Fracture resistance of CAD/CAM milled versus direct hand-made interim laminate veneers.

Background: Comparative studies of interim veneer restorations crafted using subtractive computer-aided manufacturing (s-CAM) milling technology and traditional direct hand-made approaches are needed. Purpose: This comparative in vitro study evaluated the fracture resistance of two types of provisional veneer restorations for maxillary central incisors: milled (s-CAM) and traditional direct hand-made bis-acryl veneers. Materials and methods: Fifty maxillary right central incisor veneers (25 specimens per group) were fabricated and divided according to the fabrication method: (1) s-CAM milled (Structure CAD, VOCO Dental); and (2) hand-made (Protemp Plus, 3M). The restorations were cemented onto 3D-printed resin dies using temporary cement and subjected to 1000 cycles of thermal cycling between 5° and 55 °C. These restorations subsequently were subjected to compressive loading until fracture occurred. Images of the fractured samples were captured using a scanning electron microscope (SEM). Statistical analysis was performed using the one-way ANOVA test and the Mann-Whitney U test. Results: Significant differences (p < 0.001) in the fracture resistance were observed between the two groups. s-CAM milled interim veneers displayed higher fracture resistance values (439.60 ± 26 N) compared to the traditional method (149.15 ± 10 N). Conclusion: The manufacturing method significantly influences the fracture resistance of interim veneer restorations. s-CAM interim laminate veneer restorations for maxillary central incisors exhibit a fracture resistance superior to that of the traditional method using bis-acryl.Clinical relevanceClinicians should consider CAD/CAM milled veneers for scenarios demanding long-term interim restoration and the withstanding of high occlusal forces.

Ceramic soft tissue trimming bur gingival depigmentation: clinical performance and patient experience. A split mouth randomized controlled trial.

BACKGROUND: The ceramic soft tissue trimming bur (CeraTip™) was initially introduced for use in gingivoplasty but has recently been used for gingival depigmentation. The aim of this study is to compare the efficacy of depigmentation between the novel CeraTip™ and the gold-standard surgical scalpel technique. METHODS: Eight healthy, nonsmokers with moderate to severe gingival hyperpigmentation in both arches were randomly assigned for CeraTip™ depigmentation in one arch as the test group (TG) and scalpel depigmentation in the opposite arch as the control group (CG). Pigmentation indices were used to assess clinical performance. Treatment time, pain level, and esthetic satisfaction were the parameters of patient experience. The assessments were performed at baseline, one week, one month, and three months. RESULTS: At all assessment visits, pigmentation intensity represented by the Dummet oral pigmentation index (DOPI), and pigmentation distribution represented by the Hedin melanin index (MI), were significantly lower than those at baseline (p < 0.001) in both groups. When comparing the two groups, Scalpel depigmentation had better initial clinical outcomes, while CeraTip™ had less visible repigmentation, pain scores, treatment time, and greater esthetic satisfaction. However, none of the differences were statistically significant. CONCLUSION: Both techniques successfully removed gingival hyperpigmentation with comparable clinical performance. The patients preferred CeraTip™ depigmentation. TRIAL REGISTRATION: The study protocol was registered on 11/09/2023 on the www. CLINICALTRIALS: gov database (NCT06031116) after the approval of the Ethics Committee, Faculty of Dentistry, Ain Shams University (FDASU-Rec012124).

Veneer crowns in anterior endodontically-treated teeth: A case report with 1-year follow-up.

