In-office Bleaching Research Articles

Effects of Different Light-Assisted Power Bleaching Techniques on the Penetration of Hydrogen Peroxide into the Pulp Chamber.

Background: In-office bleaching is one of the most commonly used procedures for discolored tooth treatment. Although the efficacy of tooth bleaching has been investigated, depending on the applied technique and the used materials, bleaching procedures might irritate the tooth pulp and induce surface changes in enamel. The aim of this study was to evaluate the effect of four different bleaching techniques on the penetration of hydrogen peroxide (HP) into the pulp chamber. Materials and methods: Seventy-two single-rooted sound human teeth were used. The samples were prepared and evaluated in four groups. Group 1: 35% HP gel alone (HP Gel); group 2: Nd:YAG laser (0.25 W and 10 Hz with a fiber tip size of 200 μm) irradiation was added (HP Gel+laser); group 3: HP gel mixed with graphite particles (10th of millimeter in size) derived from crashed pencil lead in association with Nd:YAG laser (HP Gel+laser+graphite); and group 4: HP gel in association with light-emitting diode (LED) (litex 686, 50 Hz, 450-490 nm) (HP Gel+LED). The amount of HP penetrating into the pulp chamber was evaluated using acetate buffer and standard graphs. Data were analyzed with one-way ANOVA test, using SPSS 17. Post hoc Tukey test was used for between-group comparisons (α = 0.05). Results: Statistical analyses showed that the HP Gel+laser+graphite group had significantly higher level of HP penetration than other groups (p < 0.001). Moreover, pulp chamber penetration of HP in the HP Gel+laser group was greater than the LED and control groups (p < 0.001). The difference between control and LED groups was not significant (p = 0.99). Conclusions: Laser bleaching associated with HP Gel and graphite particles resulted in increased penetration of HP into the pulp chamber compared with the LED and control groups.

Evaluation of hydrogen peroxide permeability, color change, and physical-chemical properties on the in-office dental bleaching with different mixing tip.

This study aims to assess hydrogen peroxide (HP) penetration into the pulp chamber, color change (CC), physical-chemical properties, and material wastage (MW) and material used (MU) in mixing tips when using in-office bleaching gels with two different mixing tips. Forty teeth were divided into five groups (n = 8) based on the bleaching gels used (Pola Office +37.5% [PO+] and Whiteness HP Automixx Plus 35% [AM+]) and the mixing tip types (T-Mixer and Helical). A negative control group was treated with ultra-purified water. HP concentration was measured using UV-Vis, and CC was evaluated with a digital spectrophotometer. Initial concentration, pH, and viscosity were measured through Titration, a Digital pH meter, and Rheometer, respectively. MW and MU were measured using a precise analytical balance. Statistical analysis included two-way ANOVA, Tukey's, and Dunnett's test (α = 0.05). A higher HP concentration was observed with PO+ with the Helical mixing tip in comparison with AM+ (p = 0.01). No significant differences in CC or MU were found for different mixing tips (p = 0.001). The T-mixer mixing tip resulted in significantly less MW (p < 0.00001) and improved mixture homogeneity and viscosity. Utilizing a T-mixer with self-mixing bleaching gels achieves comparable CC while reducing MW. Moreover, it decreases HP penetration when using PO+. For the application of a self-mixing in-office bleaching gel, a T-mixer mixing tip should be recommended, as it reduces the penetration of hydrogen peroxide into the pulp chamber when using PO+, while also minimizing gel wastage.

Effect of whitening concepts on surface roughness and optical characteristics of resin-based composites: An AFM study.

