In-office dental bleaching in adolescents using 6% hydrogen peroxide with and without gingival barrier: a randomized double-blind clinical trial

Abstract At low concentrations used for in-office bleaching gels, such as 6% HP, gingival barrier continues to be performed. If we take into account that, in the at-home bleaching technique, no barrier is indicated, it seems that the use of a gingival barrier fails to make much sense when bleaching gel in low concentration is used for in-office bleaching. Objective This double-blind, split-mouth, randomized clinical trial evaluated the gingival irritation (GI) of in-office bleaching using 6% hydrogen peroxide (HP) with and without a gingival barrier in adolescents, as well as color change and the impact of oral condition on quality of life. Methodology Overall, 60 participants were randomized into which side would or would not receive the gingival barrier. In-office bleaching was performed for 50 minutes with 6% HP in three sessions. The absolute risk and intensity of GI were assessed with a visual analogue scale. Color change was assessed using a digital spectrophotometer and color guides. The impact of oral condition on quality of life was assessed using the Brazilian version of the Oral Health Impact Profile (α=0.05). Results The proportion of patients who presented GI for the "with barrier" group was 31.6% and for the "without barrier" group, 30% (p=1.0). There is an equivalence for the evaluated groups regarding GI intensity (p<0.01). Color change was detected with no statistical differences (p>0.29). There was a significant impact of oral condition on quality of life after bleaching (p<0.001). Conclusions The use or not of the gingival barrier for in-office bleaching with 6% HP was equivalent for GI, as well as for bleaching efficacy, with improvement in the impact of oral condition on quality of life.

Qualitative Characterization of the Abrasive Component of Charcoal-Containing Toothpastes and the Effect on Dentin Roughness / Caracterización Cualitativa del Componente Abrasivo de las Pastas Dentales que Contienen Carbón Vegetal y la Rugosidad de la Dentina

This study investigated the effect of commercially available whitening toothpastes containing charcoal on dentin. Nine charcoal-containing toothpastes were compared with 3 whitening toothpastes (positive control) and distilled water (negative control). Periodontally hopeless molars were cleaned and washed and the occlusal table removed to expose dentin. The teeth were mounted in auto-polymerizing resin and exposed dentine surfaces polished with water-cooled decreasing grits of silica carbide paper up to 1500 grit. Baseline average roughness (Ra) measurements were taken. Specimens were then mounted in an automatic tooth-brushing machine and brushed for 5000 cycles. Repeat Ra measurements were taken. Specimens were brushed in 5000-cycle increments up to 25,000 cycles with Ra measurements being taken at each time point. Between abrasive challenges specimens were stored in distilled water. All toothpaste samples were sputter coated and examined under a scanning electron microscope to qualify the shape and size of the abrasive components of the formulations. Data were analyzed using a two-way analysis of variance with post hoc Bonferroni. The results demonstrated that the abrasive effect, in terms of increasing Ra, on dentin was noted as early as 5000 cycles for all the tested toothpastes (p<0.05). The effect of continued brushing showed an overall cumulative effect on dentine roughness up to 25000 cycles. When toothpastes were compared between groups at each time-point, dentin specimens brushed with Pursito were statistically similar to the control group. At 25,000 cycles all dentin samples were significantly rougher compared to Pursito and the control groups. It may be concluded that all the tested toothpastes have an abrasive effect on dentin surfaces.

Este estudio investigó el efecto sobre la dentina de las pastas dentales blanqueadoras disponibles en el mercado que contienen carbón vegetal. Se compararon nueve dentífricos que contenían carbón vegetal con 3 dentífricos blanqueadores (control positivo) y agua destilada (control negativo). Los molares sin material periodontal se limpiaron y lavaron y se retiró la tabla oclusal para exponer la dentina. Los dientes se montaron en resina autopolimerizable y las superficies expuestas de la dentina se pulieron con papel de carburo de sílice de grano decreciente enfriado con agua hasta grano 1500. Se tomaron medidas de rugosidad promedio (Ra) de referencia. Luego, las muestras se montaron en una máquina automática de cepillado de dientes y se cepillaron durante 5000 ciclos. Se tomaron medidas repetidas de Ra. Las muestras se cepillaron en incrementos de 5000 ciclos hasta 25 000 ciclos y se tomaron medidas de Ra en cada punto de tiempo. Entre periodos abrasivos, las muestras se almacenaron en agua destilada. Todas las muestras de pasta de dientes se recubrieron por pulverización catódica y se examinaron bajo un microscopio electrónico de barrido para calificar la forma y el tamaño de los componentes abrasivos de las formulaciones. Los datos se analizaron utilizando un análisis de varianza de dos vías de Bonferroni post hoc. Los resultados demostraron que el efecto abrasivo, en términos de aumento de Ra, sobre la dentina se notó ya en 5000 ciclos para todas las pastas dentales probadas (p<0,05). El efecto del cepillado continuo mostró un efecto acumulativo general sobre la rugosidad de la dentina hasta 25.000 ciclos. Cuando se compararon las pastas dentales entre los grupos en cada momento, las muestras de dentina cepilladas con Pursito fueron estadísticamente similares al grupo de control. A los 25.000 ciclos, todas las muestras de dentina eran significativamente más ásperas en comparación con Pursito y los grupos controles. Se puede concluir que todas las pastas dentales probadas tienen un efecto abrasivo sobre las superficies dentinarias.

Effects of whitening dentifrices on the enamel color, surface roughness, and morphology

The aim of this study was to evaluate the whitening and abrasion effects of dentifrices containing different whitening agents on artificially stained and unstained enamel. 160 human dental enamel discs were distributed into four groups according to the type of dentifrices applied on them (n=40): Group I, non-whitening dentifrice (control group); Group II, dentifrice containing charcoal; Group III, dentifrice containing blue covarine; Group IV, dentifrice containing hydrogen peroxide. Half of the specimens in each group were immersed in coffee solution. Color measurements were evaluated from stained and unstained specimens before and after brushing by a spectrophotometer. The surface roughness of each unstained specimen was analyzed using a profilometer after the brushing and bleaching. The surface of one randomly selected specimen from each group was observed using a scanning electron microscope (SEM). Statistical analysis of the color change was performed using the Kruskal-Wallis test. The one-way ANOVA was used to evaluate surface roughness. Group III provided significantly higher recovery on ΔE00 values than other groups on the unstained enamel (p<0.05). Group IV showed significantly the highest ΔE00 values on stained enamel (p<0.05) and also Group IV showed the highest surface roughness values (p<0.05), SEM revealed a more irregular surface in groups III and IV. It can be stated that dentifrice containing blue covarine is both an effective and a safe way to provide whiter teeth with routine home tooth brushing.

