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PubMed2005

Carbamide peroxide bleaching agents: effects on surface roughness of enamel, composite and porcelain.

This study examined the effect of 10 and 35% carbamide peroxide bleaching agents on the surface roughness of enamel, feldspathic porcelain, and microfilled and microhybrid composite resins. Standardized cylindrical specimens were prepared for restorative materials. Enamel samples were obtained from buccal and lingual surfaces of human molars. Samples from each substrate were divided in three subgroups (n=10), according to surface treatment: distilled water (control), and 10 and 35% carbamide peroxide. The 10% agent was applied 3 h daily and the 35% agent was applied for 30 min/week, at 37 degrees C, during 21 days. Control samples remained stored in distilled water, at 37 degrees C. Roughness measurements (Ra, microm) were made at 24 h and repeated after 7, 14 and 21 days of exposure. Data were analyzed using ANOVA (split-plot design) and Tukey's test (5% significance level). Samples from control groups showed no significant alteration during all test periods, while for exposure to 10% agent, only the porcelain presented a rougher surface after 21 days (p<0.05). For the 35% product, roughness means significantly increased during the first and second weeks for enamel (p<0.05), and after 21 days for porcelain (p<0.05) and for the microhybrid composite (p<0.05). Microfilled samples showed no significant alteration throughout the 21-day period, regardless of the surface treatment.

Aluminum Silicates↗
PubMed2006

Additive effects of TEGDMA and hydrogenperoxide on the cellular glutathione content of human gingival fibroblasts.

OBJECTIVES: Only few data are available about cytotoxic effects of leachable dental resin compounds in combination with hydrogen peroxide (H(2)O(2)) segregated from dental bleaching agents. Therefore, the purpose of this study was to evaluate the effects of various concentrations of triethylene-glycol dimethacrylate (TEGDMA) and H(2)O(2) on intracellular glutathione levels (GSH) and viability of human gingival fibroblasts (HGF) that are primary target cells of cytotoxic actions of these substances. METHODS: HGF were grown in 96-well plates for 24h, treated with various concentrations of TEGDMA (0.5-5.0mM) for 24h and subsequently for 90min with 0.2mM H(2)O(2) or culture medium (control). The relative intracellular GSH concentration was determined using a fluorescence assay with monobromobimane. Readings were normalized to cell numbers, which were determined by a propidium iodide assay. Data were statistically analyzed by t-test and ANOVA with Tukey's post test. A significance level of p<0.05 was used. RESULTS: Exposure to TEGDMA reduced the viability of HGF at concentrations > or =1.0mM. TEGDMA induced a decrease of the GSH pool in a concentration-dependent manner (p<0.05). The depletion of GSH was correlated with a reduction of viability (p<0.05) and the total cell number. Furthermore, a significant decrease of the intracellular GSH content was found when cells were exposed to TEGDMA in combination with H(2)O(2), compared to experiments without H(2)O(2). SIGNIFICANCE: We conclude from our findings that TEGDMA and H(2)O(2) have additive adverse effects on GSH metabolism and cell viability.

Analysis of Variance↗
PubMed2001

Nightguard vital bleaching and its effect on enamel surface morphology.

BACKGROUND: The effect that nightguard vital bleaching (NGVB) has on enamel surface morphology is a subject of debate. Previous studies that have evaluated the effect of NGVB on the enamel surface report minimal changes to changes that appear to worsen post-treatment. The purpose of this in vivo NGVB study was to evaluate by scanning electron microscopy (SEM) the effects that 10% carbamide peroxide has on enamel morphology after 2 weeks of treatment and at 6 months post-treatment. MATERIALS AND METHODS: Ten patients participated in the study. Each participant wore a guard filled with an active whitening solution for 8 to 10 hours per day for 14 treatment days. An impression of the study teeth (maxillary incisors) was taken at baseline, after 14 days of treatment, and at 6 months post-treatment, and an epoxy cast made. The epoxy casts were prepared for viewing under the SEM and photographs were taken at 200 times and 2,000 times magnification. Six examiners evaluated changes in enamel surface morphology by comparing the SEM photographs taken at baseline, on treatment day 14, and at 6 months post-treatment. Still masked, the examiners also compared each patient's baseline:treatment day 14 and baseline:6 months post-treatment photographs with photographs of a known standard. RESULTS: This in vivo study demonstrated that a 14-day regimen of NGVB using a 10% carbamide peroxide solution had minimal effect on the surface morphology of enamel and that the effects did not worsen over time.

