Effect of 1.5% potassium oxalate on sensitivity control, color change, and quality of life after at-home tooth whitening: A randomized, placebo-controlled clinical trial.

OBJECTIVE: This clinical trial evaluated the effect of 1.5% potassium oxalate (PO) in controlling sensitivity and color change after at-home tooth whitening. It also evaluated the influence of PO on health-related quality of life (HRQoL) and the degree of patient satisfaction after bleaching treatment. MATERIALS AND METHODS: Fifty volunteers were randomized into two groups (n = 25): At-home bleaching gel with 22% carbamide peroxide for 45 min + placebo gel (GP) or 1.5% PO (GPO) for 10 min. The intensity of tooth sensitivity was assessed daily through the visual analog scale. The color analysis was performed three times: baseline, 21 days, and 1 month after the last application of the whitening gel. The impact of the oral condition on the patient's quality of life (OIDP) was used to measure the impact caused by the whitening treatment in relation to the individuals' ability to carry out their daily activities and its influence on HRQOL. RESULTS: No difference in tooth sensitivity was observed (p > 0.05). In addition, there was no difference in color change between groups (p > 0.05). However, there was an intragroup statistical difference throughout the evaluation period (p <0.05). The OIDP analysis showed a statistical difference between the groups (p > 0.05) and there was no difference between the groups regarding the degree of satisfaction with the bleaching (p > 0.05). CONCLUSIONS: The 1.5% PO was effective in preventing sensitivity and did not interfere with tooth whitening. Desensitizing therapy had a positive impact on quality of life and patient satisfaction.

Effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) on dental hypersensitivity: A randomized controlled clinical trial.

OBJECTIVE: This randomized controlled clinical trial aimed to evaluate the effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) in the treatment of dentin hypersensitivity (DH), and the impact of this on the health-related quality of life (HRQL). METHODS: Eighty teeth with DH were randomized into four groups and received three treatment sessions: PLACEBO = placebo + LASER application mimicking; CPP-ACPF = CPP-ACPF + LASER application mimicking; PBM = placebo + LASER active application; CPP-ACPF+PBM = CPP-ACPF + LASER active application. Tactile (exploratory probe) and evaporative (triple syringe) stimuli were used to measure DH and were recorded with the aid of a visual analogue scale (VAS) after the 1st, 2nd and 3rd treatment sessions and one-month follow-up. The HRQL was recorded in the DH experience questionnaire (DHEQ). RESULTS: The intragroup comparison showed a significant reduction in DH (p < 0.05) with both stimuli after one-month follow-up. The intergroup comparison with the evaporative stimulus showed that CPP-ACPF+PBM significantly reduced DH when compared to the rest of treatments, after one-month follow-up. CPP-ACPF+PBM group statistically differed from the other treatment groups in the DHEQ evaluation after one-month follow-up. CONCLUSION: After one-month follow-up, the association of CPP-ACPF with PBM was effective in the reduction of DH and promoted a positive impact on the HRQL of the participants of this study.

Effect of low-level laser therapy combined with 5000 parts per million fluoride dentifrice on postbleaching sensitivity: A clinical, randomized, and double-blind study.

OBJECTIVE: The aim of this double-blind, randomized, controlled clinical study was to assess the efficacy of low-level laser therapy (LLLT) combined with 5000 ppm fluoride dentifrice on postbleaching sensitivity in teeth exposed to 35% hydrogen peroxide for four weeks. MATERIALS AND METHODS: Twenty-five volunteers were evaluated using the split-mouth model in which the right and left maxillary/mandibular quadrants were randomized and allocated to one of two groups: GPLACEBO, in which the laser tip was positioned without the emission of light (placebo effect) + 5000 ppm sodium fluoride, or GLASER, which comprised LLLT + 5000 ppm sodium fluoride. For both groups, LLLT and placebo were used before bleaching, whereas fluoride was applied after bleaching. LLLT was applied at two points: on the central cervical and medial regions of the incisors, canines, and premolars in the corresponding hemi-arch. At each point, 60 J/cm2 was applied for 16 seconds with an irradiance of 3.75 W/cm2 using the therapeutic infrared device. To assess tooth sensitivity, a modified visual analogue scale was used after an evaporative stimulus, and a daily pain questionnaire was also applied. RESULTS: The Wilcoxon and Friedman tests demonstrated a significant difference in the incidence of sensitivity pain between GPLACEBO and GLASER (P ≤ .05), with different evaluation times. CONCLUSION: Teeth treated with laser therapy in combination with the topical use of sodium fluoride at each bleaching session demonstrated less sensitivity compared with the application of sodium fluoride only. CLINICAL SIGNIFICANCE: The use of a low-level laser therapy in combination with topical use of sodium fluoride improves symptoms of dentin sensitivity at each bleaching session.

