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At least 667 records · Page 37Linked to original sources

PubMed1995

Enamel microabrasion: 10 years experience.

Enamel microabrasion was developed in the mid 1980's as a method of eliminating enamel discolouration defects and improving the appearance of teeth. Ten years after the method was developed, much has been learned about the best technique, long term results of treatment and microscopic changes to the enamel surface that have distinguishable clinical implications. In addition, certain patients can benefit from combined enamel microabrasion/tooth bleaching therapy that yields the most attractive cosmetic results. This article reviews the current status of enamel microabrasion one decade after its introduction to the profession. The latest treatment protocol is presented and photographic case histories document results of treatment. Clinical observations made over ten years are discussed.

Adolescent↗

PubMed1998

Nightguard vital bleaching removes brown discoloration for 7 years: a case report.

Nightguard vital bleaching with 10% carbamide peroxide was used to remove a brown stain from the maxillary central incisor of a 13-year-old-boy. After 7 years, during which there was no touch-up treatment, the discoloration had not returned. This conservative technique should be considered before more invasive procedures for the treatment of discolored vital teeth in young patients.

Adolescent↗

PubMedDate not supplied

Removal of surface stains from enamel surfaces with at-home vital bleaching: a case report.

Stone model casts of a patient's maxillary and mandibular arches were used to fabricate a clear, soft, vacuum-formed custom mouth guard that was scalloped to end 1.0 mm supragingivally. The patient was given prophylaxis and oral hygiene home care instruction, and instructions regarding the placement of an at-home bleaching gel into the mouth guard and the mouth guard into the mouth. The patient was asked to wear the mouth guard for two hours daily before bedtime for one week and to return to the clinic for evaluation. This protocol was followed for three weeks for each arch. At the end of the three weeks, the stains on the most affected teeth were reduced dramatically.

Adult↗

PubMed1992

Modified internal bleaching of severe tetracycline discoloration: a 6-year clinical evaluation.

Since 1985, 534 severely discolored teeth have been treated with intentional endodontics and internal bleaching; of these, 258 were treated with the conventional technique and 276 were treated with the modified technique. Six years of clinical and radiographic evaluation revealed that the results obtained with the first group (conventional technique) remain stable and that a very noticeable improvement has been achieved with the second group of teeth, treated with the modified technique.

Adolescent↗

PubMed2000

Current status of nightguard vital bleaching.

Indications for using a 10% carbamide peroxide material in a custom-fitted tray to whiten teeth include teeth discolored from aging, chromogenic foods and drinks, and smoking, and also brown fluorosis-stained teeth, single dark teeth, and tetracycline-stained teeth. Tetracycline-stains may require 2 to 6 months of nightly treatment, whereas after discolorations generally resolve in 2 to 6 weeks. After an initial relapse in the first 2 weeks after the end of treatment, color tends to be stable for 1 to 3 years, with some treatments being permanent. The ADA has approved only six 10% carbamide peroxide materials, which have extensive research and publications on safety and efficacy. Considering the average cost of $196 per arch, and the noninvasive nature of this treatment, nightguard vital bleaching is probably the safest, most cost-effective, patient-pleasing method to improve the appearance of a smile. However, it should be supervised by a dentist for the proper examination, diagnosis of the cause of discoloration, treatment options, and fabrication and fitting of the carrier. Sensitivity during whitening may be treated with fluoride and potassium nitrate.

Anti-Bacterial Agents↗

PubMed1991

[Bleaching of teeth: a review].

Bleaching of vital and non-vital teeth is becoming a routine procedure in esthetic dentistry. In a relative safe way many types of discoloration can be treated. Four treatment systems are available at present. For an appropriate choice it is essential to know the cause of the discoloration. Long term results are still scarce. Most treatment systems show slight to moderate side-effects, varying from demineralisation of enamel to soft tissue problems.

Adult↗

PubMedDate not supplied

Vital bleaching: a new light-activated hydrogen peroxide system.

With ever increasing interest in cosmetic enhancement of dentition by dentists and patients alike, this article introduces a new light-activated bleaching system that adds up to total patient satisfaction and reduced chair time. The chairside application of hydrogen peroxide 30% was effective in lightening a moderate case of tetracycline staining. The uniqueness of this system allows the practitioner complete control within an office setting, and it provides the patient with an immediate result. The ease of application and strict supervision of a dentist has allowed this system to satisfy recent watchdogs of the Federal Drug Administration.