Carbamide Peroxide↗
PubMedDate not supplied

Using double-poured alginate impressions to fabricate bleaching trays.

Esthetic and diagnostic treatment often requires two casts of one arch, one for baseline and one for alterations (diagnostic wax-up, bleaching tray, occlusal analysis). The purpose of this study was to compare the accuracy of stone casts generated from a second pour of a properly handled alginate impression with first-poured casts. A maxillary dentoform was indexed with six reference spaces (#8-15, 9-2, 2-15, and incisal-to-gingival of #3, 9, 14). Irreversible hydrocolloid (Jeltrate) impressions were made in perforated steel trays by a single investigator. Impression material was spatulated for 1 minute. The seated impression and dentoform were wrapped in a damp paper towel to simulate intraoral conditions, and allowed to set for 2 minutes. Upon separation, the impression was stored in a damp towel for 5 minutes. The impression was poured in cast stone (Microstone) according to the manufacturer's instructions. The stone-filled impression was immediately rewrapped in a damp paper towel and allowed to set for 45 minutes at room temperature. Upon removal of the stone, the impression was rinsed with cold water, shaken dry, and repoured in the same manner. Ten impressions were made: the first five impressions were poured to make casts for Group A, then repoured as described above for casts for Group B. The remaining five impressions were poured once to make casts for Group C. The six spaces of each cast were measured three times in random order using a dial caliper and the space average calculated for the cast. At each space, analysis of variance showed no significant difference among Groups A, B, or C (P < 0.05). When alginate impressions that have been poured with cast stone are kept moist during stone setting and repoured within 45 minutes, two casts can be generated from one impression with the same degree of accuracy as two casts made from taking two separate impressions, providing the alginate does not tear during first cast removal.

Alginates↗
PubMed2003

Effects of bleaching with carbamide peroxide gels on microhardness of restoration materials.

The objective of this in vitro study was to quantitatively assess the effects of bleaching with 10 and 15% carbamide peroxide (CP) on restoration materials by performing superficial microhardness analysis. Acrylic cylindrical containers (4 x 2 mm) were filled with the following restoration products: Charisma (Heraues Kulzer, Vila Santa Catarina, São Paulo, Brazil), Durafill VS (Heraeus Kulzer), Vitremer (3M, Sumaré, São Paulo, Brazil), Dyract (Dentsply, Petrópolis, Rio de Janeiro, Brazil), and Permite C (SDI, São Paulo, São Paulo, Brazil). Sixty samples were prepared of each restoration material. Twenty samples received bleaching treatment with 10% CP, 20 samples received bleaching treatment with 15% CP, and 20 samples were kept submerged in artificial saliva, which was replaced daily. The treatment consisted of immersion of the specimens in 1 cm3 of CP at 10 and 15% for 6 hours per day during 3 weeks, whereupon the test specimens were washed, dried, and kept immersed in artificial saliva for 18 hours. Then the test and control specimens were analyzed using a microhardness gauge. The Knoop Hardness Number (KHN) was taken for each test and control specimen at five different locations by applying a 25 g force for 20 seconds. The values obtained were transformed into KHNs and the mean was calculated. The data were submitted to statistical analysis by analysis of variance and Tukey test, p < .05. The means/standard deviations were as follows: Charisma: CP 10% 38.52/4.08, CP 15% 34.31/6.13, saliva 37.36/4.48; Durafill VS: CP 10% 18.65/1.65, CP 15% 19.38/2.23, saliva 18.27/1.43; Dyract AP: CP 10% 30.26/2.81, CP 15% 28.64/5.44, saliva 33.88/3.46; Vitremer: CP 10% 28.15/3.04, CP 15% 17.40/3.11, saliva 40.93/4.18; and Permite C: CP 10% 183.50/27.09, CP 15% 159.45/5.78, saliva 215.80/26.15. A decrease in microhardness was observed for the materials Dyract AP, Vitremer, and Permite C after treatment with CP at 10 and 15%, whereas no effect on either of the two composites (Charisma and Durafill) was verified. CLINICAL SIGNIFICANCE The application of the carbamide peroxide gels at 10 and 15% did not alter the microhardness of the composite resins Charisma and Durafill. In situ and clinical studies are necessary to enable one to conclude that the reduction in microhardness of the materials effectively results in clinical harm to the restorations.