El objetivo de este estudio fue evaluar los efectos de blanqueamiento y abrasión de los dentífricos que contienen diferentes agentes blanqueadores en el esmalte teñido y no teñido artificialmente. Se distribuyeron 160 discos de esmalte dental humano en cuatro grupos según el tipo de dentífrico aplicado sobre ellos (n=40): Grupo I, dentífrico no blanqueador (grupo control); Grupo II, dentífrico que contiene carbón vegetal; Grupo III, dentífrico que contiene azul; Grupo IV, dentífrico que contiene peróxido de hidrógeno. La mitad de los especímenes de cada grupo se sumergieron en una solución de café. Las mediciones de color se evaluaron a partir de especímenes teñidos y no teñidos antes y después del cepillado con un espectrofotómetro. La rugosidad de la superficie de cada muestra sin teñir se analizó utilizando un perfilómetro después del cepillado y del clareamiento. La superficie de un espécimen seleccionado al azar de cada grupo se observó utilizando un microscopio electrónico de barrido (MEB). El análisis estadístico del cambio de color se realizó utilizando la prueba de Kruskal-Wallis. Se utilizó el ANOVA para evaluar la rugosidad de la superficie. El grupo III proporcionó una recuperación significativamente mayor en los valores de ΔE00 que otros grupos en el esmalte no teñido (p<0,05). El Grupo IV mostró significativamente los valores más altos de ΔE00 en el esmalte teñido (p<0.05) y también el Grupo IV mostró los valores más altos de rugosidad superficial (p<0.05), el análisis en MEB reveló una superficie más irregular en los grupos III y IV. Se puede afirmar que el dentífrico que contiene azul es una forma efectiva y segura de proporcionar dientes más claros con el cepillado de rutina en el hogar.

Harmonização do sorriso: aliando ortodontia e estética / Smile harmonization: combining orthodontics and aesthetics

Atualmente é evidente a demanda contínua por padrões de beleza, cada vez mais impecáveis, um sorriso alinhado e harmônico com dentes brancos para se sorrir com confiança. O tratamento odontológico interdisciplinar tem como intuito proporcionar uma boa saúde periodontal, restabelecer a estética e a função do sistema estomatognático. Objetivo: apresentar um relato de caso clínico envolvendo harmonização do sorriso como cirurgia plástica periodontal para alinhamento da margem gengival na região anterior e restaurações diretas em resina composta após a finalização do tratamento ortodôntico, evidenciando a importância da abordagem conservadora e multidisciplinar no âmbito do tratamento estético. Relato de caso: Realizamos o tratamento ortodôntico com aparelho autoligado cerâmico para alinhamento do arco dental e intrusão do elemento 13, em sequência executamos um recorte gengival nos elementos 12 e 22, clareamento dental associado após 15 dias, subsequentemente, reanatomização dentária no elemento 44 para que o elemento 13 não voltasse a extruir pela falta de contato oclusal, e por fim, remodelação dental fazendo uso de resina composta nos elementos 12, 21 e 22 devido a manchas de hipocalcificação dental. Conclusão: Contudo, a estética bucal tem a capacidade de possibilitar a melhoria na autoestima, devolvendo à função, proporcionando satisfação e bem-estar ao indivíduo, enaltecendo o sorriso.

Currently, the continuous demand for increasingly impeccable beauty standards is evident, an aligned and harmonic smile with white teeth to smile with confidence. Interdisciplinary dental treatment aims to provide good periodontal health, restore the aesthetics and function of the stomatognathic system. Objective: to present a clinical case report involving smile harmonization as periodontal plastic surgery for aligning the gingival margin in the anterior region and direct composite resin restorations after completion of orthodontic treatment, highlighting the importance of a conservative and multidisciplinary approach in the field of aesthetic treatment . Case report: We performed orthodontic treatment with a self-ligating ceramic appliance for aligning the dental arch and intruding element 13, then performed a gingival cutout on elements 12 and 22, associated tooth whitening after 15 days, subsequently, dental reanatomization on element 44 to that element 13 would not extrude again due to the lack of occlusal contact, and finally, dental remodeling using composite resin in elements 12, 21 and 22 due to dental hypocalcification stains. Conclusion: However, oral aesthetics has the ability to improve self-esteem, returning to function, providing satisfaction and well-being to the individual, enhancing the smile.

Efficacy Evaluation of DENTE91 Anti-Stain Toothpaste: Review of In-Vitro Studies

Background: Tooth stains on the front teeth are a common esthetic issue caused by tooth discoloration. Good oral hygiene habits, such as brushing your teeth twice daily with fluoride toothpaste and after meals, flossing daily, and using a whitening toothpaste, can help reduce staining and prevent cavities. Material & Methods: Many in-vitro studies has conducted to develop Dente91 Anti-Stain Toothpaste that can help in resolving the issue of demineralization, hypersensitivity, microbial strains, plaque, dental caries/tooth decay, and dental stain more effectively than other marketed products. Its composition includes ingredients such as Sodium Hexametaphosphate (SHMP), Polyvinylpyrrolidone (PVP), Tetrasodium Pyrophosphate, Covarine Blue, Zinc Citrate, Potassium Citrate, and Xylitol. Results: DENTE91 Anti-Stain toothpaste has over 99.9% significant antimicrobial efficacy and effectively reduces demineralization while enhancing the remineralization process. It also provides protection against acid attacks, promotes cell proliferation in NIH/3T3 cells, and shows significant healing activity on dental cavities. Additionally, it has the ability to occlude dentine disc lesions and reduce hypersensitivity. The findings of this study suggest that the toothpaste after using it twice a day for three days removes 63.02 % stains and also shows 80.33% improvement in teeth whitening from baseline.Conclusion: These in-vitro studies of dente91 anti-stain toothpaste concluded that toothpaste helps in resolving demineralization, hypersensitivity, plaque, dental caries/tooth decay, and dental stains. It has antimicrobial activity and teeth whitening effect too

