ABSTRACT
Background: Tooth discoloration has become a common esthetic problem in recent years. Removal of stains by bleaching is well-documented. Low concentration home bleaching products are available in market in different forms and concentrations. Aim: The aim of this study is to evaluate and compare the efficacy of low concentration commercially available home bleaching products (whitening strip, gel, and mouthwash) in removing stains and whitening the tooth using clinical and digital methods. Materials and Methods: Sixty permanent enamel samples mounted in an acrylic block were artificially stained and randomly divided into four groups. Negative control, 15 % Carbamide peroxide gel group, 2% Hydrogen 16 peroxide mouthwash group and 6% Hydrogen peroxide strip group respectively. The samples were bleached with respective agents according to the manufacturer's instructions. The efficacy on 7th and 14th day was evaluated clinically (SGU change), photographically (?E), and using quantitative light-induced fluorescence (?F). The data were analyzed using paired t-test and analysis of variance. Results: Postbleaching, 6% hydrogen peroxide strips and 15% carbamide peroxide gel showed maximum improvement (??F – 15.73 and 11.89, ?E – 19.8 and 18.9, respectively) when compared to 2% hydrogen peroxide mouthwash and negative control group (??F – 9.68 and 6.59, ?E – 15.04 and 9.44, respectively). The difference was statistically significant (P = 0.001). Conclusion: 6% hydrogen peroxide strips and 15% carbamide peroxide gel showed maximum improvement in stain removal and tooth whitening however, the strips showed better efficacy than the gel. Strips have the added advantage of lesser contact period, less salivary dilution, and no gingival contact. Therefore, strips can be a better alternative for gels and mouthwashes.
ABSTRACT
Objective: This study's aim was to quantify the hydrogen peroxide (HP) penetration into the pulp chamber of teeth submitted to different protocols of bleaching. Material and Methods: Ninety premolars were randomly divided into nine groups according to the bleaching agent protocol (n = 10): control (no bleaching), carbamide peroxide 10% [10% CP], carbamide peroxide 16% [16% CP], carbamide peroxide 22% [22% CP], hydrogen peroxide 4% [4% HP], hydrogen peroxide 6% [6% HP], hydrogen peroxide 7.5% [7.5% HP], hydrogen peroxide 10% [10% HP] and hydrogen peroxide 35% [35% HP]. The penetration of HP was measured via spectrophotometric analysis of the acetate buffer solution from the pulp chamber. The absorbance of the resulting solution was determined in a spectrophotometer and converted into equivalent concentration of HP (µg/ mL). To analyze the concentration of HP, the titration of bleaching agents with potassium permanganate was used. Data were subjected to ANOVA and Tukey's test for pairwise comparison (α = 0.05). Results: Higher concentration of HP in the pulp chamber was found in the HP 35% group (p < 0.0001). No significant difference between at-home protocols were observed (p = 0.64). Titration values showed that the concentration of the products was similar to that claimed by the manufacturer. Conclusion: It follows that the amount of HP that reaches the pulp chamber is not proportional to the concentration of whitening gels, but depends on the application time recommended by the manufacturers (AU)
Objetivo: o objetivo deste estudo foi quantificar a penetração do peróxido de hidrogênio (PH) na câmara pulpar dos dentes submetidos a diferentes protocolos de clareamento. Material e Métodos: Noventa pré-molares foram divididos aleatoriamente em nove grupos, de acordo com o protocolo do agente clareador (n = 10): controle (sem clareamento), peróxido de carbamida 10% [PC 10%], peróxido de carbamida 16% [PC 16%], peróxido de carbamida 22% [PC 22%], peróxido de hidrogênio 4% [PH 4%], peróxido de hidrogênio 6% [PH 6%], peróxido de hidrogênio 7,5% [PH 7,5%], peróxido de hidrogênio 10% [PH 10%] e peróxido de hidrogênio 35% [PH 35%]. A penetração de PH foi medida por análise espectrofotométrica da solução de tampão de acetato da câmara pulpar. A absorvância da solução resultante foi determinada em um espectrofotômetro e convertida em concentração equivalente de PH (µg / mL). Para analisar a concentração de PH, foi utilizada a titulação de agentes clareadores com permanganato de potássio. Os dados foram submetidos à ANOVA e teste de Tukey para comparação pareada (α = 0,05). Resultados: Foi encontrada maior concentração de PH na câmara pulpar no grupo PH 35% (p < 0,0001). Não foi observada diferença significativa entre os protocolos domiciliares (p = 0,64). Os valores de titulação mostraram que a concentração dos produtos era semelhante à reivindicada pelo fabricante. Conclusão: Conclui-se que a quantidade de PH que atinge a câmara pulpar não é proporcional à concentração de géis clareadores, porém depende do tempo de aplicação recomendado pelos fabricantes.(AU)