Adult↗

PubMed2001

Effect of scenario and experience on interpretation of mach bands.

The creation of the radiographic illusion known as a mach band at the intersection of two images of differing radiopacities can be misinterpreted as pathosis in certain situations. After reviewing instances where misinterpretation may occur, this study asked 33 fourth-year dental students and 40 dentists to interpret the same radiograph involving a maxillary central incisor under two different hypothetical scenarios: first, in the case of a patient requesting vital bleaching, and second, where a patient has received recent trauma to the mouth. Results showed that dental students are more susceptible than dentists to misinterpreting as a horizontal root fracture (a mach band illusion) what is known to be the junction of alveolar crestal bone and root. Furthermore when presented with a scenario of trauma, both students and dentists are more likely to mistake what is being seen as being a fracture line.

Adolescent↗

PubMed1990

Internal bleaching of severe tetracycline discolorations: four-year clinical evaluation.

Two hundred fifty-eight teeth severely discolored by tetracycline were treated with an internal bleaching technique. Endodontic treatment was required in all teeth before the walking bleaching procedure could be undertaken. Four years of clinical and radiographic evaluation revealed good esthetic results for all patients. Endodontic procedures were considered to be successful, and not one patient showed external cervical resorption after 4 years. This type of treatment is a valid alternative to porcelain laminate veneers for those teeth that exhibit severe tetracycline discoloration and in which the dental enamel and anatomic crown are intact.

Adolescent↗

PubMed1999

Nightguard vital bleaching of tetracycline-stained teeth: 54 months post treatment.

PURPOSE: The purpose of this longitudinal whitening study was to determine the stability, post-treatment side effects, and patient satisfaction after 6 months of active treatment of tetracycline-stained teeth with 10% carbamide peroxide at 0 and 54 months post treatment. MATERIALS AND METHODS: Twelve patients who completed the study (80%) were contacted and asked to participate in a survey concerning their whitening experience. Subjects were asked whether there had been any change in the shade of their teeth after treatment, and if they had experienced any side effects that they believed were treatment-related. Eight of the twelve patients underwent clinical examination. RESULTS: Ten patients (83%) reported no obvious shade change or only a slight darkening not noticed by others. Two (17%) reported a slight darkening that is probably noticeable by other people, but no one reported moderate darkening or significant darkening back to original shade. All respondents (n = 12) denied having to have a crown or root canal that they believed was treatment-related. Examiners who compared preoperative and post-treatment photographs and Vita shade values were in agreement with the patient's perceptions of shade change. The degree of improvement was significant for both the immediate (0 mo) and the 54-month post-treatment comparison with the pretreatment shade (p < .005 and p < .01 respectively). CLINICAL SIGNIFICANCE: Results of this nightguard vital bleaching study indicate that tetracycline-stained teeth can be whitened successfully using extended treatment time, and that shade stability may last at least 54 months after treatment. Patients who participated in this study were overwhelmingly positive about the procedure in terms of shade retention and lack of post-treatment side effects.

Carbamide Peroxide↗

PubMed1993

Clinical evaluation of a dual-activated bleaching system.

Bleaching has been accepted as one of the methods of treating discoloured teeth. The object of this study was to assess the effectiveness of treating discoloured teeth with a dual activated bleaching system (Hi Lite) that utilises both light and chemical activation of hydrogen peroxide. The results achieved with a 19% hydrogen peroxide solution were compared with those using 35% hydrogen peroxide solution provided in a standard kit. Twenty-three university students with various complaints of discoloured teeth were treated with the bleaching system utilising both concentrations of hydrogen peroxide. Colour change was monitored by using Vita Shade Guide and a camera. The teeth were observed to be 1/2 to 2 shades lighter after each treatment session. It required one to three treatment sessions to achieve the desired results except for severe tetracycline stained teeth. There was no visible difference between the results achieved by the different concentrations of hydrogen peroxide although it took 3 to 5 minutes longer for the 19% hydrogen peroxide to effect a change in colour.

Adult↗

PubMedDate not supplied

The whitening effect of bleaching agents on tetracycline-stained rat teeth.

