Efeito do pH do gel clareador de consultório na cor e na sensibilidade dentária / Effect of the pHof the in-office tooth bleaching gelon color and tooth sensitivity / Efecto del pH del gel blanqueador dental de consultorio sobre el color y la sensibilidad dental

Introdução:Sabe-se que a busca pela estética é algo cada vez mais crescente. Dentre os procedimentos mais procurados na odontologia estética, destaca-se o clareamento dental de consultório. Diante disso, ainda são poucos os estudos que avaliam os efeitos dos agentes clareadores de diferentes pHs na efetividade clareadora e na sensibilidade dentária.Objetivo:Avaliar a sensibilidade dentária e a eficácia clareadora de géis clareadores à base de peróxido de hidrogênio a 35% com diferentes pHs.Metodologia:Trata-se de um relato de três casos, descritivo e observacional, do tipo boca dividida (split-mouth) para cada estratégia clareadora (gel clareador com pH básico e gel clareador com pH ácido). Foram avaliados três pacientes de25, 26e 27anos de idade.Realizou-se registro de cor por meio da escala VITAClassical e avaliação da sensibilidade dentária pela escala visual analógica. Resultados:Todos os pacientes avaliados apresentaram cor A3 no registro de cor inicial e, após o clareamento dental,atingiram a cor A1. Todos relataram uma maior sensibilidade no hemiarco direito (local onde foi aplicada o gel clareador Whiteness HP que possui pH ácido. Dois pacientes relataram sensibilidade dentária no hemiarco esquerdo em que foi aplicado o gel clareador de pH básico. Conclusões:Observa-se a eficácia clínica dos géis clareadores de consultório à base de peróxido de hidrogênio a 35% na estabilidade de cor após o tratamento clareador, independente do seu pH. Ademais, nota-se que o gel clareador de pH básico promoveu menor sensibilidade pós-operatória (AU).

Introduction:It is known that the search for aesthetics is something increasingly growing. Among the most sought-after procedures in cosmetic dentistry, in-office tooth bleaching stands out. Therefore, there are still few studies that evaluate the effects of bleaching agents ofdifferent pHs on bleaching effectiveness and tooth sensitivity.Objective:To evaluate tooth sensitivity and bleaching efficacy of 35% hydrogen peroxide-based tooth bleaching gels with different pHs.Methodology:This is a report of three cases, descriptive and observational, of the split-mouth type for each bleaching strategy (bleaching gel with basic pH and bleaching gel with acidic pH). Three patients aged 25, 26 and 27 years were evaluated. Color registration was performed using the VITA Classical scale and tooth sensitivity was evaluated using the visual analogue scale.Results:All evaluated patients presented color A3 in the initial color registration and, after tooth bleaching, reached color A1. All reported greater sensitivity in the right hemi-arch (place where the Whiteness HP bleaching gel with an acid pH was applied. Two patients reported tooth sensitivity in the left hemi-arch where the basic pH bleaching gel was applied.Conclusions:The clinical efficacy of in-office tooth bleaching gels based on 35% hydrogen peroxide in terms of color stability after bleaching treatment is observed, regardless of its pH. In addition, it is noted that the basic pH bleaching gel promoted less postoperative sensitivity (AU).

