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Gaidarji B, Perez BG, Durand LB. Effectiveness of Three Bleaching Techniques for Endodontically Treated Teeth: A Randomized Clinical Trial. Oper Dent 2024; 49:519-530. [PMID: 39187959 DOI: 10.2341/24-005-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Various techniques, products, and protocols are used for the bleaching of non-vital teeth. The walking bleach technique involves sealing the bleaching agent in the pulp chamber. In the inside/outside technique, a low-concentration bleaching agent is applied at home using a custom tray. In the in-office technique, a high-concentration bleaching agent is applied by a dental professional. Limited research has compared the effectiveness of these techniques. OBJECTIVE This clinical trial aimed to evaluate the effectiveness of the walking bleach, the inside/outside, and the in-office bleaching techniques. METHODS AND MATERIALS Fifty-four discolored teeth were selected according to eligibility criteria, randomized, and assigned to three treatment groups (n=18): walking bleach (sodium perborate - SP), inside/outside bleaching (7.5% hydrogen peroxide -HP7.5), and in-office bleaching (35% hydrogen peroxide - HP35). A cervical seal was placed in all the teeth, and nonvital bleaching was performed according to each technique. The CIELab color coordinates were measured using a clinical spectrophotometer at baseline, weekly, and at the 1-week follow-up. ΔE00 and ΔWID were calculated between the baseline and each evaluation time point. The ANOVA, Fisher exact, and Kruskal-Wallis tests were used to compare the quantitative variables, and the Fisher exact test, to determine the association among categorical variables. Bleaching effectiveness was interpreted by 50:50% perceptibility and acceptability thresholds. RESULTS As the treatment progressed, all techniques presented a significant increase in L* and WID (p<0.001), and a significant decrease in a* and b* (p<0.001). HP7.5 and HP35 presented greater increases in WID mean values, in comparison with SP (p=0.006). No significant differences were observed among the techniques for ΔE00 after treatment completion (p=0.383). There were no statistical differences in bleaching effectiveness among the techniques after treatment completion (p=0.098). CONCLUSION All techniques presented excellent effectiveness after treatment completion. However, HP7.5 and HP35 techniques provided a more rapid whitening response.
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Affiliation(s)
- B Gaidarji
- Bruna Gaidarji, Post-Graduate Program in Oral Science, Division of Restorative Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - B G Perez
- Bibiana Gabardo Perez, Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - L B Durand
- *Letícia Brandão Durand, Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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Solanki D, Fulzele P, Thosar N, Shirbhate U. Management of Turner's Hypoplasia Using Resin Infiltration: A Case Report. Cureus 2023; 15:e48870. [PMID: 38106735 PMCID: PMC10724612 DOI: 10.7759/cureus.48870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
The causes of enamel discoloration can vary, leading to aesthetic concerns for patients. Injuries to primary teeth can lead to developmental issues in permanent successors, with enamel hypoplasia, commonly referred to as Turner's tooth. Diverse methods are available for addressing tooth discoloration. A case of an 11-year-old pediatric patient with a brown patch on the upper left central incisor was reported to the Pediatric Dentistry Department. A well-demarcated, yellowish-brown lesion was present on the labial surface of 21 and was diagnosed as Turner's hypoplasia. Resin infiltration was done using the Icon Smooth Surface (DMG America Company, Englewood, NJ) resin infiltration kit. The resin infiltration technique provides an approach to meet aesthetic requirements. In this case, the resin infiltration technique was successfully utilized to address the discoloration of the left maxillary central incisor, which was affected by Turner's hypoplasia.
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Affiliation(s)
- Dhruvi Solanki
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Punit Fulzele
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nilima Thosar
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Unnati Shirbhate
- Department of Periodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Kahler B. Present status and future directions - Managing discoloured teeth. Int Endod J 2022; 55 Suppl 4:922-950. [PMID: 35188275 PMCID: PMC9790475 DOI: 10.1111/iej.13711] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 12/30/2022]
Abstract
Managing tooth discolouration involves a range of different protocols for clinicians and patients in order to achieve an aesthetic result. There is an increasing public awareness in the appearance of their teeth and management of tooth discolouration may be inter-disciplinary and involve both vital and nonvital teeth. Vital teeth can be easily treated with low concentration hydrogen peroxide products safely and effectively using an external approach and trays. For endodontically treated teeth, the walking bleach technique with hydrogen releasing peroxide products is popular. However, there is an association with external cervical root resorption with higher concentrations of hydrogen peroxide of 30%-35%. There are also regulatory considerations for the use of hydrogen peroxide in certain jurisdictions internationally. Prosthodontic treatments are more invasive and involve loss of tooth structure as well as a life cycle of further treatment in the future. This narrative review is based on searches on PubMed and the Cochrane library. Bleaching endodontically treated teeth can be considered a safe and effective protocol in the management of discoloured teeth. However, the association between bleaching and resorption remains unclear although there is likely to be a relation to prior trauma. It is prudent to avoid thermocatalytic approaches and to use a base/sealer to cover the root filling. An awareness expectations of patients and multidisciplinary treatment considerations is important in achieving the aesthetic result for the patient. It is likely that there will be an increasing demand for aesthetic whitening treatments. Bleaching of teeth has also become increasingly regulated although there are international differences in the use and concentration of bleaching agents.
