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1.
Braz. dent. sci ; 25(1): 1-8, 2022. tab
Article in English | LILACS, BBO | ID: biblio-1354734

ABSTRACT

Objective: The present study compared the effect of whitening mouthrinses (WM) on the color change of stained resin composites (RC). Material and Methods: Cylindrical specimens (6mm-diameter and 1mm-thickness) were prepared with the following RC (n=60/group): Filtek Z350XT (Z350- methacrylate-based), Admira Fusion (AD- ormocer-based), TPH3 (TPH- methacrylate-based), and Beautifil II (BII- giomer/methacrylate-based). The initial color was assessed with reflectance spectrophotometer using CIE L*a*b* system. The specimens were immersed in staining broth during 14 days, submitted to color evaluation (ΔE1) and randomly allocated in 4 subgroups (n=15), according to WM adopted: Listerine Whitening (LW-2% hydrogen peroxide), Plax Whitening (PW-1.5% hydrogen peroxide), Bromelain/papain (BP-experimental solution), and Deionized water (DW-negative control). The whitening cycle consisted of RC immersion in WM for 1 min and in artificial saliva for 30 min, simulating 12 weeks, and final color assessment was performed (ΔE2). Color change data were analysed by ANOVA and Tukey's tests (α=5%). Results: After staining, TPH showed the lowest ΔE1 values and Z350 showed the highest color change (p=0.001). The whitening effect promoted by LW was significantly higher than color alteration obtained with PW (ΔE2), and BII showed the highest color change values (ΔE2) after whitening cycle. Conclusion: LW exhibited the greatest whitening potential on stained RC, mainly with the Giomer (Beautifill II) and the Ormocer-based (Admira Fusion) materials. Bromelain/papain solution showed no whitening effect on stained RC. (AU)


Objetivo: O presente estudo comparou o efeito de enxaguatórios clareadores (EC) na alteração de cor de resinas compostas (RC) previamente manchadas. Material e Métodos: Espécimes cilíndricos (6mm de diâmetro e 1mm de espessura) foram preparados com as seguintes RC (n=60/grupo): Filtek Z350XT (Z350- metacrilato), Admira Fusion (AD- ormocer), TPH3 (TPH- metacrilato), e Beautifil II (BII- giomer/metacrilato). A cor inicial foi mensurada com espectrofotômetro de reflectância utilizando o sistema CIE L*a*b*. Os espécimes foram imersos em um caldo de manchamento durante 14 dias, submetidos a avaliação de cor (ΔE1) e alocados aleatoriamente em 4 subgrupos (n=15), de acordo com EC adotado: Listerine Whitening (LW-peróxido de hidrogênio a 2%), Plax Whitening (PW- peróxido de hidrogênio a 1,5%), Bromelina/papaína (BP-solução experimental), e Água deionizada (AD- controle negativo). O ciclo clareador consistiu na imersão da RC no EC por 1 min e na saliva artificial por 30 min, simulando 12 semanas, e a cor final foi mensurada (ΔE2). Os dados de alteração de cor foram analisados pelos testes ANOVA e Tukey (α=5%). Resultados: Após o manchamento, TPH apresentou o menor valor de ΔE1 e Z350 apresentou a maior alteração de cor (p=0,001). O efeito clareador promovido pelo LW foi significativamente maior que o obtido com o PW (ΔE2) e BII teve a maior alteração de cor (ΔE2) após o ciclo clareador. Conclusão: LW exibiu maior potencial clareador nas RC manchadas. BII apresentou maior alteração de cor em resposta à ação clareadora de ambos enxaguatórios à base de peróxido de hidrogênio testados.(AU)


Subject(s)
Composite Resins , Tooth Bleaching Agents , Organically Modified Ceramics , Hydrogen Peroxide
2.
Braz. j. oral sci ; 20: e219320, jan.-dez. 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1253013

ABSTRACT

Aim: This study analyzed the effect of whitening mouth rinses on water sorption (WS), solubility (SL), color change, and surface roughness of a nanofilled composite. Whitening perceptibility and acceptability (WID) were also studied. Methods: Forty specimens of Filtek Z350XT, shade EA2 were produced and randomly distributed (n=8) to AS ­ artificial saliva (control); LWE ­ Listerine Whitening Extreme; CLW ­ Colgate Luminous White; LCM ­ Listerine Cool Mint; and CP ­ Colgate Plax. They were immersed in the mouth rinses 2x/day, for one minute, during 28 days. The color was assessed using an Easyshade spectrophotometer (CIE-L*a*b* system). Surface roughness (Ra-µm) was measured with three parallel measures, using an RP-200 roughness meter. The WS and SL (µg/mm-3) were analyzed based on the ISO 4049 recommendations. The data were analyzed using one- and two-way ANOVA/Tukey tests (α=0.05). Results: Surface roughness significantly increased after immersion in AS and LCM, with no significant differences between the groups either before or after immersion. The ΔE* was not significantly different between the groups. All substances produced a ΔWID higher than the 50%:50% perceptibility and acceptability thresholds. The WS and SL were not significantly affected by the mouth rinses. Conclusion: Whitening mouth rinses did not affect WS, SL, surface roughness, and color stability of a nanofilled composite, regardless of the presence of ethanol in the composition


Subject(s)
Color , Composite Resins , Nonprescription Drugs , Tooth Bleaching Agents , Mouthwashes
3.
Braz. j. oral sci ; 20: e211711, jan.-dez. 2021. tab
Article in English | LILACS, BBO | ID: biblio-1253790