Subject(s)
Tooth Bleaching , Dental Enamel Permeability , Bleaching Agents , Carbamide Peroxide , Hydrogen PeroxideABSTRACT
Abstract To answer the following focused question through a systematic review: "Are the risk and intensity of tooth sensitivity (TS) and bleaching efficacy different between adult patients who undergo at-home bleaching using trays with reservoirs and those who use trays without reservoirs?". A comprehensive search was performed in the MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library, and grey literature without restrictions. Abstracts from conferences; unpublished and ongoing trial registries, dissertations and theses (ProQuest Dissertations and Periódicos Capes Theses databases) were searched. Only randomized clinical trials (RCTs) were included. We used the Risk of Bias tool (RoB) from the Cochrane Collaboration for quality assessment. After the removal of duplicates, title and abstract screening and full-text examination, nine RCTs remained for qualitative analyses. The great majority of the studies did not report the method of randomization, allocation concealment, and examiner blinding during color assessment. From the nine studies, eight were at unclear risk of bias. In regard to color change, four studies reported no change and two reported improved color change with reservoirs. Only four studies recorded tooth sensitivity and they reported no significant differences. Only one study reported greater gingival irritation with reservoirs. Lack of data reporting prevented us from running a meta-analysis. Further well-designed RCT should be conducted to answer this research question. So far there is not evidence to support that reservoirs in bleaching trays improve color change. PROSPERO - CRD42016037628
Resumo Para responder a seguinte questão de pesquisa através de uma revisão sistemática: "O risco e a intensidade de sensibilidade dentária (SD) e eficácia de clareamento são diferentes entre pacientes adultos que realizam clareamento caseiro usando moldeiras com reservatórios e aqueles que usam moldeiras sem reservatórios?". Uma pesquisa abrangente foi realizada no MEDLINE via PubMed, Scopus, Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Biblioteca Cochrane e literatura cinzenta, sem restrições. Os resumos da conferência anual da Associação Internacional para Pesquisa Dental além de estudos registrados ou em andamento também foram pesquisados. Dissertações e Teses foram pesquisados utilizando o Capes Journal Dissertações e Teses ProQuest. Apenas ensaios clínicos randomizados (ECR) foram incluídos. Usamos a ferramenta Risk of Bias (RoB) da Cochrane para avaliação de qualidade. Após a remoção de duplicatas, triagem de título e resumo e exame de texto completo, nove ECRs permaneceram para análises qualitativas. A grande maioria dos estudos não relatou o método de randomização, ocultação de alocação e cegamento do examinador durante a avaliação de cores. Dos nove estudos, oito estavam sob risco claro de viés. Em relação à mudança de cor, quatro estudos não relataram nenhuma mudança e dois relataram melhora na mudança de cor com reservatórios. Apenas quatro estudos registraram a sensibilidade dentária e não relataram diferenças significativas. Apenas um estudo relatou maior irritação gengival com reservatórios. A falta de relatórios de dados nos impediu de executar uma meta-análise. Outros ECR bem desenhados devem ser conduzidos para responder a esta questão de pesquisa. Até agora não há evidências que sustentem que reservatórios em moldeiras de clareamento melhorem a mudança de cor. PROSPERO - CRD42016037628
Subject(s)
Humans , Adult , Tooth Bleaching/adverse effects , Dentin Sensitivity , BrazilABSTRACT
