Polymeric biomaterials maintained the esthetic efficacy and reduced the cytotoxicity of in-office dental bleaching

Influence of coating dental enamel with a TiF4-loaded polymeric primer on the adverse effects caused by a bleaching gel with 35% H2O2

OBJECTIVE

To evaluate whether coating enamel with a polymeric primer (PPol) containing titanium tetrafluoride (TiF4) before applying a bleaching gel with 35% H2O2 (35% BG) increases esthetic efficacy, prevents changes in morphology and hardness of enamel, as well as reduces the cytotoxicity from conventional in-office bleaching.

MATERIALS AND METHODS

Standardized enamel/dentin discs were stained and bleached for 45 min (one session) with 35% BG. Groups 2TiF4, 6TiF4, and 10TiF4 received the gel on the enamel previously coated with PPol containing 2 mg/mL, 6 mg/mL, or 10 mg/mL, respectively. No treatment or application of 35% BG directly on enamel were used as negative control (NC), and positive control (PC), respectively. UV-reflectance spectrophotometry (CIE L*a*b* system, ΔE00, and ΔWI, n = 8) determined the bleaching efficacy of treatments. Enamel microhardness (Knoop, n = 8), morphology, and composition (SEM/EDS, n = 4) were also evaluated. Enamel/dentin discs adapted to artificial pulp chambers (n = 8) were used for trans-amelodentinal cytotoxicity tests. Following the treatments, the extracts (culture medium + bleaching gel components diffused through the discs) were collected and applied to odontoblast-like MDPC-23 cells, which were assessed concerning their viability (alamarBlue, n = 8; Live/Dead, n = 4), oxidative stress (n = 8), and morphology (SEM). The amount of H2O2 in the extracts was also determined (leuco crystal violet/peroxidase, n = 8). The numerical data underwent one-criterion variance analysis (one-way ANOVA), followed by Tukey's test, at a 5% significance level.

RESULTS

Regarding the ΔE00, no difference was observed among groups 2TiF4, 6TiF4, and PC (p > 0.05). The ΔWI was similar between groups 2TiF4 and PC (p > 0.05). The ΔWI of group 6TiF4 was superior to PC (p < 0.05), and group 10TiF4 achieved the highest ΔE00 and ΔWI values (p < 0.05). Besides limiting enamel microstructural changes compared to PC, group 10TiF4 significantly increased the hardness of this mineralized dental tissue. The highest cellular viability occurred in 10TiF4 compared to the other bleached groups (p < 0.05). Trans-amelodentinal H2O2 diffusion decreased in groups 2TiF4, 6TiF4, and 10TiF4 in comparison with PC (p < 0.05).

CONCLUSION

Coating enamel with a PPol containing TiF4 before applying a 35% BG may increase enamel microhardness and esthetic efficacy and reduce the trans-amelodentinal cytotoxicity of conventional in-office tooth bleaching. The PPol containing 10 mg/mL of TiF4 promoted the best outcomes.

Catalysis-based approaches with biopolymers and violet LED to improve in-office dental bleaching

This in vitro experimental investigation aimed to evaluate the impact of the combined application of a nanofiber scaffold (NS), a polymeric catalyst primer (PCP) containing 10 mg/mL of heme peroxidase enzyme, and violet LED (LEDv) on the esthetic efficacy (EE), trans-amelodentinal cytotoxicity (TC), and procedural duration of conventional in-office bleaching therapy. To achieve this, 96 standardized enamel/dentin discs were individually placed in artificial pulp chambers. A 35% hydrogen peroxide (H2O2) bleaching gel was administered for 45, 30, or 15 min to the enamel, either previously coated with NS + PCP or left uncoated, followed by irradiation with LEDv for 15 min or no irradiation. The established groups were as follows: G1, negative control (no treatment); G2, 35% H2O2/45 min; G3, NS + PCP + LEDv; G4, NS + PCP + 35%H2O2/45 min + LEDv; G5, NS + PCP + 35%H2O2/30 min + LEDv; and G6, NS + PCP + 35%H2O2/15 min + LEDv. Extracts (culture medium + gel components diffused through the discs) were collected and applied to odontoblast-like MDPC-23 cells. EE (ΔE00 and ΔWI) and TC were assessed using ANOVA/Tukey analysis (p < 0.05). The EE analysis revealed no statistical differences between G6 and G2 (p > 0.05). Cells in G6 exhibited higher viability and lower oxidative stress compared to other bleached groups (p < 0.05). In conclusion, employing NS + PCP + LEDv to catalyze a 35%H2O2 bleaching gel applied for 15 min to the enamel resulted in successful esthetic improvements and reduced the cytotoxicity commonly linked with traditional in-office bleaching procedures.

A new approach for professional dental bleaching using a polymeric catalyst primer

OBJECTIVE

Evaluate the influence of a polymeric catalyst primer (PCP) on esthetic efficacy (EE), degradation kinetics of hydrogen peroxide (H₂ O₂ ), and trans-amelodentinal cytotoxicity (TC) of bleaching gels.