ABSTRACT

Aim: The present study aimed to investigate if the Guatemalan dentist's options on tooth bleaching could be influenced by their time in clinical practice, the level of specialization or their working place. Methods: A representative sample of dentists working in clinical practice in Guatemala was selected. Data were collected using a self-administered questionnaire with information related to gender, professional characteristics (time since graduation in years and working place) and preferences regarding vital (at-home or in-office; type and concentration of bleaching agent) and the nonvital tooth bleaching (bleaching agent used). The analysis was performed and the association between preference for bleaching technique and independent variables were investigated using Fisher's exact test. Results: 200 dentists were interviewed. More than half of dentists were male (57.0%) with time since graduation between 11 and 20 years (n= 64; 32.3%). Dentists mostly (60.5%) preferred in-office technique for vital bleaching, with 10-20% Carbamide peroxide (CP) as the preferred agent (50%). For nonvital teeth, the preferred agent (46.8%) was 37% Hydrogen Peroxide (HP). About the associations, younger dentists (< 20 years of graduation) selected mostly in-office technique, while those with more than 20 years indicated more the at-home technique. Also, the dentists working in private practice chose more frequently in-office technique. Thus, the in-office technique was more popular among Guatemalan dentists, with 10-20% CP and 37% HP selected as favorite bleaching agents for vital and nonvital techniques, respectively. Conclusion: The time of clinical practice and working place influenced some choices


Subject(s)
Humans , Male , Female , Cross-Sectional Studies , Surveys and Questionnaires , Practice Patterns, Dentists' , Tooth Bleaching Agents
4.
Braz. dent. j ; 32(4): 19-30, July-Aug. 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1345519

ABSTRACT

Abstract: This study investigated the bleaching effectiveness and the physicochemical effects on enamel of violet light and ozone, associate or not to hydrogen peroxide, compared to 35%-hydrogen peroxide. Enamel-dentin blocks from human molars were randomly allocated to receive one of the following bleaching protocols (n=15): (HP) 35%-hydrogen peroxide, (VL) violet light, (OZ) ozone, the association between hydrogen peroxide with ozone (OZ+HP) or violet light (VL+HP). All protocols were performed in two sessions with a 48h interval. Color (spectrophotometer) and mineral composition (Raman spectroscopy) were measured before and after the bleaching. Color changes were calculated by ΔEab, ΔE00, and whitening index (WI). The surface roughness was measured with an atomic force microscope. Data were analyzed by One-way or Two-way repeated measure ANOVA followed by the Tukey's test (α = 0.05). The lowest color change values (either measured by WI, ΔEab, or ΔE00) were observed for VL and OZ used with no HP. Violet light associate with HP was unable to improve the color changes observed for the peroxide alone, in combination with OZ and HP, the highest color changes were verified. Regardless of bleaching protocol, the bleached enamel presented higher contents of PO4 and CO3 -2 than those observed at baseline. All bleaching protocols resulted in similar enamel surface roughness. Both the VL and the OZ caused reduced effects on the enamel color change when used alone. The ozone therapy improved the bleaching effect in the group that received the association of HP.


Resumo O objetivo deste estudo foi avaliar o efeito clareador e físico-químico no esmalte de luz violeta e ozônio, associado ou não ao peróxido de hidrogênio, comparado a 35% de peróxido de hidrogênio. Blocos de esmalte-dentina de molares humanos foram alocados aleatoriamente para receber um dos seguintes protocolos de clareamento (n = 15): (HP) peróxido de hidrogênio a 35%, (VL) luz violeta, (OZ) ozônio, a associação entre peróxido de hidrogênio com ozônio (HP+OZ) ou luz violeta (HP+VL). Todos os protocolos foram realizados em duas sessões, com intervalo de 48 horas entre eles. A cor (espectrofotômetro) e a composição mineral (espectroscopia Raman) do dente foram medidas antes e após os procedimentos de clareamento. As alterações de cor foram calculadas por ΔEab e ΔE00, e o índice de brancura foram calculados. A rugosidade da superfície das amostras clareadas foi medida por microscópio de força atômica. Os dados foram analisados por ANOVA One way ou ANOVA two way de medidas repetidas seguida pelo teste de Tukey (α = 0,05). Os menores valores de alterações de cor (medidos por WI, ΔEab ou ΔE00) foram observados para VL e OZ usados na ausência de HP. VL associada ao HP não foi capaz de melhorar as alterações de cor observadas com o uso do HP, mas a combinação de OZ e HP produz as maiores alterações de cor. Independentemente do protocolo de clareamento, o esmalte clareado apresentou maiores teores de PO4 e CO3 -2 do que os observados inicialmente. Não foi observada diferença significativa entre os protocolos de clareamento testados em relação à rugosidade da superfície do esmalte. É possível concluir que a VL ou o OZ tiveram efeitos reduzidos na mudança de cor do esmalte quando usados sozinhos. A terapia com OZ melhorou o efeito clareador do HP.


Subject(s)
Humans , Ozone , Tooth Bleaching , Tooth Bleaching Agents , Color , Dental Enamel , Hydrogen Peroxide
5.
Braz. dent. j ; 32(3): 105-115, May-June 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1345503

ABSTRACT

Abstract This clinical trial evaluated the effect of the coadministration of ibuprofen/caffeine on bleaching-induced tooth sensitivity (TS). A triple-blind, parallel-design, randomized clinical trial was conducted on 84 patients who received ibuprofen/caffeine or placebo capsules. The drugs were administered for 48 hours, starting 1 hour before the in-office bleaching. Two bleaching sessions were performed with 35% hydrogen peroxide gel with 1-week interval. TS was recorded up to 48 hours after dental bleaching with a 0-10 visual analogic scale (VAS) and a 5-point numeric rating scale (NRS). The color was evaluated with VITA Classical and VITA Bleachedguide scales (ΔSGU) and VITA Easyshade spectrophotometer (ΔE*ab and ΔE00). The absolute risk of TS in both groups was evaluated using Fischer's exact test. Comparisons of the TS intensity (NRS and VAS data) were performed by using the Mann-Whitney test and a two-way repeated measures ANOVA, respectively. The color alteration between the groups was compared with the Student's t test. The significance level was 5%. There was no statistically significant difference between the groups for the absolute risk of TS (p = 1.00) or for the intensity of TS (p > 0.05). A bleaching of approximately 7 shade guide units was observed on the Vita Classical and Vita Bleachedguide scales, with no statistical difference between the groups. It was concluded that coadministration of ibuprofen and caffeine did not reduce the absolute risk or intensity of TS and did not interfere with the efficacy of dental bleaching.