Analysis of Variance↗
PubMed2004

Accelerated aging effects on color and translucency of bleaching-shade composites.

PURPOSE: This study was performed to evaluate the influence of accelerated aging on the color and translucency parameter (TP) of bleaching-shade resin composites. MATERIALS AND METHODS: Thirty-three bleaching shades and two control conventional shades of microhybrid (MH) and microfill (MF) resin composite specimens (n = 5) were aged in an accelerated aging chamber set to standard CAM 180 cycles. One side of each specimen was evaluated for surface color and TP changes compared with baseline in increments of 150 kJ/m2 for intervals up to 450 kJ/m2 using a spectrophotometer. A deltaE* > or = 3.7 was considered to be a poor match, and the total TP range was divided into three equal parts representing low, medium, and high translucency. Data were analyzed with analysis of variance. RESULTS: Compared to the baseline, deltaL*, deltaa*, deltab*, and deltaE* ranges at 450 kJ/m2 were -0.8 to 5.0, -0.6 to 1.2, -8.3 to 0.0, and 0.7 to 8.6 for MH and 0.2 to 1.3, 0.1 to 1.3, -2.5 to 1.1, and 1.7 to 2.7 for MF composites. Scheffé's S intervals (p = .05) for comparisons of deltaL*, deltaa*, deltab*, and deltaE* values of MH composites between baseline and 450 kJ/m2 were 1.6, 0.6, 1.7, and 1.5, respectively. Corresponding Tukey-Kramer intervals for MF composites were 0.7, 0.3, 0.6, and 0.6, respectively. TP values at baseline ranged from 0.9 to 4.3 for MH and from 1.4 to 2.2 for MF composites, whereas deltaTP for baseline minus 450 kJ/m2 ranged from -1.1 to 1.7 for MH and from -0.1 to 0.3 for MF composites. Scheffé's S interval (p = .05) for comparisons of deltaTP values of MH composites for baseline minus 450 kJ/m2 was 1.0. Corresponding Tukey-Kramer interval for MF composites was 0.4. CONCLUSIONS: Aging-dependent color changes at 450 kJ/m2 were above the limit that indicated a poor match for 18/26 MH, while corresponding values for microfills were within acceptable range. Accelerated aging generally caused decreases in L* (specimens became darker) and a* values (specimens became redder), while b* values increased (specimens became more chromatic) for both MH and MF composites. TP was relatively stable during aging for both MH and MF composites.

Color↗
PubMed2005

Effect of whitening gels on the surface roughness of restorative materials in situ.

Peroxide gels are effective in changing tooth colour but their effect on restorative materials has been poorly studied. The purpose of this investigation was to assess the impact of a commercially available whitening gel containing hydrogen peroxide and a sodium percarbonate formulation on the surface of restorative materials. A total of 12 subjects participated in a double-blinded crossover study. Each wore an intra-oral appliance containing five bovine enamel blocks restored with amalgam, posterior composite, microfilled composite, glass ionomer cement and porcelain. Appliances were worn continuously for 14 days and whitening products were applied twice daily. After 14 days the appliances were removed and values for roughness (R(a)) were obtained using atomic force microscopy. Mean values of R(a) were assessed between baseline and 14 days, and although minor variations were seen, there were no statistically significant differences detected for any material or any whitening product.