Key Clinical Message: Veneer crowns can be used in anterior endodontically-treated teeth with light occlusal force and enamel substrate consideration as a more conservative approach instead of conventional all ceramic crowns. Abstract: All-ceramic anterior crowns and veneers have been used widely in dentistry with high clinical success rate. The development of new reinforced ceramics in recent years has led to more use of extended defect-oriented preparation designs, that is, extended veneers, instead of full crown preparations which are less invasive. A veneer crown is simply a veneer that covers the entire tooth. The preparation preserves remaining enamel and uses a conservative preparation design. Its indication should be carefully raised taking into consideration various factors. The preparation design is crucial to ensure longevity of such restoration. The balance is between sufficient preparation for the material thickness and adequate strength against occlusal load and the enamel preservation. A 24-year-old man referred to the restorative department of the Dentistry School of Tehran University of Medical Sciences complaining from his poor esthetics in the maxillary incisors. In clinical and radiographic evaluation, he had open bite, composite discoloration due to corrosion of the pre-fabricated posts in all four incisors, a periapical lesion in tooth 21 and under-filled root canal therapy in tooth 22. All four posts and composite restorations were removed and teeth 21 and 22 were retreated. Although the amount of remaining tooth tissue was low, it had enough enamel thickness, especially in the buccal area. Taking into consideration this mixed enamel and dentin substrate, endodontics access, esthetics needs and canine guidance occlusion with no parafunction history, bonded lithium disilicate veneer crowns were selected to restore the maxillary incisors. A 12-month follow-up showed promising clinical (healthy gingival tissue and successful restorations) and radiographic (reduced periapical lesion) outcomes.

Suggestion for Determining Treatment Strategies in Dental Ethics.

Contemporary medicine views health as the individual's physical, mental, and social well-being. Oral health plays a crucial role in one's well-being, as the oral cavity and its surrounding regions execute essential functions in verbal and nonverbal communication, sensing, digestion, and significantly contribute to aesthetic appearance. The multifaceted nature of the notion of oral health, as well as the patient's needs and autonomous will result in various treatment options for the same oral state, favouring often contrasting ethical values and different aspects of oral health. The objective of this article is to suggest alternative treatment strategies in dentistry with respect to the following factors: extent of rehabilitation, preserving one's anatomical structures, aesthetic outcome, number of sessions, patient autonomy. Additionally, this article describes the suggested treatment strategies in an ethical context and determines the conditions of their employment. The suggested treatment strategies are divided in two categories, extensive treatment strategies focusing on the patient's entire craniofacial complex, while specific treatment strategies focus on specific paramount issues.

Impact of Orthodontic Appliances on Hiring Prospects in Saudi Arabia: A Cross-Sectional Study.

This study provides valuable insights into the cosmetic impact of orthodontic appliances on job-hiring prospects in Saudi Arabia. Both ceramic braces and clear aligners are considered cosmetic corrective devices compared to traditional metallic braces. This survey-based, cross-sectional study used two models, one male, and one female. Four standardized smiling frontal photographs were taken for each model: one without any appliance and three with different orthodontic appliances (i.e., metal braces, ceramic braces, and clear aligners). The photographs of each model were shown to potential employers, followed by three questions for each photo to assess the employers' views on the applicants' professionalism, communication skills, and the likelihood of being hired. The survey was distributed via an electronic questionnaire to employers in Saudi Arabia, collecting feedback from 189 participants. The sample was collected from October 2022 to February 2023. The models' scores while wearing metal and ceramic bracket appliances were significantly lower than when the models were wearing clear aligners or were not wearing any appliance in each domain. In conclusion, orthodontic appliances have cosmetic implications that affect job-hiring prospects, with a higher chance of being hired if the candidate does not have an orthodontic appliance.

Socioeconomic determinants of demand for dental cosmetic treatments.

