single discoloured tooth and, through evaluation of the literature and discussion of clinical cases, explore the theory, safety and bleaching techniques available.


Assuntos
Clareamento Dental , Descoloração de Dente , Dente não Vital , Estética Dentária , Humanos , Peróxido de Hidrogênio , Planejamento de Assistência ao Paciente
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