Tooth Bleaching: A bibliometric analysis of the top 100 most-cited papers

Abstract This study analyzes the characteristics of the top 100 most-cited papers related to tooth bleaching. A literature search was performed on the Web of Science up to March 2022. The number of citations was cross-matched with the citation count on Scopus and Google Scholar. The following data were collected: number and density of citations; authorship; year and journal of publication; study design and thematic; keywords; institution and country of origin. Spearman's correlation and Poisson regression were used to determine associations between the number of citations and study characteristics. The VOSviewer software was used to generate collaborative network maps for the authors and keywords. The number of citations ranged from 66 to 450. Papers were published between 1981 and 2020. The most frequent study design and topic were laboratory-based studies and 'interaction of the bleaching agent with dental tissues', respectively. Cochran M, Loguercio AD, Matis B, Reis A, and Suliman M were the authors with the highest number of papers. The countries with the most papers were the United States of America (USA) (28%) and Brazil (20%). Indiana University and State University of Ponta Grossa were the institutions with the most papers (6% each). There was a very strong correlation among the number of citations of the three databases. The 100 most-cited papers related to tooth bleaching were mainly published by the USA and Brazil, with laboratory-based studies addressing topics related to the effects of bleaching agents on tooth structure being the most prevalent.

Resumo Este estudo analisa as características dos 100 artigos mais citados relacionados ao clareamento dental. Uma pesquisa bibliográfica foi realizada na Web of Science até março de 2022. O número de citações foi cruzado com a contagem de citações na Scopus e na Google Scholar. Foram coletados os seguintes dados: número e densidade de citações; autoria; ano e periódico de publicação; desenho do estudo e temática; palavras-chave; instituição e país de origem. A correlação de Spearman e a regressão de Poisson foram usadas para determinar associações entre o número de citações e as características do estudo. O software VOSviewer foi utilizado para gerar mapas de rede colaborativa para os autores e palavras-chave. O número de citações variou de 66 a 450. Os artigos foram publicados entre 1981 e 2020. O desenho e o tópico de estudo mais frequentes foram estudos laboratoriais e interação do agente clareador com tecidos dentários, respectivamente. Cochran M, Loguercio AD, Matis B, Reis A e Suliman M foram os autores com maior número de artigos. Os países com mais artigos foram os Estados Unidos da América (EUA) (28%) e o Brasil (20%). A Universidade de Indiana e a Universidade Estadual de Ponta Grossa foram as instituições com mais artigos (6% cada). Houve uma correlação muito forte entre o número de citações das três bases de dados. Os 100 artigos mais citados relacionados ao clareamento dentário foram publicados principalmente pelos EUA e Brasil, sendo os estudos laboratoriais que abordaram tópicos relacionados aos efeitos dos agentes clareadores na estrutura dentária os mais prevalentes.

Odontología restauradora mínimamente invasiva: caso clínico / Minimally invasive restorative dentistry: a clinical case

La decoloración de las piezas dentarias puede te-ner un impacto estético y social que lleva a los pa-cientes a buscar una intervención para mejorar su sonrisa. Las manchas superficiales y las irregula-ridades del esmalte pueden deberse a hipoplasias, hipomineralización molar, fluorosis, uso de medica-mentos, manchas blancas causadas por traumatis-mos o infección en la dentición primaria, o manchas post ortodóncicas. El diagnóstico de los defectos del esmalte se realiza a través de un examen visual por transiluminación. Se han propuesto técnicas micro abrasivas con diferentes agentes para eliminar las manchas superficiales del esmalte, así también como el uso de agentes blanqueadores a baja concentra-ción para equilibrar el color de las piezas dentarias. Si las manchas son profundas se requiere de una mega abrasión y posterior restitución anatómica con resinas compuestas. Los avances tecnológicos en los materiales de restauración adhesivos permi-ten imitar las piezas dentarias naturales permitien-do la mínima destrucción de la estructura dental sin comprometer futuras opciones de restauración. El objetivo de este trabajo es mostrar una secuencia de procedimientos mínimamente invasivos para devol-ver la estética perdida en una paciente que concurre a la Cátedra de Odontología Restauradora (AU)

The discoloration of dental pieces can have an aesthetic and social impact that leads patients to seek an intervention to improve their smile. Superficial stains and enamel irregularities may be due to hypoplasia, molar hypomineralization, fluorosis, drug use, white spots caused by trauma or infection in the primary dentition, or post-orthodontic stains. The diagnosis of enamel defects is made through a visual examination by transillumination. Microabrasive techniques with different agents have been proposed to remove surface stains from the enamel, as well as the use of low-concentration whitening agents to balance the color of the teeth. If the stains are deep, a mega abrasion and subsequent anatomical restoration with composite resins are required. Technological advances in adhesive restorative materials make it possible to mimic natural teeth, allowing minimal destruction of tooth structure without compromising future restorative options. The objective of this work is to show the sequence of minimally invasive procedures to return the lost aesthetics in a patient who attends the Chair of Restorative Dentistry (AU)

Influence of Bleaching Agent Containing Bioactive Glass on Color and Microhardness of Bovine Enamel

To try to reduce the deleterious effects of tooth whitening, bioactive materials have been used. Forty enamel/dentin blocks were stained on dark tea and randomly assigned into four groups (n=10): control group (unbleached), HP35 % (35 % hydrogen peroxide), BG45S5 (Bioglass 45S5® incorporated into HP35 %), and BIO (Biosilicate® incorporated into HP35 %). Colorimetric analysis and microhardness evaluation was performed at baseline, 24 hours and 7 days after the final whitening session. Two-way ANOVA for repeated measures and Bonferroni test was used at a significance level of 5 %. All the coordinates (ΔL*, Δa*, Δb*, ΔE00 and WID) showed a difference between the control group and the experimental ones (p0.05), which suggest a color stability over a week. In contrast, after 7 days, the WID showed that control and PH35 % were different than the other groups (p 0.05). The microhardness did not change over time (p>0.05), except for 35 % HP. In conclusion Bioglass 45S5® and Biosilicate® prevented enamel damage without negatively affect the whitening efficacy.