Resumo Este ensaio clínico avaliou o efeito da coadministração de ibuprofeno/cafeína na sensibilidade dental decorrente de clareamento (SD). Um estudo clínico randomizado, paralelo, triplo-cego, foi realizado em 84 pacientes que receberam cápsulas de ibuprofeno/cafeína ou placebo. Os fármacos foram administrados por 48 horas, começando 1 hora antes do clareamento em consultório. Duas sessões de clareamento foram realizadas com gel de peróxido de hidrogênio 35% com intervalo de 1 semana. A SD foi registrada até 48 horas após o clareamento dental com uma escala visual analógica (VAS) de 0-10 e uma escala de classificação numérica (NRS) de 5 pontos. A cor foi avaliada com as escalas Vita Classical e Vita Bleachedguide (ΔSGU) e com o espectrômetro Vita Easyshade (ΔE*ab e ΔE00). O risco absoluto de SD em ambos os grupos foi avaliado por meio do teste exato de Fischer. As comparações da intensidade da SD (NRS e VAS) foram realizadas utilizando-se o teste Mann-Whitney e uma ANOVA de dois fatores com medidas repetidas, respectivamente. A alteração de cor entre os grupos foi comparada com a o teste t de Student. O nível de significância foi de 5%. Não houve diferença estatisticamente significante entre os grupos para o risco absoluto de SD (p = 1,00) ou para a intensidade de SD (p > 0,05). Observou-se clareamento de aproximadamente 7 unidades nas escalas Vita Classical e Vita Bleachedguide, sem diferença estatística entre os grupos. Concluiu-se que a coadministração de ibuprofeno e cafeína não reduziu o risco absoluto ou intensidade da SD e não interferiu na eficácia do clareamento dental.


Subject(s)
Humans , Tooth Bleaching , Caffeine/therapeutic use , Ibuprofen/therapeutic use , Dentin Sensitivity/chemically induced , Tooth Bleaching Agents/adverse effects , Treatment Outcome , Hydrogen Peroxide
6.
J. appl. oral sci ; 29: e20200511, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1143152

ABSTRACT

Abstract Objective To evaluate the effect of the association between external and internal tooth bleaching on color changes in dentin and enamel, individually or recombined, previously stained with triple antibiotic paste (TAP). Methodology Forty enamel-dentin specimens from bovine incisors were separated into ten blocks according to similarity in their whiteness index (WID). Three specimens within each block were stained by dentin exposure to TAP, and the remaining specimen was used as control to estimate color changes. Specimens were sectioned to separate tissues, and dentin and enamel colors were measured individually and after being recombined. Alterations in color (CIEDE2000 - ΔE00) and translucency parameter (TP) resulting from staining were estimated by color difference between stained and control specimens. The contribution of each tissue to the color change (CTCC) was also calculated. Non-sectioned stained specimens were bleached by applying sodium perborate on dentin, associated or not with 35% hydrogen peroxide on enamel. Color changes caused by bleaching procedures were estimated and data were analyzed using the paired t-test or Two-way repeated measures ANOVA. Results TAP caused more pronounced changes in dentin, but enamel color was also affected. Both protocols presented a similar ΔE00, and dentin showed the greater color change. After exposure to TAP, we observed a reduction in WID; WID values were the same for bleached and control specimens regardless of protocol. We found no significant effect of substrate and bleaching technique on TP. Enamel played a more critical role in color changes caused by either staining or bleaching procedures. Conclusion Enamel color played a greater role on tooth color changes than dentin. External and internal bleaching association did not improve bleaching effect on specimens stained with TAP.


Subject(s)
Animals , Cattle , Color , Dental Enamel , Dentin , Tooth Bleaching Agents , Tooth Bleaching , In Vitro Techniques , Hydrogen Peroxide
7.
Odontoestomatol ; 23(37): e402, 2021. graf
Article in Spanish | LILACS | ID: biblio-1250425

ABSTRACT

Resumen Introducción: El oscurecimiento de un diente anterior interfiere negativamente en el aspecto de la sonrisa, y varias son las causas que pueden ser responsables por este oscurecimiento. Objetivo: Describir las técnicas de blanqueamiento mixto e inmediato a través del reporte de dos casos clínicos. Caso 1: Individuo de sexo masculino, con Síndrome de Treacher Collins, se quejó sobre alteración cromática del diente 33, verificada mediante examen clínico, radiográficamente presencia de tratamiento endodóntico satisfactorio. Por lo que fue planeado el blanqueamiento interno mediante técnica mixta. Caso 2: Individuo de sexo masculino, con Síndrome de Apert reportó cambio cromático en el diente 22, observado en el examen clínico, radiográficamente presentando tratamiento endodóntico insatisfactorio. Se realizó retratamiento endodóntico y a los 6 meses se realizó blanqueamiento interno mediante técnica inmediata. Conclusión: El blanqueamiento dental ejecutado con las técnicas mixtas e inmediatas, devuelve la armonía de la sonrisa, recuperando el color ideal y elevando la autoestima a los pacientes.