Randomized clinical trial of the effect of NovaMin and CPP-ACPF in combination with dental bleaching.

OBJECTIVE: This randomized, controlled, double-blind clinical study evaluated the effect of calcium sodium phosphosilicate (NovaMin) and casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) on the prevention of post-operative sensitivity and on the effects of clinical bleaching treatment. MATERIAL AND METHODS: Sixty volunteers were selected according to inclusion and exclusion criteria and were randomly assigned into three groups (n=20): CG (control group) patients, who were treated with 35% hydrogen peroxide; NOVAG (NovaMin group) patients, who were treated with 35% hydrogen peroxide followed by the application of NovaMin; and CPPG (CPP group) patients, who were treated with 35% hydrogen peroxide followed by the application of CPP-ACPF. Both bioactive agents were applied for five minutes. An evaporative stimulus associated with a modified visual scale was used to analyze sensitivity 24 hours after each bleaching session. The color evaluation was performed on the maxillary central incisors using a spectrophotometer. Associations between the intervention group, bleaching session, and reported sensitivity were tested using Chi-square partitioning. RESULTS: Color change values (ΔE) were analyzed using analysis of variance (ANOVA). The significance level used for both tests was 5%. In the intragroup assessment, the Friedman test showed that only the CPP-ACPF group showed no statistically significant difference (p<0.05) between baseline and first bleaching session. In the intergroup assessment, the Kruskal-Wallis test showed that the CPPG had less postoperative sensitivity after the first session, when compared to the other groups (p<0.05). Color change analysis (ΔE) showed a significant difference between the means obtained in the different bleaching sessions in all groups (p<0.05). CONCLUSIONS: This study showed that the combination of CPP-ACPF with 35% hydrogen peroxide significantly reduced post-operative sensitivity in the first session, compared with the other evaluated treatments. The association of CPP-ACPF and NovaMin did not affect the color change induced by tooth bleaching.

Randomized clinical trial of the effect of NovaMin and CPP-ACPF in combination with dental bleaching

Abstract Objective This randomized, controlled, double-blind clinical study evaluated the effect of calcium sodium phosphosilicate (NovaMin) and casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) on the prevention of post-operative sensitivity and on the effects of clinical bleaching treatment. Material and Methods Sixty volunteers were selected according to inclusion and exclusion criteria and were randomly assigned into three groups (n=20): CG (control group) patients, who were treated with 35% hydrogen peroxide; NOVAG (NovaMin group) patients, who were treated with 35% hydrogen peroxide followed by the application of NovaMin; and CPPG (CPP group) patients, who were treated with 35% hydrogen peroxide followed by the application of CPP-ACPF. Both bioactive agents were applied for five minutes. An evaporative stimulus associated with a modified visual scale was used to analyze sensitivity 24 hours after each bleaching session. The color evaluation was performed on the maxillary central incisors using a spectrophotometer. Associations between the intervention group, bleaching session, and reported sensitivity were tested using Chi-square partitioning. Results Color change values (ΔE) were analyzed using analysis of variance (ANOVA). The significance level used for both tests was 5%. In the intragroup assessment, the Friedman test showed that only the CPP-ACPF group showed no statistically significant difference (p<0.05) between baseline and first bleaching session. In the intergroup assessment, the Kruskal-Wallis test showed that the CPPG had less postoperative sensitivity after the first session, when compared to the other groups (p<0.05). Color change analysis (ΔE) showed a significant difference between the means obtained in the different bleaching sessions in all groups (p<0.05). Conclusions This study showed that the combination of CPP-ACPF with 35% hydrogen peroxide significantly reduced post-operative sensitivity in the first session, compared with the other evaluated treatments. The association of CPP-ACPF and NovaMin did not affect the color change induced by tooth bleaching.

