RESUMO
O clareamento dental pode ser realizado através da técnica caseira ou de consultório, utilizando agentes como o peróxido de carbamida (PC) e peróxido de hidrogênio (PH). Apesar de seguro, existem alguns efeitos adversos relacionados ao clareamento dental, como a sensibilidade dentinária (SD), que pode estar presente em diferentes graus dependendo da técnica utilizada. A aplicação de agentes dessensibilizantes antes, durante ou depois do clareamento dental vem sido estudada para evitar ou reduzir a sensibilidade associada ao clareamento. O estudo visa revisar a literatura em relação a aspectos e conceitos importantes do clareamento dental, discutindo seus possíveis efeitos adversos com foco na sensibilidade dentinária. Foi realizada uma pesquisa digital da base de dados Medline, via PubMed, utilizando palavras-chave relacionadas ao tema, priorizando artigos publicados há menos de 20 anos e escritos em inglês ou português. Artigos também foram buscados manualmente e foram utilizados livros de odontologias relacionados ao tema. De um total de 48 artigos, 28 foram escolhidos para a composição do trabalho, além de 2 livros de dentística que abordam o clareamento dental. Constata-se que a sensibilidade dentinária é um efeito adverso comum relacionado ao clareamento dental, que possui causa exata desconhecida, porém sabe-se que está relacionada à difusão do peróxido de hidrogênio pelos tecidos dentários. A sensibilidade dentinária é mais frequente na técnica de clareamento de consultório do que na técnica caseira, e pode ser agravada por fatores relacionados ao indivíduo e/ou ao dente. Alguns agentes como o nitrato de potássio, fosfopeptídeos de caseína-fosfato de cálcio amorfo (CPP-ACP), vidros bioativos e partículas de hidroxiapatita, se mostraram efetivos no controle da sensibilidade dentinária.
Dental bleaching can be performed in at-home or in-office techniques, using agents such as carbamide peroxide or hydrogen peroxide. Although it's safe, there are some side effects related to dental bleaching, such as tooth sensitivity, which may be present in different degrees, depending on the chosen technique. The application of desensitizing agents before, during or after dental bleaching is being studied to avoid or reduce the bleaching related sensitivity. The study aims to review the literature over important aspects and concepts of dental bleaching, discussing its possible side effects, focusing on tooth sensitivity. Methods: an online search was done on Medline's database, through PubMed, using keywords related to the theme, prioritizing articles published less than 20 years ago, written in English or Portuguese. Articles were also researched manually, and dentistry books related to the theme were used as well. Out of 48 articles, 28 were chosen to this study's composition, in addition to 2 books that approach dental bleaching. Tooth sensitivity is a common side effect related to dental bleaching, with an unknown cause, however, it is known that it's related to hydrogen peroxide's diffusion through dental tissues. Tooth sensitivity is more frequent within in-office technique than within at-home technique, and may be worsen by individual and/or dental related factors. Agents such as potassium nitrate, CPP-ACP, bioactive glasses and hydroxyapatite particles, showed up to be effective in dental sensitivity control.
Assuntos
Clareamento Dental , Sensibilidade da Dentina , Dessensibilizantes DentináriosRESUMO
Context and Aims: This study evaluated the effect of calcium silicate and sodium phosphate (CSSP) dentifrice and serum on the surface of enamel bleached with hydrogen peroxide (H2O2). Materials and Methods: A total of 160 bovine enamel slabs were bleached with 35% H2O2 and treated with sodium fluoride (NaF) dentifrice-GI, CSSP dentifrice-GII; CSSP dentifrice + CSSP serum-GIII, or NaF dentifrice + NaF gel-GIV. The dentifrices were applied using a brushing machine three times daily for 7 days. After brushing, sodium phosphate gel and CSSP serum were applied. The microhardness (KNH, n = 14), surface roughness (Ra, n = 14), energy dispersive spectroscopy (n = 6), and scanning electron microscopy (n = 6) were assessed at t0 (before bleaching), t1 (after bleaching), and t2 (after postbleaching treatments). Statistical Analysis Used: The data were subjected to a two-way analysis of variance and Bonferroni's test. Results: The KNH decreased at t1 (P < 0.001) but recovered at t2 for all treatments, although only GII showed restored baseline values (P = 0.0109). The surface roughness increased at t1 (P < 0.001) and reduced at t2 (P < 0.001) for all groups, with no significant differences among groups. Enamel composition and morphology did not differ after the treatments, except for silicon accumulation in GIII. Conclusions: Postbleaching treatment with CSSP dentifrice and serum yielded superior remineralizing effects on bleached enamel.
RESUMO
To assess the effect of bleaching with gel of pregabalin associated with 35% hydrogen peroxide on the mechanical and chemical properties and ultramorphology of dental enamel. Thirty-six (36) specimens of bovine dental incisors were obtained and divided into three groups (n = 12), namely: CG = bleaching with 35% hydrogen peroxide; KFG = bleaching with 5% potassium nitrate and 2% sodium fluoride gel + 35% hydrogen peroxide; and PGG = bleaching with experimental gel of pregabalin + 35% hydrogen peroxide. The specimens were assessed with respect to Knoop microhardness, surface roughness, and colour change, before and after bleaching. They were also assessed using scanning electron microscopy and energy-dispersive spectroscopy after treatments. All groups exhibited an increase in surface roughness and a reduction in Knoop microhardness after the protocols. There was colour change in all groups, with no difference between them. In addition, there were changes in enamel morphology and non-significant loss of calcium and phosphorus. The experimental gel of pregabalin did not influence the action of 35% hydrogen peroxide, yielding results similar to those of the other groups assessed in all the parameters. Therefore, the gel of pregabalin can be an alternative for topical application on the surfaces of the teeth in association with bleaching treatments.