Resumo Introdução: O escurecimento de um dente anterior interfere negativamente na aparência do sorriso, e várias são as causas que podem ser responsáveis por esse escurecimento. Objetivo: Descrever as técnicas clareadoras mista e imediata através do relato de dois casos clínicos. Caso 1: Indivíduo do gênero masculino com Síndrome de Treacher Collins, queixou-se de alteração cromática no dente 33, constatado no exame clínico, radiograficamente apresentando tratamento endodôntico satisfatório. O clareamento interno foi planejado e realizado pela técnica mista. Caso 2: Indivíduo do gênero masculino, com Síndrome de Apert, relatou alteração cromática no dente 22, constatado ao exame clínico, apresentando tratamento endodôntico insatisfatório. Foi realizada a reintervenção endodôntica e após 6 meses, foi realizado clareamento interno pela técnica imediata. Conclusão: O uso das técnicas clareadoras mista e imediata, resulta na devolução da harmonia do sorriso, recuperando a coloração ideal e devolvendo a autoestima aos pacientes.


Abstract Introduction: The darkening of a single anterior tooth negatively affects the smile's appearance, and several factors may cause this darkening. Objective: To describe the mixed and immediate bleaching techniques by reporting two clinical cases. Case 1: A male individual with Treacher Collins Syndrome. He complained of chromatic alteration in tooth 33, which was verified on clinical examination. X-ray imaging showed satisfactory endodontic treatment. Internal bleaching was performed with the mixed technique. Case 2: A male individual with Apert Syndrome reported chromatic alteration in tooth 22, observed on clinical examination. X-ray imaging showed unsatisfactory endodontic treatment. Endodontic retreatment was performed. Six months later, internal whitening was performed immediately. Conclusion: The use of mixed and immediate whitening techniques restores the smile's harmony, the tooth's ideal color, and patients' self-esteem.


Subject(s)
Tooth Bleaching/methods , Tooth, Nonvital , Tooth Bleaching Agents
8.
Braz. oral res. (Online) ; 35: e066, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1249366

ABSTRACT

Abstract: This study developed experimental gels containing titanium tetrafluoride (TiF4) combined with commercial 35% hydrogen peroxide (HP), and evaluated bleaching efficacy and pH of the gels, and mineral content and morphology of enamel submitted to these treatments. In phase-1, different stock gels mixed with TiF4 were combined with HP. In phase-2, the selected gels were tested on enamel/dentin specimens (n=8): HP; HP and Natrosol+TiF4 (HPnT); HP and Natrosol+Chemygel+TiF4 (HPncT); HP and Aristoflex+TiF4 (HPaT). Bleaching was performed in four sessions (3x15min-application/session). Color (CIEL*a*b*) and whiteness index (WID) were measured after each session, whereas whiteness index differences (ΔWID), color alteration (CIELab-ΔE, CIEDE2000-ΔE00), enamel morphology and pH, at end of bleaching therapy. The change in Knoop microhardness (ΔKHN) was compared before and after bleaching. Data were analyzed by two-way repeated measures ANOVA and Bonferroni (CIEL*, a*, b*), one-way ANOVA and Tukey (ΔWID, ΔE, ΔE00), and LSD (ΔKHN) tests (α=5%). SEM and pH measurements were submitted to descriptive analysis. No differences were observed in lightness (L*) or WID among the groups (p > 0.05), but HP exhibited lower b* values (p<0.05), higher ΔWID than HPnT, and the highest ΔE among the groups (p < 0.05). No differences in ΔE00 were observed between HP and HPncT (p > 0.05), and HPncT showed higher ΔKHN than HP (p < 0.05). HP presented pH values closer to neutral (6.9), whereas experimental agents showed acidic pH values (2.3-3.9). No morphological changes were observed in HP or HPncT groups. HPncT was able to bleach the enamel and maintain enamel microhardness and surface integrity, even at low pH.


Subject(s)
Tooth Bleaching , Bleaching Agents , Tooth Bleaching Agents , Titanium , Fluorides , Hydrogen Peroxide
9.
Article in English | LILACS, BBO | ID: biblio-1287487

ABSTRACT

ABSTRACT Objective: To assess the 6-month efficacy of natural tooth color change in in-office bleaching treatment in terms of time by using a spectrophotometer. Material and Methods: A total of 20 participants were chairside treated with 40% hydrogen peroxide (HP), three applications each 20 minutes, in one appointment. Instrumental color measurement was performed on six anterior maxillary teeth before bleaching (baseline-t0), immediately after in-office bleaching and rehydration of the teeth (t1), 3 months (t2), and 6 months after bleaching treatment (t3). The spectrophotometer measured the tooth shades based on the CIE L*a*b* color notation system and Bleach index during the period of observation. CIE L*a*b* (ΔEab) color differences were calculated. Results: The color change at t1 was ΔEab = 3.2, at t2 was ΔEab = 1.8, at t3 was ΔEab = 1.2 and overall color change of in-office method was ΔEab = 3.6 (p<0.05). A significant effect for the mean CIEL*a*b* values was detected as within time b* values decreased significantly (p<0.05). Bleach index values significantly decreased during the time of observation, too (p<0.05). Conclusion: The in-office bleaching treatment using 40% hydrogen peroxide was effective, and the results showed a statistically significant decrease in color change during the period of 6-month observation.


