Tooth Bleaching Research Articles

Role of DDR1 in Regulating MMPs in External Root Resorption

Human periodontal ligament cells (hPDLCs) express matrix metalloproteinases (MMPs), a group of enzymes responsible for the destruction of most extracellular matrix proteins in dental tissues, especially MMP-1, MMP-2, and MMP-13. Exploring the regulatory mechanism of MMPs is crucial for understanding external root resorption (ERR), one of the most severe complications, along with substantial loss of dental tissue, induced by trauma, pulpal infection, tooth bleaching, and orthodontic treatment, etc. Discoidin domain receptor 1 (DDR1), a cell surface receptor binding to collagen, has the potential to regulate the expression of MMP-1, MMP-2, and MMP-13, but the mechanism remains unclear. Thus, the present study aimed to investigate the connection and underlying mechanism between MMP-1, MMP-2, MMP-13, and DDR1 in hPDLCs. Our post-replantation ERR model revealed that Mmp-1, Mmp-2, Mmp-13, and Ddr1 all increased in the sites of ERR. hPDLCs with DDR1 knockdown exhibited a substantial reduction in MMP-1, MMP-2, and MMP-13 expression. To further confirm the underlying mechanism, we conducted further in vitro experiments, including RNA sequencing, RNA interference, RT-qPCR, Western blotting, and ELISA. Based on our results, MMP-1 was positively regulated by the Smad2/3 and MEK-ERK1/2 pathways and negatively regulated by the PI3K-Akt pathway through CCN2. MMP-2 and MMP-13 were positively regulated by the Smad2/3 pathway. MMP-13 was positively regulated by the MEK-ERK1/2 and PI3K/Akt signaling pathways. Collectively, DDR1 is a potent regulator of MMP-1, MMP-2, and MMP-13 expression through the Smad2/3, MEK-ERK1/2, and PI3K/Akt signaling pathways. Clarifying the significance and underlying mechanism by which DDR1 is involved in ERR might bring the chances to hinder the pathogenic process of ERR, hence reducing its incidence rate.

White diet is not necessary during dental bleaching treatment: A systematic review and network meta-analysis of clinical studies

White diet is not necessary during dental bleaching treatment: A systematic review and network meta-analysis of clinical studies

Wearable Multifunctional Hydrogel for Oral Microenvironment Visualized Sensing Coupled with Sonodynamic Bacterial Elimination and Tooth Whitening.

Bacterial-driven dental caries and tooth discoloration are growing concerns as the most common oral health problems. Current diagnostic methods and treatment strategies hardly allow simultaneous early detection and non-invasive treatment of these oral diseases. Herein, a wearable multifunctional double network hydrogel combined with polyaniline and barium titanate (PANI@BTO) nanoparticles is developed for oral microenvironment visualized sensing and sonodynamic therapy. Due to the colorimetric properties of polyaniline, the hydrogel displays a highly sensitive and selective response for visualized sensing of oral acidic microenvironment. Meanwhile, the barium titanate in the hydrogel efficiently generates reactive oxygen species (ROS) under ultrasound irradiation, realizing non-invasive treatment in the oral cavity. Through bacterial elimination experiments and tooth whitening studies, the hydrogel can achieve the dual effect of effectively inhibiting the growth of cariogenic bacteria and degrading tooth surface pigments. Owing to the visualized sensing of the oral acidic microenvironment and efficient sonodynamic therapy function, the proposed hydrogel system offers a solution for the prevention of caries and tooth whitening, which is promising in developing the biomedical system targeting the simultaneous sensing and therapy for oral diseases.

AVALIAÇÃO DA INFLUÊNCIA DE CORANTES DURANTE O CLAREAMENTO

A harmonious smile has a significant influence on people´s lives, especially from a social point of view, as a pleasant smile, like having teeth in the correct positiion and with a whiter color, are associated with an individual as being beautiful and healthy. Teeth color is one of the biggest concerns that people have and to make it whiter, they turno to tooth whitening. However, many patientes are faced with a recommendation commonly given by dentists about diet restriction during the whitening procedure, which can become an obstacle for many people. This issue is still subject to divergence as to its effectiveness, whether coloring foods can interfere or not in the final result. Therefore, the objective of the present work is to verify if there is a relantionship between the consumption of dyes and the deteroriation in the performance of tooth whitening. For this, 17 scientific articles were analyzed, in online databases, during the period from 2011 to 2021, ranging from laboratory to clinical studies. It was possible to conclude that the use of food and coloring beverages during the procedure did not negatively influence the final bleaching result, however, this issue is still not unanimous. As there are divergences in the literature, further studies on the subject are needed.