This study compared the whitening effect of three bleaching agents on the teeth of rats and demonstrated differences in bleaching where dentin was exposed or enamel was thin. Thirty Albino rats were peritoneally injected with tetracycline solution daily for two weeks. Thirty-two disc-shaped specimens were cut from the crowns of incisors removed from sacrificed rats and were irradiated with UV light for 16 hours. Sections were stored in saline. Eight sections served as controls and were not bleached. Three bleaching agents (Opalescence, Rembrandt and Nite White) were applied to eight specimens each, five times a day for two weeks, and images of the sections were recorded at the following times: before bleaching (baseline), day 1, day 3, day 5, day 7, day 9, day 11 and day 14. Mean colors to demonstrate any change (deltaE) from baseline for each time period were as follows: control-9.78 (baseline), 9.17, 9.36, 9.65, 9.40, 9.99, 10.57, 11.36; Opalescence-10.08, (baseline) 7.63, 6.72, 6.04, 5.10, 4.87, 4.89, 4.27; Rembrandt-9.83 (baseline), 11.27, 9.55, 8.36, 7.75, 6.94, 7.11, 7.04; Nite White-10.44 (baseline), 9.92, 7.58, 6.80, 5.45, 5.05, 4.73, 4.01. All bleached teeth were lightened (p<.01). Another 56 tetracycline-stained rat incisors were UV irradiated for three days. Three different penetration depths were tested: penetration through lingual dentin and labial enamel (DN group), penetration through labial enamel only (RE group) and penetration through labial enamel covered with 1.0 mm human enamel (HE group). Specimens were bleached with Opalescence for one hour five times a day for one week or four weeks. A control group of unbleached teeth was also examined. Results (deltaE) were as follows: control--11.67; 1-week DN--13.55; 1-week RE--12.80; 1-week HE--12.07; 4-week DN--7.48; 4-week RE--7.50; 4-week HE--11.69. The color change in the 4-week DN and the 4-week RE groups showed the greatest reduction (p<.01).

Analysis of Variance↗

PubMed2005

Microhardness evaluation of in situ vital bleaching on human dental enamel using a novel study design.

OBJECTIVES: The aim of this 'in situ' study was to evaluate the microhardness of dental enamel following treatment with an in-office and an at-home vital bleaching agent through a novel approach using samples temporarily bonded 'in vivo'. METHODS: Human dental enamel slabs (n=88) were subjected to sequential polishing and initial Knoop microhardness tests were performed. The slabs were fixed to the facial surfaces of the maxillary first molars of 44 human volunteers. They were divided into four groups (n=11) according to the treatment group: G1- in-office-CP37+ at-home-CP10; G2- in-office-CP37+ at-home-PLA; G3- in-office-PLA and at-home-CP10; G4- in-office and at-home-PLA. After 3 weeks of treatment, final microhardness measurements were performed. RESULTS AND SIGNIFICANCE: ANOVA and Tukey's HSD hoc analysis (alpha=0.05) revealed no differences among initial or final microhardness values (p>0.05); however, significant differences occurred between initial and final values for each group (p<0.01), The evaluation of microhardness revealed a reduction of 6.8% for G1, 4.1% for G2, 3.4% for G3 and 3.5% for G4. In-office bleaching with 37% carbamide peroxide, an at-home bleaching with 10% carbamide peroxide, and a combination of both resulted in lower enamel microhardness when measured immediately post-treatment. However, long-term effects of these treatments are not known, and are believed to be clinically insignificant due to the relatively small reductions observed in enamel microhardness. Interestingly, the carrier, Cabopol 934P, also resulted in similar reduction in enamel microhardness even when administrated alone as a placebo.

Acrylates↗

PubMed1996

Intracoronal bleaching of nonvital teeth in children and adolescents: interim results.

This study was undertaken to investigate the outcomes in 20 children and adolescents who had undergone an intracoronal nonvital bleaching technique. Twenty-one discolored central incisor teeth were treated by the walking bleaching method and reviewed at intervals for 18 months following completion of bleaching. All teeth bleached lightened to varying degrees, and 62% of patients expressed satisfaction with the result. When a porcelain shade guide was used as a reference before bleaching, the percentage of teeth deemed off the shade guide, gray or reddish gray, was 97%. Immediately postbleaching, the percentage had been reduced to 57%, and relatively more teeth were at the lighter end of the scale for each color band. At 18 months, three teeth (17%) had been veneered, and 33% of the remainder were found to be off the shade guide, gray or red-gray. Radiographically, 81% of teeth were classified as healthy at 18 months, with no evidence of cervical or progressive apical resorption.