RESUMO
BACKGROUND: Although several studies indicate the harmful effects of bleaching on pulp tissue, the demand for this procedure using high concentrations of hydrogen peroxide (HP) is high. OBJECTIVES: To investigate the influence of bleaching on the pulp tissue. METHODS: Electronic searches were conducted (PubMed/MEDLINE, Scopus, Cochrane Library and grey literature) until February 2021. Only in vivo studies that evaluated the effects of HP and/or carbamide peroxide (CP) bleaching gels on the inflammatory response in the pulp tissue compared with a non-bleached group were included. Risk of bias was performed according to a modified Methodological Index for Non-Randomized Studies scale for human studies and the Systematic Review Centre for Laboratory Animal Experimentation's RoB tool for animal studies. Meta-analysis was unfeasible. RESULTS: Of the 1311 studies, 30 were eligible. Of these, 18 studies evaluated the inflammatory response in animal models. All these studies reported a moderate-to-strong inflammatory response in the superficial regions of pulp, characterized by cell disorganization and necrotic areas, particularly during the initial periods following exposure to 35%-38% HP, for 30-40 min. In the evaluation of human teeth across 11 studies, seven investigated inflammatory responses, with five observing significant inflammation in the pulp of bleached teeth. In terms of tertiary dentine deposition, 11 out of 12 studies noted its occurrence after bleaching with 35%-38% HP in long-term assessments. Additionally, three studies reported significant levels of osteocalcin/osteopontin at 2 or 10 days post-treatment. Other studies indicated an increase in pro-inflammatory cytokines ranging from immediately up to 10 days after bleaching. Studies using humans' teeth had a low risk of bias, whereas animal studies had a high risk of bias. DISCUSSION: Despite the heterogeneity in bleaching protocols among studies, High-concentrations of HP shows the potential to induce significant pulp damage. CONCLUSIONS: High-concentrations of bleaching gel increases inflammatory response and necrosis in the pulp tissue at short periods after bleaching, mainly in rat molars and in human incisors, in addition to greater hard tissue deposition over time. However, further well-described histological studies with long-term follow-up are encouraged due to the methodological limitations of these studies. REGISTRATION: PROSPERO (CRD42021230937).
Assuntos
Peróxido de Carbamida , Polpa Dentária , Peróxido de Hidrogênio , Clareadores Dentários , Clareamento Dental , Clareamento Dental/métodos , Clareamento Dental/efeitos adversos , Polpa Dentária/efeitos dos fármacos , Polpa Dentária/patologia , Humanos , Animais , Peróxido de Carbamida/farmacologiaRESUMO
OBJECTIVES: This study aims to assess hydrogen peroxide (HP) penetration within the pulp chamber, color change (CC), physical-chemical properties, and temperature using in-office different concentration bleaching gels with or without violet light. MATERIALS AND METHODS: Fifty teeth were divided into five groups (n = 10) based on the HP concentration bleaching gels used (6% and 35%) and the used violet light (with or without). HP penetration within the pulp chamber was measured using UV-Vis. The CC was evaluated with a digital spectrophotometer. Initial and final concentration, and pH were measured through titration, and a Digital pHmeter, respectively. Temperature analyses were measured through a thermocouple. Statistical analysis included two-way ANOVA, Tukey's, and Dunnett's test (α = 0.05). RESULTS: The presence of violet light did not affect the amount of HP within the pulp chamber, or the CC (p > 0.05). Greater penetration of HP was observed within the pulp chamber, as well as CC when using 35% HP (p < 0.05). The final concentration of both gels was lower than the initial concentration, regardless of the use of violet light (p < 0.05). The initial and final pH levels remained neutral and stable (p > 0.05). The pulp temperature increased when the gels were used in conjunction with violet light (p < 0.05). CONCLUSIONS: Using violet light in conjunction with 6% or 35% HP does not alter the physical properties of the bleaching agents, the penetration of HP or enhance color change. However, an increase in temperature was observed when violet light was applied associated with bleaching gels. CLINICAL RELEVANCE: While the simultaneous use of violet light with hydrogen peroxide 6% or 35% does not alter the material's properties, it also does not bring benefits in reducing hydrogen peroxide penetration and improving color change. Furthermore, the use of violet light increases pulp temperature.
Assuntos
Clareadores Dentários , Clareamento Dental , Peróxido de Hidrogênio , Peróxidos , Ácido Hipocloroso , GéisRESUMO
BACKGROUND: The photo-acceleration of bleaching gels by lights has been extensively researched. However, the induced temperature increase during this process needs to be further evaluated to prevent damage to the dental pulp. Therefore, the objective of this study was to evaluate the surface and intrapulpal temperature kinetics of different concentrations of hydrogen peroxide (HP) gels photo-accelerated by blue or violet light and infrared laser. METHODS: The whitening gels at concentrations of HP35, HP15, and HP6 % were irradiated with blue and violet LED/laser on the surface of a human canine tooth. The surface temperature variation (∆Ts) was evaluated using a pH meter, while the intrapulpal temperature variation (∆Ti) was assessed using a digital thermometer at intervals of 1, 15, and 30 min. Statistical analysis was conducted using a Two-way repeated measures ANOVA test, and Bonferroni post-test was applied at a significance level of 5 %. RESULTS: All violet LED photo-accelerated groups showed a higher increase in ∆Ts compared to the blue LED/laser groups. However, there were no significant differences between the groups for ∆Ti. CONCLUSION: Although the photo-acceleration of HP35 and HP15 % gels with violet LED/laser has a greater increase in surface temperature compared to HP6 % gel, the different light systems do not significantly increase the intrapulpal temperature.