Which Whitening Mouthwash With Different Ingredients Is More Effective on Color and Bond Strength of Enamel?

To examine the effects of six whitening mouthwashes on tooth color and immediate bond strength to the enamel. Human incisors were divided into seven groups (n = 10) according to mouthwashes (R.O.C.S Black Edition White, Splat White Plus, Colgate Plax White Charcoal, Signal White Now, Listerine Advanced White, Colgate Optic White, and distilled water). After the initial color measurements, the teeth were exposed to mouthwash for 4 weeks. Then, the color measurements were repeated. Then, cylindrical composite resin blocks were immediately applied to the enamel surfaces and subjected to shear bond strength tests. Data were analyzed using Kruskal-Wallis and Bonferroni tests (α = 0.05). Δ𝑏, Δ𝐿, and ΔE00 values did not present significant differences among the groups. Significant differences among the groups were determined for Δ𝑎 and ΔWID values (p < 0.05). R.O.C.S Black Edition White and Splat White Plus produced clinically acceptable color changes. Signal White Now, Splat White Plus, and Listerine Advanced White created acceptable whiteness changes. The mouthwashes did not statistically affect the bond strength compared to the distilled water (p > 0.05). Whitening mouthwash containing blue covarine revealed more acceptable color and whitening changes. Mouthwash containing charcoal led to the lowest enamel bond strength values. The content of whitening mouthwashes affected the degree of tooth whitening and shear bond strength to enamel.

Effectiveness of Laser-Assisted Teeth Bleaching: A Systematic Review

Objective: Esthetic dentistry is an important factor in increasing patients’ quality of life. This study aimed to investigate the impact of laser use on bleaching procedures for natural teeth and dental restorative materials. Methods: In January 2024, an electronic search was conducted using PubMed, Web of Science (WoS), and Scopus databases with the keywords (tooth) AND (laser) AND (bleaching), following PRISMA guidelines and the PICO framework. The initial search yielded 852 articles, of which 441 were screened. After applying inclusion criteria, 376 articles were excluded as they did not focus on the use of lasers in bleaching natural teeth and restorative materials. Consequently, 40 articles were included in the final review. Results: Of the 40 qualified publications, 29 utilized a diode laser, of which 10 authors concluded that it increases the whitening effect comparing classical methods. Three of included publications investigated the whitening of dental materials, while another three focused on endodontically treated teeth. Whitening procedures on ceramics effectively removed discoloration, but the resulting color did not significantly differ from the initial shade. Conversely, composite materials not only failed to bleach but also exhibited altered physical properties, thereby increasing their susceptibility to further discoloration. The KTP laser demonstrated promising outcomes on specific stains. The Er,Cr:YSGG and Er:YAG lasers also showed beneficial effects, although there were variations in their efficacy and required activation times. Conclusions: The findings partially indicate that laser-assisted bleaching improves the whitening of natural teeth. Further research on the effect of laser bleaching on the physical parameters of restorative materials is necessary.

The influence of dental bleaching on patient's quality of life: A multistudy analysis of aesthetic and psychosocial outcomes

