Search Results (36)

Background/Objectives: Tooth bleaching is a widely requested aesthetic procedure in modern dentistry. However, the structural effects of high-concentration peroxide-based bleaching agents on enamel remain insufficiently understood. This study aims to evaluate and compare the effects of three in-office bleaching agents—Opalescence Boost (40% hydrogen peroxide [HP]), Opalescence Quick (45% carbamide peroxide [CP]), and BlancOne Ultra + (35% hydrogen peroxide [HP])—on enamel surface characteristics and color change using confocal laser scanning microscopy (CLSM) and spectrophotometric analysis. Methods: Forty-two extracted human teeth were sectioned and divided into experimental and control halves. Each experimental specimen underwent bleaching according to the manufacturer’s protocol. Color measurements were conducted at baseline, immediately post-treatment, at 3 days, 7 days, and 6 months following treatment using the Vita Easyshade^® spectrophotometer. Color differences were calculated using the CIEDE2000 (ΔE₀₀) formula. Enamel surface morphology was assessed by CLSM. Data were analyzed using Wilcoxon and Kruskal–Wallis tests (p < 0.05), performed with SPSS v23. Results: All bleaching agents produced clinically perceptible color changes (ΔE₀₀ > 3.3). Opalescence Boost achieved the highest and most consistent whitening effect (mean ΔE₀₀ > 11), while Opalescence Quick showed moderate efficacy (ΔE₀₀ ~6–8), and BlancOne Ultra+ induced milder changes (ΔE₀₀ ~4–5). CLSM imaging revealed surface alterations in all bleached samples, with more pronounced changes observed in specimens treated with higher peroxide concentrations. Conclusions: All three bleaching systems were effective in improving enamel color, with Opalescence Boost delivering the most substantial and durable effect. CLSM analysis confirmed morphological changes in enamel without evidence of severe damage. These results underscore the importance of selecting bleaching protocols that balance efficacy with enamel safety. Further in vivo studies are recommended to validate long-term structural effects and support clinical decision-making. Full article

Background: This study aimed to evaluate the effect of in-office bleaching with 38% hydrogen peroxide (HP) on the surface roughness of a nanohybrid composite resin by comparing two measurement techniques: Scanning Electron Microscopy (SEM) and profilometry. Methods: Sixty composite specimens of identical shade and thickness were prepared, light-cured, and polished following the manufacturer’s guidelines. These samples were divided into six groups based on the applied surface treatments: group 1: fresh composite (the control group), group 2: old composite, group 3: bleached fresh composite, group 4: bleached old composite, group 5: old repolished composite, and group 6: old repolished bleached composite. Surface roughness was measured using profilometry and SEM. Results: Pearson correlation analysis revealed a moderately significant linear relationship (r = 0.548, p < 0.001) between the surface roughness measurements obtained using SEM and the profilometer, indicating that both methods provide comparable results. A comparison of most groups showed significant differences (p < 0.001), highlighting the increased surface roughness observed after bleaching both fresh and aged composites. Conclusions: Bleaching increased the surface roughness of nanohybrid composites. It might be better to use SEM and a profilometer together to obtain a more comprehensive understanding of the surface characteristics. Full article

In-office teeth bleaching is an esthetic dental procedure performed to whiten teeth. A desensitizing procedure often requires prior in-office bleaching to relieve tooth hypersensitivity. The objective of this study was to evaluate the bleaching efficiency of teeth specimens pre-treated with different desensitizing agents by analyzing the color parameters. A total of 25 bovine specimens were stained and divided into five groups (n = 5). The specimens were pre-treated with GLUMA, ICON, bonding, or fluoride varnish according to the manufacturer’s instructions. Subsequently, the samples underwent three consecutive 20 min bleaching sessions using an in-office bleaching product. Color values in the CIE L*, a*, and b* color space were initially recorded, both before any treatment and after each bleaching session. The color difference (ΔE) was then computed. The data were analyzed using SPSS 24.0 software. The color alteration after pre-treatment was analyzed using a one-way ANOVA test, and the color alteration in each bleaching session was compared using a repeated-measure ANOVA test. A one-way ANOVA analysis showed a statistically significant difference in the bleaching efficiency of teeth specimens pre-treated with different desensitizers (p < 0.001). The repeated-measure ANOVA analysis showed no statistically significant difference in additional bleaching sessions (p = 0.133). The ICON and bonding pre-treatment showed the color alteration of teeth specimens before the bleaching procedure. Although the different desensitizer pre-treatments showed significant differences in bleaching efficiency, the differences in color parameters of the teeth specimens at the end of three bleaching sessions were statistically insignificant. Desensitizer pre-treatment influenced the degree of color change during multiple bleaching sessions; however, the outcome of bleaching was not affected by desensitizer pre-treatment. Full article