The aim of this study was to evaluate the effects of various whitening agents on the surface roughness and optical characteristics of different types of resin composite restorations. Fifty specimens were prepared for each resin [G-aenial Posterior (GP), SonicFill-2 (SF), Solidex (SDX), and Nova Compo HF (NC)]. Following baseline color and surface roughness (Ra) measurements, the specimens were randomly divided into 5 groups (n = 10/group) according to whitening concepts: control (distilled water), in-office bleaching [OB-(Opalescence Boost)], at-home bleaching [HB-(Opalescence PF)], whitening toothpaste [WT-(Signal White Now)], and whitening mouthwash [WM-(Listerine Advanced White)]. ∆E00 , ∆TP00 , and ∆WID values were calculated before and after the whitening procedure with a spectrophotometer using the CIEDE2000 formula. Surface roughness measurements were repeated. The surface topography was determined using atomic force microscopy. Two- and three-way analyses of variance and Tukey's post-hoc test were performed, with p < 0.05 regarded as indicative of significance. No significant differences were detected among the resin composite materials in terms of the ΔE00 values (p > 0.05). Color change of all resin materials was above the AT threshold (>1.8) and the PT threshold (>0.8). All restorative materials presented acceptable (AT<2.62) TP00 values. Solidex specimens demonstrated the lowest WID values compared to the other composites. There were significant differences among the whitening procedures with respect to ΔE00 , ΔTP00 , and WID values (p < 0.001). SF/WT combination showed the highest and clinically unacceptable ΔE00 values. The highest roughness values were observed in the SDX specimens and the combination of SDX/OB. The effect of whitening agents on the optical characteristics and surface roughness of restorative materials depends on the type of material, agent, and time. RESEARCH HIGHLIGHTS: Clinicians should be aware that long-term use of over-the-counter products due to the abrasive effects of their ingredients and repeated bleaching session applications may affect the color stability and surface roughness of resin composites.

The effect of in-office bleaching agents on the Vickers hardness and surface topography of polished and unpolished CAD/CAM composite materials

In-office bleaching, using hydrogen peroxide, is effective to remove dental enamel stains. However, bleaching agents can deteriorate surface properties of CAD-CAM materials. This in vitro study aimed to investigate the effect of in-office bleaching agents on Vickers hardness and surface topography of polished and unpolished dental CAD-CAM composite materials (Grandio blocs, Lava Ultimate, BRILLIANT Crios, Cerasmart), and a polymer-infiltrated ceramic network block (Vita Enamic). The specimens were randomly divided into two groups: unpolished or polished. The micro-hardness and surface topography of each group were measured before bleaching, after a 60 min bleaching period, and 24-h and one-month post-bleaching. In-office bleaching significantly influenced the Vickers hardness of both the polished and unpolished CAD/CAM composite blocks, with Vita Enamic exhibiting the least hardness stability among all groups. Furthermore, in-office bleaching significantly influenced the surface roughness of unpolished CAD/CAM composite blocks. There was a significant difference in hardness reduction between the polished and unpolished specimens for most of the investigated materials at different time points. The bleaching did not influence the surface roughness of the investigated polished group, except for Vita Enamic and Lava Ultimate. However, it did influence the surface roughness of the investigated materials in the unpolished group.

Effectiveness of changing the color of darker teeth is potentiated by association with violet LED light

BackgroundThe effectiveness of in-office bleaching protocols performed with violet LED light either combined with a bleaching agent containing 37% carbamide peroxide, or not, was determined by comparing teeth with different degrees of darkening. MethodologyEighty bovine incisors were separated into groups of “light” teeth (luminosity greater than or equal to B3) and “dark” teeth (less than or equal to A3.5) to receive the protocols: HP - 35% hydrogen peroxide (Whiteness HP), CP - 37% carbamide peroxide (Whiteness SuperEndo), LED - violet LED light (Bright Max Whitening), CPLED - CP associated with the LED. For color analysis the CIEL*a*b* e WID, ΔEab, ΔE00 e ΔWID parameters were used. Data were analyzed using Mann-Whitney, Kruskal-Wallis, Dunn, Friedman or Nemenyi tests (α = 5%). ResultsHP and CP resulted in similar color change values (ΔEab, ΔE00 e ΔWID) for light and dark teeth (p > 0.05). Dark teeth showed better bleaching effectiveness (ΔEab, ΔE00 e ΔWID) than light teeth when CPLED was used (p < 0.05). LED showed color change that were below the limits of acceptability and perceptibility for ΔWID. Conclusionlight teeth are effectively bleached with the use of HP or CP, whereas dark teeth respond better to treatment with the CPLED protocol. Violet LED used alone did not show a satisfactory result.

Effect of pH of In-Office Bleaching Gels and Timing of Fluoride Gel Application on Microhardness and Surface Morphology of Enamel.

