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Removal of the glass ionomer provisional restoration to a depth that matches the reference measure (see Fig 3). The depth of the pulp chamber is greater at the buccal wall than at the lingual wall.
Source publication
The aim of this case report is to report esthetic rehabilitation with combined
tooth bleaching, enamel microabrasion, and anterior restoration
replacement in a 26-year-old man. Clinical examination showed deficient
restorations in the maxillary anterior teeth, significant discoloration of
the maxillary left central incisor, and hypoplastic stains a...
Context in source publication
Context 1
... 1 week, the clinical crown was measured through the labial aspect with an endodontic file to determine a depth of removal for the resin-modified glass iono- mer temporary restorative material that would ensure the presence of an adequate cervical barrier within the tooth (Fig 3). Care was taken so that the measurement of the internal space of the crown would not exceed the previously registered exter- nal measurement (Fig 4). ...
Citations
... In recent years, the increasing aesthetic demands over the vast majority of dental patients has resulted in a relentless effort of the scientific society to provide efficient, minimally invasive, and side effect-free clinical techniques to improve smile aesthetics. 1 Tooth whitening has been for decades one of the most widespread and conservative treatment options for treating dental color abnormalities. 2,3 Bleaching agents, such as hydrogen peroxide and carbamide peroxide, release oxygen radicals, which through a series of oxidizing reactions break down aromatics, aliphatic N compounds, and compounds with double or triple bonds of organic chromophores. [4][5][6] This subsequent destabilization leads to an instant enhancement in whitening effect. ...
Objective
To evaluate the influence of air‐abrasion of enamel with three different desensitizing powders on the whitening effect of a bleaching gel containing 40% H 2 O 2 , which was used for in‐office tooth bleaching.
Materials and Methods
Forty human incisors, extracted and prepared, were acquired for this study and subsequently randomized into four groups ( n = 10). The control group specimens underwent no pretreatment prior to the bleaching procedure, whereas the remaining three groups underwent air abrasion using distinct desensitizing powders; (a) Sylc, which contains bioglass 45S5; (b) BioMinF, which contains calcium phospho‐fluoro‐silicate glass; and (c) MI Pearls, which contains nano‐hydroxyapatite, 1 h preceding the Opalescence Boost PF 40% bleaching procedure. Color measurements were conducted using a double‐beam UV–Vis spectrophotometer at four distinct time points (prior to bleaching, 24 h, 15 days, and 30 days post‐bleaching).
Results
Tooth color change outcomes revealed that there were no statistically significant results with respect to the interaction of the two criteria (treatments and time) ( p = 0.990). Additionally, there were no statistically significant results with respect to the main effects of treatments ( p = 0.385), while there were statistically significant effects with respect to the time criterion ( p = 0.013).
Conclusions
The use of the tested desensitizing powders prior the bleaching procedure did not affect the tooth color change induced by the tested bleaching agent.
Clinical Significance
Tooth color change and whiteness are not affected by air‐abrasion desensitizing treatments when applied prior to in‐office bleaching procedures.
... In the 21st century, an aesthetically pleasing smile is patients' highest demand when seeking non-invasive treatments, such as tooth whitening, as an alternative to potentially invasive treatment modalities, such as veneers or crowns, entirely for cosmetic gain [1]. Several studies in the literature have highlighted patients' desire for pearly white teeth, whereby tooth colour is considered one of the most important key factors for patient satisfaction [2]. ...
... In summary, laser whitening light has the following three advantages [42]: (1) it shortens the whitening time to 15 s per spot; (2) it shortens the whitening gel resting time to 8 min and 30-45 min for LED cold light bleaching; (3) it causes much less tooth sensitivity to patients, while LED cold light whitening has a strong acid dissolution reaction; and (4) laser teeth whitening works better and lasts longer. Hence, in our study, for the first time, a λ 450 nm blue laser delivered with a flattop beam profile was utilised. ...