Assuntos
Peróxido de Hidrogênio , Fotoquimioterapia , Humanos , Temperatura , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes , Ácido Hipocloroso , GéisRESUMO
AIM: To evaluate the bleaching efficacy and effects on enamel properties of experimental gels with carbamide peroxide (CP; 10%) or hydrogen peroxide (HP; 6%) containing calcium polyphosphate sub-microparticles (CaPPs). METHODS: A total of 216 bovine tooth specimens were divided for microhardness and color analyses (n = 108) and block randomized into nine groups (n = 12): (G1) commercial CP (Whiteness Perfect, FGM; Brazil); (G2) experimental CP; (G3) CP-0.5%CaPPs; (G4) CP-1.5%CaPPs; (G5) commercial HP (Potenza Bianco, PHS; Brazil); (G6) experimental HP; (G7) HP-0.5%CaPPs; (G8) HP-1.5%CaPPs; (G9) artificial saliva. The gels' pH values were determined with a bench pH meter. Color (ΔE, ΔE00, ΔWID) and microhardness variation were evaluated before and after the therapy. Part of the specimens used for microhardness was submitted to the scanning electron microscopy (SEM) (n = 3) and energy-dispersive X-ray spectroscopy EDX (n = 3) analyses. Statistical analyses were performed in the R statistical software (α = 0.05). Linear mixed models for repeated measures in time were used to analyze microhardness and L* values. Generalized linear models were used to analyze the a*, b*, ΔE, ΔE00, and ΔWID, considering a group effect. The EDX data were analyzed using a one-way ANOVA with Tukey's test. RESULTS: The gels' pH remained over 6,0. All gels effectively bleached the specimens and did not differ significantly. When compared to the control group, the hardness was significantly lower in the G1, G2, G6, and G7 groups. The G3, G4, G5, and G8 groups did not differ significantly (p > 0.05). CONCLUSION: The incorporation of CaPPs in low-concentration whitening gels reduces its negative effects on microhardness without interfering with their bleaching efficacy.
Assuntos
Peróxido de Carbamida , Esmalte Dentário , Géis , Peróxido de Hidrogênio , Microscopia Eletrônica de Varredura , Polifosfatos , Clareadores Dentários , Clareamento Dental , Bovinos , Esmalte Dentário/efeitos dos fármacos , Animais , Peróxido de Hidrogênio/química , Clareadores Dentários/farmacologia , Clareadores Dentários/química , Polifosfatos/farmacologia , Polifosfatos/química , Clareamento Dental/métodos , Peróxido de Carbamida/farmacologia , Dureza , Propriedades de Superfície , Espectrometria por Raios X , Técnicas In Vitro , Cor , Peróxidos/farmacologia , Ureia/análogos & derivados , Ureia/farmacologia , Ureia/química , Concentração de Íons de Hidrogênio , Tamanho da PartículaRESUMO
OBJECTIVE: To evaluate in vitro the effect of dental bleaching using high concentration hydrogen peroxide (HP) photoactivated with violet LED on fracture strength and hybrid layer formation. METHODS: forty endodontically-treated bovine teeth were randomized into four groups (n = 10): C - Control, HP - 35% hydrogen peroxide, HP-BL - 35% hydrogen peroxide photoactivated with blue LED, HP-VL - 35% hydrogen peroxide photoactivated with violet LED. Three bleaching sessions with an interval of 7 days between them were performed. After 10 days of the last bleaching session, the dental crowns were restored and submitted to the fracture strength test. Five specimens from each group were used to evaluate the hybrid layer formation by scanning electron microscope (SEM) images. One-way ANOVA and Kruskal-Wallis test were used for parametric and non-parametric data, respectively. Significance level of 5% was adopted to all the tests. RESULTS: No differences on fracture strength among the groups were observed (p > 0.05). HP and HP-BL showed alterations on hybrid layer formation compared to C group (p < 0.05), but not for HP-VL (p > 0.05). No differences on hybrid layer formation were observed among HP, HP-VL and HP-BL groups (p > 0.05). CONCLUSION: Dental bleaching, photoactivated or not, did not affect the fracture strength of endodontically-treated teeth. Regardless of the protocol used, hydrogen peroxide altered the hybrid layer formation at some level when the restoration was placed after 10 days of the last bleaching session.