Introduction: The demand for cosmetic dentistry is a growing trend globally. Increased media coverage, availability of free online information, and the improved economic status of the general population have led to an increase in the patient's aesthetic expectations. Since no study has measured the relationship between the economic status of people and the choice of cosmetic dentistry in Iran and due to the growing demand for it, this study was designed. Method: In this descriptive epidemiological study, we visited three completely different areas in terms of Socioeconomic status (SES) in Tehran. A checklist was used to record the gender, job, age, education level, maternal status, and source of payment for cosmetic dentistry treatment. Result: The majority of the volunteers for dental cosmetic restoration were 23-26 years. Of 498 cosmetic restoration volunteers, 50 were men and 448 were women. As for the education level, most of the participants had a high school diploma. The cost of cosmetic restoration of 351 patients (70%) was paid by the parents or the spouse, and 147 patients paid the cost from their income. Our study showed that 7% of visits to dental clinics were only for cosmetic treatment demands in Tehran in 2021. Conclusion: Type of job, education level, and marital status had no significant relationship with the choice of cosmetic treatment while age had a significant relationship with the choice of cosmetic dental restoration treatment. In addition, the choice of cosmetic dental treatment was completely related to gender, and women were the main users of it.

Ethical and Medico-Legal Considerations with Aesthetic Dentistry Involving the Aesthetic Zone.

The bedrock of delivering cosmetic dentistry remains good communication underpinned by a clear and transparent consent process. This article looks at this while exploring the ethical and risk management issues that have started to challenge the profession. While patients' demand for cosmetic dentistry has exploded, this article explores the ethical conundrums faced by these treatments against the backdrop of whether their happiness is affected by their image.

The effect of color vision resolution on intra-oral shade-selection accuracy.

BACKGROUND: Dentists must be able to identify subtle color changes as shade-matching is crucial in aesthetic dentistry. OBJECTIVE: To determine whether color discrimination ability is related to shade-matching accuracy among dentists. METHODS: The sensitivity of the normal-color vision population to different colors was investigated using Farnsworth Munsell 100 Hue (FM-100) test results. The FM-100 test was administered to 37 dentists at the Hospital of Stomatology, Jilin University. Sensitivity of dentists with normal-color vision to different colors was investigated using the FM-100 test. Participants were instructed to arrange color caps of various colors according to the gradual change in colors and the results were scored. Visual shade matching test using Vita 3D-MASTER shade guide was performed to determine shade-matching accuracy. The relationship between color discrimination ability and shade-matching accuracy was analyzed. The number of misplaced color caps in the FM-100 test was also calculated. RESULTS: The FM-100 test revealed that 16 and 21 participants had excellent and average color discrimination ability, respectively, and their shade-matching accuracies were 68.75% and 66.67%, respectively. No significant difference was observed in the shade-matching accuracy between the two groups. No significant correlation was observed between the color discrimination ability and shade-matching accuracy. In addition, the number of wrong color caps on the 43-63 color tray with the transition from blue-green to blue-purple was the highest according to Friedman's test. CONCLUSION: Color discrimination ability of dentists does not affect their visual shade-matching accuracy. Additionally, people with normal color vision are not sensitive to the transition from blue-green to blue-purple.

Effect of sintering on the translucency of CAD-CAM lithium disilicate restorations: A comparative in vitro study.

PURPOSE: The available independent data on the translucency of novel pre and fully sintered chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate are limited. This comparative in vitro study evaluated the translucency degree of pre and fully sintered chairside CAD-CAM lithium disilicate crowns after optional, required, and additional firing processes. MATERIALS AND METHODS: One hundred and five maxillary left central incisor crowns manufactured by three different CAD-CAM lithium disilicate brands shade A1 were assigned into seven groups as follows (n = 15): (1) Straumann n!ce without sintering; (2) Straumann n!ce with one additional sintering process; (3) Straumann n!ce with two additional sintering processes; (4) Amber Mill with one sintering process; (5) Amber Mill with two sintering processes; (6) IPS e.max CAD with one sintering process; and (7) IPS e.max CAD with two sintering processes. The translucency of all crowns was evaluated with a color imaging spectrophotometer. All statistical analyses were performed using statistical software. A standard level of significance was set at α < 0.05. RESULTS: All the milled crowns presented different degrees of translucency, and additional sintering processes altered it. IPS e.max CAD with two (4.33 ± 0.26) and one (4.01 ± 0.15) sintering processes displayed the highest translucency, whereas Straumann n!ce with no sintering process provided the lowest value (2.82 ± 0.16). CONCLUSIONS: The translucency of chairside lithium disilicate single-unit full-coverage restorations manufactured with subtractive technology was significantly influenced by the brand and the number of sintering processes. The traditional presintered IPS e.max CAD and the fully crystallized glass-ceramic Straumann n!ce considerably increased the translucency after one additional firing process, whereas Amber Mill decreased its translucency.

