Abstract
Objectives This study evaluated if the use of a bioactive glass-ceramic-based gel, named Biosilicate (BS), before, after or mixed with bleaching gel, could influence the inflammation of the dental pulp tissue of rats’ molars undergoing dental bleaching with hydrogen peroxide (H2O2).Methodology The upper molars of Wistar rats (Rattus norvegicus, albinus) were divided into Ble: bleached (35% H2O2, 30-min); Ble-BS: bleached and followed by BS-based gel application (20 min); BS-Ble: BS-based gel application and then bleaching; BS/7d-Ble: BS-based gel applications for 7 days and then bleaching; Ble+BS: blend of H2O2 with BS-based gel (1:1, 30-min); and control: placebo gel. After 2 and 30 days (n=10), the rats were euthanized for histological evaluation. The Kruskal-Wallis and Dunn statistical tests were performed (P<0.05).Results At 2 days, the Ble and Ble-BS groups had significant alterations in the pulp tissue, with an area of necrosis. The groups with the application of BS-based gel before H2O2 had moderate inflammation and partial disorganization in the occlusal third of the coronary pulp and were significantly different from the Ble in the middle and cervical thirds (P<0.05). The most favorable results were observed in the Ble+BS, which was similar to the control in all thirds of the coronary pulp (P>0.05). At 30 days, the pulp tissue was organized and the bleached groups presented tertiary dentin deposition. The Ble group had the highest deposition of tertiary dentin, followed by the Ble-BS, and both were different from control (P<0.05).Conclusion A single BS-based gel application beforehand or BS-based gel blended with a bleaching gel minimize the pulp damage induced by dental bleaching.
Highlights
This study evaluated if the use of a bioactive glass-ceramicbased gel, named Biosilicate (BS), before, after or mixed with bleaching gel, could influence the inflammation of the dental pulp tissue of rats’ molars undergoing dental bleaching with hydrogen peroxide (H2O2)
This study evaluates the in vivo therapeutic effect of the different application protocols of a bioactive glass-ceramic-based gel, the BS-based gel, on the dental pulp tissue of Wistar rat molars undergoing dental bleaching with H2O2
The Ble group had a significant alteration in the pulp tissue, with necrosis and severe inflammation in the occlusal third of the coronary pulp; severe inflammation was observed in the middle third in most specimens, with a disrupted odontoblastic layer, and the cervical third presented moderate inflammation
Summary
Studies on the bleaching gel containing hydrogen peroxide (H2O2) have indicated some adverse effects caused by this product. For example, there are reports on the morphological changes in the structure of dental enamel after contact with H2O2, such as increase in roughness and decrease in hardness. Histochemical changes in dental tissues are observed as a loss of calcium and phosphorus ions in enamel and dentin. Decrease in the flexural strength of the teeth was observed.3These damages occur due to H2O2 releasing reactive oxygen species (ROS), which react with organic and inorganic molecules. ROS can reach the dental pulp due to their low molecular weight and cytopathological effects are mutation, enzymatic inactivation, protein degradation, and cellular apoptosis or tissue necrosis. As a consequence, most patients who undergo dental bleaching have postoperative sensitivity characterized by tingling or needles. This sensitivity can affect healthy teeth, unlike common dental sensitivity which occurs only in the presence of exposed dentin or cracks in the enamel.. Histochemical changes in dental tissues are observed as a loss of calcium and phosphorus ions in enamel and dentin.. Decrease in the flexural strength of the teeth was observed.. Decrease in the flexural strength of the teeth was observed.3 These damages occur due to H2O2 releasing reactive oxygen species (ROS), which react with organic and inorganic molecules.. Most patients who undergo dental bleaching have postoperative sensitivity characterized by tingling or needles.. Most patients who undergo dental bleaching have postoperative sensitivity characterized by tingling or needles.11 This sensitivity can affect healthy teeth, unlike common dental sensitivity which occurs only in the presence of exposed dentin or cracks in the enamel.
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