Para intentar reducir los efectos nocivos del aclaramiento dental, se han usado materiales bioactivos. Cuarenta bloques de esmalte/dentina se tiñeron con té oscuro y se asignaron al azar en cuatro grupos (n=10): grupo de control (sin blanquear), HP35% (peróxido de hidrógeno al 35 %), BG45S5 (Bioglass 45S5® incorporado en HP35%) y BIO (Biosilicato® incorporado a HP35%). El análisis colorimétrico y la evaluación de la microdureza se realizaron al inicio del estudio, 24 horas y 7 días después de la última sesión de blanqueamiento. Se utilizó ANOVA de dos vías para medidas repetidas y la prueba de Bonferroni a un nivel de significancia del 5 %. Todas las coordenadas (ΔL*, Δa*, Δb*, ΔE00 y WID) mostraron diferencia entre el grupo control y el experimental (p0.05), lo que sugiere una estabilidad del color durante una semana. En cambio, a los 7 días, el WID mostró que el control y el PH35 % eran diferentes a los demás grupos (p 0.05). La microdureza no cambió con el tiempo (p>0.05), excepto para 35 % HP. En conclusión Bioglass 45S5® y Biosilicate® previnieron el daño del esmalte sin afectar negativamente la eficacia del blanqueamiento.

Influence of F-18 Bioactive Glass Incorporation into Whitening Gel on Properties of Bovine Dental Enamel

ABSTRACT: Bioactive materials have shown positive results in reducing the deleterious effects of tooth whitening. However, their effects on whitening efficacy is still uncertain. Therefore, the aim of this study was to evaluate the effects of F- 18 bioactive glass incorporation into a bleaching gel on color and microhardness of enamel after tooth whitening. Thirty bovine enamel-stained specimens were randomly divided into three groups (n=10) according to the whitening protocol: control group (unbleached), HP35 % (35 % hydrogen peroxide) and F-18 (F-18 bioactive glass incorporated into HP35 %). pH, color change and microhardness analyzes were performed at baseline, 24 hours and 7 days after tooth whitening. Color evaluation showed that experimental groups were different than control group for all coordinates (p 0.05). No differences in enamel microhardness were found among the groups within the same evaluation time (p > 0.118). Regarding the intragroup comparisons, no differences were observed for control and F-18 groups (p > 0.129). It was concluded that F-18 bioactive glass incorporation did not affect the whitening efficacy and the enamel microhardness.

RESUMEN: Los materiales bioactivos han mostrado resultados positivos en la reducción de efectos nocivos del aclaramiento dental. Sin embargo, sus efectos sobre la eficacia del aclaramiento aún son inciertos. Por lo tanto, el objetivo de este estudio fue evaluar los efectos de la incorporación de vidrio bioactivo F-18 en un gel aclarador sobre el color y la microdureza del esmalte después del aclariamiento dental. Treinta especímenes bovinos teñidos con esmalte se dividieron aleatoriamente en tres grupos (n=10) de acuerdo con el protocolo de aclaramiento: grupo control (sin aclaramiento), HP35 % (peróxido de hidrógeno al 35 %) y F-18 (vidrio bioactivo F-18 incorporado en HP35 %). Se realizaron análisis de pH, cambio de color y microdureza al inicio del estudio, 24 horas y 7 días después del aclaramiento dental. La evaluación del color mostró que los grupos experimentales eran diferentes al grupo de control en todas las coordenadas (p 0,05). No se encontraron diferencias en la microdureza del esmalte entre los grupos dentro del mismo periodo de evaluación (p > 0,118). En cuanto a las comparaciones intragrupos, no se observaron diferencias para los grupos control y F-18 (p > 0,129). Se concluyó que la incorporación de vidrio bioactivo F-18 no afectó la eficacia de aclaramiento ni la microdureza del esmalte.

Comparative assessment of the efficacy of low concentration bleaching agents using quantitative light induced fluorescence in removing stains An In vitro study

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.

A Dieta Branca é Necessária Durante e Após o Clareamento Dental? Uma Revisão de Literatura / Is The White Diet Necessary During and After Tooth Whitening? A Review of the Literature

A valorização da estética tornou-se usual durante o tratamento odontológico, sendo o clareamento dental um dos procedimentos mais procurados para o tratamento de alterações na cor e diversos autores consideram que a dieta branca é importante para que o seu resultado estético não seja comprometido. Porém, outros autores afirmam que a ingestão de alimentos e de bebidas com corantes não interfere imediatamente e posteriormente no resultado do tratamento clareador. Este artigo verifica, por meio de revisão de literatura, se a dieta branca é realmente necessária durante ou após o clareamento dental. Foi realizado um levantamento bibliográfico nas bases LILACS e PUBMED, sendo encontrados 16 artigos que se enquadravam nos critérios de inclusão. Estudos in vitro, in situ e in vivo expostos nesse trabalho, relatam que não há interferência dos pigmentos durante o clareamento no resultado do procedimento. Há consenso também de que após o tratamento clareador, o vinho tinto interfere na manutenção da cor. Portanto, indicar a dieta branca ainda é uma recomendação que parcialmente não é baseada em evidências científicas, devido à falta de congruência nos resultados das pesquisas.

The appreciation of aesthetics has become usual during dental treatment, with tooth whitening being one of the most sought procedures for the treatment of color changes and several authors consider that the white diet is important so that its aesthetic result is not compromised. However, other authors state that the ingestion of food and drinks with dyes does not interfere immediately and later in the result of the bleaching treatment. This article verifies, through literature review, if the white diet is really necessary during or after tooth whitening. A bibliographic search was performed in LILACS and PUBMED, and 16 articles were found that met the inclusion criteria. In vitro, in situ and in vivo studies exposed in this work report that there is no interference of pigments during bleaching on the result of the procedure. There is also a consensus that after the bleaching treatment, red wine interferes with color maintenance. Therefore, indicating the white diet is still a recommendation that is partially not based on scientific evidence, due to the lack of congruence in research results.