Introducción: Se sabe que la búsqueda de la estética es algo cada vez más creciente. Entre los procedimientos más populares en odontología estética, se destaca el blanqueamiento dental en consultorio. Ante esto, aún existen pocos estudios que evalúen los efectos de agentes blanqueadores de diferentes pHs sobre la efectividad del blanqueamiento y la sensibilidad dental.Objetivo: Evaluar la sensibilidad dental y la eficacia blanqueadora de geles blanqueadores a base de peróxido de hidrógeno al 35 % con diferentes pH. Metodología: Este es un reporte de tres casos, descriptivo y observacional, del tipo boca partida para cada estrategia de blanqueamiento (gel blanqueador con pH básico y gel blanqueador con pH ácido). Se evaluaron tres pacientes de 25, 26 y 27 años. El registro de color se realizó con la escala clásica VITA y la sensibilidad dental se evaluó con la escala analógica visual.Resultados: Todos los pacientes evaluados presentaron color A3 en el registro de color inicial y, después del blanqueamiento dental, alcanzaron el color A1. Todos refirieron mayor sensibilidad en la hemiarcada derecha (lugar donde se aplicó el gel blanqueador de pH ácido Whiteness HP). Dos pacientes refirieron sensibilidad dental en la hemiarcadaizquierda donde se aplicó el gel blanqueador de pH básico.Conclusiones: Se observala eficacia clínica de los geles blanqueadores de consultorio a base de peróxido de hidrógeno al 35% en cuanto a la estabilidad del color tras el tratamiento blanqueador, independientemente de su pH. Además, se observa que el gel blanqueador de pH básico promovió una menor sensibilidad postoperatoria (AU).

Preemptive analgesia with ibuprofen increases anesthetic efficacy in children with severe molar hypomineralization: a triple-blind randomized clinical trial

Abstract Molar incisor hypomineralization (MIH) is often accompanied by dental hypersensitivity and difficulty in achieving effective analgesia. Objective: This study evaluated the effectiveness of preemptive analgesia in children with severe MIH, post-eruptive enamel breakdown, and hypersensitivity. Methodology: Ibuprofen (10 mg/kg child weight) or placebo was administered, followed by infiltrative anesthesia and restoration with resin composite. Hypersensitivity was evaluated in five moments. The data were analyzed using the chi-square test, Fisher's exact test, and t-test. Results: Preemptive analgesia provided benefits for the treatment of severe cases of MIH, with an increase in the effectiveness of infiltrative anesthesia and improved patient comfort during the restorative procedure. Conclusion: Preemptive analgesia has shown efficacy in reducing hypersensitivity during restorative dental procedures, evidencing the significance of this study for patients with MIH and hypersensitivity.

Feldspathic and Lithium Disilicate Onlays with a 2-Year Follow-Up: Split-Mouth Randomized Clinical Trial

Abstract The present study was a prospective, controlled, randomized, clinical short-term trial aiming to evaluate the clinical performance of adhesively luted, lithium disilicate and feldspathic glass-ceramics onlays over a period up to 2 years. A total of 11 patients (7 female, 4 male; age range: 18-60 years, mean age: 39 years) were selected for this study. Each patient received a maximum of two restorations per group in a split-mouth-design. LD: Eleven onlays, performed with lithium disilicate-based ceramic (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein), and FP: Eleven onlays, performed with feldspathic ceramic (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Recalls were performed at 2 weeks (baseline = R1), 1 year (R2) and 2 years (R3) after the cementation by three calibrated blinded independent investigators using mirrors, magnifying eyeglasses, probes and bitewing radiographs. The postoperative sensitivity, secondary caries, marginal integrity, marginal discoloration, color match, surface roughness, tooth integrity, and restoration integrity were evaluated. The Friedman test was used to determine if there was a statistically significant difference in time-to-time comparison of the parameters in the ceramics restorations. A total of 95.4% of the restorations were clinically acceptable at the 2-year recall, without a difference for any evaluation parameter for both ceramic materials. Based on the 2-year data, the CAD-CAM onlays manufactured with feldspathic and lithium-disilicate based ceramics showed similar clinical performance.

