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At least 1,225 records · Page 68Linked to original sources

PubMed2005

The effect of bleaching agents on the surface hardness of tooth colored restorative materials.

AIM OF THE STUDY: The aim of this study was to evaluate the effect of at-home (Opalesence/Dr. kit 15%, Ultradent, Products, Inc. South Jordan, UT, USA) and in-office (Superoxol 35%, Sultan Chemists, Inc., Englewood, NJ, USA) bleaching on the surface hardness of the following tooth colored restorative materials: composite resin, Point-4 (P4), Kerr Corporation, Orange, CA, USA; ormocer, Admira (AD),VOCO, Germany; compomer Dyract AP (DY), Dentsply DeTrey GmbH, Germany; and resin modified glass ionomer cement, Fuji II LC (FL), GC Corporation, Japan. METHODOLOGY: Sixty specimens were prepared; 15 specimens of each material (each group n = 5, control after 15 days, at-home and in-office). All specimens were stored in distilled water at room temperature for 24 hrs before testing. A universal testing machine (Micromet 2100 series micro hardness testers) was used for testing Vicker's surface hardness for the three groups for every tested material. All results were statistically analyzed with one way analysis of variance (ANOVA), Post hoc Tukey HSD tests (P < 0.05), and percentage changes for Tukey. RESULTS: All the tested materials showed an increase in Vicker's surface hardness between base line (24 hrs) and the control group after 15 days storage in distilled water except DY which showed a decrease in surface hardness. All tested materials showed a decrease in surface hardness from control group after 15 days and both at-home and in-office bleaching agents except DY which showed increased values. SIGNIFICANCE: At-home as well as in-office bleaching agents have a softening effect on some tooth colored restorative material, and the patient must be aware before using them.

Analysis of Variance↗

PubMed2005

The art and science of tooth whitening.

Although tooth whitening is one of the most popular dental procedures, it is also one of the least understood. We are still unclear as to its mechanism of action. There is little data as to the effects of both concentration and dose on outcome. The techniques for measuring color change have been brought into question. The cause(s) of sensitivity and the effects of long-term exposure to hydrogen peroxide are not clear. The issue of rebound in color has not been well examined, and issues related to maintenance of the whitening effect are also poorly understood. The immediate placement of composite resin on bleached teeth has been controversial. According to a study evaluating the shear bond strength of composite restorations placed on bleached and nonbleached teeth, there was no statistically significant difference when the composites were placed at 24 hours, 48 hours, four days, or six days. A different study, which evaluated the effects of take-home bleaching systems on enamel surfaces, suggests that a period of four days must elapse before bonding to a tooth bleached with a peroxide material, while no delay is necessary for a non-peroxide-based bleaching system. Most recently, there has been a push to find ways to accelerate and improve the delivery of the whitening process. These include the application of a number of different light sources believed to accelerate the breakdown of peroxide and thus speed up the whitening process. However, the research in this area has been controversial, with publications having quite different conclusions as to the efficacy of light-activated bleaching. Finally, the issues of adverse events and possible side effects were reviewed. The toxicological side effects of tooth bleaching systems seem to be minimal. However, tooth sensitivity can be quite significant. Although its causes are poorly understood, tooth sensitivity is most often seen as the result of tooth dehydration. So while patient demand for tooth whitening is at an all-time high, and dentists have more options for treatment, it's important that dentists evaluate which of these options is most ideal for their patients, factoring in the patients' cost and time issues, as well as sensitivity to the procedure.

Color↗

PubMedDate not supplied

[Clinical evaluation of external radicular resorption in non-vital teeth submitted to bleaching].

The purpose of this study was to evaluate the presence of external resorption in non-vital teeth submitted to bleaching. The evaluated patients had at least one non-vital tooth, which had been bleached between 1986 and 1996. All teeth were submitted to bleaching with hydrogen peroxide and sodium perborate, as described by Busato et al.5,6. From 193 patients recalled for clinical and radiographic evaluation of bleached teeth, only 43 attended (54 teeth). The average time elapsed after bleaching was 3.5 years. The results revealed that none of the examined teeth had any degree of external cervical resorption.