MATERIALS AND METHODS

The following groups were established: G1: No treatment (NC, negative control); G2: PCP; G3: 10% H₂ O₂ ; G4: PCP + 10% H₂ O₂ ; G5: 20% H₂ O₂ ; G6: PCP + 20% H₂ O₂ ; G7: 35% H₂ O₂ (positive control); G8: PCP + 35% H₂ O₂ . To determine EE, enamel/dentin discs (E/DDs) were stained and subjected or not to bleaching protocols for 45 min. To assess TC, the E/DDs were adapted to artificial pulp chambers. The extracts (culture medium + gel components diffused through E/DDs) were applied to odontoblast-like MDPC-23 cells. The viability (VB), oxidative stress (OxS), morphology (SEM), amount of H₂ O₂ diffused and the production of hydroxyl radical (OH^• ) were assessed (two-way ANOVA/Tukey/paired Student t-test; p < 0.05).

RESULTS

The highest EE was found in G8 (p < 0.05), and G4, G6, and G7 did not differ statistically (p > 0.05). In G4, the limited H₂ O₂ diffusion reduced OxS and increased cell VB (p < 0.05).

CONCLUSIONS

Coating the enamel with PCP containing 10 mg/ml of manganese oxide before applying the 10% H₂ O₂ bleaching gel maintains the EE of conventional in-office bleaching and minimizes the toxic effects of this esthetic therapy.

CLINICAL SIGNIFICANCE

Coating the enamel with a PCP before applying the bleaching gel may potentiate the EE of the conventional in-office tooth bleaching and reduce the toxicity of this professional therapy to the dental pulp.

Improved esthetic efficacy and reduced cytotoxicity are achieved with a violet LED irradiation of manganese oxide-enriched bleaching gels

Gels with high concentrations of hydrogen peroxide (H2O2) have been associated with cytotoxicity and consequent post-bleaching tooth sensitivity. This study assessed the bleaching efficacy (BE) and cytotoxicity (CT) of bleaching gels with low concentrations of H2O2 containing manganese oxide (MnO2) and photocatalyzed with violet LED (LEDv). The following groups were established: G1: no treatment (negative control, NC); G2: 35% H2O2 (positive control, PC); G3: LEDv; G4: 10% H2O2; G5: 6% H2O2; G6: 10% H2O2 + MnO2 + LEDv; G7: 6% H2O2 + MnO2 + LEDv. To analyze BE, standardized enamel/dentin discs (E/DDs) were subjected to the bleaching procedures for 45 min (1 session). The color change was determined before and after performing the bleaching protocols (ΔE00; ΔWI). To analyze CT, the E/DDs were adapted to artificial pulp chambers, and the extracts (culture medium + diffused gel components) were applied to cultured odontoblast-like MDPC-23 cells. Then, the cells were assessed concerning their viability (VB), oxidative stress (OxS), and Live/Dead. The amount of H2O2 diffused was also determined (ANOVA/Tukey; p < 0.05). Cell viability decreased in all bleached groups compared to G1 (NC; p < 0.05). The cells in G6 and G7 presented higher viability than in G2, G4, and G5 (p < 0.05). The BE in G7 was similar to G2 (PC; p < 0.05). The lowest OxS and H2O2 diffusion values were found in G6 and G7, compared to the other bleached groups (G2, G4, and G5; p < 0.05). The 6% H2O2 bleaching gel (G7) submitted to both methods of catalysis (MnO2 + LEDv) caused only a mild cytotoxicity and maintained the excellent esthetic outcome promoted by in-office conventional tooth bleaching.

Manganese oxide increases bleaching efficacy and reduces the cytotoxicity of a 10% hydrogen peroxide bleaching gel

OBJECTIVE

The study aims to assess the effects of a 10% H₂O₂ bleaching gel with different MnO₂ concentrations on the bleaching efficacy (BE), degradation kinetics (DK) of H₂O₂, and trans-amelodentinal cytotoxicity (TC).

MATERIALS AND METHODS

Standardized bovine enamel/dentin disks (n = 96) were placed in artificial pulp chambers, and the bleaching gels were applied for 45 min. Thus, the following groups were established: (G1) no treatment (negative control/NC); (G2) 35% H₂O₂ (positive control/PC); (G3) 10% H₂O₂; (G4) 10% H₂O₂ + 2 mg/mL MnO₂; (G5) 10% H₂O₂ + 6 mg/mL MnO₂; and (G6) 10% H₂O₂ + 10 mg/mL MnO₂. After analyzing bleaching efficacy (ΔE₀₀ and ΔWI), the degradation kinetics of H₂O₂ and trans-amelodentinal cytotoxicity were determined (n = 8, ANOVA/Tukey; p < 0.05).