Subject(s)
Humans , Male , Female , Adult , Tooth Bleaching , Spectrophotometers , Dental Offices , Tooth Bleaching Agents/chemistry , Hydrogen Peroxide/therapeutic use , Analysis of Variance , Data Interpretation, Statistical , Treatment Outcome , Bosnia and Herzegovina , Statistics, Nonparametric
10.
Arq. odontol ; 57: 8-16, jan.-dez. 2021. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1150644

ABSTRACT

Objetivo: Avaliar capacidade seladora de um cimento resinoso autoadesivo como tampão cervical para clareamento interno. Métodos: Quarenta incisivos inferiores bovinos recém-extraídos foram tratados endodonticamente. Após 72 horas, foi realizada a desobturação parcial do canal radicular para confecção de tampão cervical dividido em quatro grupos aleatório (n = 40), cada um contento dez amostras (n = 10), com os seguintes materiais: cimento resinoso autoadesivo, cimento resinoso adesivo, cimento de óxido de zinco sem eugenol com presa por água e cimento de ionômero de vidro quimicamente ativado (grupo controle). Após 24 horas de presa dos materiais, os elementos dentais foram submetidos ao clareamento interno com perborato de sódio misturado com água destilada pelo período de 7 dias em câmara umidificadora a 37 ºC. Posteriormente, o material clareador foi removido e um corante (fucsina básica 0,5%) foi colocado no interior da câmara pulpar, sendo renovado de 8 em 8 horas, pelo período de 24 horas. Os elementos dentais foram seccionados no sentido longitudinal em máquina de corte para avaliação quantitativa em um microscópio óptico sob aumento de 20x. O grau de penetração do corante foi analisado ao longo do tampão cervical (topo até base). Resultados: Não houve diferença significativa entre os materiais tamponantes utilizados (p = 0,5997). Conclusão: O cimento resinoso autoadesivo apresentou baixo grau de infiltração, sendo uma opção de material alternativo com finalidade de tampão cervical.


Aim: To evaluate the sealing ability of a self-adhesive resin cement as a cervical barrier for internal bleaching. Methods: Forty recently extracted bovine lower incisors were endodontically treated. After 72 hours, partial disobturation of the root canal was performed, a cervical barrier was placed, and the teeth were divided into four random groups (n = 40), each containing ten samples (n = 10), using the following materials: self-adhesive resin cement, adhesive resin cement, zinc oxide cement without eugenol cured by water, and chemically activate glass ionomer cement (control group). Twenty-four hours after the materials were cured, the teeth were subjected to internal bleaching with sodium perborate and distilled water for a period of seven days in a humidified chamber at 37°C. After, the bleaching material was removed and a dye (0.5% basic fuchsin) was placed inside the pulp chamber and renewed every eight hours for a period of 24 hours. The teeth were sectioned longitudinally in a cutting machine for quantitative evaluation using an optical microscope under 20x magnification. The degree of dye penetration was evaluated through the cervical barrier (top to bottom). Results: No significant difference was observed among the cervical barrier materials used in this study (p = 0.5997). Conclusion: The self-adhesive resin cement had low degree of leakage and represents an alternative material option to be used as a cervical barrier.


Subject(s)
Tooth Bleaching , Resin Cements , Dental Cements/analysis , Endodontics , Tooth Bleaching Agents/analysis , Glass Ionomer Cements , Epidemiology, Experimental
11.
Rev. cient. odontol ; 8(2): e021, mayo-ago. 2020. ilus
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1119299

ABSTRACT

La reabsorción cervical externa es un proceso patológico con una etiología no comprendida en su totalidad. Los posibles factores predisponentes son el tratamiento de ortodoncia, los traumatismos, el blanqueamiento interno, el bruxismo, entre otros. El blanqueamiento interno es una forma efectiva y mínimamente invasiva de blanquear dientes no vitales, con un riesgo asociado con reabsorción, que al no ser tratado podría provocar incluso la pérdida dentaria. Este reporte de caso describe el manejo de dos incisivos superiores con reabsorciones cervicales externas, que tienen como antecedente tratamiento de conducto y blanqueamiento interno. (AU)


External cervical resorption is a pathological process, with an etiology that is not completely understood. Possible predisposing factors are orthodontic treatment, trauma, internal whitening, bruxism, etc. Internal whitening is an effective and minimally invasive method for the whitening non-vital teeth. This method is associated with a risk of resorption, which if not treated, can lead to tooth loss. This case report describes the management of two upper incisors with external cervical resorption, with a previous history of root canal treatment and internal whitening. (AU)


Subject(s)
Humans , Female , Adult , Root Resorption , Tooth Resorption , Tooth Bleaching Agents
12.
Braz. dent. j ; 31(3): 221-235, May-June 2020. graf
Article in English | LILACS, BBO | ID: biblio-1132300

ABSTRACT

Abstract There is an increased accessibility of over-the-counter (OTC) whitening agents with very little data in the literature regarding their effectiveness. This review was done to determine their effectiveness of the predominant OTC whitening agents from 2006 until 2018 where a comparison of each agent was made with a placebo, no treatment or with other OTC whitening agents. The major categories of OTC whitening agents such as dentifrices, whitening strips and paint on gels. Dentist prescribed bleaching applied at home and in-office bleaching studies and studies that demonstrated whitening products to participants were excluded. Articles were searched for in the databases of Medline (Ovid), PubMed, the Cochrane Library and Cochrane Central Register of Controlled Trials. Twenty-four articles were included in the systematic review and the quality of studies was determined by the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) ranking criteria. Compared to other OTC, strips are reported to be effective. Two studies determined whitening strips to be effective. Whitening strips have been shown to be effective when compared with placebos and other OTC whitening agents. Dentifrices are effective in changing the shade of the tooth "by removing extrinsic stains" when compared to a placebo and non-whitening dentifrices, but they are not as effective in comparison to whitening strips. There is a lack of evidence with regards to the effectiveness of paint-on gels. While there is some evidence that OTC can alter shade in the short term, there is a need for better-designed studies.