Dental Restoration, Permanent↗

PubMed1992

Adverse response to vital bleaching.

A case study is presented that described an acute flare-up of a tooth following a vital bleaching procedure. The case illustrates (a) the importance of assessing the pulpal and periradicular status of a tooth prior to any vital bleaching procedure; and (b) the alteration of the local adaptation syndrome by the bleaching agent.

Adult↗

PubMed2006

[In vitro tests of internal tooth whitening agents on colored solutions do not replace tests on teeth].

Two in vitro tests for the assessment of whitening agents were evaluated. A simple, reproducible and cost-effective model using coloured solutions was compared to a tooth model. The following bleaching agents were investigated: 1) Sodium perborate tetrahydrate/30% H2O2, 2) sodium perborate tetrahydrate/3% H2O2, 3) thermocatalytic procedure with 30% H2O2 and 4) Opal-escence Endo. In the model using coloured solutions, the light absorption of the solutions was assessed one and 24 hours after application of the whitening agents. In discoloured teeth, whitening agents were placed in a simulated access cavity. In groups 1, 2, and 4, the agents were left in the cavity for three days, whereas in group 3 the substance was applied three times for 30 seconds. Bleaching processes were repeated three times. All bleaching agents proved effective in the model with coloured solutions, as well as in the tooth model. The effect was most pronounced after the first bleaching step. The results showed, however, that the simplified experiment with coloured solutions cannot replace the tooth model.

Analysis of Variance↗

PubMed2003

Randomized clinical trial comparing overnight use of two self-directed peroxide tooth whiteners.

PURPOSE: To directly compare tooth color change and spatial uniformity of two brush-applied, peroxide-based overnight tooth whiteners in a 2-week randomized clinical trial. METHODS: 57 adult volunteers were randomly assigned to Crest Night Effects, a 19% sodium percarbonate system packaged in unit dose sachets that when applied, dries to form an adherent film, or Colgate Simply White Night, a paint-on liquid in an applicator bottle at a concentration of 8.7% hydrogen peroxide. Both groups applied their assigned gel on the facial surfaces of the six maxillary anterior teeth for 14 nights. Efficacy was measured objectively as change in L*a*b* tooth color from standard digital images of maxillary teeth, while safety was evaluated by clinical examination and interview. RESULTS: After 14 nights treatment, adjusted mean (SE) change in yellowness (delta b*) was -0.95 (0.092) for the 19% sodium percarbonate film and -0.17 (0.096) for the 8.7% hydrogen peroxide gel, with these groups differing statistically (P < 0.0001). Other individual and composite color parameters also demonstrated significantly greater whitening for the 19% sodium percarbonate film compared to the 8.7% hydrogen peroxide gel after 14 nights use. Only the 19% sodium percarbonate film exhibited significant (P< 0.0001) proximal color improvement (delta b*) after 2 weeks, approximately 98% of that seen on the body of the tooth, providing evidence of proximal bleaching and uniform spatial whitening following use of this barrier-free system. Both products were well-tolerated, with no subjects discontinuing treatment early due to a causal adverse event.

Administration, Topical↗

PubMed2002

Daily use of whitening strips on tetracycline-stained teeth: comparative results after 2 months.

This article reviews the efficacy of a new 6.5% hydrogen peroxide tooth-whitening gel strip for bleaching teeth that have been intrinsically stained from tetracycline. Given the severity of staining in the cases presented during a recently conducted clinical trial, the resulting efficacy is dramatic. Additionally, the continuous use of these strips for 30 minutes per day, twice daily for 2 months with no meaningful adverse effects is noteworthy.

Adult↗

PubMed1997

Risk factors for developing tooth sensitivity and gingival irritation associated with nightguard vital bleaching.

