Clinical evaluation of in-office tooth whitening with violet LED (405 nm): A double-blind randomized controlled clinical trial

Bleaching efficacy of in-office bleaching with violet light using low-concentration hydrogen peroxide nanoparticulate photocatalyst gel: A randomized controlled trial

OBJECTIVE

This randomized controlled trial aimed to evaluate the bleaching efficacy and tooth sensitivity (TS) of participants submitted to different application protocols of in-office bleaching with violet light using 6 % hydrogen peroxide (HP) nanoparticulate photocatalyst gel.

MATERIALS AND METHODS

Sixty-six participants were randomized and bleached using either a 6 % HP (Nano White, DMC), and/or violet light (Bright Max Whitening, MMOptics), according to the following protocols: 1) only violet light (VIOL); 2) only bleaching gel application (BG) and; 3) combined bleaching gel application + violet light (BG+VIOL). The bleaching efficacy was evaluated with the Vita Easyshade spectrophotometer, Vita Classical and Vita Bleachedguide scales. The risk and intensity of TS were recorded using a 0-10 visual analogue scale (VAS) and a 0-4 numerical scale (NRS). Color change and intensity of TS values were compared using one-way ANOVA and Tukey's test were used. The absolute risk of TS was compared using the Chi-square test (α = 0.05).

RESULTS

A significant and higher degree of bleaching was observed in the BG and BG+VIOL groups compared to the VIOL group (p < 0.003). Despite no significant differences in the risk (p > 0.07) and intensity (p > 0.28) of TS among groups, a higher risk of TS was observed in the BG and BG+VIOL groups.

CONCLUSIONS

Using VIOL reduced the risk of TS but did not improve bleaching. However, BG+VIOL with low-concentration HP nanoparticulate photocatalyst gel achieved equal efficacy and was less likely to cause TS compared to BG.

Influence of using different toothpaste during bleaching with violet LED light (405 nm) on the colour and roughness of dental enamel: an in vitro study

This in vitro study aimed to investigate potential changes in the color and roughness of dental enamel resulting from the use of different toothpaste formulations during bleaching with violet LED light (405 nm). Sixty specimens of bovine incisors, each measuring 6 × 6 × 3 mm, were segregated into six distinct experimental groups based on their respective treatments (n = 10): C + VL: Brushing with Colgate® Total 12 + bleaching with violet LED; LB + VL: Brushing with Colgate® Luminous White Brilliant + bleaching with violet LED; LI + VL: Brushing with Colgate® Luminous White Instant + violet LED bleaching; C: Brushing with Colgate® Total 12; LB: Brushing with Colgate® Luminous White Brilliant; LI: Brushing with Colgate® Luminous White Instant. The examined variables included alterations in color (∆L*, ∆a*, ∆b*, ∆Eab, and ∆E00), surface roughness (Ra), and scanning electron microscopy observations. No statistically significant distinctions emerged in total color variations (∆E00 and ∆E) among the groups under scrutiny. Notably, the groups that employed Colgate® Luminous White Instant displayed elevated roughness values, irrespective of their association with violet LED, as corroborated by scanning electron microscopy examinations. It can be concluded that whitening toothpastes associated to violet LED do not influence the color change of dental enamel in fifteen days of treatment. Toothpastes with a higher number of abrasive particles showed greater changes in enamel roughness, regardless of the use of violet LED.

Time-dependent efficacy and safety of tooth bleaching with cold plasma and H2O2 gel

Background

Hydrogen peroxide (H2O2) is the commonly used bleaching agent for teeth. But it is highly corrosive to teeth for the high concentration. The cold atmospheric pressure plasma has been witnessed a novel tooth bleaching technology and could help strengthen the bleaching effect when combined with H2O2. However, the efficacy and safety might highly correlated with processing time. The present study aims to evaluate the time-dependent efficacy and safety of tooth bleaching with cold plasma and H2O2 gel in vitro.

Methods

The H2O2 concentrations of the gel used in the study are 6%, 15%, 25% and 35%, respectively and the treatment time varies from 5 to 20 min. The tooth bleaching effect was evaluated by a Crystaleye Spectrophotometer and the overall change of the colorimetric value based on three independent measurements. Meanwhile, the microhardness, roughness and tooth temperature were evaluated. The surface morphology and the elemental composition were determined by scanning electron microscope and energy-dispersive X-ray spectroscopy.

Results

5 min bleaching treatment contributed to 60% of the bleaching effect maximum, the 10 min effect was close to 15 min effect. Meanwhile, the microhardness reduced and roughness increased under a treatment which was longer than 20 min. Tooth pulp chamber temperature was keeping in a safe range within 20 min treatment.

