ABSTRACT
Abstract Objectives This randomized, split-mouth, single-blinded trial assessed whether the use of reservoirs in at-home bleaching trays is equivalent to non-reservoir trays. Our choice of an equivalence trial was based on the expectation that a non-reservoir tray is sufficient to produce a color change. Secondary outcomes such as tooth sensitivity (TS) and gingival irritation (GI) were also assessed. Methodology Forty-six patients were selected with canines shade A2 or darker. In half of the patient's arch, bleaching trays were made with reservoirs and the other half, without reservoirs. At-home bleaching was performed with carbamide peroxide (CP) 10% (3 h daily; 21 days). Color change was evaluated with a digital spectrophotometer (ΔE, ΔE00, and Whiteness Index) and shade guide units (ΔSGU) at baseline, during and one-month post-bleaching. TS and GI were assessed with a numeric scale (NRS) and a visual analog scale (VAS). Results After one month, the equivalence of reservoir and non-reservoir groups were observed in all color instruments (p>0.05). Fifteen and sixteen patients presented pain (absolute risk: 33% and 35%, 95%, confidence interval (CI) 21-46% and 23-49%) in the reservoir and non-reservoir side, respectively. The odds ratio for pain was 0.8 (95%CI 0.2-3.0) and the p-value was non-significant (p=1.0). TS intensity was similar between both groups in any of the pain scales (p>0.05). No difference in the GI was observed (p>0.05). Conclusions The protocol with reservoirs is equivalent in color change to the non-reservoir, although no superiority of the latter was observed in terms of reduced TS and GI with at-home 10% carbamide peroxide bleaching. Clinical Relevance The presence of reservoirs in a bleaching tray did not improve color change or affect tooth sensitivity and gingival irritation.
Subject(s)
Humans , Tooth Bleaching , Dentin Sensitivity , Tooth Bleaching Agents , Peroxides , Urea , Single-Blind Method , Treatment Outcome , Carbamide Peroxide , Hydrogen PeroxideABSTRACT
Objetivo: Avaliar in vitro a capacidade de remoção de pigmentos ocasionados em resina composta após aplicação de peróxido de hidrogênio 35%. Material e método: Confeccionaram-se 20 amostras de resina composta Opallis (FGM), cor A1, em matriz metálica circular. As amostras foram divididas em quatro grupos (n=5) dos seguintes agentes corantes: água destilada (controle), café, vinho tinto e Coca-Cola®. No manchamento, as amostras ficaram imersas nas soluções durante 72 horas, com troca diária das bebidas. Procedeu-se à aplicação do gel de peróxido de hidrogênio 35% (Whiteness HP Blue Calcium, FGM) em três sessões, sendo uma aplicação do gel por sessão, o qual permaneceu nas amostras durante 40 minutos. Medidas de cor foram feitas inicialmente, após manchamento, após aplicação do peróxido e por mais 21 dias, usando espectrofotômetro Vita Easyshade. Os dados foram submetidos à análise de variância de dois fatores (tempo vs. corante) e ao teste de Tukey, para o contraste das médias (alfa=0,05). Resultado: Apresentaram alteração de cor (delta E - média/desvio padrão de L*) o café (15,7 ± 2,0) e o vinho (15,2 ± 4,6), quando comparados à Coca-Cola® (4,8 ± 1,9). O peróxido de hidrogênio removeu a pigmentação das amostras, porém, para nenhum dos corantes, houve retorno à coloração inicial, principalmente no grupo manchado por café (12,9 ± 1,5); este mostrou diferença significativa quando comparado ao controle (1,6 ± 0,6), diferentemente do vinho (3,3 ± 0,6) e da Coca-Cola® (2,1 ± 0,9), que se aproximaram do grupo controle. Conclusão: As soluções corantes pigmentaram a resina composta, principalmente o café. A aplicação do peróxido de hidrogênio 35% foi eficaz na remoção de pigmentos das amostras, porém, em nenhum dos grupos, com diferentes corantes, houve retorno à coloração inicial (p> 0,005).
Objective: Evaluate in vitro the ability to removal pigments of composite resin after application of hydrogen peroxide 35%. Material and method: Concocted to-20 resin samples composed Opallis (FGM), A1 color, in circular metal matrix. The samples were divided into 4 groups (n = 5) the following coloring agents: distilled water (control), coffee, red wine and Coca-Cola®. In the staining, the samples were immersed in the solutions for 72 hours, with daily change of beverages. Proceeded to the application of 35% hydrogen peroxide gel (Whiteness HP Blue Calcium, FGM) in 3 sessions, one application of gel per session that remained in the samples for 40 minutes. Color measurements were made initially after staining after application of the peroxide and for 21 days using Vita Easyshade spectrophotometer. The data were submitted to two-way ANOVA and Tukey's test (alfa = 0.05). Result: Significant color change was observed in specimens after immersion in the solutions, except the control group. Hydrogen peroxide was capable of removing the stains, however the color did not return to the baseline in any of the staining groups, especially for the groups immersed in coffee. Conclusion: Staining solutions can stain the composite resin. The application of 35% hydrogen peroxide can remove partially the staining, minimizing the color change produced by the staining solutions. However, the bleaching gel was not capable of removing all staining, especially for the coffee group.
Subject(s)
Spectrophotometry , In Vitro Techniques , Pigmentation , Analysis of Variance , Composite Resins , Hydrogen Peroxide , Tooth Bleaching , Wine , Beverages , Distilled Water , Coffee , Esthetics, DentalABSTRACT
As restaurações indiretas metal tiee têm sido amplamente utilizadas por serem capazes de mimetizar as estruturas do dente natural. O sucesso dessas restaurações pode ser atribuído às propriedades do material empregado, o domínio da técnica pelo Cirurgião-Dentista, além de uma estreita relação com o ceramista. Dentre as várias opções cerâmicas metal free existentes no mercado odontológico o dissilicato de lítio tem sido uma grande opção devido principalmente as nuances estéticas permitidas com este sistema (lPS Empress 2 Ivoclar/Vivadent). Assim, este trabalho demonstra clinicamente por meio da realização de um caso clínico, o emprego de uma cerâmica pura para devolver a harmonia de um sorriso comprometido pela alteração de posição e coloração dos dentes anteriores, alcançando um resultado altamente satisfatório proporcionando bem estar ao paciente e um aumento de sua autoestima.
The indirect restorations free metal has been widely used because they are able to mimic the structures of natural tooth. The success of these restorations can be attributed to the properties of the material used, mastery of technique by a dentist, and a close relationship with the potter. Among the ceramics on the market, the IPS Empress2 (Ivoclar/Vivadent) has featured works by providing durable, aesthetic and high marginal accuracy. This study demonstrates clinically by conducting a case study, the use of a ceramic lithium disilicate to restore the harmony of a smile compromised by changing color and position of the anterior teeth. Providing welf are to the patient and increase their self esteem.