ObjectivesTo assess the Quality of Life (QoL) of participants treated with dental bleaching using different techniques by administering two questionnaires Oral Health Impact Profile (OHIP-14) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), as well as the bleaching efficacy and tooth sensitivity (TS). Materials and MethodsSecondary results for nine randomized clinical trials were included, involving 489 participants who underwent bleaching procedures. The questionnaires were applied at baseline and 30-day post-bleaching. Bleaching efficacy (ΔSGU/ΔEab) and TS were also evaluated (VAS/NRS). The effect of bleaching on aesthetic self-perception was evaluated using the Paired t-test. The Kruskal-Wallis test assessed variations by technique. Also, the correlations between questionnaires and outcomes was evaluated (α = 0.05). ResultsAfter the bleaching treatment, both questionnaire revealed significant differences compared to the baseline, regardless of the factor evaluated (p < 0.05), except for Physical pain in OHIP-14 (p = 0.53). No correlation was found between OHIP-14 and bleaching efficacy (p < 0.008). A significant correlation was found between bleaching efficacy and dental self-confidence, indicating that dental self-confidence increased as the number of SGU (ΔSGU) increased, while social impact (ΔEab) and aesthetic concern (ΔSGU) decreased. Additionally, a significant correlation was observed between TS and OHIP-14 (Physical pain). For PIDAC, both dental self-confidence and psychological impact were correlated with TS in the VAS. ConclusionSubjects who underwent dental bleaching treatment improved their self-perception and dental self-confidence. Dental bleaching, besides enhancing the patient's smile, also improves their self-esteem. Clinical RelevanceDental bleaching, besides improving the patient's smile, also enhances their self-esteem.

Procedures And Adverse Effects Of Teeth Whitening

Now a days people are giving much more importance to perfect smiles. Expectations about aesthetic appearance has been increasing day by day in the recent times. Aesthetic smiles including tooth colour and appearance is very important to patients. So teeth whitening procedures are one of the most frequently demanded treatment options by public. Besides oral health and hygiene, there is an increasing number of oral care products that focus on teeth whitening. There are various reasons for people to choose teeth whitening as a treatment option which includes: staining of teeth which may include extrinsic or intrinsic stains, to improve their smiles etc. Among all of these, teeth discolouration is the most common cause. Discolouration of teeth are mostly associated with staining. Therefore, excellent approach to discolouration of teeth is teeth whitening techniques. There are various procedures of teeth whitening. Here we are going to discuss about vital and non-vital teeth whitening techniques which is also called bleaching and the adverse effects associated with these procedures. Both vital and non-vital teeth whitening procedures come up in in either at-home technique or in-office procedure and over-the- counter modalities. carbamide peroxide, hydrogen peroxide or sodium perborate are the different types of chemical agents that are being used for these procedures which are going to be discussed in the coming sections. These procedures not only produce excellent whitening effects but also some of the adverse effects which are discussed in this paper. Finally, the result of the treatment is whiter teeth and perfect smiles. Dentist plays an important role to bring about a perfect smile on people’s face

FORMULATION AND EVALUATION OF HERBAL TOOTHPASTE

The present study is concerned with the formulation and evaluation of herbal toothpaste, which contains various properties like tooth abrasives, tooth whitening, anti-caring, antibacterial, anti-inflammatory, desensitivity, etc. The herbal toothpaste was prepared using mango leaf extract and guava leaf extract as active ingredients, along with various excipients, which include calcium carbonate, sodium chloride, sodium lauryl sulphate, sodium benzoate, glycerine, camphor, honey and distilled water. The toothpaste was prepared by homogeneous mixing of all the excipients and the herbal extract. Four formulations were prepared using mango leaf extract as an active ingredient along with varying excipient concentrations, four formulations were prepared using guava leaf extract as an active ingredient along with varying excipient concentrations, and a polyherbal formulation consisting of four formulations containing both mango leaf extract and guava leaves extract as active ingredients along with varying excipient concentrations. The formulations were tested for various parameters such as homogeneity, abrasiveness, foamability, moisture content, Spreadability, extrudability, colour, PH, and antibacterial activity. The study concluded that polyherbal formulation showed best results and was found to be best among all batches. The polyherbal formulation, F4 showed was found to be best among all other formulations.