Conclusion

5–10 min was the best treatment time from which we can get an ideal tooth bleaching effect and less influence on tooth enamel and pulp tissue when using cold plasma and H2O2 gel.

VIOLET LED DENTAL WHITENING: EFFECTIVENESS AND BIOLOGICAL SAFETY: AN IN VITRO STUDY

INTRODUCTION

The light-emitting diode (Led) in the violet spectrum associated or not with hydrogen peroxide (HP) has been suggested as a promising technique for dental bleaching. Violet led has a wavelength of 405-410 nm, which is very close to that of ultraviolet (UV) radiation, and this has raised biological safety concerns.

AIM

To investigate the effectiveness of the violet led dental bleaching technique by evaluating color parameters, enamel surface microhardness, and biological safety analysis.

METHODS

One hundred bovine dental blocks were divided into groups according to the bleaching technique (G1 - only HP; G2 - HP associated with blue led; G3 - only blue led; G4 - HP associated with a violet led; and G5 - only violet led). The color analysis (ΔE, ΔL, and WID) and enamel surface microhardness were assessed before and after bleaching (immediately, 5, 14, and 30 days). The biological safety of the violet led irradiation was assessed by measuring the number of micronuclei formed in human cells in culture in response to irradiation. Data analysis included Kruskal-Wallis test, Friedman test, and Mann-Whitney test.

RESULTS

In groups G4 and G5 there was the formation of precipitates on the enamel surface. At the time of 14 days, it was observed that the G2 group had lower values of microhardness than G5. ΔL and ΔE showed differences between groups in experimental times. Mean percentages of micronuclei occurrence were similar in the control group and the violet led group.

CONCLUSION

The violet led irradiation can be applied for dental bleaching because this approach produces significant color changes preserving tooth enamel integrity and causes no genotoxic effects on vital cells.

Blinded, Parallel and Randomized Clinical Evaluation of In-office Dental Bleaching with Violet LED (405-410 nm)

This clinical study evaluated the effect of bleaching performed with violet LED light (405-410 nm), either combined with hydrogen peroxide (HP) gel, or not, on color change, dental sensitivity, participants' satisfaction and impact on their quality of life. A hundred participants were divided into one of the groups (n = 25): G1 - 35% HP (4 sessions, 1x/week); G2 - violet LED (4 sessions, 1x/week); G3 - violet LED (4 sessions, 2x/week); G4 - hybrid technique (violet LED + 35% HP; 4 sessions, 1x/week). Color evaluation was performed with colorimetric tests (objective and subjective), before, 14 days and 3 months after completion. Additionally, satisfaction with treatment, impact on quality of life (OHIP-14) and dental sensitivity were recorded. The data were submitted to statistical analysis, considering a significance level of 5%, with the exception of the data from the questionnaire on satisfaction (descriptive analysis). Two-way ANOVA and Tukey tests showed that there was no difference between color variation resulting from techniques used in G1 and G4; those used in G2 and G3 did not differ and were less effective for bleaching than those of the other groups, in both subjective and objective evaluations. Regarding tooth sensitivity, subjects in G2 and G3 experienced no sensitivity, ​​while those in G4 showed lower sensitivity values than those in G1. With respect to quality of life, only subjects in G1 and G2 showed a significant positive impact. Among the evaluated techniques, the hybrid type seemed to be a good alternative, showing effective bleaching with less tooth sensitivity.

Interdental Plaque Microbial Community Changes under In Vitro Violet LED Irradiation

Oral microbiome dysbiosis has important links to human health and disease. Although photodynamic therapy influences microbiome diversity, the specific effect of violet light irradiation remains largely unknown. In this study, we analyzed the effect of violet light-emitting diode (LED) irradiation on interdental plaque microbiota. Interdental plaque was collected from 12 human subjects, exposed to violet LED irradiation, and cultured in a specialized growth medium. Next-generation sequencing of the 16S ribosomal RNA genes revealed that α-diversity decreased, whereas β-diversity exhibited a continuous change with violet LED irradiation doses. In addition, we identified several operational taxonomic units that exhibited significant shifts during violet LED irradiation. Specifically, violet LED irradiation led to a significant reduction in the relative abundance of Fusobacterium species, but a significant increase in several species of oral bacteria, such as Veillonella and Campylobacter. Our study provides an overview of oral plaque microbiota changes under violet LED irradiation, and highlights the potential of this method for adjusting the balance of the oral microbiome without inducing antibiotic resistance.