Resumo O presente estudo é um estudo clínico prospectivo, controlado, randomizado e de longo curto prazo, com o objetivo de avaliar o desempenho clínico de restauraç ões adesivas cerâmica vítrea reforçada com dissilicato de lítio e cerâmica feldspática por um período de até 2 anos. Um total de 11 pacientes (7 mulheres, 4 homens; faixa etária: 18-60 anos, idade média: 39 anos) foram inseridas para este estudo. Cada paciente recebeu duas restaurações por grupo em um delineamento de boca dividida. LD: Onze onlays, realizados com cerâmica à base de dissilicato de lítio (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein); e FP: Onze onlays, realizados com cerâmica feldspática (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Os retornos foram realizados em 2 semanas (linha de base = R1), 1 ano (R2) e 2 anos (R3) após a cimentação, por três investigadores independentes, cegos e calibrados, usando espelhos, óculos de aumento, sondas e radiografias interproximais. Foram avaliadas a sensibilidade pós-operatória, cárie secundária, integridade marginal, descoloração marginal, correspondência de cores, rugosidade da superfície, integridade dentária e integridade da restauração. O teste de Friedman (95%) foi utilizado para determinar se havia uma diferença estatisticamente significante na comparação periódica dos parâmetros nas restaurações cerâmicas. Um total de 95,4% das restaurações estava clinicamente aceitável no retorno de 2 anos, sem diferença para qualquer parâmetro de avaliação para ambos os materiais cerâmicos. Com base nos dados de 2 anos, as restaurações CAD-CAM fabricados com cerâmica feldspática e à base de dissilicato de lítio apresentaram desempenho clínico semelhante.

Preemptive use of piroxicam on tooth sensitivity caused by in-office bleaching: a randomized clinical trial

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

Resumo Este ensaio clínico avaliou o efeito do uso preemptivo do anti-inflamatório não-esteroidal piroxicam em dose única 30 minutos antes do clareamento de consultório na prevenção de sensibilidade dentária (SD) relatada pelos pacientes. Cinquenta pacientes foram submetidos a duas sessões de clareamento dental em consultório com peróxido de hidrogênio a 35% por 2 sessões, consistindo de aplicação única de 45 minutos, com um intervalo de 7 dias entres as sessões. Trinta minutos antes do procedimento, o paciente recebia aleatoriamente dose única de piroxicam (200 mg) ou do placebo em um desenho duplo-cego, randomizado e cruzado. A SD foi avaliada usando a escalas de gradação verbal (EGV) e visual analógica (EVA) durante o procedimento clareador e 24h após o procedimento. As mudanças de cor foram avaliadas usando a escala Vita Bleachedguide uma semana após cada sessão de clareamento. O risco de SD foi calculado a partir de EGV a analisado pelo teste de McNemar, enquanto o nível de SD foi analisada pelo teste de Mann-Whitney. Para EVA, testes T foram usados para comparar dados dos tratamentos em cada tempo de avaliação. Dados de mudança de cor foram submetidos aos testes de Wilcoxon e Mann-Whitney (α=0.05). A administração preemptiva de piroxicam não afetou o risco e nível de SD quando comparado ao placebo, independentemente do tempo de avaliação. A sequencia de tratamento não afetou a efetividade do clareamento. Como conclusão, a administração de dose única de piroxicam previamente ao clareamento dental de consultório não foi efetiva em reduzir significantemente o risco e nível de SD.

Uso de dentífricos y colutorios para el control de la hipersensibilidad dentinaria en adultos: una revisión narrativa / Use of toothpastes and mouthwashes for the control of dentin hypersensitivity in adults: a narrative review