Tooth sensitivity in different arches post in-office dental bleaching: A multicenter randomized controlled trial

ObjectiveTo compare the risk and intensity of tooth sensitivity (TS) and gingival irritation (GI), as well as bleaching efficacy (BE) in the maxillary and mandibular arches after in-office dental bleaching. Materials and Methods90 participants were randomly into two groups according to the arch (maxillary or mandibular) in which the patient will first receive a 35 % hydrogen peroxide gel (2 sessions; 1 × 30 min; 1 week apart). TS and GI were recorded immediately after, up to 1 h, 24 h and 48 h after bleaching, using the 0–10 Visual Analogue Scale (VAS). BE was assessed before bleaching and 30 days after the end of the treatment (shade guide units [ΔSGU], CIELab [ΔEab], CIEDE2000 [ΔE00], and Whiteness Index for Dentistry [WID]). TS and GI were compared using McNemar's and paired t-test. BE were compared with Wilcoxon Signed Rank Test (ΔSGU) and paired t-test (ΔEab, ΔE00, and WID) (α = 0.05). ResultsThe risk and the intensity of TS was statistically higher for the mandibular arch (p < 0.003). The risk and intensity of GI did not differ between arches (p > 0.38). Both arches demonstrated significant BE (ΔSGU, ΔEab, ΔE00 and WID), without differences between them (p > 0.08). ConclusionsIn-office dental bleaching induces higher risk and the intensity of TS in the mandibular arch when compared to maxillary arch, without significant differences in gingival irritation, or bleaching efficacy. Clinical RelevanceMost patients experience tooth sensitivity regardless of the dental arch involved. However, when performing in-office dental bleaching, clinicians should consider that the mandibular arch is more likely to experience greater sensitivity compared to the maxillary arch.

Biological action of bleaching agents on tooth structure: A review.

The use of bleaching agents to remove stains is one of the main dental procedures to improve the aesthetics of teeth. This review presents the main agents used for tooth whitening, existing clinical protocols, and the structural changes that may occur through their use. The main bleaching agents consist of hydrogen peroxide and carbamide peroxide, which are used in bleaching techniques for vital teeth. These techniques can be performed in the office by a professional or by the individual in a home en-vironment under professional guidance. Bleaching agents come in a variety of concentrations and there are over-the-counter products available on the market with lower concentrations of hydrogen peroxide. Due to the chemical characteristics of the agents, changes in the organic and inorganic content of the tooth structure can be observed. These changes are related to morphological changes characterized by in-creased permeability and surface roughness, such changes compromise the mechanical resistance of the tooth. Furthermore, bleaching agents can promote molecular changes after reaching the dental pulp, resulting in oxidative stress of pulp cells and the release of pro-inflammatory mediators. Despite the bleaching effectiveness, tooth sensitivity is considered the main side effect of use. Therefore, among the heterogeneity of protocols, those that used the bleaching agent for a prolonged time and in lower con-centrations presented more harmful effects on the tooth structure.

Sono-Catalytic Tooth Whitening and Oral Health Enhancement with Oxygen Vacancies-Enriched Mesoporous TiO2 Nanospheres: A Nondestructive Approach for Daily Tooth Care.

Tooth discoloration and the breeding of oral microorganisms pose threats to both one's aesthetic appearance and oral health. Clinical whitening agents based on H2O2 with high concentrations are effective in tooth whitening and bacterial elimination but may also cause enamel demineralization, gingival irritation, or cytotoxicity, necessitating professional supervision. Herein, leveraging sono-catalysis effects, a nondestructive and convenient tooth whitening strategy was developed, utilizing oxygen vacancies (OVs)-enriched mesoporous TiO2 nanospheres. The introduction of OVs leads to TiO2 bandgap narrowing, boosting the generation of reactive oxygen species (ROS) by TiO2 under ultrasound treatment. Additionally, through the chemocatalysis effect, the ROS yield can be further augmented by employing OVs-enriched TiO2 in conjunction with an extremely low concentration of H2O2 (1%) during ultrasound treatment. Hence, under ultrasound treatment simulating daily tooth brushing using an electronic toothbrush, the combination of OVs-enriched TiO2 and 1% H2O2 proves to be effective in whitening teeth stained by tea, coffee, and mix juice. Furthermore, the combination of OVs-enriched TiO2 and 1% H2O2 demonstrates potent bacterial-killing and biofilm-eradicating effects under ultrasound treatment within an extremely short duration (5 min). Additionally, given the mesoporous structure, curcumin, serving as an anti-inflammatory agent, can be efficiently loaded into OVs-enriched TiO2 and then controllably released through ultrasound treatment. The curcumin-loaded TiO2 facilitates the transition of macrophages to the anti-inflammatory M2 phenotype, potentially alleviating oral inflammation induced by bacterial infection without showing any biotoxicity. The OVs-enriched TiO2 based sono-catalysis tooth whitening procedure provides the convenience of whitening teeth during daily brushing without requiring professional supervision.

