Search Results (8)

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

In modern times, patients are not only seeking oral health but also aiming for a flawless smile. Despite the progress made in aesthetic dentistry, there are instances where insufficient teeth whitening results contrast with the considerable cost of professional treatments. Patient discomfort and the potential for tooth damage further compound these challenges. In this study, we conducted a comparative split-mouth ex vivo investigation to evaluate the innovative BlancOne ULTRA⁺ (IDS SpA) in comparison with established professional products: Opalescence Extraboost (ULTRADENT), Zoom WhiteSpeed (Philips Research Eindhoven High Tech), and Pola Office (SDI Limited). Our initial focus was on the whitening effectiveness of each product, which was measured using a spectrophotometer. Subsequently, we assessed any structural changes in enamel post-treatment using an atomic force microscope (AFM) and a nanoindentation procedure. All tested bleaching agents demonstrated teeth-brightening effects. BlancOne ULTRA⁺, Zoom WhiteSpeed, and Pola Office caused minor alterations in the texture of the enamel surface within nanometric limits. However, Opalescence Extraboost exhibited notably more pronounced changes, indicating significant modifications in surface roughness and potential reductions in material hardness due to consequential shifts in mechanical properties. BlancOne ULTRA⁺ appears to offer the most favourable cost–benefit outcome. Full article

Objective. The causes of internal posteruptive discoloration of teeth are bleeding, necroses, infections, and endodontic filling materials. The aim of this study was to establish the results of bleaching endodontically treated teeth using walking bleach, in-office, and combined techniques, using 30% carbamide peroxide and 35% hydrogen peroxide, as well as the effect of etiological factors, and the time elapsed after endodontic treatment on the success of bleaching. Materials and Methods. The research involved 30 endodontically treated teeth in healthy patients. Retroalveolar X-rays were taken to check the quality of root canal obturation. Endodontic treatment and obturation were carried out on the discolored non-vital teeth without any previous endodontic treatment. Before bleaching, two millimeters of the filling were removed from the root canal and the very entry into the canal was protected with glass ionomer cement. The teeth were divided into three groups, depending on the bleaching technique: walking bleach technique (10 patients), in-office technique (10 patients), and combined technique (10 patients). The teeth were bleached with 30% carbamide peroxide and 35% hydrogen peroxide. The bleaching procedure was repeated in all the patients three times. The color of all teeth was determined based on the Vita Classic guide before and after bleaching. The Χ² square and Kruskal–Wallis tests were used to identify differences in teeth bleaching results. Results. A statistically significant difference (p < 0.05) was established between bleaching success and the time elapsed after endodontic treatment. There were no statistically significant differences observed between the bleaching success and etiological factors, bleaching techniques, or bleaching agents. Conclusions. The effectiveness of non-vital tooth bleaching is affected by the time elapsed after endodontic treatment. Full article

Intra-coronal bleaching is a treatment that whitens non-vital teeth from within the pulp chamber, a procedure by which oxygen and free radicals are released. This in vitro study analyzed and compares the oxygen expansion produced when different bleaching agents encounter dental tissues during this type of bleaching. Here, 120 lower incisors were included and prepared to achieve conditions as close as practicable to internal bleaching with the walking bleach technique. The access cavity of the lingual surface was prepared to seal glass tubes with oil inside them by adhesive restoration once the bleach was placed inside the pulp chamber. The following bleaching groups were used: hydrogen peroxide (HP) 30% (n = 30), sodium Perborate (SP) with distilled water (n = 30), a mixture of HP 30% with SP (n = 30) and a control group (n = 30). After 10 days, the oil displacement that took place through the tube due to oxygen release was measured daily. Displacement of the oil was observed in all groups except the control group. The final mean expansion at 10 days was 335.24 ± 76.85 mm for the HP 30% group, 8.40 ± 1.74 mm for the SP group and 183.07 ± 49.93 mm for the HP30% + SP mixture. Significant statistical differences were observed between the three groups using the Games–Howell post hoc test, where HP30% caused the greatest expansion and SP the least expansion. These results suggest that the higher the amount of HP in the sample, the more oxygen expansion is observed, so that temporary restoration must be performed more carefully to avoid displacement. Full article

