Preliminary in vitro evaluation of a tooth-lightening prophylaxis paste.
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An ideal porcelain veneer placed on a non-discolored tooth requires the least amount of tooth preparation and the use of a translucent porcelain that interferes minimally with the transmission of light. In contrast, veneering a discolored tooth requires additional tooth preparation and the use of a chromatic or opacious porcelain. This article discusses several criteria for the selection of porcelain for porcelain veneers, including some steps to enhance the esthetic properties of these restorations.
UNLABELLED: Often the first evidence of variation from normal in human dentition is an observable difference in the color of the teeth. During the past decade, the demand for conservative esthetic dentistry has grown dramatically. Tooth discoloration is a frequent dental finding, associated with clinical and esthetic problems. It differs in etiology, appearance, composition, location, severity, and firmness in adherence to the tooth surface. Basically, there are two types of tooth discolorations: those caused by extrinsic factors and those caused by intrinsic congenital or systemic influence. The intensity of stains may be worsened if there are enamel defects. Tooth discoloration presents two major challenges to the dental team. The first challenge is to ascertain the cause of the stain; the second is its management. CLINICAL SIGNIFICANCE: This article reviews the etiology and clinical presentation of dental stains and outlines treatment options.
Enamel microabrasion is a proven method of removing superficial intrinsic enamel discoloration defects. The method is safe, easily performed, and causes no discomfort for the patient. A new commercially available microabrasion system has been introduced by Ultradent Products Inc. In addition, a new tooth isolation material is available, along with a visible light-activated in-office hydrogen peroxide solution. This article describes these new products and documents tooth-color correction for two young patients using this new tooth-color correction approach.
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PURPOSE: Little knowledge exists regarding the potential remineralizing benefits of adding fluoride to carbamide peroxide-based whitening gels. The aim of this project was to evaluate whether a whitening system with fluoride will remineralize previously demineralized enamel. MATERIALS AND METHODS: Twenty-four extracted teeth were sectioned into quadrants labeled A to D. Tooth quadrants in groups A, B, and D were demineralized with a lactic acid, methyl-cellulose gel system to mimic incipient carious lesions. Group C was neither demineralized nor treated. Group D was demineralized, but not treated with a whitening gel. Groups A and B were exposed to one of two commercially prepared 10% carbamide peroxide whitening gels: one that was fluoride free (group A) and one that contained fluoride (0.463%NaF) (group B). Remineralization was evaluated histologically and analyzed statistically using paired t tests accepting p < 0.05 as significant. RESULTS: Shade comparisons showed equal whitening efficacy of both gel A and B. Paired t tests show a significant reduction in lesion depth after treatment with the fluoride containing gel (B: mean lesion depth = 100 microm; p < 0.01), while there was no difference for the gel lacking fluoride (A: mean lesion depth = 110 microm). CONCLUSION: Under the conditions of this study, the addition of fluoride to a tooth whitening system does not affect the gel's whitening efficacy. The addition of fluoride could provide remineralization properties to the gel. As tooth whitening therapies continue to grow and evolve, a strong focus should rest on improving these materials in ways that will provide ever greater patient benefits. Coupling the esthetic benefits of whitening with the preventive benefits of fluoride is a natural step in this direction. CLINICAL SIGNIFICANCE: Therapuetic quantities of fluoride can impact remineralization properties of commercially available tooth whitening gels without altering whitening properties.
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OBJECTIVE: The current study was designed to determine the effect of natural calcium carbonate toothpaste containing Perlite and microgranules (Whitening toothpaste) on extrinsic tooth stain compared to a standard commercial toothpaste formulation with precipitated calcium carbonate (PCC) as abrasive and a commercial toothpaste with dicalcium phosphate dihydrate (DCPD) as abrasive. METHODS: The toothpastes were evaluated in a double blind, three-cell, stratified (tobacco use; baseline tooth stain level), parallel group design study involving 600 subjects with extrinsic tooth stain. Subjects brushed twice daily with their allocated toothpaste for four weeks. Extrinsic tooth stain was measured using the Macpherson modification of the Lobene stain index. RESULTS: ANCOVA showed significant differences between toothpastes (p=0.037). Subsequent multiple comparisons using pairwise t-tests, showed the Whitening toothpaste to be superior to the DCPD toothpaste (p=0.014) and the PCC toothpaste (p=0.067). When a Box-Cox transformation was made to the data (y0.6) to improve normality, these two differences were more accurately estimated at p=0.004 and p=0.03 respectively. CONCLUSION: The Whitening toothpaste has been shown to be significantly more effective in tooth stain removal than the two standard commercial toothpaste formulations.
There has been an increase in the demand from consumers and patients for products that whiten teeth. To meet this demand, a whitening toothpaste containing calcium carbonate and perlite as the abrasive system and an efficacious fluoride source has recently been launched. The aim of the current paper is to review the toothpaste's stain removal efficacy and its effects on enamel and dentine wear. It has been shown to be effective at removing model extrinsic stain in vitro. Further, it has been shown to be more effective in removing naturally occurring extrinsic tooth stain than a silica non-whitening control toothpaste after two weeks of twice daily brushing in a parallel group, double-blind clinical study using 152 adult volunteers. In addition, the enhanced whitening effect did not give a clinically relevant level of wear to enamel or a significant increase in dentine wear compared to marketed non-whitening toothpaste formulations, as shown by using an in situ type model with ex vivo brushing.