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Affiliation(s)
- Bill Kahler
- School of DentistryThe University of QueenslandBrisbaneQueenslandAustralia
- The University of Queensland Oral Health CentreHerstonQueenslandAustralia
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Lin XJ, Hong DW, Lu ZC, Yu H. Effect of quercetin pretreatment on the immediate and aged bond strength of bleached dentin. J Mech Behav Biomed Mater 2022; 135:105476. [PMID: 36179613 DOI: 10.1016/j.jmbbm.2022.105476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/16/2022] [Accepted: 09/18/2022] [Indexed: 11/29/2022]
Abstract
This in vitro study aimed to investigate the effect of quercetin pretreatment on the bond strength of bleached dentin. Human dentin blocks (2 × 2 × 1 mm) were prepared and randomly divided into 5 groups (n = 16): deionized water pretreatment + no bleaching treatment (DNB); deionized water pretreatment + bleaching treatment (DYB); 75 μg/mL quercetin pretreatment + bleaching (Q75B); 150 μg/mL quercetin pretreatment + bleaching (Q150B); and 300 μg/mL quercetin pretreatment + bleaching (Q300B). The surfaces of superficial dentin (bonding surfaces) were treated with the respective solutions for 2 min, and then the surfaces opposite to the bonding surfaces (near pulp, bleaching surfaces) were subjected to bleaching treatment with 40% hydrogen peroxide (Ultradent, USA) for two 15-min sessions (groups DYB, Q75B, Q150B, and Q300B). After the bleaching procedure, the bonding surfaces were bonded with resin cements (Panavia V5, Kuraray, Japan). The bonded specimens were then divided into 2 subgroups (n = 8): the aging group (subgroup T), which was subjected to 10,000 thermocycles, and the nonaging group (subgroup N), which was not subjected to thermocycling. The microshear bond strength (μSBS) was obtained using a universal testing machine (AGS-X, Shimadzu, Tokyo, Japan). Additional dentin blocks (5 × 5 × 1 mm) were prepared and treated the same as the groups DYB, Q75B, Q150B, and Q300B (n = 8) to evaluate the color change, defined as groups CCDYB, CCQ75B, CCQ150B, and CCQ300B, respectively. Color evaluation was performed using a spectrophotometer (Vita Easyshade Advance 4.0, Vident, USA) to obtain a baseline and again at the end of the bleaching treatment. The data were analyzed via two-way analysis of variance (ANOVA) and Tukey's post-hoc test (α = 0.05). For the immediate bond strength, the specimens in the groups Q75B, Q150B, and Q300B showed significantly higher μSBS values than those in the group DYB (all P < 0.05). No significant differences in the μSBS values were found among the groups Q75B, Q150B, Q300B, and DNB, respectively (all P > 0.05). For the aged bond strength, both the groups Q150B and Q300B exhibited significantly higher μSBS values than groups DYB and DNB (all P < 0.05), whereas no significance differences were found between groups Q150B and Q300B (P = 1.00) or between the groups DYB and DNB (P = 1.00). No significant differences were observed in the △E values among all the groups tested (P = 0.80). Therefore, the application of quercetin for 2 min prior to the bleaching procedure preserved the immediate bond strength and improved the aged bond strength of bleached dentin while maintaining the effectiveness of bleaching.
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Affiliation(s)
- Xiu-Jiao Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China; Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, China
| | - Deng-Wei Hong
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China; Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, China
| | - Zhi-Cen Lu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China; Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, China
| | - Hao Yu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China; Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, China; Clinic of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Switzerland; Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Japan.