Avaliação in silico da afinidade de drogas ao receptor TRPA1 como preditor para o manejo farmacológico da sensibilidade provocada pelo clareamento dentário / In silico assessment of drug affinity to the TRPA1 receptor as a predictor for the pharmacological management of sensitivity caused by tooth whitening

Introdução: Reduzir a sensibilidade do clareamento dental em consultório representa um desafio para os profissionais. Pesquisadores associaram o bloqueio do receptor de dor TRPA1 com a redução da sensibilidade ao clareamento. No entanto, a afinidade química dos analgésicos/anti-inflamatórios para o TRPA1 ainda precisa ser averiguada. Objetivo: Realizar uma triagem virtual de múltiplos medicamentos (analgésicos e antiinflamatórios) para verificar a afinidade química pelo receptor TRPA1. Metodologia: A estrutura cristalina das proteínas do receptor TRPA1 foi recuperada do Protein Data Bank. Os códigos SMILES dos ligantes foram extraídos do PubChem. A energia de ligação do complexo foi obtida em ∆G - kcal/mol pelo AutoDock Vina© e replicada nos servidores SwissDock©, Dockthor© e CbDock©. LigPlus© confirmou os sítios de ligação. Resultados: Apesar dos antagonistas dos receptores analisados apresentarem alta afinidade, codeína e dexametasona apresentaram regularidade em todos os servidores, mesmo apresentando valores de energia de ligação de -7,9 kcal/mol para codeína e -8,1 kcal/mol para dexametasona. Conclusão: A codeína e a dexametasona podem ser drogas potenciais para controlar a sensibilidade ao clareamento dental caso atinjam o receptor TRPA1 da polpa dentária (AU).

Introduction: Reducing in-office tooth bleaching sensitivity represents a challenge for professionals. Researchers have associated the block of the pain receptor TRPA1 with reducing bleaching sensitivity. However, the chemical affinity of analgesic/antiinflammatory drugs to the TRPA1 needs to be verified. Objective: To perform a virtual screening of multiple drugs (analgesic and anti-inflammatory drugs) to verify chemical affinity for the TRPA1 receptor. Methodology: The crystal structure of the TRPA1 receptor proteins was retrieved from the Protein Data Bank. The SMILES codes of the ligands were extracted from PubChem. The binding energy of the complex was obtained in ∆G - kcal/mol by AutoDock Vina© and replicated in the webservers SwissDock©, Dockthor©, and CbDock©. LigPlus© confirmed the binding sites. Results: Although the receptor antagonists analyzed showed high affinity, codeine and dexamethasone showed regularity among all servers, even showing binding energy values of -7.9 kcal/mol for codeine and -8.1 kcal/mol for dexamethasone. Conclusion: Codeine and dexamethasone may be potential drugs to manage tooth bleaching sensitivity if they reach the dental pulp TRPA1 receptor (AU).

Determination of the whitening effect of toothpastes on human teeth / Determinación del efecto blanqueador de los dentífricos en dientes humanos

Abstract The desire of individuals to have whiter teeth increases the interest in tooth whitening products. Our aim was to in vitro study the whitening effect of hydrogen peroxide, blue covarine and active charcoal containing whitening toothpastes on human teeth. A total of 40 extracted human incisor teeth were used in the study. To measure the whitening effect of toothpastes, the teeth were divided into four subgroups and placed in the phantom tooth jaw model. Then, daily brushing was done with an electric toothbrush. The colors of the teeth were measured initially using the spectrophotometer (single point and bleached shade mode) and at the end of 7th, 14th and 28th days. Whitening effectiveness of toothpastes were studied according to CIEDE2000 formula (ΔE00) and shade guide units (SGU). One- way analysis of variance (ANOVA) and Tukey test were used in the statistical analysis of the data. (p0.05). Blue covarine containing toothpaste had statistically the lowest whitening effect (p<0.05). All toothpastes showed a whitening effect on the teeth after 7 days of use. Activated charcoal containing toothpaste showed more whitening effect after 28 days of use than hydrogen peroxide, blue covarine and traditional toothpaste.

Resumen El deseo de los individuos de tener unos dientes más blancos aumenta el interés por los productos de blanqueamiento dental. Nuestro objetivo fue estudiar el efecto blanqueador de las pastas dentales blanqueadoras que contienen peróxido de hidrógeno, covarina azul y carbón activo en dientes humanos in vitro. En el estudio se utilizaron un total de 40 dientes incisivos humanos extraídos. Para medir el efecto blanqueador de los dentífricos, los dientes se dividieron en cuatro subgrupos y se colocaron en el modelo de diente fantasma en mandíbula. A continuación, se realizó un cepillado diario con un cepillo eléctrico. El color de los dientes se midió inicialmente con un espectrofotómetro (modo de punto único y tono blanqueado) y al final de los días 7, 14 y 28. Se estudió la eficacia blanqueadora de los dentífricos según la fórmula CIEDE2000 (ΔE00) y las unidades de guía de color (SGU). En el análisis estadístico de los datos se utilizó el análisis de varianza de una vía (ANOVA) y la prueba de Tukey. (p0,05). El dentífrico que contiene covarina azul tuvo estadísticamente el menor efecto blanqueador (p<0,05). Todos los dentífricos mostraron un efecto blanqueador en los dientes después de 7 días de uso. Los dentífricos con carbón activado mostraron un mayor efecto blanqueador tras 28 días de uso que el peróxido de hidrógeno, la covarina azul y el dentífrico tradicional.

Violet LED-Based Tooth Whitening and Resin Composite Restorations to Reestablish Smile Aesthetics Case Report

ABSTRACT: This clinical case described the aesthetic treatment of a patient complaining about the aspect of their upper teeth. After anamnesis and clinical examination, the association of tooth whitening photoactivated by violet LED and resin composite restorations was indicated. Prior to restorative treatment, three bleaching sessions were performed with low concentration hydrogen peroxide (6 %; Nano white flex) for 30 minutes. During this period, violet LED irradiation was intercalating performed every 1 minute, totalizing 15 minutes. Ten days after the final bleaching session, old restorations in the upper lateral incisors were removed for better color selection of resin composites. Then, all upper anterior teeth were directly restored with nanofilled resin composite (Filtek Z350XT), reestablishing anatomy, form, and function. At the end of the treatment, the association of techniques proved to be cost-effective, restoring the esthetics satisfactorily and promoting the patient's well-being by a minimally invasive approach.

