RESUMO
Introduction: Currently dental aesthetics during fixed orthodontic treatment is an option required by patients, due to the frequent pigmentations that can occur in tooth enamel as a result of inadequate oral hygiene and plaque retention caused by fixed appliances. Objective: To determine the effectiveness of dental whitening and its side effects during active fixed orthodontic treatment, as an alternative aesthetic treatment in certain cases that merit it. Materials and methods: This narrative review evaluated 35 scientific articles from the Medline information sources (via PUBMED), EMBASE, SCOPUS, SCIELO and LILACS from the last 10 years, published in Spanish, Portuguese and English. We included 17 articles that met the selection criteria which were randomized clinical trials and observational studies, in vitro studies and in vivo studies that evaluated in-office dental clearance, performed on patients using fixed orthodontic treatment at that time. Systematic reviews, case reports and editorials were excluded. Results: It was observed that dental whitening in patients with active orthodontic treatment minimally affects the adhesion of the orthodontic apparatus to the tooth surface. In addition, some studies observed that the brackets interfere with the extension of the dental lightening, evidencing slightly darker areas. Conclusions: Dental whitening during orthodontic treatment can be given efficiently in clinical practice, depending on the aesthetic requirement of the patient. However, it is a recommended procedure in certain cases of great need for immediate aesthetics, since, the material with which the brackets are installed on the dental surface, will interfere with the extension of the lightening material, resulting in a darker shade in that sector and different from the surrounding tissue. Likewise, it will intervene in the adhesion to the dental surface, having many probabilities that the orthodontic apparatus can detach.
Introducción: Actualmente, la estética dental durante el tratamiento de ortodoncia fija es una opción requerida por los pacientes, debido a las frecuentes pigmentaciones que se pueden presentar en el esmalte dental como consecuencia de una inadecuada higiene bucal y la retención de placa provocada por la aparatología fija. Objetivo: Determinar la efectividad del blanqueamiento dental y sus efectos secundarios durante el tratamiento de ortodoncia fija activa, como alternativa de tratamiento estético en determinados casos que lo ameriten. Materiales y métodos: Esta revisión narrativa evaluó 35 artículos científicos de las fuentes de información Medline (vía PubMed), Embase, Scopus, SciELO y LILACS de los últimos 10 años, publicados en español, portugués e inglés. Se incluyeron 17 artículos que cumplieron con los criterios de selección, los cuales fueron ensayos clínicos aleatorizados y estudios observacionales, estudios in vitro y estudios in vivo que evaluaron el aclaramiento dental en consultorio, realizados en pacientes que utilizaban tratamiento de ortodoncia fija en ese momento. Se excluyeron revisiones sistemáticas, informes de casos y editoriales. Resultados: Se observó que el blanqueamiento dental en pacientes con tratamiento de ortodoncia activa afecta mínimamente la adherencia del aparato de ortodoncia a la superficie del diente. Además, algunos estudios observaron que los brackets interfieren en la extensión del aclaramiento dental, al evidenciar áreas ligeramente más oscuras. Conclusiones: El blanqueamiento dental durante el tratamiento de ortodoncia se puede dar de manera eficiente en la práctica clínica, dependiendo del requerimiento estético del paciente. Sin embargo, es un procedimiento recomendado en ciertos casos de gran necesidad de estética inmediata, ya que el material con el que se instalan los brackets sobre la superficie dentaria interferirá en la extensión del material aclarante, lo que da como resultado una tonalidad más oscura en ese sector y diferente del tejido circundante. Asimismo, intervendrá en la adhesión a la superficie dentaria, por lo que existen muchas probabilidades de que el aparato de ortodoncia pueda desprenderse.
RESUMO
Introduction: The main consequence of not treating tooth decay in time is the total or partial loss of the tooth. One of the alternatives to replace the lost tooth and return the functions is through fixed prostheses. Today there are 3 generations of yttrium-stabilized zirconium polycrystals (Y-TZP). Seeing that in the third Generation the yttrium content was increased to approximately 5% in moles (5Y), stabilizing the materials approximately 50% of cubic phase and 50% of tetragonal phase, thus giving a translucent zirconium (5Y) with a high aesthetics and greater naturalness to the dental crown. Objective: To identify the different optical and mechanical properties of translucent zirconium compared to other restorative materials used in fixed prostheses. Materials and methods: This narrative review evaluated 115 scientific articles from the Medline information sources (via PubMed), Science Direct, Scopus, SciELO and LILACS from the last 5 years, published in Spanish, Portuguese and English. We included 51 articles that met the selection criteria which were randomized clinical trials and observational studies, in vitro studies and in vivo studies that evaluated the optical and mechanical properties of translucent zirconium as an optimal restorative material in fixed prostheses. We excluded systematic reviews, case reports and editorials. Results: It was observed that zirconium being a relatively new material and in constant evolution has studies mostly in vitro, among which stand out those that speak both of the mechanical and optical properties that vary depending on the generation to which the material belongs, as well as the adhesiveness of the material which is for now not viable, therefore, it is essential that more studies be carried out on this material. Conclusions: We can mention that zirconium has evolved over time, providing better optical properties, but as a consequence it has been reducing flexural strength and fracture toughness. However, this material provides good biocompatibility with oral structures. On the other hand, translucent zirconium according to studies is a non-recordable material, so new methods are sought to improve its adhesion.