Effect of Tooth Bleaching on The Color Change of Laminate Veneer Restorations: A Pilot Study

Objective: This pilot study aimed to evaluate the effect of tooth bleaching on the long-term color change of laminate veneers restored with different translucency CAD/CAM materials. Methods: In this study, 20 upper central teeth extracted due to periodontal, orthodontic problems and trauma were used. The teeth were embedded in acrylic blocks and divided into 4 groups of 5 teeth each. Groups A and B were bleached with a vital bleaching agent for two 20-minute sessions before preparation and teeth were prepared for laminate veneer restoration following bleaching. Groups C and D were prepared without bleaching treatment. Groups A and C were restored with high translucent A1 IPS Emax CAD material and Groups B and D were restored with low translucent A1 IPS Emax CAD material. For all restorations adhesive cementation was applied and aged for 2 years by thermal cycling. The color of the restorations was measured using a spectrophotometer after cementation and the measurement was done again after 2 years aging. The Kruskal Wallis test was used to compare data and multiple comparisons were tested with Dunn’s test. Results: The translucency of the blocks and tooth bleaching caused a significant difference between the groups according to the Kruskal Wallis test. Color changes (ΔE00) of Group A, B, C and D was 0.89±0.01, 0.87±0.01, 0.81±0.01, 0.8±0.01 respectively. Conclusion: Tooth bleaching causes a greater color change in laminate veneer restorations and the translucency of the material affects the color change of the laminate veneer restorations after aging.

Influence of dental bleaching on the microhardness and flexural strength of resin composites

Purpose. This study aimed to examine the influence of dental bleaching systems (home bleaching system and two in-office bleaching systems) on the surface microhardness, and flexural strength of the two resin composite restorative materials (Beautifil II and OliREVO). Methods. For each test, a total of 48 samples were prepared with both types of composites. The samples of each type of composite were divided at random into four groups each of six samples, control group (C) was not bleached and kept in distilled water, other three groups (G1, G2, and G3) were bleached with 10% hydrogen peroxide (HP) home beaching, 35% and 40% HP in-office bleaching systems, respectively. To measure the composite resin's microhardness, a Vickers microhardness tester was used, while a universal testing machine was used to measure its flexural strength. Results. For statistical analysis, Duncan and ANOVA tests were used. A p-value ≤0.01 indicates statistically significant results. In-office bleaching systems (35% and 40% HP) significantly reduced microhardness and flexural strength of the used resin composites. Generally, the hardness and flexural strength of Beautifil II were better than OliREVO composite. Conclusion. Regarding the physical properties of composite resins, the microhardness and flexural strength may be compromised by bleaching treatments.

Co-doped titanium dioxide nanoparticles decrease the cytotoxicity of experimental hydrogen peroxide gels for in-office tooth bleaching.