The purpose of this study was to determine risk factors in the development of tooth sensitivity and gingival irritation associated with the nightguard vital bleaching technique. The potential risk factors evaluated (sex, age, reported allergy, whitening solution, number of times the solution was changed daily [its usage pattern], and dental arch) were collected from the daily log form turned in by each of the 64 participants after completion of the 6-week lightening process. Also evaluated for each participant, from color slides, were tooth characteristics such as gingival recession, defective restorations, abfraction lesions, enamel-cementum abrasion, etc, and reported side effects. The generalized Mantel-Haenszel statistic was used to assess the association between the potential risk factors and the development of tooth sensitivity and/or gingival irritation. No statistical relationship existed between age, sex, allergy, tooth characteristics, or the dental arch lightened and the development of side effects. Initially, a statistically significant association existed between side effects and the whitening solution used. However, when the analysis was controlled for usage pattern, this relationship disappeared. Patients who changed the whitening solution more than once a day reported statistically significantly more side effects than did those who did not change the whitening solution during their usage time.

Acrylic Resins↗

PubMed2005

Tooth whitening: tooth color changes following treatment by peroxide and light.

OBJECTIVE: This study examined the use of color measurement to determine tooth color in a study of bleaching with peroxide and light used separately and in combination. Two measurement protocols were evaluated for their ability to reveal differences between treatments and confirm tooth shade evaluations. METHODOLOGY: Before and after treatment, 43 subjects were evaluated for tooth color using a shade guide and a chromameter. Two measurement procedures were used: one measured a single location on each tooth using a fabricated plastic stent, and the other measured nine locations across the buccal surface. Values from the two procedures were compared to each other, and to shade guide measurements. RESULTS: Tooth color, as measured by both procedures, significantly correlated with shade evaluation. Statistically significant differences between treatment groups were found more often with data from the multiple-site procedure than from the single-site procedure. Incisal-gingival color gradation on tooth surfaces was diminished as a result of whitening treatments. Chromameter measurement data showed that tooth whitening procedures reduced tooth yellowness (b) more reproducibly than they increased whiteness (L). CONCLUSION: When more sites per surface were measured, tooth color measurement by the chromameter more closely matched shade with less variability and greater statistical power. Chromameter-derived values can be used to estimate shade values to a reasonable level of accuracy. Decreasing yellowness, particularly at the gingival margin, was an important component of the tooth whitening effect. Following tooth whitening, teeth were more uniform in their color, and this may contribute substantially to the subjective patient recognition of whiter teeth.

Adolescent↗

PubMed1989

[Bleaching of discolored teeth. Examination and evaluation of the effect of various bleaching agents].

Many patients suffer from tooth discoloration, a condition that produces more psychological distress than generally thought, especially when the anterior teeth are involused. In this study, tests were carried out to determine the effect of various agents applied discolored teeth for bleaching. Blood, colored tissue fluids I and II, attached to filter papers after being naturally exposed for a week were selected as object bleaching. Each subject was soaked in 30% hydrogen peroxide solution (30%H2O2), 3% hydrogen peroxide (3%H2O2), sodium hypochlorite solution (NaOCl), sodium perborate (NaBO3) and combination of them, then effect of agents were observed according to time-lapse. The following results were obtained. 1. NaOCl was most effective. 2. The action of 3%H2O2 was slow, showing only a slight bleaching effect after one week. 3. NaBO3 alone did not have any bleaching effect.

Borates↗

PubMed2005

Pulpal temperature rise during light-activated bleaching.

The purpose of this study was to measure intrapulpal temperature rise induced by two kinds of bleaching gels when the tooth was exposed to a variety of light-curing units and a diode laser in vitro. The root portions of 80 extracted intact human maxillary central incisors were sectioned with a carborundum disk approximately 2 mm below the cementoenamel junction perpendicular to the long axis of the teeth. Two bleaching agents containing heat-enhancing colorant was applied to the labial surface. Light-curing units used were a conventional halogen (40 s), a high-intensity halogen (30 s), a light-emitting diode unit (40 s), and a diode laser (15 s). The temperature rise was measured in the pulpal chamber with a J-type thermocouple wire that was connected to a data logger. Ten specimens were used for each system and bleaching-agent combination. Differences between the starting temperature and highest temperature reading were taken and the calculated temperature changes were averaged to determine the mean value in temperature rise. Temperature rise values were compared using two-way analysis of variance (ANOVA) at a preset alpha of 0.05. Temperature rise varied significantly depending on curing unit and diode laser used. The diode laser induced significantly higher temperature increases than any other curing unit (11.7 degrees C). The light-emitting diode unit produced the lowest temperature changes (6.0 degrees C); however, there were no statistically significant differences among the curing units and there were no statistically significant differences between bleaching agents. Light activation of bleaching materials with diode laser caused higher temperature changes as compared to other curing units and the temperature rise detected was viewed as critical for pulpal health.