Adolescent↗

PubMedDate not supplied

Comparison of 10% carbamide peroxide and sodium perborate for intracoronal bleaching.

The purpose of this study was to compare 10% carbamide peroxide to the combination of sodium perborate and water as intracoronal bleaching agents. Forty-four extracted teeth were discolored in vitro. Bleaching agents were placed intracoronally to the level of the cemento-enamel junction for 12 days; solutions were replaced after four and eight days. Standardized slides were used to rank color changes; a colorimeter was used to quantify color change. After 12 days, 65% of the discolored teeth in the 10% carbamide peroxide group and 67% of the discolored teeth in the sodium perborate group had lightened to their original shade or lighter. While there was no statistical difference between the two treatments, sodium perborate was easier to use.

Borates↗

PubMed2003

Long-term treatment results with nightguard vital bleaching.

Since its introduction into dentistry in 1989, nightguard vital bleaching has been proven to be a simple and safe procedure to lighten discolored teeth. Efficacy of the technique is 98% for nontetracycline-stained teeth, and with extended treatment time, tetracycline-stained teeth can be expected to lighten in at least 86% of cases. Satisfactory retention of the shade change without re-treatment can be expected in at least 43% at 10 years posttreatment. Side effects are usually mild and transient, disappearing within days of treatment completion with no long-term sequelae. Participants report that they are glad they went through the procedure, and wild recommend the procedure to a friend.

Humans↗

PubMed2002

Vital bleaching with two at-home professional systems.

PURPOSE: To compare the whitening effectiveness of two professional vital bleaching systems in a randomized clinical trial. MATERIALS AND METHODS: Balancing for baseline color, 6 9 adult volunteers were randomized to either a whitening strip containing 6.5% hydrogen peroxide (Professional Crest Whitestrips) or a custom tray-based system using both hydrogen and carbamide peroxide (Nite White Excel2). Total contact time was 21 hours for the strip system and 28 hours for the 10% carbamide peroxide equivalent tray system. Whitening response was measured objectively as L*a*b* from digital images of the maxillary anterior teeth. RESULTS: Both treatments resulted in significant (P < 0.01) improvements in yellowness (deltab*), brightness (deltaL*) and overall color (deltaE*). For between group comparisons, strip subjects had a statistically significant or directionally favorable whitening response relative to the tray system at intermediary time points, while at the end-of-treatment, the strip group had highly statistically significant (P < or = 0.005), superior whitening response for all color parameters measured in the study. Both treatments were generally well tolerated, with 35-40% of the subjects in each group reporting minor tooth sensitivity or gingival irritation.

Adolescent↗

PubMedDate not supplied

Comparison of the clinical efficacy and safety of carbamide peroxide and hydrogen peroxide in at-home bleaching gels.

OBJECTIVE: The aim of this study was to evaluate the clinical efficacy of home-administered vital bleaching procedures and possible adverse effects derived from their use. One gel containing 3.5% hydrogen peroxide with a 5% potassium nitrate component (FKD, Kin Lab) was compared with a carbamide peroxide-based gel with a concentration of 10% (Opalescence, Ultradent). METHOD AND MATERIALS: Two sample groups were designed, each composed of 8 patients. All patients employed both bleaching products, 1 in the maxillary arch and the other in the mandibular arch on a random basis. The treatment was applied for 3 hours a day for 4 weeks. The degree of bleaching was evaluated using the Vita guide arranged by brightness. Dental sensitivity was measured with a specially designed 4-point scale. Gingival irritation was registered by the presence or absence of lesions in the marginal gingiva related to treatment. RESULTS: The degree of bleaching was similar with both products (4.8 Vita shade tabs). The hydrogen peroxide product with potassium nitrate provoked less dental sensitivity, although the difference between the 2 products was insignificant (P = .063). Gingival irritation appeared in 6 subjects, but was unrelated to the applied product. CONCLUSION: Under the conditions of this study, no statistically significant differences were detected between 3.5% hydrogen peroxide containing 5% potassium nitrate (FKD) and the 10% carbamide peroxide-based product (Opalescence).

Acrylic Resins↗