Assuntos
Fotoquimioterapia , Clareadores Dentários , Clareamento Dental , Dente não Vital , Animais , Bovinos , Humanos , Peróxido de Hidrogênio , Clareamento Dental/métodos , Resistência à Flexão , Fármacos Fotossensibilizantes , Fotoquimioterapia/métodos , Ácido HipoclorosoRESUMO
BACKGROUND: Dental color change and the temperature of the pulp chamber and of the buccal surface were evaluated during bleaching with 37% carbamide peroxide (CP) with continuous vs fractionated violet LED light protocols. METHODOLOGY: Bovine incisors received in-office bleaching for 30 min using different light protocols (Bright Max Whitening, MMOptics). Teeth were separated into groups (n = 10): HP) 35% hydrogen peroxide (Whiteness HP, FGM)/no light; CP) 37% carbamide peroxide (Whiteness SuperEndo, FGM)/no light; CP10) CP+10 min of continuous light; CP20) CP+20 min of continuous light; CP30) CP+30 min of continuous light; CPF) CP+20 cycles of 60 s light / 30 s no light (fractionated). Color evaluations were performed at different times. Evaluations of pulp and buccal surface temperatures were performed before and throughout the 30 min of bleaching. RESULTS: Generalized linear models for repeated measures over time were applied to the data (α=5%). After the 1st session, CP20 and CP30 had significantly lower b* values ââthan CP and CP10 (p = 0.0071). For ΔEab and ΔE00, CPF, CP20 and CP30 showed the highest color change among the treatments after the third bleaching (p<0.05). For temperature evaluations, CP30 showed higher pulp and buccal surface temperatures than the other protocols (p<0.0001) after 20 min. CONCLUSION: Fractionated or continuous application of violet LED for 20 or 30 min leads to greater effectiveness of color change. All protocols with the application of LED led to an increase in pulp and buccal surface temperatures during bleaching, although the fractionated application appeared to be safer than the use of continuous light.
Assuntos
Fotoquimioterapia , Clareadores Dentários , Clareamento Dental , Animais , Bovinos , Peróxido de Carbamida , Clareamento Dental/métodos , Temperatura , Polpa Dentária , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes , CorRESUMO
Abstract Natrosol and Aristoflex® AVC polymers are widely applied in the cosmetic industry and have recently been applied as a thickener option in the composition of dental bleaching gels, with the purpose to reduce the adverse effects on enamel mineral components. The aim of this study was to evaluate the color variation (ΔE* ab, ΔE00, ∆WID), surface roughness (Ra), and mineral content quantification (Raman Spectroscopy) of dental enamel after bleaching treatment with experimental gel-based on 10% carbamide peroxide (CP), containing Carbopol, Natrosol, and Aristoflex® AVC. Sixty bovine teeth were randomly divided into 6 groups (n=10): Negative Control (NC) - no treatment; Positive Control (PC) - Whiteness Perfect 10% - FGM; CP with Carbopol (CPc); CP with Natrosol (CPn); CP with Aristoflex® AVC (CPa); NCP - no thickener. Data were analyzed, and generalized linear models (∆WID -T0 x T1) were used for repeated measurements in time for Ra and with a study factor for ΔE* ab and ΔE00. For the evaluation of the mineral content, data were submitted to one-way ANOVA and Tukey tests. For enamel topographic surface analysis the Scanning Electron Microscope (SEM) was performed. A significance level of 5% was considered. ΔE* ab and ΔE00 were significantly higher for CPc, CPn, CPa, and NCP groups. (∆WID) showed a significantly lower mean than the other groups for NC in T1. After bleaching (4-hour daily application for 14 days), Ra was higher in the CPc, CPn, and PC groups. For CPa, Ra was not altered. No significant difference was found in the quantification of mineral content. CPa preserved the surface smoothness more effectively. Aristoflex® AVC is a viable option for application as a thickener in dental bleaching gels, presenting satisfactory performance, and maintaining the whitening efficacy of the gel, with the advantage of preserving the surface roughness of tooth enamel without significant loss of mineral content.
Resumo Os polímeros Natrosol e Aristoflex® AVC são amplamente utilizados na indústria cosmética e foram recentemente aplicados como uma opção de espessante na composição de géis de clareamento dental, com o objetivo de reduzir os efeitos adversos sobre os componentes minerais do esmalte. O objetivo deste estudo foi avaliar a variação de cor (ΔE*ab, ΔE00, ∆WID), rugosidade da superfície (Ra), e quantificação do conteúdo mineral (Raman Spectroscopy) do esmalte dentário após clareamento dental com gel experimental baseado em 10% de peróxido de carbamida (CP), contendo Carbopol, Natrosol e Aristoflex® AVC. Sessenta dentes bovinos foram divididos aleatoriamente em 6 grupos (n=10): Controle Negativo (CN) - sem tratamento; Controle Positivo (CP) - Brancura Perfeita 10% - FGM; CP com Carbopol (CPc); CP com Natrosol (CPn); CP com Aristoflex® AVC (CPa); NCP - sem espessante. Os dados foram analisados e modelos lineares generalizados (∆WID -T0 x T1) foram usados para medições repetidas no tempo para Ra e com um fator de estudo para ΔE*ab e ΔE00. Para a avaliação do conteúdo mineral, os dados foram submetidos a testes unidirecionais de ANOVA e Tukey. Para a análise da superfície topográfica do esmalte, o Microscópio Eletrônico de Varredura (SEM) foi realizado. Um nível de significância de 5% foi considerado. ΔE*ab e ΔE00 foram significativamente maiores para os grupos CPc, CPn, CPa e NCP. (∆WID) mostrou uma média significativamente menor do que os outros grupos para NC em T1. Após o clareamento (aplicação diária de 4 horas por 14 dias), Ra foi maior nos grupos CPc, CPn e PC. Para CPa, Ra não foi alterado. Nenhuma diferença significativa foi encontrada na quantificação do conteúdo mineral. O CPa preservou a suavidade da superfície de forma mais eficaz. Aristoflex® AVC é uma opção viável para aplicação como espessante em géis de clareamento dental, apresentando desempenho satisfatório e mantendo a eficácia clareadora do gel, com a vantagem de preservar a rugosidade da superfície do esmalte dentário sem perda significativa de conteúdo mineral.