The objective of this research was to synthetize a hydroxyapatite-capsaicin composite (HAp-CAP) and assess its physicochemical properties for potential use in an in-office dental bleaching gel. The HAp-CAP nanocomposite was prepared by the precipitation method using a 4:1 ratio of nano-hydroxyapatite (nano-HAp) to capsaicin (CAP) dissolved in 99.5% ethyl alcohol (q.s.p) with the assistance of zirconia beads in a SpeedMixer^®. Characterization of HAp-CAP involved morphological, spectroscopic, and thermal analyses. Subsequently, HAp-CAP was incorporated into an in-office dental bleaching agent to evaluate its impact on reducing hydrogen peroxide diffusion into the pulp chamber and its effect on tooth color alteration during the bleaching process. The HAp-CAP in a bleaching gel slightly decreased the amount of hydrogen peroxide inside the pulp chamber and did not interfere in the bleaching effectiveness of dental bleaching. The physicochemical characterization indicates that the synthesis process of the HAp-CAP composite was successfully carried out, and its use in dental materials poses a challenging task that warrants further investigation since its incorporation. Full article

Background/Objectives: Tooth whitening is a cosmetic dental treatment that improves the color of natural teeth, making them whiter and brighter; this review aimed to evaluate the greater effectiveness of in-office, at-home, and combined bleaching with hydrogen or carbamide peroxide, also in relation to possible relapses and side effects (tooth sensitivity). Methods: A literature search has been carried out through electronic databases, PubMed/MEDLINE, and Cochrane Library, focused on the use of the effectiveness of in-office, at-home, and combined dental bleaching. This review has been registered on PROSPERO (ID613248). Results: 30 articles have been included. Most of the studies did not find any more effective treatment than the proposed treatments; all types of bleaching have been shown to be effective in changing color; in the studies that have compared in-office and at-home bleaching, there was a lower recurrence of treatment with the use of the at-home trays with carbamide peroxide gel. There were no clear positions regarding tooth sensitivity, which would appear to be higher in professional in-office and combined dental bleaching. Conclusions: Bleaching is an effective treatment for the change of color of the tooth regardless of the type used (concentrations, type of gel, and duration of sessions), although, at home, it would seem to be more effective over time. It is, however, a clinical feature that may give a risk of tooth sensitivity after treatment. Full article

Worldwide, synthetic compounds are used for both in-office and at-home dental care. They are a valuable resource for both prophylactic and curative treatments for various dental problems, such as tooth decay, periodontal diseases, and many more. They are typically preferred due to their broad range of actions and ability to produce targeted, rapid, and long-lasting effects. Using a 0.12% chlorhexidine mouthwash is capable of reducing the plaque index from 47.69% to 2.37% and the bleeding index from 32.93% to 6.28% after just 2 weeks. Mouthwash with 0.1% OCT is also highly effective, as it significantly lowered the median plaque index and salivary bacterial counts in 152 patients in 5 days compared to a control group (p < 0.0001), while also reducing the gingival index (p < 0.001). When povidone-iodine was used as an irrigant during the surgical removal of mandibular third molars in 105 patients, it resulted in notably lower pain scores after 2 days compared to a control group (4.57 ± 0.60 vs. 5.71 ± 0.45). Sodium hypochlorite is excellent for root canal disinfection, as irrigating with 1% NaOCl completely eliminated the bacteria from canals in 65% patients. A 0.05% CPC mouthwash proved effective for perioperative patient care, significantly decreasing gingival bleeding (p < 0.001) and suppressing Streptococcus levels even one week post-surgery. Lastly, a 6% H2O2 paint-on varnish and 6% H2O2 tray formulations successfully bleached the teeth of 40 patients, maintaining a noticeably whiter appearance up to the 6-month follow-up, with significant color differences from the baseline (p < 0.005). Synthetic compounds have a large research base, which also provides a greater awareness of their mechanism of action and potential adverse effects. For a better understanding of how they work, several methods and assays are performed. These are protocolary techniques through which a compound’s efficacy and toxicity are established. Full article