RESUMEN: Objetivo: Describir la efectividad del uso de los distintos agentes desensibilizantes contenidos en dentífricos y colutorios para el control de la hipersensibilidad dentinaria en adultos. Método: Se realizó una búsqueda electrónica de la evidencia científica en las bases de datos PubMed, Epistemónikos, EBSCO, BEIC y Cochrane Library; utilizando una estrategia de búsqueda que incluye las palabras clave. Para cada artículo encontrado se analizó el nivel y calidad de evidencia, riesgo de sesgo y ética. Resultados: En total 36 artículos fueron incluidos, 29 ensayos clínicos controlados aleatorizados y 7 revisiones sistemáticas. De los ensayos clínicos encontrados, cinco probaron la eficacia de colutorios, dos realizaron una comparación con dentífricos y colutorios y 22 evaluaron sólo el uso de dentífricos. Los agentes desensibilizantes testeados principalmente encontrados fueron sales de potasio, arginina, nano-hidroxiapatita, fosfosilicato de calcio y sodio (CSFS) y sales de estroncio. Sólo los primeros dos agentes fueron evaluados en presentación dentífrico y colutorio. Todos los ensayos clínicos demostraron reducir la hipersensibilidad dentinaria con alguno de los agentes utilizados en comparación a la medición inicial. Conclusión: Se podría recomendar el uso de nitrato y citrato de potasio, arginina, fosfosilicato de calcio y sodio y nano-hidroxiapatita en dentífricos para el tratamiento de la hipersensibilidad.

ABSTRACT: Objectives: Describe the effectiveness of the use of different desensitizing agents contained in dentifrices and mouthwashes for the control of dentin hypersensitivity in adults. Method: An electronic search of the scientific evidence available was made in PubMed, Epistemónikos, EBSCO, BEIC and Cochrane Library; using a search strategy that included the key words. For each article found the level and quality of evidence, risk of bias and ethics were analyzed. Results: A total of 36 articles were included, 29 randomized controlled clinical trials and 7 systematic reviews. Of the clinical trials, five tested the efficacy of mouthwashes, two made a comparison using dentifrices and mouthwashes and 22 tested only the use of dentifrices. The desensitizing agents mainly found were potassium salts, arginine, nano-hydroxiapatite, calcium sodium phosphosilicate (CSPS) and strontium salts. Only the first two were tested in both presentations. All the clinical trials demonstrated a reduction in dentin hypersensitivity with the use of an agent in comparison to the initial measurement. Conclusions: The use of nitrate and citrate potassium, arginine, calcium sodium phosphosilicate and nano-hydroxyapatite in dentifrices for the treatment of hypersensitivity may be recommended.

Clinical evaluation of color change and tooth sensitivity with in-office and home bleaching treatments

Among the number of vital bleaching techniques currently available to the clinicians, home bleaching and in-office bleaching are widely used in dental practice. Aim and Objectives: The aim of this in vivo study was to compare the clinical performance, durability, and related tooth sensitivity with two vital bleaching procedures (in-office and at-home bleaching), in a split-mouth design. Patients and Methods: Thirty adult participants having teeth shade mean of A2 or darker were selected for the study. One-half of the maxillary arch of each patient received in-office bleaching with 35% hydrogen peroxide gel, and the other half received 16% carbamide peroxide night guard bleaching. Shade evaluation was done with shade guide and spectrophotometer at 1, 2, 3, and 4 week intervals during bleaching and postoperatively at 3 and 6 month intervals. Tooth sensitivity was recorded using the visual analog scale during the experimental period. Statistical Analysis: Collected data of color and sensitivity readings were subjected to statistical analysis using SPSS/PC version 20 software. Intergroup comparison through unpaired t-test and within the groups using paired t-test was done. Results: At-home and in-office bleaching procedures are equally effective in producing tooth whitening. Color evaluation after 3 and 6 months showed more color decline for in-office bleaching procedure. For sensitivity parameter also, in-office procedure recorded higher sensitivity compared to home bleaching (P < 0.05). Conclusion: Both the bleaching procedures are equally effective in producing tooth whitening. In-office bleaching recorded higher levels of tooth sensitivity and greater color rebound than home bleaching.

Use of 35% hydrogen peroxide in tooth bleaching in different clinical time intervals: how long does sensitivity last, and at what times is it more exacerbated? / Uso do peróxido de hidrogênio a 35% no clareamento dental em diferentes tempos clínicos: por quanto tempo perdura a sensibilidade e em quais momentos ela é mais exacerbada?