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Tsujimoto A, Jurado CA, Villalobos-Tinoco J, Fischer NG, Alresayes S, Sanchez-Hernandez RA, Watanabe H, Garcia-Godoy F. Minimally Invasive Multidisciplinary Restorative Approach to the Esthetic Zone Including a Single Discolored Tooth. Oper Dent 2021; 46:477-483. [PMID: 34624106 DOI: 10.2341/20-211-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The case report describes a minimally invasive, multidisciplinary approach to a single discolored anterior tooth, with internal bleaching using traditional Japanese paper (Washi), a gingivoplasty with a three-dimensional (3D) printed surgical guide, and ultrathin feldspathic porcelain veneers. Clinical consideration: The patient's primary concern was improving her smile. After clinical evaluation, internal tooth bleaching for the discolored tooth and gingivoplasty with restoration of the maxillary anterior six teeth and first premolars was recommended. The internal tooth whitening was accomplished with sodium perborate mixed with 30% hydrogen peroxide impregnated in Washi and sealed in the root canal with glass ionomer. Once the tooth bleaching was completed, the 3D printed surgical guide was placed in the patient's maxillary anterior region and used to guide soft tissue recontouring. After 6 months, ultrathin feldspathic porcelain veneers were placed. CONCLUSION Well-planned restorative procedures combining internal tooth bleaching using Washi, gingivoplasty performed with electrosurgery using a 3D printed surgical guide, and ultrathin feldspathic porcelain veneers can achieve the desired results in the esthetic zone and remain successful for 4 years.
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Affiliation(s)
- A Tsujimoto
- *Akimasa Tsujimoto, BDS, DDD, Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - C A Jurado
- Carlos Alberto Jurado, DDS, MS, Texas Tech University Health Science Center El Paso, Woody L. Hunt School of Dental Medicine, El Paso, TX, USA
| | - J Villalobos-Tinoco
- Jose Villalobos-Tinoco, DDS, Department of Oral Rehabilitation, Autonomous University of Queretaro School of Dentistry, Queretaro, Mexico
| | - N G Fischer
- Nicholas G Fischer, PhD, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, MN, USA
| | - S Alresayes
- Saad Alresayes, DDS, MS, Department of Restorative Dentistry, King Saud University, Riyadh, Saudi Arabi
| | - R A Sanchez-Hernandez
- Ramon Alfredo Sanchez-Hernandez, dental technician, private practice, San Felipe, Baja California, Mexico
| | - H Watanabe
- Hidehiko Watanabe, DDS, MS, Department of Restorative Dentistry, Oregon Health and Science University School of Dentistry, Portland, OR, USA
| | - F Garcia-Godoy
- Franklin Garcia-Godoy, DDS, MS, PhD, Department of Bioscience Research, College of Dentistry, University of Tennessee, Health Science Center, Memphis, TN, USA
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Dalmolin A, Perez BG, Gaidarji B, Ruiz-López J, Lehr RM, Pérez MM, Durand LB. Masking ability of bleach-shade resin composites using the multilayering technique. J ESTHET RESTOR DENT 2021; 33:807-814. [PMID: 34060697 DOI: 10.1111/jerd.12740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/08/2021] [Accepted: 04/22/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Evaluate the masking ability of bleach-shade resin composites applied by multilayering techniques over colored substrates. MATERIALS AND METHODS Disc-shaped specimens were fabricated from bleach-shade resin composites using different multilayering techniques. Substrates were produced in opaque ceramic discs simulating colored substrates (A2, A3, A3.5, C2, C3, C4) and a bleached tooth (0M1). Color coordinates were obtained using a reflectance spectrophotometer. Color difference was calculated by CIEDE2000 using coordinates of 0 M1 ceramic as standard reference. Data were analyzed by one-way ANOVA and Tukey's post-hoc test (p ≤ 0.05). Masking ability interpretation was based on perceptibility and acceptability thresholds. RESULTS All combinations presented ΔE00 above the acceptable threshold (ΔE00 >1.8), ranging from 2.49 to 7.42, regardless of the restorative system, multilayering strategy or substrate color. Multilayering combinations placed over A2, A3 and A3.5 were moderately (1.8<ΔE00 ≤3.6) and clearly unacceptable (3.6<ΔE00 ≤5.4), combinations associated with C2, C3 and C4 were clearly unacceptable and, extremely unacceptable (ΔE00 >5.4). Lower ΔE00 was observed for combinations with 0.5 mm extra white enamel layer (2.49), or 1.0 mm white dentin layer (2.69), over A2 and A3.5 substrates. Lightness difference showed the greatest contribution to ΔE00 . CONCLUSIONS Bleach-shade resin composite systems applied by the multilayering technique were not able to ensure effective masking ability. CLINICAL SIGNIFICANCE Bleach-shade resin composites applied with different combinations of the multilayering technique were not effective in masking colored substrates. Alternative strategies, techniques and dental materials should be explored to obtain acceptable masking.