To assess microhardness (VH) of enamel treated with two in-office bleaching agents with different pH and to study the effect of post- and prebleaching fluoride therapy. Eighty bovine incisors were divided into eight groups: G1-Unbleached group; G2-2% NaF; G3-Pola Office (pH = 3.8); G4-Pola Office+ (pH = 7); G5-Pola Office followed by 2% NaF; G6-2% NaF followed by Pola Office; G7-Pola Office+ followed by 2% NaF; G8-2% NaF followed by Pola Office+. Bleaching was conducted 3x with 1-week intervals (T1/T7/T14). Specimens were kept in artificial saliva. VH was measured at T1, T7, and T14. Data were analyzed using repeated measure ANOVA. Surface morphology was assessed using scanning electron microscopy. There was no significant difference among the groups at T1. No significant difference was found between G3 and G4 at all intervals. 2% NaF (G5/G6 vs. G3) significantly prevented softening at T7 and T14. Some nonsignificant hardening was observed for 2% NaF for G7/G8 vs. G4. At T14, G3 showed the lowest VH values. G5 showed higher VH values compared to other groups apart from G6-G7. No relationship between bleaching protocols and surface morphology was observed. Pola Office caused the most softening. 2% NaF gel application after Pola Office bleaching was effective in recovering enamel hardness. Fluoride application after Pola Office+ bleaching provided little benefit.

Bleaching Gels Used After 1 Week of Mixing: Efficacy, Hydrogen Peroxide Penetration, and Physical-chemical Properties.

This in vitro study aimed to evaluate the bleaching efficacy (BE), hydrogen peroxide penetration into the pulp chamber (HPP), and physical-chemical properties (concentration, pH, and viscosity) of in-office bleaching gels immediately and after 1 week of mixing. We randomly divided 49 premolars into seven groups: control (no bleaching) and the following in-office bleaching (Opalescence Boost 40%, Total Blanc One Step 35%, and Whiteness HP Blue 35%) applied at two storage times: immediately and after 1 week. We evaluated the BE using a digital spectrophotometer and the HPP through UV-Vis spectroscopy. We measured the initial concentration, pH, and viscosity using titration, a Digital pH meter and Rheometer, respectively. For statistical analysis, we used a twoway analysis of variance and Tukey and Dunnet tests (α=0.05). We observed higher BE and HPP for Opalescence Boost and Total Blanc One Step after 1 week of mixing than for Whiteness HP Blue (p<0.001). We observed a significantly lower initial concentration for Whiteness HP Blue 1 week after mixing compared to immediately (p=0.00001). All bleaching gels showed a decrease in pH after 1 week of mixing (p=0.00003). However, Total Blanc One Step had a lower pH at both evaluation times (p<0.001). Only Opalescence Boost maintained viscosity 1 week after mixing. Opalescence Boost was the only bleaching gel able to keep bleaching efficacy, with the same characteristics of permeability and physical- chemical properties after 1 week of mixing.

Micro-Hardness and Surface Roughness of Bulk-Fill Composite Resin: Effect of Surface Sealant Application and Two Bleaching Regimens

Abstract Objectives The aim of this study was to assess the impact of applying a surface sealant and two bleaching regimens, on the micro-hardness, and surface roughness of bulk-fill composite resin Materials and Methods One-hundred twenty specimens were prepared with a diameter of 5 mm and thickness of 4 mm using bulk-fill composite. Specimens were subdivided into group 1: (n= 60), in which Fortify surface sealant was used, and group 2 (control): (n= 60), in which specimens were only finished and polished. After applying in-office and at-home bleaching, micro-hardness and surface roughness were measured before and after bleaching. Statistical analysis was performed using Student's t-test and paired test. Results Hardness values of group 1 were lower than values of group 2 before and after bleaching, with different bleaching procedures. Applying surface sealant and different bleaching regimens led to a significant difference of surface roughness (p &lt; 0.001). Conclusion Applying surface sealant decreases both micro-hardness and surface roughness. The bleaching procedures significantly affect the surface roughness, but not the micro-hardness. Clinical Significance Surface sealant can enhance the surface roughness of bulk-fill composite in nonstress bearing area as it reduces the surface micro-hardness.