Tooth color is one of the characteristics that define a smile as attractive, and Dentistry offers tooth whitening as an option for achieving this purpose. However, this therapy is almost always accompanied by an inconvenience: dentin sensitivity. The objective of this study was to analyze two 35% hydrogen peroxide-based materials, used in different clinical time intervals to evaluate not only the efficacy of color change, but also how long dentin sensitivity lasts, and at what times is it most exacerbated. A total of 24 volunteers were selected. The maxillary arch was divided at the midline, forming the Right Group (RG) composed of the right maxillary hemi-arch (tooth 11-15) and Left Group (LG) composed of the left maxillary hemi-arch (tooth 21-25). The mandibular arch formed the control group CG. The RG received 35% hydrogen peroxide - Whiteness HP® - FGM Produtos Odontológicos, Joinville, SC, Brazil in three sessions of 45 minutes each ( Material 1) and LG received 35% hydrogen peroxide - Pola Office® - SDI Limited, Bayswater, VIC, Australia in three sessions of 24 minutes each ( Material 2) with an interval of one week between sessions. Color was evaluated visually by means of the Vitapan Classical Scale (Vita Zahnfabrick, Bad Säckingen, BW, Germany) at the beginning and end of each session, and 12 days after the last session. There was no statistically significant difference (p<0.05) in relation to bleaching potential, and intensity of sensitivity when the two materials used were compared, except in the second (T=0h) (P=0.047) and third sessions (T=12h) (P=0.033) in which Material 2 demonstrated a lower level of sensitivity compared with that of Material 1. Relative to the duration of sensitivity, this gradually diminished over the course of time, not exceeding 48 hours (P=1.000). There was no difference between the products with respect to bleaching power, and hydrogen peroxide used for a shorter time generated less tooth sensitivity.

A cor dos dentes é uma das características que define um sorriso como atrativo e o clareamento dental uma opção oferecida pela odontologia para alcançar esse fim. Porém, essa terapia quase sempre vem acompanhada de um incomôdo; a sensibilidade dentinária. O próposito deste estudo foi analisar dois materiais a base de peróxido de hidrogênio a 35% usados em diferentes tempos clínicos avaliando, além da eficácia da cor, a sensibilidade dental, por quanto tempo perdura e em quais momentos é mais exacerbada. Selecionamos 25 voluntários, a arcada superior de cada um passou por uma divisão a partir da linha mediana, formando o grupo direito (GD) composto pela hemi-arcada superior direita (dente 11-15) e o grupo esquerdo (GE) composto pela hemi-arcada superior esquerda (dente 21-25). A arcada inferior formou o grupo controle (GC). O GD recebeu peróxido de hidrogênio a 35% - Whiteness HP® - FGM Produtos odontológicos, Joinville, SC, Brasil em três sessões de 45 minutos cada ( Material 1) e o GE recebeu peróxido de hidrogênio a 35% - Pola Office® - SDI Limited, Bayswater, VIC, Austrália em três sessões de 24 minutos cada ( Material 2) com intervalo de uma semana entre as sessões. A cor foi avaliada visualmente com a escala Vitapan Classical (Vita Zahnfabrick, BadSackingen, BW, Alemanha) ao iniciar e finalizar cada sessão e 12 dias após a última sessão. Não houve diferença estatística significante (p<0,05) em relação ao potencial clareador e nem em relação a intensidade da sensibilidade quando comparados os dois materiais utilizados, exceto na segunda (T=0h) (P=0.047) e terceira sessão (T=12h) (P=0.033) onde o Material 2 demonstrou menor sensibilidade comparado ao Material 1. Quanto à duração da sensibilidade, esta foi diminuindo gradativamente ao longo do tempo, não excedendo 48 horas (P=1.000). Não houve diferença entre os produtos no que diz respeito ao poder de clareamento e o peróxido de hidrogênio utilizado em menor tempo gerou menos sensibilidade dentária.