The Case for Decolonising the Dental Curricula in the UK.

Students across disciplines in UK universities are demanding decolonisation of their education. These demands aim to resist the white European colonial endeavour that create racist inequalities. To address racial inequalities, the dental discipline has predominantly focused on diversity rather than decolonisation. By using two inter-related referents of decolonisation to dental caries and cosmetic dentistry, this article demonstrates the epistemic violence exerted through the objective hierarchised knowledge practices in dentistry. First, by starting from the position of racisms, empire and slavery, the enduring colonial patterns of power and hierarchies come into view. We see how knowledge production in dentistry has neglected the interconnected histories of colonialism, racial capitalism and patriarchy that continue to shape oral health inequalities and work towards promoting white supremacist beauty ideals. Moreover, the interconnected character of inequalities - race, class and gender - begin to emerge. Second, by proceeding from the place of colonialism, the limits of dental knowledge and the violence embedded in knowledge practices emerge. This highlights the need for new ways of knowing. To decolonise is to confront and weaken the dental discipline's entanglement with the enduring colonial patterns of power and hierarchies that are complicit in maintaining inequalities. Diversity without decolonisation will simply subsume marginalised voices into the existing hierarchised knowledge paradigm and continue to reproduce a hierarchised, unequal world. I argue that if dental schools want to address racial and intersectional inequalities, they need new transformative ways of learning and knowing to equip students to work towards social justice in the outside world.

A Novel Solution to Treat Unesthetic Implant Restorations in the Esthetic Zone: A Case Report.

INTRODUCTION: Soft tissue dehiscences and deficiencies can occur around implants especially when they are malpositioned. There is a dearth of information on burying these fixtures and bridging over them to improve the prosthetic result. The patient presented with a very functional fixed dental prosthesis (FDP) from #7 to #10 which had been in place for 20 years. The patient requested replacement of the restoration for a better esthetic outcome. CASE PRESENTATION: The FDP was intact and did not need replacement other than for esthetic improvement. Implants were placed in the #8,9 sites and complications developed. After multiple hard and soft tissue surgeries, the case worsened. It was referred to a periodontist who reconstructed the site to ideal tissue levels. The patient had a very high smile line showing all of the soft tissue framework around the missing teeth. The prosthodontist and periodontist decided to leave the implants buried and bridged over them which resulted in an excellent esthetic outcome. CONCLUSION: This case points out the importance of considering all possible treatment plans and involving the patient in the final decision. The seemingly apparent obvious plan would have been to restore the implants and try to achieve an esthetic result. However, after the implants were placed and developed complications, the decision to bury them improved the probability of a better esthetic outcome. The gingival levels and height of papillae were esthetically more acceptable with an FDP than what would have resulted if the fixtures were re-uncovered and restored.

Gingival Melanin Depigmentation Using a Diode 808-nm Laser: A Case Series.

Introduction: Gingival hyperpigmentation is caused by an increase in the amount of melanin production or the number of melanocytes in the epithelium, which can impair smile esthetics. The current study aimed to report the experience of using a diode laser for gingival depigmentation of three different patients. Case Presentation: Three adult patients are presented with hyperpigmentation in labial gingivae of both jaws. The depigmentation was done using a diode laser at a wavelength of 808 nm, fiber diameter of 300 µm, and power of 1 W and in continuous mode. All three patients showed proper resolution of hyperpigmented areas in short- and long-term follow-up sessions. However, degrees of recurrence were noticeable in two cases. Conclusion: The 808-nm diode laser can be utilized safely and efficiently in gingival depigmentation, resulting in an acceptable cosmetic outcome.