Maintenance of enamel properties after bleaching with high-concentrated hydrogen-peroxide gel containing calcium polyphosphate sub-microparticles.

To assessed the physical and chemical properties of human-enamel after treatment with an experimental bleaching gel containing 35%-hydrogen peroxide (HP) and calcium polyphosphate sub-microparticles (CaPP). Enamel/dentin specimens (4 × 4 × 3mm) were obtained (n = 120) and allocated to different groups: control (saliva only); experimental (HP35%); commercial (whiteness-HP-Maxx); CaPP0.5% (HP35% + CaPP0.5wt%); CaPP1.5% (HP35% + CaPP1.5wt%). Three sessions were performed. The specimens' color was assessed using a spectrophotometer and the color (ΔE/ΔE00) and bleaching index (ΔWID) determined. The surface roughness and microhardness were assessed with a roughness tester and Knoop indenter. Raman spectroscopy was performed to obtain the ratios between the areas under the 431, 580, and 1070cm-1 and the 960cm-1 bands (430:960, 580:960, 1070:960). Kruskal-Wallis and Dunn compared the color, Ra, and SMH data. The Raman data was analyzed with Kruskal-Wallis and Dunn (α = 5%). The ΔE, ΔE00, and ΔWID were similar among the bleached groups (p > 0.05). The roughness was not different between the groups (p > 0.05). After the 3rd session, CaPP0.5% had higher microhardness than the experimental (p < 0.05). The 1070:960 was higher in the experimental than in the CaPP1.5% and control (p < 0.05). In human enamel, CaPP did not alter the bleaching effectiveness or roughness, and additionally, CaPP-containing gels increased the microhardness and preserved the mineral content when compared to the experimental without CaPP. Experimental bleaching gels containing calcium polyphosphate sub-microparticles as a mineral source reduce the mineral content alteration and superficial microhardness reduction, known potential side effects of the in-office bleaching treatments.

Efficiency of Various Tubular Occlusion Agents in Human Dentin after In-Office Tooth Bleaching.

The aim of this laboratory study was to investigate and compare the impact of five desensitizing techniques as a treatment fortooth sensitivity on the exposed dentin after an in-office tooth bleaching procedure. Thirty intact human molars were collected for this investigation. The specimens were obtained by transversely cutting 2.5 mm of the crowns, leading to exposure of the dentin. The specimens were cleaned in an ultrasonic bath and treated initially with EDTA gel 15% for 4 min and then with Opalescence Boost bleaching gel (40% H2O2) for two sets of 20 min. Then, the samples were randomly divided into six groups (n = 5) and received one of the following treatments: Group 1 (no treatment-control group), Group 2 (Emofluor gel-0.4% SnF2), Group 3 (MI Paste-CPP-ACPF), Group 4 (BioMinF paste-calcium phospho-fluoro-silicate), Group 5 (air-abrasion with ProSylc-Bioglass 45S5), and Group 6 (Er,Cr:YSGG laser). Subsequently, each sample was observed utilizing scanning electron microscopy (SEM) in order to detect the rate of occlusion of dentin tubules. SEM-EDS analysis revealed no occlusion of the dentin tubules in the control group, while Groups 2, 4, and 5 presented high effectiveness (>95% percentage of occluded tubules), and Groups 3 and 6 presented lower values (21.6 and 26.8%, respectively). It was concluded that althoughall the tested groups presented higher percentages of occlusion of the dentinal tubules compared to the control group, there were differences in effectiveness among them. The most effective treatments were the daily use of BioMinF paste and SnF2-containing gel, as well as air-abrasion with ProSylc powder.

Comparative Effects of Three Bleaching Techniques on Tooth Discoloration Caused by Tea.