The aim of this investigation was to conduct a systematic review and meta-analysis to determine the necessity of a white diet during or following a bleaching procedure. This systematic review and meta-analysis followed the PRISMA guidelines meticulously. The research question was: Is a white diet necessary during and/or after a bleaching treatment? In vitro studies or clinical trials reporting the color change in bleached enamel after the use of a free-staining diet were considered for full-text review. For the analyses, a random-effects model was employed. Statistical significance was defined as a p-value < 0.05. A total of 17 documents were eligible for qualitative analysis: 5 clinical trials and 12 in vitro studies. Only data from the clinical trials were included in the meta-analysis. For at-home bleaching, differences in the color among the subjects were not statistically significant during the first (p = 0.64), second (p = 0.26) or third (p = 0.43) weeks of treatment. Also, the color difference one month after finishing the bleaching treatment were not statistically significant (p = 0.27). The color difference one month after finishing an in-office treatment showed that the restrictions on diet did not significantly improve the bleaching outcomes (p = 0.90). According to the findings of this review, dietary restrictions are not necessary during or after bleaching procedures. Full article

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. Full article

Laser-activated tooth bleaching is discussed as a means to optimize results, while minimizing adverse side effects, but it lacks consensus in the scientific literature. Therefore, this systematic review aims to evaluate the protocols and outcomes of laser-activated vs. non-activated bleaching methods for safe and effective approaches. The PubMed, Cochrane, Scopus, ScienceDirect, and Google Scholar search engines, with the following MeSH terms and keywords: (bleaching OR whitening) AND laser AND (tooth OR dental OR enamel OR dentine), were used to identify human clinical trials and in vitro studies regarding laser-activated dental bleaching. After applying the keywords and additional filters, and inclusion and exclusion criteria, the final number of included articles was 19 clinical and 20 in vitro studies. Laser activation yielded no significant color improvement, but reduced gel contact time (10 min). Laser-activated bleaching required 24% less hydrogen peroxide (HP) concentration to achieve similar results. Additionally, there were no significant differences in terms of sensitivity and hard tissue alterations between the laser-activated and conventional groups. The benefits associated with laser-activated bleaching render it a compelling option. Nevertheless, a comprehensive evaluation of bleaching gels and activation protocols is imperative. Ultimately, this analysis provides clinical guidance pertaining to the facilitatory employment of laser irradiation. Full article