RESUMEN: En este reporte de caso se describió el tratamiento para una paciente que se quejaba del aspecto de sus dientes superiores. Tras anamnesis y exploración clínica, se indicó la asociación de blanqueamiento dental fotoactivado por LED violeta y restauraciones de resina compuesta. Antes del tratamiento restaurador, se realizaron tres sesiones de blanqueamiento con peróxido de hidrógeno de baja concentración (6 %; Nano white flex) durante 30 minutos. Durante este período, la irradiación con LED violeta se intercalaba cada 1 minuto, totalizando 15 minutos. Diez días después de la última sesión de blanqueamiento, se retiraron las restauraciones antiguas de los incisivos laterales superiores para una mejor selección del color de la resina compuesta. Luego, todos los dientes anteriores superiores fueron restaurados de manera directa con resina de nanorrelleno (Filtek Z350XT), restableciendo la anatomía, forma y función. Al final del tratamiento, la asociación de las técnicas resultó beneficioso, restaurando la estética de forma satisfactoria y promoviendo el bienestar de la paciente mediante un abordaje mínimamente invasivo.

Eficácia e segurança do enxaguatório clareador sobre o esmalte dental: estudo clínico controlado randomizado e estudo in vitro / Efficacy and safety of whitening mouthrinse on enamel: randomized clinical trial and in vitro study

Enxaguatórios clareadores tornaram-se muito populares devido ao seu fácil uso e disponibilidade. Contudo, não há evidência dos efeitos e segurança desses produtos sobre o esmalte sadio e desmineralizado. Esta proposta foi dividida em duas partes. A primeira foi um estudo clínico randomizado que avaliou a eficácia e segurança do enxaguatório clareador. Participantes (n=45) foram alocados aleatoriamente em três grupos de tratamento: LWE (Listerine Whitening Extreme­peróxido de hidrogênio a 2,5%); PL (Enxaguatório placebo); e OPF (Opalescence PF­peróxido de carbamida a 10%). O tratamento foi realizado 1x/dia por 14 dias durante 2h para OPF, e 2x/dia por 90 dias durante 30s para LWE e PL. A cor dos dentes foi avaliada com escalas de cor (DUEC) e por espectrofotometria. Foram avaliados sensibilidade dental, condição gengival, potencial de desmineralização do esmalte, e a satisfação do participante. As avaliações foram realizadas em diferentes tempos. Para as escalas de cor, KruskalWallis mostrou diferença significante entre os tratamentos nos tempos avaliados (p<0,05). LWE apresentou maiores valores de DUEC comparado ao PL a partir de 60 dias. PL e OPF exibiram valores constantes, sendo significativamente maiores para OPF. Para o espectrofotômetro, RM-ANOVA mostrou diferença significante para os grupos e interação (p<0,05). LWE apresentou maiores valores de alteração de cor do que PL a partir de T14. OPF exibiu os maiores valores de alteração de cor durante todo o período de estudo. Após 2 anos, houve manutenção da cor dos dentes para todos os grupos. Houve baixa intensidade de sensibilidade para LWE e OPF. Nenhum participante apresentou inflamação gengival. LWE e OPF promoveram uma diminuição significativa na concentração de cálcio, mas após 1 semana, os valores foram intermediários. A concentração de fosforo não apresentou alteração nos tempos avaliados. Todos os participantes ficaram satisfeitos com o tratamento com OPF e 67% dos participantes do grupo LWE apresentaram satisfação. A segunda parte consistiu em um estudo in vitro que comparou o efeito do enxaguatório clareador na desmineralização do esmalte e em lesões incipientes de cárie durante ciclagem de pH. Espécimes de esmalte/dentina bovino (n=120) com a superfície dividida em três áreas [esmalte sadio controle, esmalte tratado (ET); e lesão incipiente de carie tratada (LICT)] foram distribuídos aleatoriamente nos grupos experimentais: LWE; PL; OPF e água deionizada (AD). Os tratamentos (2min para LWE, PL e AD; e 2h para OPF) foram realizados durante uma ciclagem de pH de 28 dias (6´60min desmineralização). Intensidade de reflexão superficial (rSRI), perda mineral e concentração de flúor (espécimes adicionais) foram avaliados. Para ET, foi observado maior valor de rSRI em LWE (89,99%±6,94) e maior diminuição de rSRI foi observada para OPF e AD. Não houve perda mineral nos grupos (p>0,05). Para LICT, rSRI diminuiu significativamente após a ciclagem para todos os grupos sem diferença entre eles (p>0,05). Maior concentração de flúor foi encontrada em OPF. LWE e OPF exibiram efeitos semelhantes na perda mineral com valores intermediários. Houve eficácia clareadora tanto para LWE quanto para OPF e manutenção da cor após 2 anos. Houve efeito protetor do enxaguatório durante a ciclagem. (AU)