A prospective observational case series included six patients who presented with discoloured upper and lower teeth extending from the right second premolar to the left second premolar. The photoactivation dosimetry and treatment protocol were as follows: λ 450 nm, 1 W, CW; flattop beam profile; 1 cm2; 15 J/spot; 10 irradiated spots; an irradiation time of 15 s/spot; three whitening cycles in a single session. Blanc One ULTRA+ was the bleaching agent. A visual analogue scale (VAS) was utilised to evaluate the pain intensity and dental hypersensitivity during treatment immediately after complete treatment (T1), 24 h (T2), and 8 h (T3) postoperatively, and at an 8-month follow-up timepoint (T4), whereas the dental colour shade change was assessed using the VITA colour shade guide pre-treatment (T0), T1, and T4. The Gingival index and modified Wong Baker faces scale were utilised to evaluate gingival inflammation and patients’ treatment satisfaction, respectively. Our findings revealed a reduction in the dental colour shade of the six cases between 2 and 10- fold (average of 3.5-fold) at T1 and maintained at T4, indicating significant improvement in the colour shade change with optimal outcomes. The percentage of this improvement for all the patients was ranged between 16.6% and 33.3%. At all timepoints, a “0” score was provided for pain intensity, dental hypersensitivity, and gingival inflammation. Our study demonstrates the feasibility and safety of a λ 450 nm laser delivered with a flattop handpiece to achieve optimal whitening outcomes without adverse effects. This offers a useful guide for dental clinicians for vital in-office tooth whitening. Extensive clinical studies with large data are warranted to validate our study protocol.
... The bleaching procedure is a topic of extensive discussion in modern dentistry because it is a technique that is quite easy to achieve and, at the same time, conservative, which has been shown to be effective in improving the color of natural teeth, but which has generated many contradictory discussions regarding its effects on dental restoration materials and especially on composites. In current practice, peroxides are used in gel form in different concentrations from 4% to 22% in home bleaching techniques and in concentrations of 25% up to 40% concentrations for bleaching techniques in the dental office [26][27][28][29][30][31][32]. ...
Background and Objectives: This study aimed to evaluate the surface roughness evolution of several finished and polished composites when bleaching materials are applied. The research was conducted on four microhybrid or nanofilled composites that are used in dental restorations. Materials and Methods: For each composite type, 5 samples were selected for control, 5 samples were subjected to the bleaching protocol “office bleach” with 40% hydrogen peroxide, and 5 other samples were subjected to the “home bleach” protocol with 16% carbamide peroxide, resulting in a total number of 60 samples. The surfaces of all the samples were tested for roughness, and the values of the most relevant parameter (Ra), were collected. Comparisons between composites and samples were performed using one-way ANOVA (in Statistical Package for Social Sciences). Results: After the bleaching protocol with 40% hydrogen peroxide gel, it was found that the roughness of the group increased considerably compared to the control group, so the highest roughness was found at GC Gradia direct anterior group, and the lowest value was registered for the 3M ESPE Valux Plus group. Following the bleaching protocol with 16% carbamide peroxide (home bleach), it was noted that the sample surfaces were not as affected. In this case, the lowest roughness was found at 3M ESPE Valux Plus group, and the highest roughness was registered for the GC G-aenial anterior group. Following the interpretation of the results, all four types of dental composites tested showed significant surface roughness differences between the groups subjected to bleaching protocols and those kept as control (p < 0.05). Conclusions: The surfaces of the samples were affected by the bleaching protocols by increasing the roughness compared to the control samples.
... Operative Dentistry options. 5 It has been shown that bleaching treatment is highly efficient and has a positive influence on patients' esthetic perception and psychosocial impact. 6 Currently, two types of dentist-supervised bleaching techniques are available: at-home bleaching and inoffice bleaching. ...
Objective:
The aim of this study was to compare the clinical efficacy of at-home, in-office, and combined bleaching regimens.
Methods:
Forty-eight participants were recruited and randomly divided into four groups based on the bleaching regimen (n=12) as follows: 1) at-home bleaching using 10% carbamide peroxide (Opalescence PF 10%, Ultradent) for 14 days (HB); 2) two sessions of in-office bleaching using 40% hydrogen peroxide (Opalescence BOOST PF 40%, Ultradent) with a one-week interval (OB); 3) one session of in-office bleaching followed by at-home bleaching for seven days (OHB); and 4) at-home bleaching for seven days followed by one session of in-office bleaching (HOB). Tooth color was measured using a spectrophotometer (Easyshade, Vita ZahnFabrik) at baseline (T0), day 8 (T1), day 15 (T2), and day 43 (T3, four weeks after the end of the bleaching treatment). The color data were calculated using the CIEDE2000 (ΔE00) and whiteness index for dentistry (WID) formulas. Tooth sensitivity (TS) was recorded using a visual analogue scale (VAS) for 16 days. Data were analyzed by one-way analysis of variance (ANOVA) and the Wilcoxon signed-rank test (α=0.05).
Results:
All bleaching regimens resulted in a significant increase in WID values (all p<0.05), while no significant differences in WID and ΔWID values were found among the different groups at each time point (all p>0.05). Significant differences in ΔE00 values were observed between T1 and T3 for all groups (all p<0.05), while no significant differences in ΔE00 values were found among the different groups at any time point (all p>0.05). Significantly lower TS values were observed in the HB group than in the OB and HOB groups (p=0.006 and p=0.001, respectively).