RESUMO
BACKGROUND: Few studies have investigated the effect of violet LED irradiation associated or not with bleaching agents on blood-stained teeth. This in vitro study aimed to evaluate the whitening efficacy and color stability of non-vital dental bleaching using 35% hydrogen peroxide (HP) photoactivated with violet LED (VL) compared to 35% HP alone and 35% HP photoactivated with blue LED (BL). METHODS: Fifty bovine dental crowns were used to obtain specimens of 5 × 5 × 2 mm. After selection based on a previous colorimetric analysis, the specimens were blood-stained and randomly assigned into five groups (n = 10): control (no treatment); 35% HP, 35% HP/BL; 35% HP/VL; and VL. Three bleaching sessions were performed and the colorimetric analysis (∆Eab, ∆L, and ∆WID) was recorded after 7 days, 30 days, and 9 months of the last bleaching session. Two-way repeated measures ANOVA followed by Bonferroni post-hoc test was used at a significance level of 5%. RESULTS: 35% HP, 35% HP/BL, and 35% HP/VL showed higher values of ∆Eab, ∆L, e ∆WID (P < 0.05), without intra- and intergroup differences (P > 0.05). C and VL were similar in all the evaluation times (P > 0.05), showing lower values of ∆Eab, ∆L, and ∆WID (P < 0.05). CONCLUSIONS: 35% HP/VL can be a viable alternative for dental bleaching in endodontically-treated teeth, showing bleaching efficacy similar to 35% HP solely used, even after a 9-month follow-up. VL used alone was not effective to bleach blood-stained teeth.
Assuntos
Fotoquimioterapia , Clareadores Dentários , Clareamento Dental , Animais , Bovinos , Cor , Peróxido de Hidrogênio , Fotoquimioterapia/métodos , Fármacos FotossensibilizantesRESUMO
PURPOSE: There has been growing demand for dental bleaching worldwide, however, despite being effective, hydrogen peroxide (HP) can negatively affect the dental structure. Thus, new techniques, such as violet LED light have emerged and need to be studied. The aim of this study was to analyze and compare the effectiveness of violet LED light alone or combined with 35% HP gel. METHODS: Six different tooth bleaching techniques (n = 10) were performed in intrinsically pigmented bovine teeth: G1 - 35% HP (1x/week for 4 weeks, 45 min of gel application); G2 - 35% HP (1x/week for 4 weeks, 15 min of gel application); G3 - violet LED (1x/week for 4 weeks); G4 - violet LED (2x/week for 2 weeks); G5 - violet LED (4x/week for 1 week); G6 - Violet LED + 35% HP (hybrid technique, 1x/week for 4 weeks, 15 min of gel application). Specimens were submitted to color evaluation at predetermined times using Konica Minolta® spectrophotometer, and the surface morphology (n = 3) was qualitatively analyzed by Scanning Electron Microscope (SEM). Data of the color change test were analyzed considering a 5% level of significance. RESULTS: There was significant difference in color (p <0.05) for all groups after bleaching protocols. SEM analysis revealed that the greatest change in surface occurred in Group G1, with demineralization of the dental enamel. When considering the same time interval, there were no statistical differences for axis L*, but differences were shown for axis a* (G2, G3, G4 ≥ G1, G5 ≥ G6) and b* (G1, G2, G3, G4, G5 > G6). Regarding the comparison of ΔE00 between groups, results showed statistical difference between groups, with G1 ≥ G2, G5, G6 ≥ G3, G4. CONCLUSION: Bleaching protocols with less time (15 min) or no exposure to 35% HP (violet LED, 4x/week) could promote bleaching results as those obtained by the conventional technique using 35% HP for 45 min, with no enamel surface changes, showing to be a promising alternative to tooth bleaching.
Assuntos
Fotoquimioterapia , Clareadores Dentários , Clareamento Dental , Animais , Bovinos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes , Peróxido de Hidrogênio , Clareamento Dental/métodos , Clareadores Dentários/farmacologia , Ácido HipoclorosoRESUMO
OBJECTIVES: The effects of different concentrations of titanium dioxide (TiO2) into 40% hydrogen peroxide (HP) were evaluated as regards the effectiveness of dental color change either associated with activation by polywave LED light or not. MATERIALS AND METHODS: TiO2 (0, 1, 5, or 10%) was incorporated into HP to be applied during in-office bleaching (3 sessions/40 min each). Polywave LED light (Valo Corded/Ultradent) was applied or not in activation cycles of 15 s (total time of 2 min). The color of 80 third molars separated into groups according to TiO2 concentration and light activation (n = 10) was evaluated at baseline and at time intervals after the 1st, 2nd, and 3rd bleaching sessions. RESULTS: WID value was significantly higher when using HP with 5% TiO2 in the 2nd session than the values in the other groups (p < 0.05). After the 2nd and 3rd sessions, the ΔEab value was significantly higher when activated with light (p < 0.05) for all agents containing TiO2 or not. Zeta potential and pH of the agents were not modified by incorporating TiO2 at the different concentrations. CONCLUSIONS: The 5% TiO2 in the bleaching agent could enhance tooth bleaching, even without light application. Association with polywave LED light potentiated the color change, irrespective of the presence of TiO2 in the bleaching gel. CLINICAL SIGNIFICANCE: HP with 5% TiO2 could lead to a greater tooth bleaching response in the 2nd clinical session, as well as the polywave light can enhance color change.