The long-term color stability and surface properties of anterior laminate veneers are among the crucial factors affecting the clinical longevity of aesthetic restorations. Novel 3D-printed materials are being introduced as definitive restorative treatment. In light of the existing variety of indirect yet minimally invasive composite resin veneers, research on their surface properties is warranted. This in vitro study evaluated the effect of artificial aging by immersion in different staining solutions on the color changes, gloss, and surface roughness (Ra) of 3D-printed veneers compared to the prefabricated resin composite veneer systems (PRCVs) manufactured by Componeer and Edelweiss. Moreover, this study compared the effects of two methods for stain removal: repolishing with Sof-Lex disks and in-office bleaching with 40% hydrogen peroxide. The veneers (n = 24) were randomly divided according to the immersion solutions used, i.e., tea and coffee. Colorimetric measurements, surface roughness, and surface gloss were determined before and after staining and surface treatment with either in-office bleaching or surface polishing. The data were statistically analyzed using two-way ANOVA followed by the Tukey’s post hoc test (α = 0.05). Artificial aging with immersion in staining solutions led to significant color changes, increased surface roughness, and gloss reduction in all materials (p  <  0.05). The 3D-printed veneers showed higher ΔE values (coffee = 10.112 ± 0.141) and (tea = 10.689 ± 0.771) compared to baseline after 7 days of aging. The 3D-printed veneers had a statistically significant surface roughness Ra (0.574 µm ± 0.073). The gloss was >70% in all groups at baseline; these values dropped in all groups after 7 days of artificial aging. After the stain-removing procedures, the ΔE values decreased in all tested veneers. That being said, they failed to return to the baseline values, and both stain-removing methods were found to have an adverse effect on surface roughness and gloss retention in all tested veneers. Full article

The aim of this laboratory study was to investigate and compare the impact of five desensitizing techniques as a treatment fortooth sensitivity on the exposed dentin after an in-office tooth bleaching procedure. Thirty intact human molars were collected for this investigation. The specimens were obtained by transversely cutting 2.5 mm of the crowns, leading to exposure of the dentin. The specimens were cleaned in an ultrasonic bath and treated initially with EDTA gel 15% for 4 min and then with Opalescence Boost bleaching gel (40% H₂O₂) for two sets of 20 min. Then, the samples were randomly divided into six groups (n = 5) and received one of the following treatments: Group 1 (no treatment—control group), Group 2 (Emofluor gel—0.4% SnF₂), Group 3 (MI Paste—CPP-ACPF), Group 4 (BioMinF paste—calcium phospho-fluoro-silicate), Group 5 (air-abrasion with ProSylc—Bioglass 45S5), and Group 6 (Er,Cr:YSGG laser). Subsequently, each sample was observed utilizing scanning electron microscopy (SEM) in order to detect the rate of occlusion of dentin tubules. SEM-EDS analysis revealed no occlusion of the dentin tubules in the control group, while Groups 2, 4, and 5 presented high effectiveness (>95% percentage of occluded tubules), and Groups 3 and 6 presented lower values (21.6 and 26.8%, respectively). It was concluded that althoughall the tested groups presented higher percentages of occlusion of the dentinal tubules compared to the control group, there were differences in effectiveness among them. The most effective treatments were the daily use of BioMinF paste and SnF₂-containing gel, as well as air-abrasion with ProSylc powder. Full article

In-office bleaching with high concentrations of hydrogen peroxide (H₂O₂) agents causes undesirable alterations in the enamel. Surface pre-reacted glass-ionomer (S-PRG) filler is a functional material known for its acid-neutralizing and demineralization-inhibition properties. This study evaluates the effect of S-PRG filler incorporation in H₂O₂-based bleaching on the enamel surface. Bovine enamel surfaces were bleached using a bleaching paste formulated with a liquid (35% H₂O₂) and a powder containing 5% or 10% S-PRG filler. The surface roughness and the Vickers microhardness of the treated enamel surfaces were evaluated. The enamel surfaces were observed under a scanning electron microscope (SEM) and analyzed using energy dispersive X-ray (EDX) technology. The surfaces were challenged by citric acid and observed by SEM. The specimens bleached with the paste containing the S-PRG filler showed lower enamel surface roughness and higher microhardness values than did those bleached with the plain paste (0% S-PRG filler); meanwhile, there were no significant differences between the 5% or 10% S-PRG filler groups. The S-PRG filler groups showed enamel surface morphologies similar to those of the non-bleached enamel, according to SEM observation, and EDX analysis detected the presence of fluoride and strontium ions. The S-PRG filler groups showed a higher resistance to erosion. The S-PRG filler mitigated the detrimental effects of bleaching agents on the enamel surface and provided resistance to erosion. Full article