Conclusions:
All bleaching regimens resulted in great color improvement, and different regimens led to similar color changes at any of the evaluation time points. The sequence of treatments applying in-office bleaching or at-home bleaching did not affect the bleaching efficacy. The in-office bleaching and combined bleaching regimens yielded a higher intensity of TS than did at-home bleaching.
... As enhancing the whiteness of the teeth is more and more a demand coming from nowadays patients, some studies suggested that bleaching treatments could be one of the solutions [8,9]. Other researches indicated the use of a certain type of toothpaste or mouthwash as a minimal invasive alternative [10][11][12], or using bleach color restorative materials for prosthodontic treatment, such as veneers or crowns, as a more invasive one [13,14]. ...
Background and aim:
A beautiful smile with white and shiny teeth is nowadays a must, according to aesthetics norms. The color of the lips, with or without lipstick, may influence the appearance of the teeth color. The objective of the study was to evaluate the influence of the lipstick on the tooth color appearance.
Methods:
Four female patient smiles were photographed from the frontal view with five different colored lipsticks. Each photo was evaluated by 100 observers and noted from 1-dark to 6-white. Data were statistically analyzed with dedicated software.
Results:
The majority of the observers noted with lower grades the nude lipstick color photos and with higher grades the red and purple ones.
Conclusion:
Within the limitation of the study, the surrounding (the lipstick) has an important influence on the appearance of the tooth color.
... Teeth discoloration is one of the most common aesthetic concerns, and several efforts have been made to develop conservative treatments to deal with this aesthetic problem [1,2]. Teeth bleaching presents a safe approach to manage teeth discoloration with minimal destructive procedures in comparison with alternative techniques such as porcelain crowns and veneers [3,4]. ...
Background
The aim of this study was to evaluate the effect of bioactive glass (BAG) 45S5 paste on colour change and tooth sensitivity (TS) when used in combination with 20% carbamide peroxide (CP) during at-home vital tooth bleaching.
Methods
Twenty-four patients were selected and assigned into two experimental groups (n = 12) in a double-blind study design. Each patient received 20% CP followed by the application of either BAG paste or non-active placebo paste. The shade evaluation was performed using a digital spectrophotometer based on the CIE L*a*b* colour space system at different time points and the overall colour changes ΔE were calculated. TS was evaluated using visual analogue scale (VAS). The values of ΔE and TS were statistically analysed using paired t-test. The level of statistical significance was established at p = 0.05.
Results
The overall colour changes (ΔE) between baseline and each time point showed no significant differences between BAG and placebo groups (p > 0.05). The use of BAG paste significantly decreased TS reported by the participants.
Conclusions
The association of BAG paste with at-home bleaching treatment presents a promising method as it decreased TS and did not deteriorate bleaching efficacy.
Trial registration This study was approved and registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under Registration number: ACTRN12621001334897.
... Public concern regarding smile aesthetics redirected clinicians and scientists towards formulating minimally invasive treatments such as tooth whitening, as an alternative to potentially destructive and harmful veneer or crown placements purely for cosmetic gain [1,2]. ...
Objectives
To provide a narrative review on vital dental whitening chemistry, toxicity and safety, vital dental whitening techniques, whitening systems, potential side effects of whitening and cyclic whitening using products with a range of concentrations and pH values. In addition, new developments and recommendations in the field of vital dental whitening will be presented to help clinicians understand the whitening process, its advantages, limitations, and the impact of whitening concentration and pH on enamel providing guidance in tailoring whitening treatments.
Data
Data were gathered using the following keywords: dental whitening, roughness, hardness, sensitivity, hydrogen peroxide, whitening pH, whitening concentration, whitening chemistry, colour, and toxicity.
Sources
An electronic search was performed using PubMed and Scopus databases. Bibliographic material from papers reviewed was then used to find other relevant publications.
Conclusions
The effectiveness of vital dental whitening depends on many factors, such as the concentration/pH of the whitening agent, application duration, chemical additives, and re-mineralising agents used. Developing new whitening products and technologies such as nano-additives and alternative carrier systems is showing promising results, and might prove efficient in maximising whitening benefits by accelerating the whitening reaction and/or minimising expected reversible/irreversible enamel structural damage.
... The process of dental bleaching has been a subject of discussion in dentistry because it is a conservative technique that is effective for whitening natural teeth [1][2][3], but conflicting results have been documented regarding its effects on restorative materials [4]. The bleaching agents in current use are peroxides in gel form, with concentrations ranging from 4% to 22% and from 25% to 40% for at-home and in-office bleaching techniques, respectively [5,6]. ...