Analysis of Variance↗
PubMed2005

Tooth whitening products and the risk of oral cancer.

Tooth whitening products (TWP) containing hydrogen peroxide (HPO) or carbamide peroxide (CPO) were evaluated in relation to potential oral cancer risk from their use. HPO is genotoxic in vitro, but such activity is not expressed in vivo. The genotoxic risk of HPO exposure of the oral mucosa encountered from TWP use is likely therefore to be vanishingly small. Available animal data on the carcinogenicity of HPO are of limited relevance to risk assessment of oral hazard of HPO exposure from TWP, and where relevant, do not indicate that there is an increased oral cancer risk for people using TWP. Clinical data on HPO-containing TWP only show evidence of mild, transient gingival irritation and tooth sensitivity, with no evidence for the development of preneoplastic or neoplastic oral lesions. Exposures to HPO received by the oral cavity, including areas commonly associated with oral cancer, are exceedingly low and do not plausibly pose a risk for the promotion of initiated cells or for induction of co-carcinogenic effects in conjunction with cigarette smoke or alcohol. The use of TWP was concluded not to pose an increased risk for oral cancer in alcohol abusers and/or heavy cigarette smokers. Furthermore, TWP were concluded to be safe for use by all members of the population, including potential accidental use by children.

Animals↗
PubMed2004

A SEM evaluation of a 6% hydrogen peroxide tooth whitening gel on dental materials in vitro.

OBJECTIVES: The aim of this study was to evaluate the effects of a novel 6% hydrogen peroxide gel on the surface morphology of dental gold, amalgam, porcelain and composite. METHODS: Admixed high-copper amalgam and hybrid resin composite specimens were prepared in extracted teeth using standard clinical procedures. Feldspathic porcelain and type III gold specimens were prepared in a mould using standard laboratory procedures. One half of the specimens were covered with nail varnish to serve as the control side, leaving the other half exposed. The specimens were treated with pooled whole saliva (1 h), followed by the peroxide gel (20 min), rinsing with water and returning to saliva. This cycling protocol was continued until a total of 28 treatments with the peroxide gel were completed. The samples were prepared for SEM. RESULTS: There were no observable differences at 200x and 2000x magnifications between the control and peroxide gel treated sides on any of the materials tested. CONCLUSIONS: There were no significant effects of the 6% hydrogen peroxide gel on the surface morphology of any of the dental materials tested.

Aluminum Silicates↗
PubMed2004

Safety evaluation of a novel whitening gel, containing 6% hydrogen peroxide and a commercially available whitening gel containing 18% carbamide peroxide in an exaggerated use clinical study.

OBJECTIVES: The aim of this study was to compare the effect on oral soft tissue of a self-applied tooth whitening gel containing 6% hydrogen peroxide (Xtra White) with a marketed paint-on whitening gel containing 18% carbamide peroxide (Colgate Simply White) after 2-weeks of using products four times daily. METHODS: A 2-week, examiner-blind, stratified, parallel design clinical trial was conducted. Twenty subjects were divided into two groups, balanced according to age and gender. Subjects followed a 2-week, twice-daily regimen of brushing with standard fluoride toothpaste and applied gel product to facial aspects of six upper and six lower incisors/canines, twice in succession with 30 min between applications. Soft tissue examinations were performed on Day 1, before the first application of the test products, and on Day 2, 5, 8 and 15. RESULTS: During the 2-week treatment period, twelve adverse reactions were recorded as potentially attributable to the study products, evenly split between the two test groups. All reports were mild in symptoms and resolved without the need of medical intervention. None of the subjects experiencing an adverse event requested to be withdrawn from the study. CONCLUSIONS: Under the exaggerated use conditions of this test, there was no evidence to suggest that either of the whitening gels produced irritation that was building or developing during the course of the study. It is concluded that both products are safe for their intended use.