Resin Infiltration Therapy: A micro-invasive treatment approach for white spot lesions.

Purpose: The demand for esthetic dentistry has led to the development of new treatments for white spot lesions (WSLs). Microinvasive therapies, such as resin infiltration, have been used to treat demineralized enamel. Recently, resin infiltration using the active ingredient triethylene glycol dimethacrylate (TEGDMA), has been used to restore WSLs. The purpose of this narrative review is to evaluate the evidence on TEGDMA, an innovative resin that has been introduced, as an alternative dental material for treating WSLs.Methods: A review of the literature was conducted using key words pertaining to WSLs and resin infiltration including cosmetic dentistry; dental caries; dental materials; general dentistry; sealants; technology for patient care. Evidence was incorporated from biomedical data bases including PubMed and the Cochrane Library, which formed the framework for the review.Results: Based on the synthesis of the evidence, resin infiltration using TEGDMA is an effective alternative treatment option for WSLs. Studies suggest that the outcomes for micro-invasive procedures using resin infiltration may vary depending on the depth of the lesion.Conclusion: Resin infiltration, using TEGDMA, removes minimal amounts of enamel and preserves the hard tissue surrounding the WSLs. Additionally, TEGDMA restores the natural fluorescence, hardness, and texture of intact enamel. Future studies are needed to assess the long-term clinical effects of resin infiltration using this material on both permanent and primary dentition.

Full digital workflow in fixed adhesive dental prosthesis: Description of a clinical technique / Fluxo de trabalho digital completo em prótese fixa adesiva: descrição de uma técnica clínica

Digital dentistry has gained space in several dental specialties. It is possible to achieve excellent results with the digital workflow, which combines the efficiency of the restorative material with a greater marginal adaptation. This study aimed to report a clinical case through the digital workflow, with a faster and clinically acceptable prosthetic resolution. In this clinical case report, digital workflow allowed a faster and clinically acceptable prosthetic resolution. A 45-year-old female patient reported cementation failure of the prosthetic crown on tooth 14. As it was a vital tooth, the tooth received a total crown preparation. In the same clinical session, the patient's mouth was scanned then a capture software obtained a virtual model. After, the design software planned a digital "diagnostic wax-up", so a leucitic ceramic was chosen for the rehabilitation. The ceramic block was milled and receive stain and glaze, dispensing the prosthesis laboratory. Then, the adhesive cementation was performed with a dual-polymerized resin cement. The final crown had ideal adaptation, with no need for interproximal and occlusal adjustments, with an excellent marginal fit. Within the limitations of this study, this case report showed that the digital workflow allowed a favorable result in a shorter working time, which brought back function and aesthetics, without the need for interproximal and occlusal adjustments. (AU)

A odontologia digital vem ganhando espaço em diversas especialidades odontológicas. Com o fluxo de trabalho digital, é possível alcançar excelentes resultados na reabilitação protética, combinando a eficiência do material restaurador com a adaptação marginal proporcionada pela odontologia digital. O objetivo desse estudo foi relatar um caso clínico através do fluxo de trabalho digital, com uma resolução protética mais rápida e clinicamente aceitável. Paciente do sexo feminino, 45 anos, relatou falha de cimentação da coroa protética do dente 26. Por ser um dente vital, o dente recebeu um preparo de coroa total e os dentes foram escaneados e um software de captura obteve um modelo virtual. Posteriormente, o software de projeto planejou um "enceramento diagnóstico" digital, sendo escolhida uma cerâmica leucítica para a reabilitação. O bloco cerâmico foi fresado e recebeu acabamento, maquiagem e glaze pelo próprio dentista, dispensando um técnico laboratorial de prótese dentária. Em seguida, foi realizada cimentação adesiva definitiva. Este relato de caso mostra que, dentro das limitações desse estudo, o fluxo digital permite um resultado favorável em um menor tempo de trabalho, devolvendo a função e estética, sem necessidade de ajustes interproximais e oclusais (AU)