To evaluate the efficacy and cytotoxicity of experimental 6% and 35% hydrogen peroxide gels (HP6 or HP35) incorporated with titanium dioxide nanoparticles (NP) co-doped with nitrogen and fluorine and irradiated with a violet LED light (LT). Bovine enamel-dentin disks adapted to artificial pulp chambers were randomly assigned to bleaching (n = 8/group): NC (negative control), NP, HP6, HP6 + LT, HP6 + NP, HP6 + NP + LT, HP35, HP35 + LT, HP35 + NP, HP35 + NP + LT, and commercial HP35 (COM). Color (ΔE00) and whiteness index (ΔWID) changes were measured before and 14days after bleaching. The extracts (culture medium + diffused gel components) collected after the first session were applied to odontoblast-like MDPC-23 cells, which were assessed concerning their viability, oxidative stress, and morphology. The amount of HP diffused through the disks was determined. Data were analyzed by generalized linear models orKruskal Wallis Tests (α = 5%). RESULTS: HP6 + NP + LT exhibited ΔE00 and ΔWID higher than HP6 (p < 0.05) and similar to all HP35 groups. HP6 + NP + LT showed the lowest HP diffusion, and the highest cell viability (%) among bleached groups, preserving cell morphology and number of living cells similar to NC and NP. HP6 + LT, HP6 + NP, and HP6 + NP + LT exhibited the lowest cell oxidative stress among bleached groups (p < 0.05). HP35, HP35 + LT, and HP35 (COM) displayed the lowest cell viability. HP6 achieved significantly higher color and whiteness index changes when incorporated with nanoparticles and light-irradiated and caused lower cytotoxicity than HP35 gels. The nanoparticles significantly increased cell viability and reduced the hydrogen peroxide diffusion and oxidative stress, regardless of HP concentration. Incorporation of co-doped titanium dioxide nanoparticles combined with violet irradiation within the HP6 gel could promote a higher perceivable and acceptable efficacy than HP6 alone, potentially reaching the optimal esthetic outcomes rendered by HP35. This approach also holds the promise of reducing cytotoxic damages and, consequently, tooth sensitivity.

Use of amazonian fruits in dental bleaching

Natural products stand out for their chemical diversity, thus plants are important candidates for screening new bioactive compounds. This study evaluated the effect of plant extracts combined with 16% carbamide peroxide (PC16%) on tooth whitening. Bovine teeth and composite resin blocks were randomly assigned to pigmentation and whitening protocols. For pigmentation, they were immersed in diluted coffee (14 days), and whitening was performed by mixing 1g of plant extract from each species and 0.5mL of PC16% (9 days). The extracts were prepared from fruits of species occurring in the Amazon biome: Myrciaria dubia (Myrtaceae), Bactris gasipaes (Arecaceae), Euterpe oleracea (Arecaceae), Theobroma grandiflorum (Malvaceae), and Paullinia cupana (Sapindaceae). PC16% was used alone as control, and a group without whitening was also included. Color analysis was performed using ΔE2000, ΔE1976, and WhiteIndex through an EasyShade Advanced 4.0 spectrophotometer before and after the protocols. The pH of the extracts at a concentration of 10% and micrographs after whitening were analyzed. Data were analyzed by one-dimensional ANOVA and Tukey's post-hoc test. Pigmentation showed significance only for bovine teeth (p 0.05). The pH of the pupunha and guaraná-de-maués extracts approached that of PC16%. Micrographs show that only the cupuaçu group had no surface alteration. Further research is needed to investigate variation factors, particularly given the study's limitations.

Role of the novel aloe vera-based titanium dioxide bleaching gel on the strength and mineral content of the human tooth enamel with respect to age.

There has been an increased demand for dental bleaching globally irrespective of age and gender. Main drawbacks associated with conventional tooth bleaching agents have been compromised strength and mineral-content of tooth enamel which results in sensitivity, discomfort, roughness, and structure loss of human teeth. Currently, nanoparticles synthesized by green synthesis have gained popularity especially in medical and dental applications because of their versatile and beneficial nano-scaled features. Titanium dioxide nanoparticles (TiO2Nps) in this study were prepared from green ecofriendly source using the aloe vera plant extract and were then characterized via dynamic light scattering (DLS), scanning electron microscope (SEM), X-ray diffraction spectroscopy (XRD), and energy dispersive X-ray (EDX), for size, shape, composition and true-phase. These TiO2 Nps were incorporated in commercial bleaching gel containing hydrogen peroxide to form a novel TiO2-bleaching gel which was used to bleach extracted anterior teeth belonging to four different age groups: 20-29 years, 30-39 years, 40-49 years and ≥50 years. These teeth were investigated for micro-hardness (Vickers microhardness tester) and mineral-content (EDX spectroscopy) including sodium, magnesium, phosphorus, calcium in an in-vitro environment both before and after bleaching. Results revealed that TiO2 Nps prepared by aloe vera plant were nanos-sized of about 37.91-49 nm, spherical shape, true anatase phase with pure titanium and oxygen in their composition. The values of Vickers micro-hardness and mineral-content (Na, Mg, P, Ca) of enamel specimens belonging to different age groups enhanced in a linear pattern before bleaching with the increase in age (p value < 0.05). There was negligible reduction observed in Vickers micro-hardness and mineral-content elements (Na, Mg, P, Ca) of all enamel specimens belonging to different ages after the bleaching (p value > 0.05). The novel TiO2-bleaching gel prepared was effective enough in preventing the declination in Vickers micro-hardness strength and mineral-content of all the enamel specimens belonging to different age groups even after the bleaching procedure which makes it a promising biomaterial.