Adolescent↗
PubMed2005

The sensitivity and responsiveness of an oral health related quality of life measure to tooth whitening.

OBJECTIVES: To assess the sensitivity and responsiveness of an oral health related quality of life measure to tooth whitening. METHODS: Following screening at a clinic, 87 subjects were given an array of tooth whitening products to use at home and reviewed 8 weeks later. Subjects self-completed the 49-item Oral Health Impact Profile (OHIP) at baseline and follow-up, and rated their satisfaction with the whiteness of their teeth compared to baseline on a global transition scale. RESULTS: In terms of sensitivity, observed changes were apparent in overall OHIP scores (P<0.05) and across several domains, notably functional limitation (P<0.01). However, the magnitude of change (effect size) was generally small except for the functional domain. There was an observed gradient in observed change in OHIP scores and in the magnitude of such changes (effect sizes) in relation to global rating of satisfaction with the outcome, supporting the responsiveness of the measure. CONCLUSION: The OHIP scale is sensitive and responsive to the effects of tooth whitening. Greatest sensitivity and responsiveness was in relation to functional limitations. These findings have implications for the use of oral health related quality of life measures as an outcome measure of interventions aimed at improving dental aesthetics through tooth whitening.

Adolescent↗
PubMed2006

Comparison of the ability of different colour indices to assess changes in tooth whiteness.

OBJECTIVES: The study investigates the suitability of different whiteness indices and colour parameters in assessing changes in tooth whiteness using a digital-colour imaging system. METHODS: Forty-six male and female subjects aged 18-70 years participated in the study and were divided into two groups. The control group was given a standard "non-whitening" dentifrice (Colgate Great Regular Flavour) and the test group received whitening strips (crest white strips). The latter contained 6% hydrogen peroxide and were worn for 30 min twice daily on the six maxillary anterior teeth. Digital images of teeth were captured using a Jai 3CCD digital camera with annular LED illumination array and the data obtained was used to calculate colour parameters (L*, a* and b*) and whiteness indices (WIC, WIO, W). Colour differences (delta L, delta a, delta b and delta E) and differences in whiteness indices were obtained and were compared between the test and control groups. Reliability and repeatability of the instrument were checked by comparing the digital data to the clinical data and also by comparing data obtained from different camera views for the same tooth. RESULTS: The test group showed significant changes in the colour parameters and whiteness indices over the 2-week period. It also showed significant correlation between the digital data obtained from lateral and central camera views for the same teeth. Digital data showed a similar trend to that of clinical data. The WIO index demonstrated the strongest discrimination between the test and control groups. CONCLUSION: The WIO index is appropriate for assessing changes in tooth whiteness. The digital imaging system is reproducible and reliable in evaluating changes in whiteness of teeth.

Adolescent↗
PubMedDate not supplied

Multicomponent evaluations of the oxidising actions and status of a peroxoborate-containing tooth-whitening system in whole human saliva using high resolution proton NMR spectroscopy.

High resolution 1H nuclear magnetic resonance (NMR) spectroscopy was employed to conduct a multicomponent investigation of the oxidation of salivary biomolecules by peroxoborate present in a tooth-whitening dentifrice formulation. The results acquired demonstrated that peroxoborate gave rise to the oxidative decarboxylation of the hydrogen peroxide scavenger pyruvate, a reaction generating acetate and CO2 as products. Experiments performed on chemical model systems confirmed the oxidative consumption of pyruvate by dentifrice-derived peroxoborate, and also revealed that the salivary electron donors cysteine and methionine (precursors to volatile sulphur compounds), were oxidised to cystine and methionine sulphoxide respectively. The biochemical and periodontal significance of these results is discussed.

Borates↗
PubMed1999

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Consumer Advocacy↗