Effects of bleaching using 10% carbamide peroxide with calcium or amorphous calcium phosphate on enamel mineral content and hardness / Asociación entre la severidad de Hipomineralización Incisivo-Molar (HIM) y lesiones cavitadas de caries en escolares

ABSTRACT This study evaluated enamel mineral content and surface microhardness before and after bleaching treatment using 10% carbamide peroxide (CP) containing calcium (Ca) or amorphous calcium phosphate (ACP). Thirty-six bovine slabs were randomly allocated into 3 groups (n = 12) according to bleaching treatment: G1 - Opalescence PF 10% (CP), G2 -NiteWhite ACP (CP+ACP), and G3 - Opalescence PF (10%) with calcium (CP+CA). The bleaching agent was applied on enamel surface for 6 h/day over a period of 21 days. Enamel surface was evaluated by Knoop microhardness (KNH) and micro energy-dispersive X-ray fluorescence spectrometry (p-EDXRF) at baseline and at after bleaching treatment. Data were statistically analyzed by repeated measures ANOVA and Tukey's test (a = 0.05). There was a significant decrease in microhardness after bleaching treatments for all study groups, but no difference between bleaching gels. There was no difference in the Ca/P ratio measured by p-EDXRF for all groups at the study times, but the mean value was lower in group CP+CA than in group CP+ACP. Group CP was similar to both CP+ACP and CP+CA. It can be concluded that enamel microhardness decreased after the bleaching process, regardless of the presence of calcium or ACP, but there was no significant change in the Ca/P ratio of enamel after bleaching for each tested gel. This indicates that the bleaching gels have erosive potential, causing softening of enamel without promoting surface loss, regardless of the presence of calcium of ACP ions.

RESUMO Este estudo avaliou o conteúdo mineral do esmalte e a microdureza superficial antes e após o tratamento clareador, utilizando peróxido de carbamida 10% (PC) contendo cálcio (Ca) ou fosfato de cálcio amorfo (ACP) em sua composigao. Trinta e seis espécimes de esmalte bovino foram alocados aleatoriamente em 3 grupos (n = 12) de acordo com os tratamentos clareadores: G1 - Opalescence PF 10% (CP), G2 -NiteWhite (CP+ACP); e G3 - Opalescence PF (10%) com cálcio (CP + CA). O agente clareador foi aplicado na superficie do esmalte por 6 h/dia por um periodo de 21 dias. A superficie do esmalte foi avaliada por microdureza Knoop (KNH) e espectrometria de fluorescencia de raios X micro-dispersiva (p-EDXRF) no inicio e após o tratamento clareador. Os dados foram analisados estatisticamente pelo teste ANOVA de medidas repetidas e Tukey (a = 0,05). Houve uma diminuigao significativa da microdureza após os tratamentos clareadores para todos os grupos estudados, mas nao houve diferenga entre os diferentes géis. Nao houve diferenga da relagao Ca/P mensurada por p-EDXRF para todos os grupos nos tempos estudados; no entanto, o grupo CP+CA apresentou menor valor comparado ao grupo CP+ACP. O grupo CP foi similar aos grupos CP+ACP e CP+CA. Portanto, pode-se concluir que houve redugao significativa da microdureza do esmalte após o clareamento, independente da presenga de cálcio ou APC na composigao dos géis, embora nao tenha havido alteragao significando na relagao Ca/P do esmalte após o clareamento. Isto indica um potencial erosivo dos géis clareadores, causando o amolecimento sem perda da estrutura do esmalte, independente da presenga dos íons cálcio e ACP.

Effects of experimental bleaching agents on the mineral content of sound and demineralized enamels

Abstract High concentrations of hydrogen peroxide can cause adverse effects on composition and structure of teeth. However, the addition of calcium and fluoride in bleaching agents may reduce enamel demineralization. Objective: To evaluate chemical changes of sound and demineralized enamels submitted to high concentrations of hydrogen peroxide containing fluoride (F) or calcium (Ca). Material and Methods: Enamel blocks of bovine incisors with standard dimensions were obtained and half of them were submitted to pH-cycling to promote initial enamel caries lesions. Sound and demineralized enamel samples were divided into (n=10): (C) Control (no whitening treatment); (HP) 35% hydrogen peroxide; and two experimental groups: (HPF) 35% HP+0.2% F and (HPC) 35% HP+0.2% Ca. Experimental groups were submitted to two in-office bleaching sessions and agents were applied 3 times for 15 min to each session. The control group was kept in remineralizing solution at 37°C during the bleaching treatment. The surface mineral content of sound and demineralized enamels was determined through Fourier Transform Raman spectroscopy (FT-Raman), Energy dispersive Micro X-ray fluorescence spectroscopy (μ-EDXRF); and the subsurface, through cross-sectional microhardness (CSMH). In addition, polarized light microscopy (PLM) images of enamel subsurface were observed. Results: According to three-way (FT-Raman and μ-EDXRF analyses) or two-way analysis of variance (ANOVA) (CSMH) and Tukey test (α=5%), the calcium or fluoride added to high-concentrated bleaching agents increased phosphate and carbonate concentrations on sound and demineralized enamels (p<0.05). However, HPC and HPF were unable to completely reverse the subsurface mineral loss promoted by bleaching on sound and demineralized enamels. The calcium/ phosphate (Ca/P) ratio of sound enamel decreased after HP treatment (p<0.001). Conclusion: Even though experimental bleaching agents with Ca or F reduced mineral loss for both sound and demineralized enamel surfaces, these agents were unable to reverse the enamel subsurface demineralization.

Avaliaçäo do manchamento dos cimentos de ionômero de vidro por soluçöes evidenciadoras de placa dental / Staining of glass-ionomer cements by two disclosing agents

Soluçöes evidenciadoras de placa têm sido amplamente utilizadas na Odontologia, com o objetivo de orientar e motivar os pacientes para a realizaçäo de adequada higiene oral. Entretanto, algumas destas soluçöes possuem a propriedade de manchar várias substâncias, dentre elas, alguns materiais restauradores. O objetivo deste trabalho é avaliar o manchamento de restauraçöes de ionômero de vidro por duas soluçöes evidenciadoras de placa dental