An in situ Evaluation of Bioactives on the Morphology of Bleached Enamel.

AIM: The aim of this study was to use surface rugosity analysis (Ra) and scanning electron microscopy (SEM) comparing effects of nano-hydroxyapatite (NANO), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and NovaMin (NOVA) on enamel's human morphology bleached with 37.5% hydrogen peroxide. MATERIALS AND METHODS: Forty specimens (3 × 3 × 3 mm) were obtained from fully included third molars and four specimens were attached in the first molars of the volunteers. The POLA-positive control has only been bleached. Three experimental groups were bleached and treated with respective bioactive: NANO, CPP-ACP, and NovaMin. The Ra analyses were performed before and after the treatment using a rugosimeter. The obtained photomicrographs were analyzed using SEM (n = 3) by three examiners, and the study was double blind. RESULTS: The Ra results were analyzed by one-way analysis of variance and Tukey's post hoc test (p < 0.05). All experimental groups showed significant differences of the others; however, the experimental groups were not significantly different from each other. CONCLUSION: The enamel morphology of the bioactive-treated groups had more regular surfaces, than the others.

Mechanical properties of nanofilled and microhybrid composites cured by different light polymerization modes.

This study compared nanofilled and microhybrid composites polymerized by different light polymerization modes, and the effects these modes had on the mechanical properties of the composites. The following mechanical properties were measured: Vickers microhardness numbers, diametral tensile strength, flexural strength, and flexural modulus. The filler content (Wt%) present in the resins was investigated. Data were treated statistically by ANOVA and Tukey's test (P ≤ 0.05) and the interaction of the inorganic content with the mechanical properties was analyzed by Pearson's correlation (P ≤ 0.05). The nanofilled material showed a higher percentage of inorganic filler and better mechanical properties when compared to the microhybrid composite. The correlation of Wt% with the tested properties was positive for all but the flexural strength test. Different light polymerization modes were shown not to have a significant influence on the mechanical properties of the composites in this study.

Transdental photo-activation technique: hardness and marginal adaptation of composite restorations using different light sources.

This study investigated the influence of different light sources associated with a transdental photoactivation technique on the marginal adaptation and hardness of composite restorations. Cavities (3 mm wide x 3 mm long x 1.5 mm in deep) were prepared on flattened bovine dentin and filled with Z250 composite (3M ESPE). Nine groups (n=10) were defined according to the curing technique (direct; transdental--photo-activation through 1 mm of enamel and 2 mm of dentin; mixed--transdental + direct) and light source (QTH XL2500, 3M ESPE; PAC Apollo 95E, DMD; LED Ultrablue Is, DMC) combination. Marginal adaptation was evaluated using a dye staining method, and the percentage of stained margins was recorded. Knoop Hardness readings were made across the transversal section of the fillings. Data were submitted to two-way ANOVA and Tukey's test (p< or =0.05). For margin analysis, although none of the curing conditions provided perfect adaptation, the mixed technique showed lower gap formation. No significant differences were detected between the transdental and other techniques, and no significant differences were detected among the light sources. For hardness, the direct technique showed slightly greater hardness than the mixed technique. Also, the mixed technique yielded greater hardness than the transdental technique. Among the light sources, the LED showed greater hardness than the PAC; whereas, no significant differences between the QTH and other sources were detected. The mixed technique might improve the marginal adaptation of restorations, while not being detrimental to composite hardness.