Tooth bleaching is a common treatment for the amelioration of the aesthetic of discoloured teeth. In this context, there are two common approaches that employ concentrated solutions (30–40 wt.%) of either hydrogen peroxide or carbamide peroxide as bleaching agents. However, there is an ongoing debate on the possible adverse effects of these different treatments on tooth health, such as variation of the enamel structure, surface morphology, and chemistry, which also affect tooth sensitivity. In the present work, a study on the effect of the two bleaching agents, a 35 wt.% solution of hydrogen peroxide and a 30 wt.% solution of carbamide peroxide, on the permeability and surface morphology of enamel is reported. The investigation was carried out on replicas of incisors obtained after different treatment times and for several patients, employing scanning electron microscopy to study the morphological features of the treated teeth. The significance of the analytical study was corroborated by a statistical analysis of the results. The collected data suggest that hydrogen peroxide treatment increases the enamel permeability, and this could be related with tooth sensitivity, whereas the carbamide peroxide solution increases the formation of precipitates on the tooth enamel. Full article

Background: Dental bleaching has become an everyday procedure for treating teeth presenting discoloration, as a therapy on its own or as a part of restorative dentistry. The most widely used bleaching products available for vital teeth are hydrogen peroxide and carbamide peroxide, marketed as a range of products adapted to different treatment modes. The purpose of the study was to evaluate the clinical whitening efficacy of four high-concentration bleaching products for vital teeth applied in single in-office sessions. Methods: This clinical trial included 40 patients divided into four groups according to the concentration of the hydrogen peroxide-based (HP) product used (Group 1: HP 35%; Group 2: HP 37.5%; Group 3: HP 38%; Group 4: HP 40%). Each patient received one in-office whitening treatment of maxillary and mandibular anterior teeth (incisors, canines, and premolars), making a total of 791 teeth. The color changes produced in central incisors and canines were measured. Results: All groups underwent significant color changes from initial to final evaluations for color parameters L*, a*, and b*. No significant differences between the four groups were found for either the L* or a* parameters. Analysis of the b* parameter found significant differences between the HP 38% group and the HP 35% group. No significant differences in ΔE were found between the four groups (ANOVA p = 0.174). HP 38% obtained the highest ΔE (4.63), while HP 40% obtained 4.01. Conclusions: A single in-office whitening session, regardless of the bleaching product used, modifies tooth color effectively. All four products achieved increases in the L* parameter and significant reductions in parameters a* and b*. The ΔE did not show significant differences between the four groups. In-office whitening with high concentration hydrogen-peroxide-based products was found to be an effective treatment for moderate and severe dental discoloration. Full article

Background: In cases of moderate to severe dental discoloration, vital tooth whitening usually requires a prolonged treatment time if it is to obtain satisfactory outcomes. Variations in the clinical efficacy of whitening products in terms of their concentration and application time mean that we need to be aware of the real bleaching capacity of each whitening method and each product. This randomized clinical trial aimed to analyze with a spectrophotometer the effect of the number of in-office vital tooth whitening sessions (one or two) on the number of weeks of ensuing home whitening until color stability was obtained. Methods: Twenty patients with moderate/severe discoloration were treated with combined vital tooth whitening. Ten patients were treated with a single in-office session consisting of two applications of a product containing 40% hydrogen peroxide, followed by home treatment with individualized splints and a 16% carbamide peroxide gel (Group 1S). The other ten patients (Group 2S) were treated in two in-office sessions with two applications of the same product as Group 1S, followed in the same way by home treatment. Results: Comparing the two groups (1S and 2S), no significant differences in Euclidean distance (ΔE) were found after in-office whitening, or when color stabilization was obtained and home whitening ceased. Significant differences in the number of weeks of home whitening until color stabilization reached the same outcomes were found between 1S and 2S; 1S required a mean of 11.6 weeks home whitening, while 2S required 8.2 weeks. Conclusions: Combined tooth whitening with two in-office sessions significantly reduces the number of weeks (by three to four weeks) of subsequent home tooth whitening needed to reach color stabilization. Full article

This systematic review aimed to describe and characterize internal tooth bleaching techniques, conventional (walking-bleach) and combined (inside–outside), referring to their efficacy. The research was conducted on the main databases: PubMed, Cochrane Library, EMBASE, and Web of Science. Only randomized controlled trials and cohort studies were considered, on humans of 18 years old or older. A Population, Intervention, Comparison, Outcome (PICO) question was designed to evaluate the scientific evidence. The quality of each randomized controlled trial and cohort study was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions and the Methodological Index for Non-Randomized Studies (ROBINS-I), respectively. The walking-bleach and the combined techniques were both effective at the end of the treatment, obtaining similar aesthetic results. Regardless of the technique used, internal tooth bleaching is an effective procedure, with good aesthetic results, in the treatment of non-vital teeth. The cervical barrier is a standard of care in internal bleaching techniques and should be used. Considering the similarity in the esthetic results obtained in both techniques, the concentrations used for both, and since the biocompatibility of the bleaching agent is more important than its efficiency or speed in obtaining results, the combined technique should be considered the method of choice rather than the walking-bleach technique. Full article