Resumo Há um aumento da acessibilidade dos agentes clareadores de venda livre com poucos dados na literatura sobre sua eficácia. Esta revisão foi feita para determinar a eficácia dos agentes clareadores de venda livre predominantes de 2006 a 2018, onde foi feita uma comparação de cada agente com um placebo, sem tratamento ou com outros agentes clareadores de venda livre. As principais categorias de agentes clareadores de venda livre, como dentifrícios, tiras branqueadoras e géis. Estudos em que o dentista prescreveu clareamento caseiro e em consultório, e estudos que demonstraram os agentes clareadores para os participantes. Os artigos foram pesquisados ​​nas bases de dados do Medline (Ovid), PubMed, Cochrane Library e Cochrane Central Register of Controlled Trials. Vinte e quatro artigos foram incluídos na revisão sistemática e a qualidade dos estudos foi determinada pelo critério de classificação GRADE (Classificação de Recomendações, Avaliação, Desenvolvimento e Avaliações). Em comparação com outros clareadores de venda livre, as tiras são relatadas como eficazes. Dois estudos determinaram que as tiras de clareamento são eficazes. As tiras de clareamento mostraram-se eficazes quando comparadas com placebos e outros agentes clareadores de venda livre. Os dentifrícios são eficazes na mudança da tonalidade do dente "removendo manchas extrínsecas" quando comparados a dentifrícios com placebo e sem clareamento, mas não são tão eficazes em comparação com as tiras de clareamento. Há uma falta de evidência com relação à eficácia dos géis de tinta. Embora exista alguma evidência de que os clareadores de venda livre possa alterar a tonalidade no curto prazo, há necessidade de estudos melhor projetados.


Subject(s)
Humans , Tooth Bleaching , Tooth Discoloration , Tooth Bleaching Agents , Urea , Carbamide Peroxide
13.
Braz. dent. j ; 31(3): 236-243, May-June 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132299

ABSTRACT

Abstract This study aimed to quantify the penetration of hydrogen peroxide, color change evaluation, surface morphology, and composition after application of desensitizing agents before in-office bleaching. Fifty premolars were sectioned, an acetate buffer was placed in the pulp chamber and divided into five groups (n=10). In the positive control group, only the in-office bleaching gel was used, and in the negative control group, no treatment was used. Three different desensitizing agents were applied: Desensibilize KF2%® group; Mi Paste® group, and Desensibilize Nano-P® group. The bleaching procedure was carried out with 35% HP. The absorbance of the resulting solution was determined in a spectrophotometer. Color change was assessed by using a digital spectrophotometer. Four additional premolars were assigned to the same groups above for analysis under scanning electron microscope, as well as to evaluate the elemental composition with X-ray dispersive energy spectrometry. Data were subjected to ANOVA and Tukey's test (α=0.05). All products reduced the penetration of HP in the pulp chamber. Mi Paste and Nano P were the products that yielded the lowest HP penetration, which was similar to the negative control group (p<0.001). No significant difference was detected in color change (p<0.001). Concerning enamel morphology, the groups that were analyzed after bleaching were observed a greater deposition of desensitizing agents on the surface. The use of desensitizing agents before tooth bleaching seems to be an alternative to reduce adverse effects of the tooth.


Resumo Este estudo teve como objetivo quantificar a permeabilidade do peróxido de hidrogênio (PH), avaliação da mudança de cor, morfologia da superfície e composição de elementos após a aplicação de agentes dessensibilizantes antes do clareamento em consultório. Cinquenta pré-molares foram seccionados, um tampão de acetato foi colocado na câmara pulpar e divididos em cinco grupos (n=10). No grupo controle positivo, apenas o gel clareador em consultório foi utilizado e no grupo controle negativo nenhum tratamento foi realizado. Foram aplicados três agentes dessensibilizantes diferentes: grupo KF2%®; grupo Mi Paste® e Desensibilize Nano-P®. O procedimento de clareamento foi realizado com PH a 35%. A absorbância da solução resultante foi determinada em um espectrofotômetro. A mudança de cor foi avaliada utilizando um espectrofotômetro digital. Quatro pré-molares adicionais foram atribuídos aos mesmos grupos acima para análise em microscópio eletrônico de varredura, bem como para avaliar a composição elementar com espectrometria de energia dispersiva por raios-X. Os dados foram submetidos ao teste ANOVA e Tukey (a=0,05). Todos os produtos reduziram a penetração de PH na câmara pulpar. Mi Paste e Nano P foram os produtos que apresentaram a menor penetração de PH, semelhante ao grupo controle negativo (p<0,001). Nenhuma diferença significativa foi detectada na mudança de cor (p<0,001). Em relação à morfologia do esmalte, os grupos analisados após o clareamento apresentou maior deposição de agentes dessensibilizantes na superfície. O uso de agentes dessensibilizantes antes do clareamento dental parece ser uma alternativa para reduzir os efeitos adversos no dente.


Subject(s)
Tooth Bleaching , Tooth Bleaching Agents , Dental Enamel , Dental Pulp Cavity , Hydrogen Peroxide
14.
J. appl. oral sci ; 28: e20190384, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1134801

ABSTRACT

Abstract 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.


Subject(s)
Animals , Male , Pulpitis/prevention & control , Tooth Bleaching/methods , Dental Pulp/drug effects , Tooth Bleaching Agents/chemistry , Glass/chemistry , Hydrogen Peroxide/chemistry , Pulpitis/chemically induced , Pulpitis/pathology , Time Factors , Tooth Bleaching/adverse effects , Random Allocation , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Dental Pulp/pathology , Tooth Bleaching Agents/adverse effects , Hydrogen Peroxide/adverse effects , Molar
15.
J. appl. oral sci ; 28: e20190720, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1134776