Assuntos
Clareadores , Nanotubos , Clareadores Dentários , Clareamento Dental , Peróxido de Hidrogênio/farmacologia , Clareadores Dentários/farmacologiaRESUMO
O objetivo desse estudo foi analisar o perfil de liberação do princípio ativo peróxido de hidrogênio por diferentes géis clareadores no decorrer do período de aplicação. Para tal diferentes géis clareadores à base de peróxido de hidrogênio para uso na técnica em consultório foram levados à câmara doadora de uma célula de difusão vertical (célula Franz). Foi empregado como meio de difusão uma membrana de éster de celulose com porosidade de 100-500 Daltons. A câmara receptora foi preenchida com água ultrapura. Os seguintes géis foram testados: Whiteness HP (FGM), Whiteness HP Blue (FGM), Whiteness HP Automix (FGM), Potenza Bianco (PHS do Brasil), Opalescence Boost (Ultradent), e Pola Office Plus (SDI); solução de peróxido 35% controle. O peróxido de hidrogênio liberado pelo gel se difundiu através da membrana e se misturou com a água na câmara receptora. Uma amostra de 40µl foi coletada da câmara receptora a cada 5 min, durante 45 minutos e foi reposto o mesmo volume de 40 µl em água ultrapura. A concentração de peróxido na amostra (mg/ml) foi determinada em triplicata a cada momento, utilizando um espectrofotômetro leitor de microplacas e reagente enzimático. A normalidade e homoscedasticidade dos dados foram avaliadas pelos testes de Shapiro-Wilk e Levene. Os dados de quantidade acumulada de peróxido foram submetidos ao teste de análise de variância ANOVA a 2 fatores (tipo de gel x tempo) e teste de Tukey. Para todas as análises foi adotado um nível de significância de 5%. Diferenças significativas foram observadas para os fatores agente clareador (p=0,0001) e tempo (p=0,0001), assim como para a interação entre eles (p=0,0001). Os resultados do teste de Tukey para o fator agente clareador quanto à quantidade cumulativa de peróxido foram: WHPB-14,04(6,60)a, WHP19,51(8,61)b, WHPA-23,20(10,48)c, POP-26,53(11,13)d, PB-28,29(10,99)de, OPB31,03(11,81)e, Controle 79,12(32,27)f. Para o fator tempo, em minutos, os resultados foram: 5 9,64(6,70)a, 10-17,42(11,60)b, 15-24,03(16,86)c, 20-29,50(20,44)d, 25-33,93(23,00)e, 30-38,41(25,83)f, 35-41,52(27,32)fg, 40-44,11(28,47)gh, 45- 46,50(29,72)h. Os resultados do teste ANOVA de medidas repetidas mostraram diferenças significativas (p=0,00) em relação a concentração inicial e final de peróxido para os fatores agente clareador, momento de leitura e para a interação entre eles. Agentes clareadores com maior concentração inicial de peróxido de hidrogênio apresentaram maior liberação cumulativa do ingrediente ativo; a liberação de peróxido de hidrogênio de diferentes géis clareadores ocorre de maneira gradual em relação ao tempo de aplicação, porém essa liberação não ocorre de maneira constante.(AU)
The aim of this study was to analyze the release profile of the active ingredient hydrogen peroxide by different bleaching gels over the course of the application period. For this purpose, different bleaching gels based on hydrogen peroxide for use in the in-office technique were taken to the donor chamber of a vertical diffusion cell (Franz cell). A cellulose ester membrane with a porosity of 100-500 Daltons was used as diffusion medium. The receiving chamber was filled with ultrapure water. The following gels were tested: Whiteness HP (FGM), Whiteness HP Blue (FGM), Whiteness HP Automix (FGM), Potenza Bianco (PHS do Brasil), Opalescence Boost (Ultradent), and Pola Office Plus (SDI); 35% peroxide control solution. The hydrogen peroxide released by the gel diffused through the membrane and mixed with the water in the receiving chamber. A 40µl sample was collected from the receiving chamber every 5 min for 45 minutes and the same volume of 40 µl was replaced in ultrapure water. The peroxide concentration in the sample (mg/ml) was determined in triplicate at each time point, using a microplate reader spectrophotometer and enzymatic reagent. Data normality and homoscedasticity were evaluated using the Shapiro-Wilk and Levene tests. Accumulated amount of peroxide data was submitted to 2-way ANOVA test of variance (type of gel x time) and Tukey's test. For all analyses, a significance level of 5% was adopted. Significant differences were observed for the factors bleaching agent (p=0.0001) and time (p=0.0001), as well as for the interaction between them (p=0.0001). The results of the Tukey test for the bleaching agent factor regarding the cumulative amount of peroxide were: WHPB-14.04(6.60)a, WHP-19.51(8.61)b, WHPA-23.20(10 ,48)c, POP-26.53(11.13)d, PB 28.29(10.99)de, OPB-31.03(11.81)e, Control-79.12(32.27) )f. For the time factor, in minutes, the results were: 5-9.64(6.70)a, 10-17.42(11.60)b, 15-24.03(16.86)c, 20- 29.50(20.44)d, 25-33.93(23.00)e, 30- 38.41(25.83)f, 35-41.52(27.32)fg, 40-44, 11(28.47)gh, 45-46.50(29.72)h. The results of the repeated measures ANOVA test showed significant differences (p=0.00) in relation to the initial and final peroxide concentration for the factors bleaching agent, reading time and the interaction between them. Bleaching agents with a higher initial concentration of hydrogen peroxide showed a greater cumulative release of the active ingredient; The release of hydrogen peroxide from different whitening gels occurs gradually in relation to the application time, but this release does not occur constantly. (AU)