Objectives:
The aim of this in vitro study was to evaluate the microhardness and surface roughness of composite resins before and after tooth bleaching procedures.
Materials and methods:
Sixty specimens were prepared of each composite resin (Filtek Supreme XT and Opallis), and BisCover LV surface sealant was applied to half of the specimens. Thirty enamel samples were obtained from the buccal and lingual surfaces of human molars for use as the control group. The surface roughness and microhardness were measured before and after bleaching procedures with 35% hydrogen peroxide or 16% carbamide (n = 10). Data were analyzed using 1-way analysis of variance and the Fisher test (α = 0.05).
Results:
Neither hydrogen peroxide nor carbamide peroxide treatment significantly altered the hardness of the composite resins, regardless of surface sealant application; however, both treatments significantly decreased the hardness of the tooth samples (p < 0.05). The bleaching did not cause any change in surface roughness, with the exception of the unsealed Opallis composite resin and dental enamel, both of which displayed an increase in surface roughness after bleaching with carbamide peroxide (p < 0.05).
Conclusions:
The microhardness and surface roughness of enamel and Opallis composite resin were influenced by bleaching procedures.
... 7 Assim, frente à alteração cromática acentuada, em benefício da estética não está descartada a opção por tratamentos mais invasivos, seja com facetas diretas, em resina composta, seja com indiretas, em resina composta ou cerâmicas. 8 Considerando o exposto, o objetivo deste trabalho é relatar e discutir o resultado obtido por meio de tratamento estético realizado para a melhora da condição clínica do incisivo central superior esquerdo (dente 21), tratado endodonticamente. FIGURA 2 | A: análise inicial da cor do dente 21 (C4), B: aplicação do agente clareador com a técnica extracoronária, C: análise da cor do de acordo com as recomendações do fabricante. ...
Objetivo: Relatar e discutir o tratamento realizado para solucionar o problema estético decorrente da alteração cromática do incisivo central superior esquerdo (21), tratado endodonticamente e com restauração insatisfatória de resina composta. Relato do caso: Agentes clareadores à base de perborato de sódio e/ou peróxido de hidrogênio foram utilizados em técnicas intra e extracoronária, imediata e mediata. Após as sessões de clareamento dentário, o resultado obtido não foi satisfatório frente aos anseios do paciente, fato que justificou a substituição da restauração em resina composta com recobrimento da face vestibular (faceta direta). Conclusão: Considerando os resultados clínicos obtidos, pôde-se concluir que o clareamento dentário, embora conservador às estruturas dentárias, não foi efetivo à resolução do problema decorrente da alteração cromática. Por sua vez, o desgaste da face vestibular e posterior restauração direta com resina composta, embora menos conservador, foi satisfatório para solucionar o problema estético e se mostra efetivo após dois anos de controle clínico.
... However, more invasive methods are also used, such as veneers in composite resin or porcelain, or ceramic crowns in the most severe cases. 6,7 The microabrasion technique was first presented by Croll and Cavanaugh 8 (1986), who successfully removed opaque white stains from enamel using 18% hydrochloric acid and pumice under pressure with a wooden spatula. 6 Mondelli et al 9 . ...
Introduction
: Dental fluorosis is an enamel alteration characterized with opaque
stains caused by high exposures to fluoride during the dentition development.
Aim
: This
in vitro
study aimed to evaluate changes in the enamel surface of sound
human teeth after three treatment protocols for dental fluorosis: microabrasion
with 37% phosphoric acid and pumice, home bleaching with 10% carbamide
peroxide, and a combination of these techniques.
Methods
: Thirty-eight specimens
(5×5×2 mm) with enamel surface were obtained from 19 third molars. Thirty six
specimens were randomized into three treatment groups (n= 12): MAB- enamel
microabrasion; CP10- home bleaching; MAB+CP10- a combination of these
techniques and two specimens not received treatment. Surface roughness and
microhardness analyses were performed before and after treatment protocols.
Two representative specimens from each group were evaluated by scanning
electron microscopy (SEM). Analysis of variance and Tukey’s tests were used for
data analysis (p< 0.05).
Results
: All treatment protocols promoted an increased in
enamel surface roughness (p< 0.02). MAB and MAB+CP10 showed a significant
increase in the enamel microhardness (p< 0.04), while CP10 showed a
microhardness lower than MAB and MAB+CP10 (p< 0.05). SEM images
demonstrated a smoother surface from MAB and MAB+CP10 and, an irregular
pattern of enamel erosion from CP10.
Conclusions
: The treatment protocols for
dental fluorosis tested significantly changed the enamel roughness, microhardness
and micromorphology.