Dental Pulp↗

PubMed1997

Aesthetic considerations in endodontics: internal bleaching.

During endodontic treatment of any tooth, aesthetics must be considered in the same manner as during any other dental treatment. The most common aesthetic challenge associated with endodontics is the discoloration of natural tooth structure. The discoloration may be a result of pulp pathosis, especially pulpal hemorrhage prior to or during treatment, or it may be due to various endodontic and restorative materials placed in the pulp chamber. There are several simple measures that can be utilized during and following endodontic treatment to eliminate or reduce aesthetic deficiency. The learning objective of this article is to discuss internal bleaching of discolored pulpless teeth that have been endodontically treated. The discussion includes the chemical composition of bleaching agents and principles by which they function during the bleaching procedures.

Humans↗

PubMed2006

The bleaching of teeth: a review of the literature.

OBJECTIVES: To review current knowledge of tooth whitening with respect to external bleaching methods. DATA: The scope is the external bleaching of vital teeth and focuses on mechanisms; in vivo and in vitro measurement methods, and factors influencing the efficacy of the whitening process. SOURCES: "Medline" and "ISI Web of Science" databases from 1966 and 1974, respectively were searched electronically with key words tooth, teeth, colo*r, white*, bleach* and peroxide. CONCLUSIONS: The importance of tooth whitening for patients and consumers has seen a dramatic increase in the number of products and procedures over recent years, with a concomitant rise in publications on this topic. Literature suggests that the mechanisms of tooth whitening by peroxide occur by the diffusion of peroxide through enamel to cause oxidation and hence lightening of coloured species, particularly within the dentinal regions. A number of approaches are available for measuring changes in tooth colour. These include visual measurements by trained clinicians and instrumental measurements using spectrophotometry, chromameters and digital image analysis. The key factors that affect tooth whitening efficacy by peroxide containing products are concentration and time. In general, higher concentrations are faster than lower concentrations. However, lower concentrations can approach the efficacy of higher concentrations with extended treatment times. Alternative bleach systems to peroxide have received only minor attention. The efficacy of light activated systems versus non-light activated controls in clinical studies is limited and conflicting. Other factors which can influence tooth bleaching outcome include type of stain, initial tooth colour and subject age.

Age Factors↗

PubMed2004

An overview of bleaching techniques: I. History, chemistry, safety and legal aspects.

The use of a variety of bleaching techniques has attracted much interest from the profession, as they are non-invasive and relatively simple to carry out. Coupled with the uncertain legal situation within the European community, and especially within the UK, this series of articles hopes to give a broad overview of bleaching techniques, their efficacy and relative safety, as well as update the current legal situation. This article will give an overview of bleaching: history, chemistry and safety. In addition, it will summarize types of tooth discoloration, along with indications/contra-indications for bleaching. Future articles will address in detail both home and power bleaching techniques, as well as the various ways to bleach non-vital teeth.

Contraindications↗

PubMed2000

Present and future technologies of tooth whitening.