Objective To observe the aesthetic effect of low concentration of at-home bleaching combined with microabrasion and resin infiltration on stained dental fluorosis.Methods Twenty-three patients with stained dental fluorosis were selected from June 2017 to June 2018 in Stomatological Hospital of Tianjin Medical University.All patients were treated with minimally invasive whitening technology of microabrasion,10％ low concentration of at-home bleaching and resin infiltration.The aesthetic treatment effect was observed before and after treatment by VITA aesthetic shade guide matching.Stained spots were chosen and colorimetric assay was performed using CMYK shade guide before treatment.According to the color of the splash,the light and shade were divided into light grade,medium grade and heavy grade.The CMYK data of the selected spot and complete decolorization ratio (stain decolorization rate) were recorded 1 week and half a year after treatment.Meanwhile,tooth sensitivity was recorded using visual analogue scale (VAS).Results The shades of 92 teeth of 23 dental fluorosis patients were increased more than 5 degrees after a series of whitening treatment,1 tooth was 2-4 degrees,and the total effective rate was 100.00％ (92/92).Decolorization rates of light grade,medium grade and heavy grade were 100.00％ (100/100),100.00％ (120/120) and 97.78％ (88/90),respectively,1 week after treatment.Half a year after treatment,bleaching decolorization rate had no significant difference compared with that of 1 week after treatment (P ＞ 0.05).Tooth sensitivity was 91.30％ (21/23).Almost all patients had mild and moderate teeth sensitivity during treatment.The symptoms of tooth sensitivity were disappeared after the treatment.Conclusions The whitening technology of microabrasion,10％ low concentration of at-home bleaching and resin infiltration has a significant decolorization whitening effect,and has a certain degree of stability and no sensitive teeth after treatment.It is worthy of clinical application.
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Objective:To evaluate the efficiency and safty of home-bleaching.Methods:Randomised controlled trials on home-bleaching were searched using CBM,CNKI,Medline,EMBASE and Cochrane Library up to April,201 3.The articles were selected by inclusion criterion,qualified by Cochrane system and analysed by Meta method.Results:1 2 studies with 61 1 cases were finally includ-ed and analysed.The results showed that 1 0% carbamide peroxide (CP)produced better bleaching efficiency than 1 5% CP(MD, 0.21 ;CI:[0.03,0.38];Z =1 .92;P =0.002).Hydrogen peroxide(HP)at 35% lead to higher tooth sensitivity in office-bleaching than CP at 1 0% in home-bleaching(MD,-1 .68;95%CI:[-2.75,-0.61 ];Z =3.09;P =0.002);home-bleaching were asso-ciated with less tooth sensitivity than office-bleaching(MD,-2.64;95%CI:[-3.96,-1 .32];Z =3.93;P <0.000 1 ),while there was no significance of tooth sensitivity between home-bleaching using CP and HP (OR,1 .94;95%CI:[0.84,4.44];Z =1 .56;P =0.1 2).Conclusion:1 0% CP home-bleaching may produce better bleaching efficiency;home-bleaching is associated with less tooth sensitivity than office-bleaching.
ABSTRACT
OBJECTIVES: The purpose of this study was to evaluate the whitening efficacy and longevity of home bleaching. MATERIALS AND METHODS: A total of 28 patients were divided into either experimental group (Opalescence F; 15% carbamide peroxide) or control group randomly. The patients in experimental group were instructed to wear individual trays applied with bleaching gel for 2 hours a day for 4 weeks. Any treatments weren't applied to the patients in control group. The color measurements of central incisors, lateral incisors & canines of upper and lower arch were recorded at base line, immediately after the finishment of treatmemt (4 weeks), 8 weeks and 12 weeks using Colorimeter (Chroma Meter, 2600d Konica Minolta co.) and Vitapan classical shade guide (Vita Zahnfabrik). RESULTS: A significantly stronger color change was observed for overall teeth samples in experimental group immediately after treatment (at 4 weeks) compared to ones in control group (p < 0.05). There was also a significant difference between baseline and 8 weeks or 12 weeks separately though color rebouncing phenomenon occurred as time went by (p < 0.05). CONCLUSIONS: The clinical effecacy and longevity of home bleaching without combined application of in-office bleaching was observed through this experiment.