This study aims to analyze the effect of desensitizing agents on the shear bond strength (SBS) of ceramic brackets after in-office bleaching procedures. Twenty-seven extracted premolars were equally divided into three groups (n = 9). Group 1 served as the control; bleaching was performed with 37% hydrogen peroxide. In group 2, bleaching and the application of a fluoride-containing desensitizing agent (CPP-ACFP) were performed. In group 3, bleaching and the application of a non-fluoride-containing desensitizing agent (CPP-ACP) were performed. Ceramic brackets were bonded with composite resin. SBS was tested using a universal testing machine. The site of bonding failure was measured using the adhesive remnant index (ARI) score. There was a statistically significant difference in mean SBS values (p < 0.05). Group 1 showed the lowest SBS value (6.32 ± 4.83 MPa), which differed significantly with groups 2 and 3 (p < 0.05). There was no significant difference between group 2 (15.36 ± 4.67 MPa) and group 3 (12.19 ± 6.81 MPa) (p > 0.05). The ARI score did not show a significant difference. The conclusion is that the application of fluoride-containing and non-fluoride desensitizing agents increases the shear bond strength of ceramic brackets on bleached teeth with composite resin cementation. The application of both desensitizing agents had no impact on the results of the ARI score, with the highest ARI score in each group being 4, indicating that less than 10% of the adhesive substance remains on the enamel. Full article

Introduction: The present study aimed to investigate the effectiveness of low-level laser therapy (LLLT) use before in-office bleaching to prevent an increase in the risk and intensity of tooth sensitivity. Methods: Thirty patients were selected. Before bleaching with 38% hydrogen peroxide, the participants were randomly divided into two groups of 15 subjects. Test group: the patients’ teeth were subjected to a preliminary LLLT procedure by an 810 nm diode laser with 0.5 W for 30 s for an energy density of 15 J/cm² and a group placebo. All patients were instructed to report their cold sensitivity experiences immediately, 1 h, 24 h, and 48 h after the end of bleaching via a VAS score. Results: The results obtained show an increase in VAS values for both groups (290 and 490 vs. 224 and 234 of baseline time of test and placebo group, respectively); afterward, the VAS value seemingly decreases at 1 h after the end of bleaching, approaching the baseline VAS for the test group (274) in comparison to the placebo group. Conclusions: The use of preliminary diode LLLT could represent a valid possibility to reduce the occurrence of tooth sensitivity post-whitening and shorten recovery time in cases where tooth sensitivity occurs. Full article

The aim of this study is to evaluate the effectiveness of in-office bleaching in esthetic dentistry on the roughness and color stability of the enamel surface, using different concentrations of hydrogen peroxide (HP). Fifty human incisors were randomly divided into 5 groups (n = 10). No bleaching was performed in the control group. For these groups, concentrations of 40% HP with fluoride (F), 35% HP with calcium (Ca), 25% HP with nano-hydroxyapatite (nHA) and 18% HP with nHA were used for bleaching in the test groups. Surface roughness was assessed at baseline after bleaching occurred. Color measurements were first obtained at baseline, then after the first and second sessions of bleaching, and, finally, after the staining protocol. Scanning electron microscopy and atomic force microscopy were performed. Statistical analysis was conducted with a one-way ANOVA, followed by a post hoc Tukey’s test and a paired-samples t-test (p < 0.05). All the bleaching gels used exhibited a similar color change (p > 0.05). Bleaching gels containing 18% HP with nHA and that containing 35% HP with Ca caused less surface roughness of the enamel. Of these concentrations, 25% HP with nHA caused the most surface roughness and no significant difference was observed, compared with 40% HP with F. The highest coloration after bleaching was observed in 40% HP with F and 25% HP with nHA. The lowest coloration was obtained in 35% HP with Ca and 18% HP with nHA but no significant difference was observed between them and the control group. A concentration above 18% HP does not increase the bleaching effectiveness. The results show that 18% HP with nHA and 35% HP with Ca resulted in the least increase in enamel surface roughness when compared to high-concentrate HP; however, it also prevented recoloration after bleaching. Full article