ABSTRACT

Abstract Objective This study evaluated the clinical effect of violet LED light on in-office bleaching used alone or combined with 37% carbamide peroxide (CP) or 35% hydrogen peroxide (HP). Methodology A total of 100 patients were divided into five groups (n=20): LED, LED/CP, CP, LED/HP and HP. Colorimetric evaluation was performed using a spectrophotometer (ΔE, ΔL, Δa, Δb) and a visual shade guide (ΔSGU). Calcium (Ca)/phosphorous (P) ratio was quantified in the enamel microbiopsies. Measurements were performed at baseline (T 0 ), after bleaching (T B ) and in the 14-day follow-up (T 14 ). At each bleaching session, a visual scale determined the absolute risk (AR) and intensity of tooth sensitivity (TS). Data were evaluated by one-way (ΔE, Δa, ΔL, Δb), two-way repeated measures ANOVA (Ca/P ratio), and Tukey post-hoc tests. ΔSGU and TS were evaluated by Kruskal-Wallis and Mann-Whitney, and AR by Chi-Squared tests (a=5%). Results LED produced the lowest ΔE (p<0.05), but LED/HP promoted greater ΔE, ΔSGU and Δb (T 14 ) than HP (p<0.05). No differences were observed in ΔE and ΔSGU for LED/CP and HP groups (p>0.05). ΔL and Δa were not influenced by LED activation. After bleaching, LED/CP exhibited greater Δb than CP (p>0.05), but no differences were found between these groups at T 14 (p>0.05). LED treatment promoted the lowest risk of TS (16%), while HP promoted the highest (94.4%) (p<0.05). No statistical differences of risk of TS were found for CP (44%), LED/CP (61%) and LED/HP (88%) groups (p>0.05). No differences were found in enamel Ca/P ratio among treatments, regardless of evaluation times. Conclusions Violet LED alone produced the lowest bleaching effect, but enhanced HP bleaching results. Patients treated with LED/CP reached the same efficacy of HP, with reduced risk and intensity of tooth sensitivity and none of the bleaching protocols adversely affected enamel mineral content.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Phototherapy/methods , Tooth Bleaching/methods , Tooth Bleaching Agents/administration & dosage , Carbamide Peroxide/administration & dosage , Hydrogen Peroxide/administration & dosage , Light , Reference Values , Spectrophotometry , Surface Properties/drug effects , Surface Properties/radiation effects , Risk Factors , Analysis of Variance , Treatment Outcome , Colorimetry , Combined Modality Therapy , Statistics, Nonparametric , Dental Enamel/drug effects , Dental Enamel/radiation effects , Dentin Sensitivity/chemically induced
16.
J. appl. oral sci ; 28: e20190755, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1134785

ABSTRACT

Abstract Objective To clinically assess the effect of desensitizing gels and dentifrices on the reduction in pain sensitivity and color variation during tooth bleaching. Methodology A total of 108 volunteers were randomly separated into the following groups of n=12: GT/S-glycerine and thickener/sucralose; NF/S-potassium nitrate and sodium fluoride/sucralose; NA/S-potassium nitrate and arginine/sucralose; GT/AC-glycerine and thickener/arginine and calcium carbonate; NF/AC-potassium nitrate and sodium fluoride/arginine and calcium carbonate; NA/AC-potassium nitrate and arginine/arginine and calcium carbonate; GT/PN-glycerine and thickener/potassium nitrate; NF/PN-potassium nitrate and sodium fluoride/potassium nitrate; and NA/PN-potassium nitrate and arginine/potassium nitrate. Sensitivity was assessed with the numerical analogue scale, and color variation (ΔE) was measured with a spectrophotometer. The sensitivity values obtained were subjected to a multivariate analysis of variance (MANOVA) and color variation values were subjected to a randomized analysis of variance (p<0.05). Results The NF/AC, NA/AC, NF/PN, and NA/PN groups presented lower sensitivity values and reduced sensitivity compared to those of the other groups throughout the clinical sessions. None of the groups showed sensitivity at the 24-week assessment. Statistically, no significant difference were observed in the color values among the groups four weeks after the beginning of bleaching (p=0.074). Additionally, the color assessment of all groups was statistically similar four weeks (p=0.084) and 24 weeks (p=0.118) after the beginning. Conclusion Our results indicate that adding NF/S, NA/S, NF/AC, and NA/AC desensitizers to tooth bleaching protocols reduces pain sensitivity without affecting its effectiveness.


Subject(s)
Humans , Tooth Bleaching , Dentin Sensitivity , Dentin Desensitizing Agents , Tooth Bleaching Agents , Pain , Follow-Up Studies , Treatment Outcome , Potassium Compounds
17.
J. appl. oral sci ; 28: e20200332, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1134784

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 Peroxide
18.
J. appl. oral sci ; 28: e20190771, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1134774

ABSTRACT

Abstract Titanium dioxide nanotubes are nanostructures that can accelerate the oxidation reaction of bleaching procedures and promote a more effective whitening effect. Objective This study evaluated physicochemical properties of bleaching agents incorporated with titanium dioxide (TiO2) nanotubes, and the effects on tooth color change at different periods. Methodology 40 premolars were treated according to the following groups (n=10): CP - 10% carbamide peroxide (1 hour daily/21 days); CPN - CP incorporated into TiO2; HP - 40% hydrogen peroxide (three 40-minute sessions/7 days apart); HPN - HP incorporated into TiO2. Color shade was evaluated at five different periods (baseline, after 7, 14 and 21 days of bleaching, and 7 days after end of treatment) according to Vita Classical, CIELab and CIEDE2000 scales. Mean particle size (P), polydispersity (PO) and zeta potential (ZP) were evaluated using dynamic light scattering. Data on the different variables were analyzed by mixed model tests for measures repeated in time (ZP e L*), generalized linear models for measures repeated in time (P, PO, Vita Classical and b*), and Friedman and Mann-Whitney tests (a* and color change/ΔE and ΔE00). Results CP and CPN presented higher P, higher PO and lower ZP than HP and HPN (p≤0.05). All groups showed a significant decrease in Vita Classical color scores after 7 days of bleaching (p<0.05), and HPN presented a greater significant reduction than the other groups. L* increased in TiO2 presence, in all groups, without any differences (p>0.05) in bleaching time. A significant reduction occurred in the a* and b* values for all the groups, and HPN presented lower a* and b* values (p<0.05) than CPN. ΔE was clinically noticeable after 7 days, in all groups, and all groups resulted in a perceptible color change according to ΔE00. Conclusion TiO2 did not influence physicochemical properties of the bleaching agents. HPN presented more effective tooth bleaching than CPN.


