Effectiveness of 6% hydrogen peroxide concentration for tooth bleaching­A double-blind, randomized clinical trial.

OBJECTIVE: The aim of this clinical randomized double-blind split-mouth study was to assess the effectiveness of a 6% hydrogen peroxide with nitrogen-doped titanium dioxide light activated bleaching agent. METHOD: 31 patients were treated with: one upper hemiarcade with a 35% hydrogen peroxide bleaching agent and the other hemiarcade with a 6% hydrogen peroxide. Two applications were completed each treatment session and three sessions were appointed, with one week interval between them. Tooth colour was registered each session and 1 week and 1 months after completing the treatment by spectrophotometer, registering parameters L*, a* and b*, and subjectively using VITA Classic guide. Tooth sensitivity was registered by VAS and patient satisfaction and self-perception result was determined using OHIP-14. Tooth colour variation and sensitivity were compared between both bleaching agents. RESULTS: Both treatment showed a change between baseline colour and all check-points with a ΔE=5.57 for 6% and of ΔE=7.98 for the 35% one month after completing the (p<0.05). No statistical differences were seen when subjective evaluations were compared. Also, no differences were seen in tooth sensitivity between bleaching agents. OHIP-14 questionnaire demonstrated a significant change for all patients after bleaching. CONCLUSIONS: A 6% hydrogen peroxide with nitrogen-doped titanium dioxide light activated agent is effective for tooth bleaching, reaching a ΔE of 5.57 one month after completing the treatment, with no clinical differences to a 35% agent neither in colour change or in tooth sensitivity. CLINICAL SIGNIFICANCE: A low concentration hydrogen peroxide bleaching agent may reach good clinical results with less adverse effects.

Low Concentration H(2)O(2)/TiO_N in Office Bleaching: A Randomized Clinical Trial.

OBJECTIVES: The purpose of this randomized double-blinded clinical trial was to test the efficacy and tooth sensitivity promoted by the use of an in-office 15% H(2)O(2) bleaching agent containing nanoparticles of TiO_N photocatalyzed with LED/laser light (HP15) and a control of 35% H2O2 (HP35). METHODS: Forty healthy volunteers, both sexes, aged 18 to 25 yr, were randomly distributed in 2 groups: HP15 (n = 20) was treated in 3 sessions of 48 min each, and HP35 (n = 20) was treated in 3 sessions of 45 min each. The efficacy (E) was evaluated by ΔE values measured via reflectance spectroscopy. The tooth sensitivity (S) was analyzed by visual analog scale (low, average, high, very high). The absolute risk reduction and the number needed to treat index were calculated. The data were analyzed by mixed repeated measures analysis of variance with Bonferroni-correction t test (α = 0.05). RESULTS: For the efficacy, significant differences were found for number of bleaching sessions (p = .0001; [Formula: see text] = 0.73 and π = 1.000) and for the interaction of number of sessions and bleaching protocols (p = .0001; [Formula: see text] = 0.319 and π = 1.000. The tooth sensitivity level showed significant differences only between the bleaching protocols. Absolute risk reduction calculated was 52% and number needed to treat, 1.92. CONCLUSIONS: The bleaching agent with the lower concentration (HP15) promoted lower levels of tooth sensitivity and presented greater efficacy compared to the control (HP35) in patients between 18 and 25 yr old. The limitation of short-term evaluation did not provide information about the longevity of the tooth bleaching (Brazilian Clinical Trials Registry Re Bec no. U1111-1150-4466).

Toll-like receptor 4 agonists adsorbed to aluminium hydroxide adjuvant attenuate ovalbumin-specific allergic airway disease: role of MyD88 adaptor molecule and interleukin-12/interferon-gamma axis.

BACKGROUND: Epidemiological and experimental data suggest that bacterial lipopolysaccharides (LPS) can either protect from or exacerbate allergic asthma. Lipopolysaccharides trigger immune responses through toll-like receptor 4 (TLR4) that in turn activates two major signalling pathways via either MyD88 or TRIF adaptor proteins. The LPS is a pro-Type 1 T helper cells (Th1) adjuvant while aluminium hydroxide (alum) is a strong Type 2 T helper cells (Th2) adjuvant, but the effect of the mixing of both adjuvants on the development of lung allergy has not been investigated. OBJECTIVE: We determined whether natural (LPS) or synthetic (ER-803022) TLR4 agonists adsorbed onto alum adjuvant affect allergen sensitization and development of airway allergic disease. To dissect LPS-induced molecular pathways, we used TLR4-, MyD88-, TRIF-, or IL-12/IFN-gamma-deficient mice. METHODS: Mice were sensitized with subcutaneous injections of ovalbumin (OVA) with or without TLR4 agonists co-adsorbed onto alum and challenged with intranasally with OVA. The development of allergic lung disease was evaluated 24 h after last OVA challenge. RESULTS: Sensitization with OVA plus LPS co-adsorbed onto alum impaired in dose-dependent manner OVA-induced Th2-mediated allergic responses such as airway eosinophilia, type-2 cytokines secretion, airway hyper-reactivity, mucus hyper production and serum levels of IgE or IgG1 anaphylactic antibodies. Although the levels of IgG2a, Th1-affiliated isotype increased, investigation into the lung-specific effects revealed that LPS did not induce a Th1 pattern of inflammation. Lipopolysaccharides impaired the development of Th2 immunity, signaling via TLR4 and MyD88 molecules and via the IL-12/IFN-gamma axis, but not through TRIF pathway. Moreover, the synthetic TLR4 agonists that proved to have a less systemic inflammatory response than LPS also protected against allergic asthma development. CONCLUSION: Toll-like receptor 4 agonists co-adsorbed with allergen onto alum down-modulate allergic lung disease and prevent the development of polarized T cell-mediated airway inflammation.