Abstract
Objectives: The purpose of this study was to evaluate the influence of remineralizing agents, including artificial saliva, neutral fluoride, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), on the susceptibility of bleached enamel to staining by cigarette smoke. Study Design: Fifty bovine enamel blocks were randomly divided into five groups (n = 10): G1- bleaching; G2- bleaching and immersion in artificial saliva; G3- bleaching and application of CPP-ACP; G4- bleaching and application of neutral fluoride; and G5- untreated (Control). Teeth were bleached with 35% hydrogen peroxide and treated with the appropriate remineralizing agent. After treatment, all groups were exposed to cigarette smoke. Enamel color measurements were performed at three different times: before treatment (T1), after treatment (bleaching and remineralizing agent) (T2), and after staining (T3), by using the CIE Lab method with a spectrophotometer. The data coordinate L* was evaluated by analysis of repeated-measures PROC MIXED and Tukey-Kramer’s test, and the ΔE values were submitted to one-way ANOVA and Tukey’s test (α = 0.05). Results: The G1 group did not show any statistically significant difference for L* values between times T1 and T2. The G4 and G5 groups showed lower L* values at T3 compared to T2. No significant differences between the groups were observed for ΔE (after treatment and staining). However, G4 showed a clinically apparent color change. Conclusions: Treatment of bleached enamel with neutral fluoride can contribute to the increased staining of enamel due to cigarette smoke. Key words:Spectrophotometer, remineralizing agents, bleaching.
Highlights
Bleaching agents are used to remove intrinsic pigments from dental enamel
Surface treatment: After bleaching, one of the following surface treatments was performed to each sample group: Group 1: Samples were submitted to the bleaching protocol and no surface treatment; Group 2 (Artificial Saliva): Samples were immersed in artificial saliva for 30 minutes; Group 3 (CPP-ACP): casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste (MI Paste, GC) was applied to the enamel surface at low speed with a polishing rubber mounted on the handpiece
After 3 minutes, excess paste was removed by air-water spray for 10 seconds; Group 4 (2% Neutral Fluoride): Neutral fluoride was applied to the enamel surface for 4 minutes, and excess fluoride was removed by a cotton-tipped flexible plastic (Swabs, Johnson & Johnson, Brazil); Group 5 (Control): No bleaching or surface treatment was performed; this group was maintained at 37 ± 2 °C in artificial saliva during the experiment
Summary
Bleaching agents are used to remove intrinsic pigments from dental enamel. Several studies have shown that bleached enamel can become stained after exposure to pigments, such as tea, coffee, and red wine [5,6,7,8]. There have been numerous studies of bleaching treatment effectiveness and its adverse effects on tooth enamel and adjacent tissues, there are no reports in the literature about the behavior of newly whitened teeth exposed to cigarette smoke. The objective of this study was to evaluate the color change of bovine enamel fragments that were bleached with 35% hydrogen peroxide, subjected to different surface treatment protocols (i.e., with saliva, fluoride, or casein phosphopeptideamorphous calcium phosphate [CPP-ACP]), and exposed to cigarette smoke
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