Subject(s)
Tooth Bleaching , Nanotubes , Bleaching Agents , Tooth Bleaching Agents , Peroxides , Titanium , Urea , Color , Dental Enamel , Hydrogen Peroxide
19.
Arq. odontol ; 56: 1-7, jan.-dez. 2020. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1120471

ABSTRACT

Objetivo: Avaliar a alteração da rugosidade superficial de uma resina composta nanoparticulada (Filtek Z350 XT ® ) após o uso de produtos clareadores de autoaplicação contento baixa concentração de peróxido de hidrogênio. Métodos: Para isto, foram confeccionados 30 corpos de prova deste material, divididos aleatoriamente em 3 grupos com 10 amostras cada, da seguinte forma: G1 (grupo controle) no qual as amostras não foram submetidas à ação de nenhum produto clareador; G2, realização de procedimento clareador com peróxido de hidrogênio a 10% (Crest 3D White Professional Effects Whitestrips ® ) em 2 aplicações de 30 minutos, por 10 dias consecutivos; e G3, tratamento com peróxido de hidrogênio a 7,7% (pincel Pretty Smile ® ) com o mesmo número de aplicações, tempo e dias do G2. Após este período cada corpo de prova foi analisado no rugosímetro Surftest SJ-301, para determinar a sua rugosidade superficial média. Estes dados foram então submetidos à análise estatística por meio da análise de variância (ANOVA) e teste de Tukey, nível de significância de 5% para comparações múltiplas. Resultados: Ao final do experimento, houve diferenças estatísticas significantes entre o grupo controle (G1) e os demais grupos (G2 e G3), com p < 0,05. Porém, quando analisados apenas os grupos submetidos ao clareamento com o peróxido de hidrogênio em diferentes concentrações (G2 e G3), não foi encontrada diferença significativa (p > 0,05). Conclusão: Após 10 dias, os produtos clareadores testados determinaram aumento significativo nos valores de rugosidade superficial média da resina composta nanoparticulada.


Aim: Tod evaluate the change in surface roughness of a nanoparticulate composite resin (Filtek Z350 XT ® ) after using over-the-counter bleaching products, containing a low concentration of hydrogen peroxide. Methods: For this, 30 specimens of this material were made, randomly divided into 3 groups with 10 samples each, as follows: G1 (control group) in which the samples were not subjected to the action of any bleaching product; G2, performing a bleaching procedure with 10% hydrogen peroxide (Crest 3D White Professional Effects Whitestrips ® ), in 2 applications of 30 minutes, for 10 consecutive days; and G3, treatment with 7.7% hydrogen peroxide (Pretty Smile ® ), with the same number of applications, time, and days as G2. After this period, each specimen was analyzed, using the Surftest SJ-301, to determine its average surface roughness. These data were then subjected to statistical analysis through analysis of variance (ANOVA) and Tukey's Test, with a significance level of 5% for multiple comparisons. Results: Statistically significant differences were found between the control group (G1) and the other groups (G2 and G3), with p < 0.05. However, when analyzing only the groups submitted to bleaching agents with hydrogen peroxide in different concentrations (G2 and G3), no significant difference was found (p > 0.05). Conclusions: After 10 days, the bleaching products tested in this study determined a significant increase in the average surface roughness values of the nanoparticulate composite resin.


Subject(s)
Tooth Bleaching , Composite Resins/analysis , Bleaching Agents , Tooth Bleaching Agents/therapeutic use , Hydrogen Peroxide/therapeutic use , Resins, Synthetic , In Vitro Techniques , Dental Materials
20.
Braz. j. oral sci ; 19: e206779, jan.-dez. 2020. ilus
Article in English | LILACS, BBO | ID: biblio-1116431

ABSTRACT

Regardless of the extensive availability of mouth rinses that claim to whiten teeth, evidence of achievement of such effect is still missing. Aim: Therefore, this study assessed in vitro the whitening effectiveness of whitening mouth rinses. Methods: Sixty intact bovine incisors were embedded in acrylic resin and had their buccal surface flattened and polished. Then, the specimens were randomly allocated to three conventional (Colgate Plax, Cepacol and Listerine Cool Mint) and three whitening mouth rinse groups (Colgate Luminous White, Cepacol Whitening and Listerine Whitening Extreme) (n=10). Following, the specimens were immersed twice a day in the mouth rinses for one minute for 28 days. In between each immersion period, the specimens remained in artificial saliva at 37oC. Color was measured at baseline, 7, 14, 21, and 28 days using a portable spectrophotometer (Easyshade, Vita Zahnfabrik, Germany) with a 6 mm of diameter probe. Color change was analyzed considering the parameters of ∆L*, ∆a*, ∆b* and, ultimately, ∆E*. The whitening efficacy of the mouth rinses was analyzed using the Whiteness Index for Dentistry (WID). Data of ∆s was analyzed using two-way ANOVA and Tukey's test (α=0.05). Results: The type of mouth rinse affected significantly all the ∆ parameters (p<0.05). A non-whitening (conventional) mouth rinse produced the highest ΔE*, followed by the three whitening mouth rinses. The application time also affected ΔE* (p<0.05), with emphasis on the third week of treatment. Only the hydrogen peroxide-containing mouth rinse (Listerine Whitening Extreme) presented a whitening effect, with an increasing trend over time. Conclusion: Although the overall color change was not different when comparing conventional and whitening mouth rinses, the hydrogen peroxide-containing whitening mouth rinse produces an increasing whitening trend over time. Not every mouth rinse that claims to whiten teeth produces the desired effect


Subject(s)
Tooth Bleaching , Color , Nonprescription Drugs , Tooth Bleaching Agents , Mouthwashes , Hydrogen Peroxide
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