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Affiliation(s)
- Andressa Dalmolin
- Graduate Program in Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Bibiana Gabardo Perez
- Graduate Program in Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Bruna Gaidarji
- Graduate Program in Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Javier Ruiz-López
- Department of Optics, Faculty of Science, University of Granada, Granada, Spain
| | - Roberta Maronesi Lehr
- Graduate Program in Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - María M Pérez
- Department of Optics, Faculty of Science, University of Granada, Granada, Spain
| | - Letícia Brandão Durand
- Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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Jandu J, Dzyuba N, Barry S. White enamel lesions in children: considering caries, chronological and congenital causes and their consequent care. Br Dent J 2021; 230:523-527. [PMID: 33893425 DOI: 10.1038/s41415-021-2838-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/31/2020] [Indexed: 11/09/2022]
Abstract
White enamel lesions are a common presentation to the general dentist and aesthetic concerns are the most frequent presenting problem. Aetiology may be multifactorial and management of such lesions is heavily dependent on the cause. In the paediatric patient, differentiating white lesions caused by caries, fluorosis and genetic and developmental disorders is key to offering optimal long-term treatment outcomes. Early intervention allows for carefully planned management of less common disorders. Many of these disorders exist along a spectrum, and white lesions offer a useful clue to prompt intervention and referral to the relevant specialists. This article overviews common white lesions of the teeth and outlines the hierarchy of management options available.
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Affiliation(s)
- Jai Jandu
- Division of Dentistry, University of Manchester, UK
| | | | - Siobhan Barry
- Division of Dentistry, University of Manchester, UK; University Dental Hospital Manchester, Manchester, UK.
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Yilmaz NA, Dönmez Özkan H. Photon-Induced Photoacoustic Streaming Activation of the Postbleaching Antioxidant Application Rapidly Improves Bonding to Pulp Chamber Dentin. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:289-296. [PMID: 33577388 DOI: 10.1089/photob.2020.4949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: This study explored whether the erbium/yttrium/aluminum/garnet (Er:YAG) laser irradiated through the photon-induced photoacoustic streaming (PIPS) method would impact on the resin bonding to pulp chamber dentin when used to activate bleaching and/or postbleaching antioxidant treatment. Materials and methods: One hundred five dentin samples prepared from freshly extracted human incisors were randomly assigned to seven groups (n = 15): control (no bleaching/antioxidant); CB (conventional bleaching only); MB (modified bleaching only); CB-NI (conventional bleaching+antioxidant with needle irrigation); MB-NI (modified bleaching+antioxidant with needle irrigation); CB-PIPSI (conventional bleaching+antioxidant with PIPS-activated irrigation); and MB-PIPSI (modified bleaching+antioxidant with PIPS-activated irrigation). Bleaching (40% hydrogen peroxide) lasted for 20 min. Modified bleaching groups were irradiated with Er:YAG laser using the PIPS tip (2940 nm, 0.90 W, 30 Hz, 30 mJ/pulse, 50-μsec pulse duration) during the first 60 sec of the procedure. The antioxidant treatment with 10% sodium ascorbate lasted for 60 sec. PIPS-activated antioxidant groups were irradiated with Er:YAG laser using the PIPS tip (2940 nm, 0.30 W, 15 Hz, 20 mJ per pulse, 50-μsec pulse duration) throughout the procedure. After completing the composite restorations, all samples were subjected to 5000 thermocycling and the shear bond strength (SBS) test at a crosshead speed of 1 mm/min. SBS data were analyzed using the Kruskal-Wallis test with Bonferroni correction (α& 0.05). Results: No significant difference was detected among the control, CB-PIPSI, and MB-PIPSI (p > 0.05), which presented a significantly higher SBS compared with the other groups (p < 0.05). Conclusions: Irrespective of the application mode of the initial bleaching, PIPS-activated irrigation of the antioxidant improved SBS to bleached dentin to the level of the control in 1 min. Postbleaching antioxidant treatment combined with the PIPS method might be a promising approach to enable immediate resin restoration of bleached dentin.
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Affiliation(s)
- Nasibe Aycan Yilmaz
- Department of Restorative Dentistry and Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey
| | - Hicran Dönmez Özkan
- Department of Endodontics, Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey
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Llaquet Pujol M, Vidal C, Mercadé M, Muñoz M, Ortolani-Seltenerich S. Guided Endodontics for Managing Severely Calcified Canals. J Endod 2020; 47:315-321. [PMID: 33278454 DOI: 10.1016/j.joen.2020.11.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022]
Abstract
Endodontic treatment of teeth with pulp canal obliteration presents a challenge given the high likelihood of procedural errors and complications during treatment. These drawbacks can be avoided by using a personalized 3-dimensional (3D) guide designed by overlaying a cone-beam computed tomographic scan with an intraoral scan of the patient. This 3D guide enables the clinician to obtain a straight access to the obliterated root canal.This article described guided endodontics in managing 7 severely obliterated teeth using both virtually designed 3D guides and a customized 1-mm-diameter cylindrical bur. This treatment approach was demonstrated to be safe and fast and can be considered as a predictable technique for the location of calcified canals, thus minimizing complications.
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Affiliation(s)
- Marc Llaquet Pujol
- Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain.
| | | | - Montse Mercadé
- Department of Dentistry, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge Institute, Barcelona, Spain
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