Whitening mouthrinses have become very popular because they are easy to use and are accessible. However, there is no evidence of the effects and safety of this product on sound and demineralized enamel. The proposal comprised in two parts. The first one was a randomized clinical trial that evaluated the efficacy and safety of the whitening mouthrinse. Participants (n=45) were randomly allocated to three treatment groups: LWE (Listerine Whitening Extreme­2.5% hydrogen peroxide); PL (placebo mouthrinse); and OPF (Opalescence PF­10% carbamide peroxide). The treatment was performed 1x/day for 14 days during 2h for OPF, and 2x/day for 90 days during 30s for LWE and PL. Tooth color was measured using shade guides (DUEC) and spectrophotometer. Tooth sensitivity, gingival condition, enamel demineralization potential, and participant satisfaction were analyzed. The analyses were performed in different times. For shade guides, Kruskal-Wallis showed a significant difference between treatments in the evaluated times (p<0.05). LWE showed higher DUEC values compared to PL after 60 days. PL and OPF exhibit constant values, being significantly higher for OPF. For spectrophotometer, RM-ANOVA showed significance for the groups and interaction (p<0.05). LWE showed higher color difference values than PL from T14. OPF exhibited the highest values throughout the study. After 2 years, there was maintenance of tooth color for all groups. There was lower intensity of sensitivity for LWE and OPF. No participant exhibited gingival inflammation. LWE and OPF promote a significant decrease in calcium concentration, but after 1 week the values were intermediate. Phosphorus concentration did not alter over time. All participants of OPF group were satisfied with the treatment and 67% of the participants of LWE group showed satisfaction. The second part of the study consisted of an in vitro study that compared the effect of whitening mouthrinse on enamel demineralization and on initial caries lesions. Bovine enamel/dentin specimens (n=120) had their surface divided into three areas [control sound enamel, enamel treated (ET); and initial caries lesion treated (ICLT)] and were randomly assigned to the experimental groups: LWE; PL; OPF; and deionized water (DW). The treatments (2min for LWE, PL and DW; and 2h for OPF) were performed during a 28-day pH cycle (6x60min demineralization). Surface reflection intensity (rSRI), mineral loss, and fluoride concentration (additional specimens) were performed. For ET, a higher value of rSRI was observed in LWE (89.99%±6.94) and a greater decrease in rSRI was observed for OPF and DW. There was no mineral loss in the groups (p>0.05). For ICLT, rSRI was significantly significant after cycling for all groups with no difference between them (p>0.05). Higher fluoride concentration was found in OPF. LWE and OPF exhibited similar effects on the mineral loss with intermediate values. There was whitening efficacy for both LWE and OPF and color maintenance after 2 years. There was a protective effect of the mouthrinse during cycling (AU)

Color change, tooth sensitivity, aesthetic self-perceptions and quality of life after at-home dental bleaching / Mudança de cor, sensibilidade dental, autopercepção estética e qualidade de vida após clareamento dental caseiro

Objective: The aim of this study was to determine the color change, tooth sensitivity, aesthetic self-perception and quality of life after at-home dental bleaching. Material and Methods: Dental examination was performed and the initial color of the upper right incisor was recorded using a spectrophotometer (Easyshade Compact, Vita Zahnfabrik) and CIELab parameters. Individual vinyl trays were delivered to the patients (n=37) who were instructed to use the carbamide peroxide 16% (Total Blanc Home C16%, DFL) for 2 hours daily for 2 weeks. One-week after the end of treatment, measurements were repeated to calculate color (ΔEab,ΔE00) and whiteness index (ΔWID) variations. Oral Health Impact Profile (OHIP) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) questionnaires were applied before and 30 days after treatment. Tooth sensitivity was by checked by visual analogue scale (VAS). Spearnan's correlation tests were used to verify the possible relation between color change parameters and sensitivity. The Wilcoxon test was applied for results obtained by OHIP and PIDAQ questionnaires. Results: Significant color change was observed after 14 days, regardless of the considered parameter. There was no significant correlation between sensitivity and color change. The dental self-confidence domain increased after bleaching (p = 0.029) and the psychological impact decreased (p = 0.001). Conclusion:At-home dental bleaching was effective on the overall whitening and the color change was not related to tooth sensitivity. The bleaching treatment had a positive impact on the quality of life, reducing psychological discomfort and improving dental self-confidence and aesthetic self-perception. (AU)

Objetivo: O objetivo deste estudo foi determinar a mudança de cor, sensibilidade dental, autopercepção estética e qualidade de vida após clareamento dental caseiro. Material e Métodos: Uma consulta inicial foi realizada e a cor inicial do incisivo superior direito foi registrada usando um espectrofotômetro (Easyshade Compact, Vita Zahnfabrik) e parâmetros CIELab. Moldeiras individuais confeccionadas em vinil foram entregues aos pacientes participantes (n = 37), que foram instruídos a usar o gel à base de peróxido de carbamida 16% (Total Blanc Home C16%, DFL) durante 2 horas diárias durante 2 semanas. Uma semana após o término do tratamento, as medidas foram repetidas para calcular a variação de cor (ΔEab, ΔE00) e o índice de brancura (ΔWID). Os questionários OHIP (Oral Health Impact Profile) e PIDAQ (Psychosocial Impact of Dental Aesthetics Questionnaire) foram aplicados antes e 30 dias após o tratamento. A sensibilidade dental foi verificada por meio da escala visual análoga (VAS). Os testes de correlação de Spearnan foram utilizados para verificar a possível relação entre os parâmetros de mudança de cor e sensibilidade. O teste Wilcoxon foi aplicado para os resultados obtidos pelos questionários OHIP e PIDAQ. Resultados: Mudança de cor significativa foi observada após 14 dias, independentemente do parâmetro considerado. Não houve correlação significativa entre a sensibilidade e a mudança de cor. O domínio da autoconfiança dental aumentou após o branqueamento (p = 0,029) e o impacto psicológico diminuiu (p = 0,001). Conclusão: O clareamento dental caseiro foi eficaz no branqueamento geral e a mudança de cor não estava relacionada à sensibilidade dental. O tratamento clareador teve um impacto positivo na qualidade de vida, reduzindo o desconforto psicológico e melhorando a autoconfiança dental e a autopercepção estética.(AU)

Effect of whitening mouthrinses on color change of stained resin composites / Efeito de enxaguatórios clareadores na alteração de cor de resinas compostas previamente manchadas

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)

Cecropia pachystachya Trécul: a promising ingredient for skin-whitening cosmetics