Objectives: This study aimed to investigate the impact of three different bleaching protocols on tooth discoloration caused by tea. Materials and Methods: Forty extracted sound premolars were cleaned, disinfected, and their initial color parameters were measured (T1). The teeth were then immersed in boiled tea solution for 24 hours, and their color was measured again (T2). The samples were divided into four groups of 10 teeth each. Group A was treated with an in-office bleaching gel followed by 30 seconds of light curing. Groups B, C, and D were respectively treated with 0.24M oxalic acid followed by bleaching gel, 5.25% sodium hypochlorite followed by bleaching gel, and a combination of 0.24M oxalic acid, 5.25% sodium hypochlorite, and bleaching gel. The color was measured once more after the interventions (T3). Data were analyzed using two-way repeated measures ANOVA, paired sample t-test, and Tukey's test. Results: The mean color change (∆E2) between T2 and T3 was significantly higher in group D compared to group A (P<0.05). However, there was no significant difference in color change between groups A, B, and C. Additionally, there was no significant difference in color change between groups B, C, and D. The groups also showed significant differences in ∆L (P=0.007), with the only significant difference found between groups B and C (P=0.001). Conclusion: The combined use of sodium hypochlorite and oxalic acid followed by in-office bleaching gel is more effective than bleaching alone in correcting tooth discoloration caused by tea. This protocol can further reduce yellow coloration.

Color match evaluation using instrumental method for three single-shade resin composites before and after in-office bleaching

Abstract The aim of this study is to evaluate the effect of an office bleaching agent on the color of various single-shade resin composites. Three single-shade resin composites were tested in this study. Thirty disk-shaped specimens were prepared with a diameter of 10 mm and a height of 1 mm, and they were divided into three groups (n = 10). After color measurements, 40% hydrogen peroxide containing bleaching agent gel was applied to all the specimens. Baseline and final color measurements were performed using a clinical spectrophotometer. Statistical analyses were performed. All bleached specimens had clinically incomprehensible color changes (ΔE &lt; 3.3). Comparisons for single-shade composites revealed no statistically significant color difference between groups. With the limitation of this study in mind, color changes in single-shade resin-composites after office bleaching were found to be clinically acceptable. It may be appropriate to use single-shade composites that shorten the in-chair clinical time by facilitating shade selection.

Does the composite attachment of clear aligners compromise the effectiveness of dental bleaching? An in vitro study

This study aimed to evaluate the effectiveness of dental bleaching with hydrogen peroxide 35% on the surface below the attachments. Twenty-four blocks of bovine incisors were equally divided into 2 groups. The control group comprises the enamel surface free of attachments, whereas the attachment group comprises the enamel surface with attachment. Initial staining of samples was performed with black tea for 7 days; then, an attachment was made in the attachment group with Z250 resin and new staining for another 7 days in all samples. After staining, in-office bleaching was performed in both groups, and the attachments from the attachment group were removed. Color reading was performed with a spectrophotometer at all stages: initial (baseline), after 7 days of staining, after 14 days of staining, after immediate bleaching, and after 24 hours of bleaching. The color difference was calculated, and data analysis was performed using the t test for intergroup analysis. The results showed effective bleaching in both groups; however, there was a statistically significant difference in color change between them 24 hours after bleaching. It was concluded that the presence of attachment did not impair the action of the bleaching agent on the tooth surface.

Potential of nano hydroxyapatite synthesized from blood clam shells as a remineralizing agent after in-office bleaching

Introduction: The effect of bleaching on tooth structure is the loss of interprismatic substance which causes prism irregularities and changes in enamel morphology such as increased porosity and demineralization. This can be stopped by encouraging remineralization if the pH is neutralized and there are enough calcium and phosphate ions in the oral cavity. One agent that can be used to help the remineralization process is nano hydroxyapatite (nHA) which is a bioactive and biocompatible material for the natural mineral enamel. This study aims to determine change in the percentage of porosity, calcium, phosphate and hydroxyapatite synthesized from blood clam shells (Anadara granosa) and CPP-ACP as a positive control. Material and methods: The research design was a pre-post test control group design. Six maxillary first premolars were cut to the CEJ with a size of 5x5x2 mm then 40% hydrogen peroxide was applied. The first group was applied nHA synthesized from blood clam shells and the second group was applied CPP-ACP. Determination the percentage of porosity, calcium, phosphate and hydroxyapatite was carried out before and after bleaching and after aplication of remineralizing agent. Results: The study showed an decrease the porosity, calcium, phospate and increase hydroxyapatite precentage after sampel was applied to the remineralizating material nHA synthesized from blood clam shells and CPP-ACP. Conlusion: nHA results of blood clam shell synthesis has the potential to be used as an enamel remineralization agent after in-office bleaching.&#x0D; Key words: Blood clam shell, Casein Phosphopeptide-Amorphous Calcium Phosphate, In-office bleaching, Nano Hydroxyapatite

Effect of Laser and Conventional Office Bleaching and Polishing on the Color Change of Stained Nanohybrid and Microhybrid Composite Resin.