Association between in-office and at-home tooth bleaching: a single blind randomized clinical trial

Abstract This controlled randomized clinical trial evaluated the effect of associating at-home and in-office bleaching procedures on tooth sensitivity (TS) and bleaching effectiveness. Forty patients subjected to on session of in-office bleaching with 38% peroxide hydrogen. Subsequently, the patients were randomly allocated to receive a second session of in-office bleaching or to use a tray containing 10% carbamide peroxide delivered during 7 consecutive days. The worst TS score reported during or after each bleaching procedure was recorded using a verbal rating scale and TS risk (score different from 0) was calculated. Color changes were measured 7 days after each in-office session (for patients receiving in-office procedures only) or after the end of at-home bleaching (for the combined protocol), and 6 months after the last procedure for both bleaching protocols. Color was assessed by a spectrophotometer and by color match with the Vita Classical and Bleach guide scales. Statistical analyses were carried out to assess possible differences between the protocols regarding the outcomes and to analyze the effect of time of assessment on color changes. The bleaching protocol did not affect the risk for and the maximum level of TS reported, irrespective of the time of assessment. In the color evaluation, the bleaching protocol also did not affect the ultimate tooth color. In conclusion, after one in-office bleaching session, there was no difference in bleaching effectiveness and TS between performing a second in-office session and associating it with 1-week at-home bleaching.

Resumo Este ensaio clínico controlado e randomizado avaliou o efeito da associação de procedimentos de clareamento caseiro e de consultório na sensibilidade dental (SD) e efetividade clareadora. Quarenta pacientes receberam uma sessão de clareamento de consultório com peróxido de hidrogênio a 38%. Em seguida, os pacientes foram aleatoriamente alocados para receberem uma segunda sessão de clareamento de consultório ou para usar uma moldeira com peróxido de carbamida a 10% por 7 dias consecutivos. O pior score de SD relatada durante ou após cada procedimento clareador foi mensurado usando uma escala verbal, e o risco a SD (escore diferente de 0) foi calculado. Mudança de cor foi mensurada 7 dias após cada sessão de clareamento de consultório (para paciente submetidos a apenas procedimentos de consultório) ou após o fim do clareamento de caseiro (para o protocolo combinado) e 6 meses após o último procedimento clareador para os dois protocolos de clareamento. A cor foi mensurada através de um espectrofotômetro e pelo uso das escalas Vita Clássica e Bleach guide. As análises estatísticas foram realizadas para verificar possíveis diferenças em relação aos desfechos e para analisar o efeito do momento da mensuração nas mudanças de cor. O protocolo clareador não afetou o risco e o nível máximo de SD relatado, independentemente do tempo de avaliação. Na avaliação de cor, o protocolo clareador também não afetou a cor final dos dentes. Como conclusão, após uma sessão de clareamento de consultório, não há diferença na efetividade clareadora e na SD em realizar uma segunda sessão de consultório ou associá-la com uma semana de clareamento caseiro.

Clinical evaluation of two dental bleaching techniques / 口腔疾病防治

Objective@#To clinically evaluate the bleaching effect, tooth sensitivity and rebound effect (3-month follow-up) of combined bleaching technique and deep bleaching technique. @*Methods@#30 Patients were recruited according to inclusion and exclusion criteria. Both two dental bleaching techniques, included in-office bleaching followed by at-home bleaching, and at-home bleaching followed by in-office bleaching and at-home bleaching, which were called combined bleaching technique and deep bleaching technique, respectively, were performed in the same mouth in each subject. All subjects received at-home bleaching with 6% hydrogen peroxide (HP) for 1 h/d within 7 days on one side of the dental arch (15 on the left side and the other on the right side), and followed by three 8-minute in-office bleaching treatments in succession with 35% HP on the maxillary anterior teeth, and finally with identical at-home bleaching on the maxillary anterior teeth. Tooth color was objectively evaluated using Olympus Crystaleye Spectrophotometer at the baseline appointment, and 1st, 7th, 30th and 90th day after treatment. The soft tissues and sensitivity of gingival and hard tooth tissues were evaluated using Loe and Silness Gingival Index and Visual Analog Scale (VAS) at baseline, 1st and 7th day after treatment. @*Results@#Significantly less prominent color change and tooth sensitivity were observed in teeth received combined bleaching technique, compared with those received deep bleaching technique (P < 0.05). There was no significant difference in color rebound effect between the two bleaching techniques (P > 0.05). @*Conclusions@#Both combined bleaching technique and deep bleaching technique show satisfactory effects and the same rebound effect during the same periods of follow-up. Deep bleaching technique is a more effective method of bleaching, however, with high frequency of tooth sensitivity.

