Vital laser‐activated teeth bleaching and postoperative sensitivity: A systematic review

Color Stability of Microhybrid Composite Resins Depending on the Immersion Medium

OBJECTIVE

 The aim of this study was to assess the color stability of two microhybrid composite resins after immersion in different coloring solutions for 4 weeks.

MATERIALS AND METHODS

 Sixty disc-shaped samples (2 mm in thickness and 10 mm in diameter) were prepared according to ISO standard 4049. Two composite resins were used: Filtek Z350 XT (3M ESPE) and Harvard Restore (Harvard Dental International GmbH). After initial color measurements, five samples of each resin were immersed in artificial saliva, Turkish coffee, lemonade, black tea, Coca-Cola 0%, and green tea for 4 weeks. The spectrophotometric measurements were carried out after 24 hours of immersion in the various solutions and then weekly, using a VITA Easyshade Advance 4.0 spectrophotometer (CIE L*a*b* system). Statistical analysis was carried out with SPSS 25.0 software.

RESULTS

 The two composite resins tested revealed discoloration after immersion in all the drinks at a variable immersion period showing different color behaviors. The one-way analysis of variance showed a significant difference in the values of brightness (L), in chromaticity from green to red (a), in chromaticity from blue to yellow (b), and in the color (ΔE) of the two materials at different time intervals. The greatest color change in all the groups was caused by coffee followed by lemonade and black tea followed by green tea, Coca-Cola 0%, and artificial saliva.

CLINICAL SIGNIFICANCE

 The importance of color stability of dental restorations is crucial for dental professionals and patients. Indeed, the quality of a restoration is considered from both a functional and esthetic points of view. The information obtained from this study should prove useful for clinicians to make informed decisions in selecting the best materials for their patients' esthetic restorations.

CONCLUSION

 The Harvard Restore showed a better colorimetric behavior compared with the Filtek Z350. Coffee, black tea, and green tea had the most marked effects on the discoloration of composites, especially on Filtek Z350. Coca-Cola 0% showed a similar behavior to artificial saliva.

Clinical decision-making in tooth bleaching based on current evidence: A narrative review

OBJECTIVE

This review consolidates current knowledge on dentist-supervised tooth bleaching for vital teeth, drawing from systematic reviews, meta-analyses, and randomized clinical trials (RCTs) that followed CONSORT guidelines.

DATA RESOURCES

MeSH and free terms like "tooth bleaching," "tooth whitening," "randomized clinical trial," and "systematic review" were used in PubMed, Scopus, and Web of Science databases STUDY SELECTION: Out of 839 articles, 444 were selected for full-text review, excluding case reports, non-randomized trials, literature reviews and those not directly related to tooth bleaching or RCTs not following CONSORT 2010. The remaining 203 studies were used to compare the dentist-supervised at-home and in-office clinical protocols, assessing factors such as color change, tooth sensitivity, and gingival irritation. In vitro studies were cited to support and explain basic concepts of different clinical decisions CONCLUSIONS: Daily at-home bleaching with 10 % carbamide peroxide or lower-concentration hydrogen peroxide over three to four weeks is effective. In-office bleaching with high-concentration hydrogen peroxide exhibits variations in protocols based on the HP concentration and gel's pH. Emerging technologies like violet LEDs and photobiomodulation with infrared lasers show promise in enhancing efficacy and reducing sensitivity, respectively, though more research is needed. The review underscores the importance of ongoing research into desensitization strategies to manage sensitivity related to bleaching.

CLINICAL SIGNIFICANCE

Tooth bleaching is central to dental aesthetics, offering a range of options that can challenge clinicians. Adverse effects, particularly sensitivity, highlight the need for practice supported in protocols clinically tested and effective desensitization approaches.