The present study investigated the effects of laser and conventional in-office bleaching, and polishing on the color of stained composite resin. A microhybrid composite (Clearfil AP-X) and a nanohybrid composite (Grandio) were selected. Twenty-four discs (2 × 10 mm) for each composite were prepared. The samples were immersed in coffee solution (25 g of coffee in 250 mL water) for seven days. Then the samples were divided into three groups (n = 8) and the stains were removed using bleaching (with Opalescence Xtra Boost), diode laser irradiation with Heydent material and a Sof-Lex polishing kit. The L ∗a ∗b ∗ color parameters were determined using a spectrophotometer before and after immersion and after stain removal procedures, and the overall color changes (ΔE) were calculated. The data were analyzed with two-way analysis of variance. In the Clearfil composite resin group, the mean ΔE compared to the baseline using in-office bleaching, laser irradiation, and Sof-Lex polishing kit were 3.31, 3.35, and 4.93, respectively. These values with the Grandio composite resin were 3.31, 6.35, and 4.57, respectively. The highest capacity to remove stains was related to the conventional in-office bleaching method. Grandio composite resin underwent more color changes than Clearfil composite resin significantly (P-value < 0.05). Both composite resins exhibited color changes after immersion in the discoloring solution. However, after staining-removing procedures, the ΔE values decreased. Decreases in the ΔE values were not sufficient to restore the color to that before immersion in the discoloring solution with any stain-removing methods.

Dental Fluorosis Management Using Power Bleach – A Magic Wand

Dental fluorosis is a particular condition brought on by long-term, excessive fluoride consumption during the formation of enamel. Fluorosis staining is frequently seen as an aesthetic problem may have psychological effect of when seen on maxillary anterior teeth. Bleaching, microabrasion, veneering, and crowning are some of the treatment options. Bleaching is a conservative approach of restoring the colour of teeth with intrinsic discolouration. Among the various bleaching techniques, In-office or Power bleaching techniques are effective to obtain result immediately. The dentist is in complete control of the process throughout the treatment. It is a fast process and results are evident in single visit. Here we present a case of management of dental fluorosis using Power bleaching technique.

Effect of an In-Office Bleaching Agent with Surface Pre-Reacted Glass-Ionomer Filler on the Enamel Surface: A In-Vitro Study.

In-office bleaching with high concentrations of hydrogen peroxide (H2O2) agents causes undesirable alterations in the enamel. Surface pre-reacted glass-ionomer (S-PRG) filler is a functional material known for its acid-neutralizing and demineralization-inhibition properties. This study evaluates the effect of S-PRG filler incorporation in H2O2-based bleaching on the enamel surface. Bovine enamel surfaces were bleached using a bleaching paste formulated with a liquid (35% H2O2) and a powder containing 5% or 10% S-PRG filler. The surface roughness and the Vickers microhardness of the treated enamel surfaces were evaluated. The enamel surfaces were observed under a scanning electron microscope (SEM) and analyzed using energy dispersive X-ray (EDX) technology. The surfaces were challenged by citric acid and observed by SEM. The specimens bleached with the paste containing the S-PRG filler showed lower enamel surface roughness and higher microhardness values than did those bleached with the plain paste (0% S-PRG filler); meanwhile, there were no significant differences between the 5% or 10% S-PRG filler groups. The S-PRG filler groups showed enamel surface morphologies similar to those of the non-bleached enamel, according to SEM observation, and EDX analysis detected the presence of fluoride and strontium ions. The S-PRG filler groups showed a higher resistance to erosion. The S-PRG filler mitigated the detrimental effects of bleaching agents on the enamel surface and provided resistance to erosion.