Abstract Because it promotes the lightening of pigment spots, tyrosinase inhibition is one of the mechanisms of depigmenting cosmetic products. Considering the adverse effects produced by synthetic depigmenting actives, the search for new therapeutic options is desirable, and plant extracts are possible candidates for hyperpigmentation treatment. Glycolic extracts of Cecropia pachystachya Trécul are, therefore, the focus of this study. Its chemical characterization, antioxidant activity, tyrosinase inhibition, and cell viability were evaluated. Glycolic extracts were obtained by macerating the leaves of C. pachystachya in grain alcohol and glycerin or propylene glycol. Both had a similar chemical constitution, the glycerin being more efficient in concentrating phenolic compounds and flavonoids. Analyses by UHPLC-MS detected quinic acid, chlorogenic acid isomers, proanthocyanidin dimers type B and C, catechin/epicatechin, orientin/isoorientin, isoorientin 2"-O-xyloside, vitexin/isovitexin, and rutin. 5-O-caffeoylquinic acid was then quantified was then quantified, with predominance in the extract produced with propylene glycol. These extracts showed a high antioxidant capacity by the method of DPPH, ß-carotene, and nitric oxide. As for depigmenting activity, both extracts were able to inhibit tyrosinase. Cell viability assay also revealed that the extracts could safely be used in concentrations of ≤ 125 µg/mL. Thus, this study demonstrated for the first time that the glycolic extracts of C. pachystachya have promising chemical and biological characteristics for the development of a multifunctional cosmetic with antioxidant and tyrosinase-inhibition activities

Riesgo biológico del blanqueamiento dental interno / Biological risk posed by internal tooth whitening

Introducción: El blanqueamiento dental interno forma parte de la práctica odontológica desde hace varias décadas, pero se han descrito riesgos biológicos de los cuales no existe mucha evidencia. Objetivo: Describir los riesgos biológicos provocados por el blanqueamiento dental interno en dientes no vitales. Métodos: Se realizó una revisión sistemática exploratoria en la base de datos bibliográfica PubMed empleando operadores booleanos y palabras clave que aparecen recogidas en los Descriptores en Ciencias de la Salud. Las variables estudiadas fueron: autor principal, título, año de publicación, tipo de artículo, revista donde se publicaron los artículos y riesgo biológico del blanqueamiento interno descrito. Se filtraron y procesaron los resultados en una base de datos y se analizaron los textos completos para evaluar su calidad y que estos cumplieran los criterios de inclusión y exclusión. Resultados: Fueron incluidos en el estudio 14 artículos, todos por investigaciones originales o revisiones sistemáticas. El 64,3 por ciento de los artículos proyectaba los hallazgos hacia la presencia de reabsorciones cervicales externas posterior al blanqueamiento dental interno. El resto no aportó evidencia alguna de riesgos biológicos luego del tratamiento descrito. Conclusiones: Más de la mitad de los artículos incluidos en el estudio concluyeron que la reabsorción cervical externa es el principal riesgo biológico que trae consigo el tratamiento blanqueador interno de dientes no vitales, apoyados por un factor desencadenante de historial de traumatismos dentarios que propician la aparición de estas afectaciones(AU)

Introduction: Internal tooth whitening has been a component of dental practice for several decades, but biological risks have been described about which not much evidence is available. Objective: Describe the biological risks posed by internal tooth whitening in nonvital teeth. Methods: An exploratory systematic review was conducted in the bibliographic database PubMed using Boolean operators and key words obtained from Health Sciences Descriptors. The variables analyzed were main author, title, year of publication, article type, journal where the articles were published and biological risk of the internal tooth whitening procedure described. Results were filtered and processed in a database and full texts were analyzed for quality and compliance with the inclusion and exclusion criteria. Results: A total 14 articles were included in the study, all of which were either original studies or systematic reviews. In 64.3 percent of the articles, findings had to do with the presence of external cervical resorption after internal tooth whitening. The remaining articles did not contribute any evidence of biological risks after the treatment described. Conclusions: More than half of the articles included in the study concluded that external cervical resorption is the main biological risk posed by internal whitening of nonvital teeth, supported by the triggering factor of a history of dental trauma leading to the occurrence of these disorders(AU)

Uso do fluoreto de sódio como dessensibilizante no clareamento dental: uma revisão de literatura / Use of sodium fluoride as a desensibilizer in dental bleaching: a literature review

Objetivo: Verificar, por meio de uma revisão de literatura, a efetividade do uso do fluoreto de sódio como dessensibilizante para casos de sensibilidade induzida por clareamento dental. Resultados: O clareamento dentário tornou-se um dos procedimentos estéticos mais procurados na odontologia. Atualmente, existem duas técnicas supervisionadas por dentistas: o clareamento caseiro e o de consultório. Os materiais mais utilizados são o peróxido de carbamida e o de hidrogênio, respectivamente. O clareamento dental baseia-se na premissa de que o peróxido de hidrogênio penetra na estrutura dentária para interagir com os cromóforos orgânicos. Embora o protocolo de clareamento exija o uso de agentes oxidantes de baixa concentração, a sensibilidade dentária ainda está presente e pode ser considerado o principal efeito adverso da técnica de clareamento. Para minimizar este problema, a aplicação tópica de dessensibilizantes antes e após o clareamento dentário tem mostrado bons resultados na redução da intensidade de sensibilidade. Considerações finais: Mediante revisão apresentada, constatou-se que fluoreto de sódio quando utilizado após o protocolo clareador, como dessensibilizante, não elimina a sensibilidade, mas diminui a intensidade da dor. Quando utilizado antes do clareamento dental, não apresenta resultados positivos. Ademais, salienta-se que quando o fluoreto é incorporado no gel clareador, resulta em menor desmineralização do esmalte dentário.(AU)

Objective: To verify, through a literature review, the effectiveness of using sodium fluoride as a desensitizer for cases of sensitivity induced by tooth whitening. Literature review: Teeth whitening has become one of the most desired aesthetic procedures in dentistry. Currently, there are two techniques supervised by dentists: home whitening and office whitening. The most used materials are carbamide peroxide and hydrogen peroxide, respectively. Teeth whitening is based on the premise that hydrogen peroxide penetrates the tooth structure to interact with organic chromophores. Although the whitening protocol requires the use of low concentration oxidizing agents, tooth sensitivity is still present and can be considered the main adverse effect of the whitening technique. To minimize this problem, the topical application of desensitizers before and after tooth whitening has shown good results in reducing the intensity of sensitivity. Final considerations: Upon the review presented, it was found that sodium fluoride, when used after the whitening protocol, as a desensitizer, does not eliminate sensitivity, but reduces the intensity of pain. When used before tooth whitening, it has no positive results. Furthermore, it should be noted that when fluoride is incorporated into the whitening gel, less enamel demineralization is induced.(AU)