Conceitos atuais sobre a performance clínica e principais falhas do tratamento restaurador com laminados cerâmicos: uma revisão da literatura / Current status on clinical performance and main failures of laminate veneers: a review of the literature

O objetivo do presente estudo foi revisar a literatura dos últimos cinco anos e identificar os índices de sobrevivência, principais causas de falha relatadas e verificar a confiabilidade dos laminados cerâmicos como tratamento estético e funcional em longo prazo. Métodos: foi realizada uma busca ativa na Biblioteca Nacional de Medicina dos Estados Unidos (pubmed.ncbi.nlm.nih.gov), através da base de dados Medline, dos últimos cinco anos (2015-2020) na língua inglesa, utilizando os descritores: Laminate Veneers, Porcelain Laminate Veneers e Ceramic Laminate Veneers, que resultou em 35 artigos. Após a leitura dos resumos, foram excluídos 9 estudos que utilizaram laminados cerâmicos não produzidos em cerâmicas feldspáticas, ou vidro ceramizados reforçados por cristais de leucita, ou dissilicato de lítio. Foram selecionados 26 artigos categorizados como: relatos de caso, estudos clínicos, estudos in vitro e revisões de literatura. Resultados: os estudos apontaram índices de sobrevivência de 100%, após 2 anos de cimentação, até valores superiores a 80%, após 14 anos. As três principais causas de falhas apontadas foram: desadaptação de marginal (37%), pigmentação das margens (30%) e fratura ou lascamento das restaurações (3%). Considerações finais: dentro das limitações do estudo, foi possível concluir que as principais causas de falha estão associadas às margens da restauração, no entanto, os laminados cerâmicos podem atingir índices elevados de sobrevivência mesmo 14 anos após a cimentação, mostrando um alto nível de confiabilidade. (AU)

The objective of the present study was to identify the survival rate and cause of failure of ceramic laminate veneers. Methods: An active search of the last five years (2015 ­ 2020) was carried out in the United States National Library of Medicine (pubmed.ncbi.nih.gov) the MEDLINE database, in English, using the descriptors: Laminate Veneers, Porcelain Laminate Veneers and Ceramic Laminate Veneers, which resulted in 35 papers. After reading the abstracts, 9 studies that evaluated ceramic laminates that were not produced using felspathic porcelain, leucite-reinforced glass-ceramicc, or lithium disilicate glass-ceramic were excluded. Twenty-six scientific papers were selected, categorized as: Case reports, clinical studies, in vitro studies and literature reviews. Result: The studies showed survival rates between 100% after two years of cementation up to values above 80% after 14 years. The three causes of failure identified were: marginal misfit (37%), pigmentation of the margins (30%), and fracture or chipping of the restorations (3%). Final Considerations: Within the limitations of this study, it was possible to conclude that the leading causes of failure are associated with the restoration's margins. However, ceramic laminates can achieve high survival rates even 14 years after cementation, showing a high-reliability level.(AU)

The Use of Botulinum Toxin and Dermal Fillers to Enhance Patients' Perceived Attractiveness: Implications for the Future of Aesthetic Dentistry.

Physical appearance and attractiveness consciously and subconsciously, affect patients' quality of life. Traditionally, dentists were tasked with improving a patient's smile, a central aspect of facial aesthetics and physical appearance. More recently, as the scope of practice of the aesthetic dentist has broadened to potentially include other components of facial cosmesis that go hand-in-hand with a patient's smile, new options have emerged with which modern aesthetic dentists should familiarize themselves. As laws surrounding their use in dental offices continue to evolve, Botox and dermal fillers represent natural next steps in aesthetic dentistry.

Evolution of Aesthetic Dentistry.