Effect of a Desensitizing Agent on Shear Bond Strength of Ceramic Bracket on Previously Bleached Teeth

This study aims to analyze the effect of desensitizing agents on the shear bond strength (SBS) of ceramic brackets after in-office bleaching procedures. Twenty-seven extracted premolars were equally divided into three groups (n = 9). Group 1 served as the control; bleaching was performed with 37% hydrogen peroxide. In group 2, bleaching and the application of a fluoride-containing desensitizing agent (CPP-ACFP) were performed. In group 3, bleaching and the application of a non-fluoride-containing desensitizing agent (CPP-ACP) were performed. Ceramic brackets were bonded with composite resin. SBS was tested using a universal testing machine. The site of bonding failure was measured using the adhesive remnant index (ARI) score. There was a statistically significant difference in mean SBS values (p &lt; 0.05). Group 1 showed the lowest SBS value (6.32 ± 4.83 MPa), which differed significantly with groups 2 and 3 (p &lt; 0.05). There was no significant difference between group 2 (15.36 ± 4.67 MPa) and group 3 (12.19 ± 6.81 MPa) (p &gt; 0.05). The ARI score did not show a significant difference. The conclusion is that the application of fluoride-containing and non-fluoride desensitizing agents increases the shear bond strength of ceramic brackets on bleached teeth with composite resin cementation. The application of both desensitizing agents had no impact on the results of the ARI score, with the highest ARI score in each group being 4, indicating that less than 10% of the adhesive substance remains on the enamel.

The Use of Diode Low-Power Laser Therapy before In-Office Bleaching to Prevent Bleaching-Induced Tooth Sensitivity: A Clinical Double-Blind Randomized Study.

The present study aimed to investigate the effectiveness of low-level laser therapy (LLLT) use before in-office bleaching to prevent an increase in the risk and intensity of tooth sensitivity. Thirty patients were selected. Before bleaching with 38% hydrogen peroxide, the participants were randomly divided into two groups of 15 subjects. Test group: the patients' teeth were subjected to a preliminary LLLT procedure by an 810 nm diode laser with 0.5 W for 30 s for an energy density of 15 J/cm2 and a group placebo. All patients were instructed to report their cold sensitivity experiences immediately, 1 h, 24 h, and 48 h after the end of bleaching via a VAS score. The results obtained show an increase in VAS values for both groups (290 and 490 vs. 224 and 234 of baseline time of test and placebo group, respectively); afterward, the VAS value seemingly decreases at 1 h after the end of bleaching, approaching the baseline VAS for the test group (274) in comparison to the placebo group. The use of preliminary diode LLLT could represent a valid possibility to reduce the occurrence of tooth sensitivity post-whitening and shorten recovery time in cases where tooth sensitivity occurs.

Effect of Bleaching Agents on Discoloured Resin-Based Composites for Direct Restorations: A Systematic Review.

The purpose of the review was to assess the influence of office and home bleaching on the color durability after staining of resin-based composites (RCs) for direct restorations. A web-based search for possibly relevant scientific papers in the English language between January 2013 and August 2022 was conducted in the databases such as PubMed, Scopus, Cochrane Library, and EMBASE. In-vitro studies that explored the influence of in-office and other bleaching treatments on the discolored RC for direct restorations in extracted human teeth were included. Case studies, case series, animal studies, systematic reviews, and letters to the editor were not considered. A total of 212 articles from a web-based search and 32 studies from a manual search were retrieved. After removal of duplicate records, 181 titles and abstracts were reviewed for eligibility; 92 were chosen for full-text analysis, and nine in-vitro studies matched the inclusion criteria. The two examiners examined the methodological quality of the selected studies independently based on the study design, methodological soundness, and data analysis. Distinct values were assigned to studies evaluating color variations of stained RC subjected to bleaching agents. The methodological quality scores were expressed as a percentage of the highest possible score based on the established scoring system and categorized as indicating a low, moderate, and high level of evidence. The reversal of color alterations following home and office bleaching was found to be dependent on the RC used. Within the limitations of the in-vitro investigations, it was deduced that the bleaching agents were successful in eliminating stains and improving the durability of the color to near baseline values.