Clinical evaluation of two dental bleaching techniques / 口腔疾病防治

Objective@#To clinically evaluate the bleaching effect, tooth sensitivity and rebound effect (3-month follow-up) of combined bleaching technique and deep bleaching technique. @*Methods@#30 Patients were recruited according to inclusion and exclusion criteria. Both two dental bleaching techniques, included in-office bleaching followed by at-home bleaching, and at-home bleaching followed by in-office bleaching and at-home bleaching, which were called combined bleaching technique and deep bleaching technique, respectively, were performed in the same mouth in each subject. All subjects received at-home bleaching with 6% hydrogen peroxide (HP) for 1 h/d within 7 days on one side of the dental arch (15 on the left side and the other on the right side), and followed by three 8-minute in-office bleaching treatments in succession with 35% HP on the maxillary anterior teeth, and finally with identical at-home bleaching on the maxillary anterior teeth. Tooth color was objectively evaluated using Olympus Crystaleye Spectrophotometer at the baseline appointment, and 1st, 7th, 30th and 90th day after treatment. The soft tissues and sensitivity of gingival and hard tooth tissues were evaluated using Loe and Silness Gingival Index and Visual Analog Scale (VAS) at baseline, 1st and 7th day after treatment. @*Results @#Significantly less prominent color change and tooth sensitivity were observed in teeth received combined bleaching technique, compared with those received deep bleaching technique (P < 0.05). There was no significant difference in color rebound effect between the two bleaching techniques (P > 0.05). @*Conclusions @#Both combined bleaching technique and deep bleaching technique show satisfactory effects and the same rebound effect during the same periods of follow-up. Deep bleaching technique is a more effective method of bleaching, however, with high frequency of tooth sensitivity.

The efficiency and safty of home-bleaching:A systematic review and Meta-analysis / 实用口腔医学杂志

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.

Beverages drinking habits and tooth sensitivity experience among adolescent secondary school students

AIM: The recent increase in consumption of acidic beverages is thought to be the leading cause of dental erosion observed among adolescents. The study assessed the drinking habits of Adolescent Secondary School Students and also evaluated their tooth sensitivity experience. MATERIALS AND METHODS: The survey was conducted among adolescent secondary school students. Purposely, students in boarding hostels were excluded. The sample was selected from twelve public and private secondary schools through the class teachers. RESULTS: 582 questionnaires were analyzed (294) females, 288 males . Soft drinks were the most consumed (97%) beverage, predominantly by females (94.6%) . Parents especially the mother mostly consume soft drinks. (78%) pointed out that that “soft drinks are good in between meals” and also 64% indicated that “soft drinks are good for the teeth”. Participants that preferred drinks at normal room temperature experienced the most tooth sensitivity. Majority (42.3% use straw but the most tooth sensitivity experience (63.3%) associated with long sipping. A statistically significant difference (X=0.252; df=1; p=0.005) in tooth sensitivity experience found between those that swish their drinks and those that did not. CONCLUSION: Soft drinks were the most consumed with a faulty believe that soft drinks are good in9between meals and for the teeth. Tooth sensitivity experience is common with preference for drinks at room temperature and long sipping. Swishing drinks is associated with tooth sensitivity.