One of the main goals of dental treatment is to mimic teeth and design smiles in a most natural and aesthetic manner, based on the individual and specific needs of the patient. Possibilities to reach that goal have significantly improved over the last decade through new and specific treatment modalities, steadily enhanced and more aesthetic dental materials, and novel techniques and technologies. This article gives an overview of the evolution of aesthetic dentistry over the past 100 y from a historical point of view and highlights advances in the development of dental research and clinical interventions that have contributed the science and art of aesthetic dentistry. Among the most noteworthy advancements over the past decade are the establishment of universal aesthetic rules and guidelines based on the assessment of natural aesthetic parameters, anatomy, and physiognomy; the development of tooth whitening and advanced restorative as well as prosthetic materials and techniques, supported by the pioneering discovery of dental adhesion; the significant progress in orthodontics and periodontal as well as oral and maxillofacial surgery; and, most recently, the implementation of digital technologies in the 3-dimensional planning and realization of truly natural, individual, and aesthetic smiles. In the future, artificial intelligence and machine learning will likely lead to automation of aesthetic evaluation, smile design, and treatment-planning processes.

Information on teeth whitening from employees at establishments in New York City.

Teeth whitening (bleaching) is a popular cosmetic procedure in the United States and the potential side-effects are well-documented. Establishments offering whitening procedures in New York City were found online and 148 were successfully contacted to inquire about the benefits, side effects, and eligibility criteria of their whitening procedures. Most had no eligibility criteria and the only stated benefit was brighter teeth. Representatives from 25 businesses stated that there were no side effects. About half of the establishments used UV light and employees at these businesses were more likely to state that there were side effects. While limited in its cross-sectional design, this study demonstrates a lack of effective communication by employees regarding the side effects of teeth whitening. Future public health research on this topic would complement existing biological and clinical research.

[Application of minimally invasive cosmetic dentistry in the clinics of pediatric dentistry].

With the minimally invasive treatment attracting considerable attention in the field of dentistry, a series of oral minimally invasive treatment technologies, including minimally invasive cosmetic dentistry (MICD) technology, is emerging. Children, as a special group of patients, are in the critical stage of the initial formation of psychological structure. Therefore, children's dental treatment should not be limited to restoring function and relieving pain. The development, aesthetics, and physical and mental health should also be given attention. Therefore, in recent years, MICD technology has been widely used in diagnosis and treatment of pediatric dentistry. This review provides a detailed introduction regarding a series of techniques in pediatric dentistry.

The effects of hybrid light activation and enamel acid etching on the effectiveness, stability and sensitivity after a single session in-office bleaching: A 12-month clinical trial.

BACKGROUND: The use of hybrid-light (HL) during in-office teeth bleaching can provide faster and reliable results after a single bleaching session, especially if associated with previous acid etching. The present in vivo, interventional, split-mouth, triple-blinded and randomized study evaluated the efficiency of a HL, with and without prior enamel acid etching, assessing the gel application time, degree of color change, sensitivity and treatment stability up to 12 months. METHODS: Thirty-four patients were selected and randomly divided into four groups. The color was evaluated using a spectrophotometer with the CIELab color system, and a VAS questionnaire was used to evaluate the sensitivity. Both upper and lower hemiarches (GI and III) received enamel acid etching with 37% phosphoric acid for 15 s prior to the application of 35% hydrogen peroxide gel (HP). For GI and II, HP was applied on both dental arches for 3-4 consecutive applications and activated by HL (2 × 3' activations with 1' interval); and 3 × 15' (HP) for GIII and IV without HL. Patients returned in 24 h, 1 week, 1-, 6- and 12-months intervals. The clinical operator was different from the clinical measurements operator. RESULTS: After 3-way ANOVA, Tukey's, Wilcoxon and Mann-Whitney tests, all with p < 0.05, no statistical differences were observed between the groups regarding color change (ΔE) and sensitivity in all evaluations. The lowest gel application time was observed for GII (acid etch + HL), followed by GI (HL). CONCLUSIONS: The present study's results reveal the advantages of HL associated with acid etching prior to in office bleaching.