Oxygen self-sufficient nanodroplet composed of fluorinated polymer for high-efficiently PDT eradicating oral biofilm

Oral biofilm is the leading cause of dental caries, which is difficult to completely eradicate because of the complicated biofilm structure. What's more, the hypoxia environment of biofilm and low water-solubility of conventional photosensitizers severely restrict the therapeutic effect of photodynamic therapy (PDT) for biofilm. Although conventional photosensitizers could be loaded in nanocarriers, it has reduced PDT effect because of aggregation-caused quenching (ACQ) phenomenon. In this study, we fabricated an oxygen self-sufficient nanodroplet (PFC/TPA@FNDs), which was composed of fluorinated-polymer (FP), perfluorocarbons (PFC) and an aggregation-induced emission (AIE) photosensitizer (Triphenylamine, TPA), to eradicate oral bacterial biofilm and whiten tooth. Fluorinated-polymer was synthesized by polymerizing (Dimethylamino)ethyl methacrylate, fluorinated monomer and 1-nonanol monomer. The nanodroplets could be protonated and behave strong positive charge under bacterial biofilm acid environment promoting nanodroplets deeply penetrating biofilm. More importantly, the nanodroplets had extremely high PFC and oxygen loading efficacy because of the hydrophobic affinity between fluorinated-polymer and PFC to relieve the hypoxia environment and enhance PDT effect. Additionally, compared with conventional ACQ photosensitizers loaded system, PFC/TPA@FNDs could behave superior PDT effect to ablate oral bacterial biofilm under light irradiation due to the unique AIE effect. In vivo caries animal model proved the nanodroplets could reduce dental caries area without damaging tooth structure. Ex vivo tooth whitening assay also confirmed the nanodroplets had similar tooth whitening ability compared with commercial tooth whitener H2O2, while did not disrupt the surface microstructure of tooth. This oxygen self-sufficient nanodroplet provides an alternative visual angle for oral biofilm eradication in biomedicine.

Evaluation of the laser wavelength role on tooth bleaching in terms of color change, roughness, and microhardness with pulpal rapid temperature monitoring: an in vitro study

This in-vitro study evaluates the efficacy of the teeth bleaching approach using different laser wavelengths (405 nm blue diode, 940 nm infrared diode, and Er,Cr:YSGG 2780 nm lasers) in comparison to the conventional method using light-emitting diode (LED) sources (420-480) nm. Eighty caries-free sound human premolars were randomly divided into four groups (N=20). Each group received a different bleaching procedure. Then each group was further subdivided into two subgroups (N=10) stained with different solutions. The pulp chamber temperature rise was recorded using an optical fiber sensor with a novel design and fabrication. The color was analyzed using a digital spectrophotometer. Five samples of each subgroup were tested for surface roughness, while the others were tested for Vickers microhardness. The bleaching process with a short wavelength 405 nm blue diode laser showed the best results for the shade, with a minimum pulpal temperature increase indicating no possible necrosis and hence maintaining tooth vitality. Additionally, a remarkable reduction in bleaching time was achieved compared to the conventional approach. This process also yielded the highest color change (Δ E) and increased microhardness, with no noticeable change to the tooth roughness. The 405 nm blue diode laser applied for bleaching showed the best bleaching activity against tested stains and negligible pulpal temperature rise with a noticeable reduction in the bleaching time. The proposed novel method to measure temperature change could be used to develop a promising smart sensor for quick, effective, repeatable, and in-situ monitoring of human body temperature.

Influence of light and laser activation of tooth bleaching systems on enamel microhardness and surface roughness

Objective

The objective of this study was to compare the effects of light and laser activation of in-office tooth bleaching systems on enamel microhardness and surface roughness.

Materials and Methods

Twenty-five enamel slabs were divided into three treatment groups: light-activated bleaching, laser-activated bleaching, and control. The baseline data were recorded for enamel microhardness (Vickers microhardness [VMH]) and surface roughness (Roughness average, Ra). The specimens were cured for 10 min upon hydrogen peroxide application for the light-activated bleaching group and activated with a laser source, 8 cycles, 10 s per cycle for the laser-activated group. The changes in VMH and Ra at days 1, 7, and 28 were evaluated. Kruskal-Wallis, Friedman, Wilcoxon, and Mann-Whitney tests were used to analyze both VMH and Ra between the treatment groups at different time intervals.

Results

There were a significant reduction in VMH values and significant differences between days 1, 7, and 28 against the baseline in the light-activated bleaching group (P = 0.001). The Ra values revealed significant differences in both light- (P = 0.001) and laser-activated (P = 0.033) groups.

Conclusion

Light activation of a bleaching agent caused a reduction in enamel microhardness and an increase in surface roughness when compared to laser activation.