Dental stains can be broadly classified as intrinsic or extrinsic. Intrinsic stains are a result of defects in tooth development, fluorosis, or acquired through the use of tetracycline. Extrinsic stains are localized mainly in the pellicle and are generated by the reaction between sugars and amino acids or acquired from the retention of exogenous chromophores in the pellicle. Three clinical methods are currently used for measuring stain removal and tooth whitening in the development of new whitening technologies: Lobene Stain Index, Shade Guide Color Change, and Minolta ChromaMeter. Professional tooth whitening products rely on proven technologies--35% hydrogen peroxide for in-office power bleaching or 10% to 15% carbamide peroxide for at-home bleaching--to reduce intrinsic stain and change the inherent tooth color. Over-the-counter tooth whitening products use a combination of surfactants, abrasives, anticalculus agents, and low levels of hydrogen peroxide to reduce extrinsic stain and help maintain tooth whiteness after professional treatment. Future technologies for whitening teeth could involve the use of activating agents to enhance the performance of hydrogen peroxide and natural enzymes.

Color↗

PubMedDate not supplied

Tooth whitening in children and adolescents: a literature review.

The purpose of this paper was to summarize the findings of a literature review on the use of peroxide-based tooth-whitening agents in children and adolescents. Safety considerations, including localized adverse effects and toxicological concerns, are described. Oral findings include: (1) 1 in every 2 to 3 patients may experience tooth sensitivity and/or gingival irritation after bleaching treatment, which may be more traumatic an experience for children than adults; (2) depending on dose, duration, frequency, and route, studies indicate excessive exposure to peroxide can be potentially harmful; (3) degree of potential toxicity and harmful outcomes increases in those who overuse whiteners--a concern in teenagers; (4) careful case selection using stringent criteria is suggested for primary teeth whitening; (5) whitening in healthy adolescents is a case-by-case determination that must include the weighing of risks (oral health and age) vs benefits (improved esthetic perception). It is hoped that the present review will lead to a better understanding of the health implications of tooth whitening in children and adolescents, and offer guidance for treatment that provides satisfactory outcomes externally (enamel and gingiva) and internally (endodontic tissues and systemic health).

Adolescent↗

PubMed2005

Comparison of two over-the-counter tooth whitening products using a novel system.

Tooth whitening is one of the most widely accepted esthetic procedures in dentistry. Various treatment options include in-office and prescribed at-home bleaching procedures, over-the-counter bleaching kits, and whitening dentifrices. This study evaluated and compared a 6% hydrogen peroxide tooth bleaching gel delivered on polyethylene film (HP) with an 18% carbamide peroxide brush-applied liquid gel (CP). A total of 59 subjects completed this 2-week, examiner blind, randomized, parallel group study. Both treatments were applied twice daily for 2 weeks according to the manufacturer's instructions. Evaluations for oral safety and Vita tooth shade were conducted by a dental examiner at baseline and 2 weeks after product use. In addition, the ShadeVision System was used to determine changes in Vita shade and L*a*b* values. Based on both the examiner and ShadeVision System assessments, both treatments significantly improved tooth shade. Improvements in Vita tooth shade based on the adjusted mean for HP were 2.64 (P < 0.001) and 2.33 (P < 0.001) for the examiner and ShadeVision System assessments, respectively, compared with improvements of 1.04 (P = .004) and 0.42 (P = 0.029) for CP users, respectively. The difference between treatments was found to be significant for both the examiner (P = .005) and ShadeVision (P = .001) assessments. Findings from the L*a*b* data derived from the ShadeVision System were in agreement with Vita assessments, with significant differences for changes in L*, a*, and b* in favor of HP users (P = .001). In this study, the ShadeVision method of color analysis was relatively easy to use and demonstrated significant differences between 2 OTC whitening products using both Vitapan and L*a*b* means of assessment.

Adult↗

PubMed1998

Dentifrice whitening after professional bleaching.

Thirty patients whose teeth had been bleached were given one of two toothpastes. One half of the group brushed with a toothpaste containing 10% carbamide peroxide (DW) and the other half with a toothpaste containing 3% hydrogen peroxide (HP) for three months. Color change from baseline was evaluated after 4 weeks and again after 12 weeks, using a shade guide and measured with a colorimeter at baseline. The DW toothpaste was able to stabilize the tooth-lightening effect of the bleaching gel better than the HP toothpaste. The HP product had a lower tooth sensitivity rating.

Analysis of Variance↗