In-Office Dental Bleaching Using 37% Carbamide PeroxideVersus 35% Hydrogen Peroxide: A Randomized, Double-Blind Clinical Trial.

Compare the tooth sensitivity (TS) and bleaching efficacy(BE) of in-office dental bleaching performed with 35% hydrogen peroxide (HP) or 37% carbamide peroxide (CP). Sixty-six participants were randomly divided into two groups according to the bleaching gel applied to the right hemiarch: 35% HP, or 37% CP. TS was recorded immediately after, up to 1, 24, and 48 h after bleaching, using the VAS and NRS scales. BE was assessed before bleaching and 1 month after using color guide units (ΔSGUs) and a spectrophotometer (ΔEab, ΔE00, and ΔWID). TS was assessed using McNemar's and paired t-test (VAS) or Wilcoxon signed rank (NRS). The paired t-test was used to analyze BE (α = 0.05). TS risk and intensity were lower for the 37% CP (p = 0.003 and p < 0.005). Despite significant differences between the groups after 1 month (ΔSGU and ΔE00; p < 0.05), the color measurements of both groups exceeded the 50%:50% perceptibility/acceptability threshold. In-office dental bleaching using 37% CP resulted in reduced risk and TS intensity, without prejudice to the BE. The use of 37% CP for in-office dental bleaching could decrease TS risk and intensity without affecting BE. ClinicalTrials.gov identifier: RBR-683qhf.

Combination bleaching technique for an aesthetic upgrade in vital teeth- A case report of two cases

Teeth stains can broadly be classified into two types; Extrinsic and Intrinsic stains, the latter being harder to remove. The etiology of discolouration is vast which could be due to diet, medication, fluorosis or any systemic illness. Extrinsic stains are mainly on the outer surface of the tooth (Ex: Tea stains, Tobacco stains) and Intrinsic stains are present mainly within the tooth structure (Ex: systemic stains, fluorosis). Tooth bleaching is a cosmetic dental procedure aimed at improving the aesthetics of the smile and thereby increasing the patient satisfaction. This case report documents the successful application of a combination therapy for vital tooth bleaching by using walk in bleach as well as laser bleaching for the patients aesthetic considerations

Low-Level Laser Therapy for Tooth Sensitivity after Tooth Bleaching: A Systematic Review

Tooth bleaching is a popular cosmetic procedure known for its effective whitening results. However, it may cause tooth sensitivity. Various desensitizing therapies, including laser treatments, are used to alleviate pain and improve patient comfort. This study aims to conduct a systematic review to evaluate the effectiveness of low-level laser therapy for treating tooth sensitivity following bleaching therapy. A comprehensive search was conducted across 13 electronic databases (PubMed, Scopus, ScienceDirect, Google Scholar, Web of Science, Ovid, BMJ evidence-based medicine, proQuest, Greylit.org, Ethos, Livivo, Clinical trials gov, and Meta register of controlled trials) to identify relevant studies according to specific eligibility criteria, following the PRISMA guidelines. Two independent reviewers screened and selected the studies, performed data extraction, and assessed the risk of bias using the revised Cochrane risk-of-bias tool for randomized clinical trials (RCTs). The initial search yielded 2875 articles, which were subsequently screened to remove duplicates. After evaluating 1532 articles based on title and 136 by abstract, 21 studies remained for full-text assessment. Ultimately, only six RCTs met all of the eligibility criteria. The application of low-level laser therapy appears to reduce tooth sensitivity following tooth bleaching. Despite the positive reported effects, further research is necessary to determine the optimal use of low-level laser therapy for effective pain relief.