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Clareamento Dental , Clareadores , Peróxido de Hidrogênio , Análise de VariânciaRESUMO
This study aims to evaluate in vitro the effect of violet LED when applied directly to dentin tissue pigmented by different substances. We analyzed the chromatic alteration, the bleaching effect and the temperature variation. Hence, 60 bovine dentin tissue discs were divided into five groups: NNatural Pigmentation; T-Black Tea; C-Soluble Coffee; W-Red Wine; B-Equine Blood. Individualized pigmentation protocols were performed and all groups reached the same chromatic change value. Subsequently, we simultaneously performed a bleaching session and measured temperature variation using a K-type thermocouple device. Data on chromatic change (∆E, ∆E00, ∆a, ∆b and ∆L), whitening effect (WID) and temperature variation were subjected to one-way Anova and Tukey's post-test at a 5% significance level. The C group showed the most relevant chromatic change values, similar to the N group, responding positively to the treatment. However, the B group differed from the control group, which showed difficulty to respond to the treatment. Regarding the whitening index, only the W group showed lower results than the others. The B group showed the greatest temperature changes. We conclude that the violet LED offered chromatic change, which generated a bleaching effect. Pigmentations with red wine and blood showed the greatest difficulty to respond to treatment, also promoting a higher temperature rise in teeth pigmented with blood.
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Fotoquimioterapia , Clareamento Dental , Animais , Bovinos , Cavalos , Clareamento Dental/métodos , Fotoquimioterapia/métodos , Temperatura , Temperatura Alta , DentinaRESUMO
The authors aimed to conduct a systematic review to assess data from the current literature on the effectiveness of low-level laser therapy (LLLT) in preventing tooth sensitivity (TS) after tooth whitening (DB). PRISMA guidelines for systematic reviews were followed. Clinical trials evaluating the treatment of LLLT in patients with sensitivity after tooth whitening were selected. A full bibliographic search was performed on May 4, 2021, in the following databases: Embase, MEDLINE via PubMed, SciELO, VHL Regional Portal, Web of Science, Gray Literature, Scopus, ClinicalTrials.gov and Cochrane Library. This study followed Cochrane's recommendations for analyzing risk of bias. A total of 1054 studies were found (255 studies were excluded because they were duplicates and 785 because of titles and abstracts). Only 14 articles were selected for analysis, of which eight were excluded because they had one or more exclusion criteria, resulting in six articles included in this systematic review, the vast majority being classified as low risk of bias. The studies reviewed indicated that LLLT showed promise in preventing TS after TB. However, evidence is limited and more clinical trials with low risk of bias are needed to reach a definitive conclusion on the action of LLLT in pain control after TB.
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Sensibilidade da Dentina , Terapia com Luz de Baixa Intensidade , Clareadores Dentários , Clareamento Dental , Sensibilidade da Dentina/tratamento farmacológico , Humanos , Clareamento Dental/métodosRESUMO
AIMS: To conduct a systematic review to determine the efficacy of violet led in promoting dental bleaching by itself or accelerating dental bleaching when associated with peroxides. METHODS: Clinical and in vitro studies were identified by a search on November 27th 2020 in the PubMed and Scopus databases. Inclusion criteria were: 1) studies related to bleaching; 2) studies related to violet LED Light (405-410nm); and 3) studies that analyzed efficacy. The authors assessed the studies for risk of bias independently. Authors extracted outcomes including color change evaluation and pain assessment independently. RESULTS: During the search process, 895 articles were found in the previously cited databases. After the first screening consisting of title and abstract evaluations, 18 articles were selected. Finally, 13 articles met the eligibility criteria and were included in this review, being 5 clinical trial/case series and 8 in vitro studies. In vitro studies showed a high risk of bias and interventional studies showed a low risk of bias. CONCLUSION: The violet Led seems to have the potential to bleach teeth without peroxides, with a clinical perceptible color alteration. However, the effect is small in comparison to bleaching using peroxides. When Violet Led is used in association with peroxides, it seems to potentialize the bleaching result. However, due to the high heterogeneity between studies, a small number of clinical studies, and the high risk of bias of the in vitro included studies, the results are not definitive, and further well-designed studies are needed to reach safe evidence.
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Fotoquimioterapia , Clareadores Dentários , Peróxido de Hidrogênio , Ácido Hipocloroso , Peróxidos , Fotodegradação , Fotoquimioterapia/métodos , Clareadores Dentários/efeitos adversosRESUMO
OBJECTIVES: Evaluate in vitro the esthetic efficacy and cytotoxicity of a bleaching gel containing 35% hydrogen peroxide (BG-35%H2O2), applied for different time intervals, on enamel coated or not with polymeric biomaterials. MATERIALS AND METHODS: Nanofiber scaffolds (NSc) and a primer catalyst (PrCa) were used to coat the bovine enamel/dentin discs before the application of BG-35%H2O2, according to the following groups: G1-negative control (NC, without treatment); G2, G3, and G4-BG-35%H2O2 applied for 3 × 15, 2 × 15, and 15 min; G5, G6, and G7-BG-35%H2O2 applied on enamel coated with NSc and PrCa for 3 × 15; 2 × 15, and 15 min, respectively. The culture medium with components of gel diffused through the discs was applied on MDPC-23 cells, which were evaluated regarding to viability (VB), integrity of the membrane (IM), and oxidative stress (OxS). The quantity of H2O2 diffused and esthetic efficacy (ΔE/ΔWI) of the dental tissues were also analyzed (ANOVA/Tukey; p < 0.05). RESULTS: Only G7 was similar to G1 regarding VB (p > 0.05). The lowest value of H2O2 diffusion occurred in G4 and G7, where the cells exhibited the lowest OxS than G2 (p < 0.05). Despite G5 showing the greatest ΔE regarding other groups (p < 0.05), the esthetic efficacy observed in G7 was similar to G2 (p > 0.05). ΔWI indicated a greater bleaching effect for groups G5, G6, and G7 (p < 0.05). CONCLUSION: Coating the dental enamel with polymeric biomaterials reduced the time and the cytotoxicity of BG-35%H2O2. CLINICAL SIGNIFICANCE: Coating the dental enamel with polymeric biomaterials allows safer and faster BG-35%H2O2 application.
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Clareadores Dentários , Clareamento Dental , Animais , Materiais Biocompatíveis , Bovinos , Esmalte Dentário , Estética Dentária , Peróxido de Hidrogênio , Ácido Hipocloroso , Clareadores Dentários/toxicidadeRESUMO
Background: Activated charcoal is a nanocrystalline form of carbon with a large specific surface area and high porosity in the nanometer range, having consequently the capacity to absorb pigments, chromophores, and stains responsible for tooth color change, while carbamide peroxide is unstable and breaks down immediately upon contact with tissue and saliva, first dissociating into hydrogen peroxide and urea and subsequently into oxygen, water, and carbon dioxide. Therefore, the aim of the present study was to assess the effect of 16% carbamide peroxide and activated-charcoal-based whitening toothpaste on enamel surface roughness in bovine teeth. Materials and Methods: The present experimental in vitro, longitudinal, and prospective study consisted of 60 teeth randomly distributed in six groups: A: artificial saliva, B: conventional toothpaste (Colgate Maximum Protection), C: whitening toothpaste with activated charcoal (Oral-B 3D White Mineral Clear), D: 16% carbamide peroxide (Whiteness Perfect 16%), E: 16% carbamide peroxide plus conventional toothpaste (Whiteness Perfect 16% plus Colgate Maximum Protection), and F: 16% carbamide peroxide plus whitening toothpaste with activated charcoal (Whiteness Perfect 16% plus Oral-B 3D White Mineral Clear). Surface roughness was assessed with a digital roughness meter before and after each treatment. For the statistical analysis, Student's t test for related samples was used, in addition to the ANOVA test for one intergroup factor, considering a significance level of p < 0.05. Results: The surface roughness variation of bovine tooth enamel, before and after application of bleaching agent, was higher in groups of whitening toothpaste with activated charcoal (0.200 µm, Confidence Interval (CI): 0.105; 0.296 µm) and 16% carbamide peroxide plus whitening toothpaste with activated charcoal (0.201 µm, (CI): 0.092; 0.309 µm). In addition, bovine teeth treated with conventional toothpaste (p = 0.041), whitening toothpaste with activated charcoal (p = 0.001), and 16% carbamide peroxide plus whitening toothpaste with activated charcoal (p = 0.002) significantly increased their surface roughness values. On the other hand, significant differences were observed when comparing the variation in surface roughness between the application of artificial saliva (control) and the whitening toothpaste with activated charcoal (p = 0.031), and the 16% carbamide peroxide plus whitening toothpaste with activated charcoal (p = 0.030). Conclusion: The use of whitening toothpaste with activated charcoal and in combination with 16% carbamide peroxide significantly increased enamel surface roughness in bovine teeth.
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Abstract This study reviews the knowledge on the use of conventional dental whitening and the use of enzymes as a new approach in bleaching. A review of the literature was based on academic articles and on patents related to the use of enzymes in dental bleaching. Tooth whitening techniques used nowadays are well reported in the literature, and its mechanism of action consists of an oxidoreduction reaction with the release of free radicals. The great instability of radicals, when in contact with the tissues, promotes oxidation and reduction in the size of the pigment chains incorporated into them. These pigments are eventually broken down into smaller and smaller molecular chains and end up being diffused from the dental structure. In turn, the use of enzymes aimed at tooth whitening can be a less harmful alternative to the tooth because their specificity regarding the substrate makes them of great interest to perform specific reactions, reducing collateral effects. The use of proteolytic enzymes and oxidoreductases paired with the application of peroxides, can be a promising alternative for obtaining even better results in the dental bleaching process.