RESULTS

G6 presented BE (ΔE₀₀ and ΔWI) statistically similar to G2, which represented conventional in-office bleaching (p = 0.6795; p > 0.9999). A significant reduction in the diffusion of H₂O₂ occurred in G3, G4, G5, and G6 compared to G2 (p < 0.0001). The highest DK of H₂O₂ occurred in G6 (p < 0.0001), which had the lowest TC in comparison with all other bleached groups (p ≤ 0.0186).

CONCLUSION

The addition of 10 mg/mL of MnO₂ in a 10% H₂O₂ bleaching gel potentiates the degradation of this reactive molecule, which increases the BE of the product and decreases TC.

CLINICAL SIGNIFICANCE

Replacing a 35% H₂O₂ gel commonly used for conventional in-office dental bleaching by a 10% H₂O₂ gel containing 10 mg/mL of MnO₂ reduces the cytotoxicity of this professional therapy, maintaining its excellent esthetic efficacy.

The effect of two different prophylaxis paste applying processes on color stability in-office bleaching: 24-month clinical follow-up

OBJECTIVE

The purpose of this study was to examine the effect of applying two different prophylaxis pastes with various protocols on the degree of bleaching and color stability in the office bleaching process with a bleaching agent containing 40% hydrogen peroxide.

MATERIAL AND METHOD

The 300 teeth of 15 (9 female, 6 male) patients were included in our study, and 5 different study groups were randomly formed. The bleaching process with Ultradent Opalescence Boost (Ultradent, South Jordan, USA) was performed according to the manufacturer's instructions. Two different prophylaxis pastes, Ultrapro (Ultradent, Cologne, Germany) and Cleanic (Kerr, Rastatt, Germany), were applied with protocols determined according to the groups. The effect on color stability at 6-, 12-, and 24-month follow-up was determined using the CIE L* a* b* color system. The changes in the parameters were analyzed using the one-way ANOVA, chi-square, and Tukey test (p > 0.05).

RESULTS

The evaluation rate of the treatments was 100% at the end of 24 months. Control group 6-month ΔE (0-6) and 12-month ΔE (0-12) values were higher than 24-month ΔE (0-12) values. UU + UU, KC + KC, and UU group 6-month ΔE (0-6) values were higher than 12-month ΔE (0-12) values. In addition, 6-month ΔE (0-6) and 12-month ΔE (0-12) values were higher than 24-month ΔE (0-24) values. KC group 6-month ΔE (0-6) and 12-month ΔE (0-12) values were higher than 24-month ΔE (0-24) values. Control, UU + UU, KC + KC, UU, and KC group ΔE (1-6) values at 6 months were lower than 12-month ΔE (1-12) and 24-month ΔE (1-12) values in all groups. In addition, 12-month ΔE (1-12) values were lower than 24-month ΔE (1-24) values. According to the study data, there was no statistically significant difference between the groups according to the prophylaxis paste and prophylaxis procedure (p > 0.05). However, it was observed that whiteness decreased in all groups over time.

CONCLUSIONS

Discoloration was observed at 6 months, 12 months, and 24 months after bleaching. However, at the end of 24 months, the tooth color was significantly whiter than the initial color.

CLINICAL RELEVANCE

Pre-bleaching prophylaxis application and pre-bleaching and post-bleaching prophylaxis application have no effect on color stability.

Innovative strategy for in-office tooth bleaching using violet LED and biopolymers as H2O2 catalysts

OBJECTIVE

To assess the influence of coating the enamel with a nanofiber scaffold (NS) and a polymeric catalyst primer (PCP) on the esthetic efficacy, degradation kinetics of hydrogen peroxide (H₂O₂), and trans-amelodentinal cytotoxicity of bleaching gels subjected or not to violet-LED irradiation.

METHODOLOGY

The following groups were established (n=8): G1- No treatment (negative control); G2- NS+PCP; G3- LED; G4- NS+PCP+LED; G5- 35% H₂O₂ (positive control); G6- NS+PCP+35% H₂O₂+LED; G7- 20% H₂O₂; G8- NS+PCP+20% H₂O₂+LED; G9- 10% H₂O₂; G10- NS+PCP+10% H₂O₂+LED. For esthetic efficacy analysis, enamel/dentin discs were stained and exposed for 45 minutes to the bleaching protocols. To assess the cytotoxicity, the stained enamel/dentin discs were adapted to artificial pulp chambers, and the extracts (culture medium + components diffused through the discs) were collected and applied to MDPC-23 cells, which had their viability, oxidative stress, and morphology (SEM) evaluated. The amount of H₂O₂ diffused and hydroxyl radical (OH^•) production were also determined (two-way ANOVA/Tukey/paired Student t-test; p<0.05).

RESULTS

G6 had the highest esthetic efficacy compared to the other groups (p<0.05). Besides the esthetic efficacy similar to conventional in-office bleaching (G5; p>0.05), G10 also showed the lowest toxic effect and oxidative stress to MDPC-23 cells compared to all bleached groups (p<0.05).

CONCLUSION

Coating the enamel with a nanofiber scaffold and a polymeric catalyst primer, followed by the application of 10%, 20%, or 35% H₂O₂ bleaching gels irradiated with a violet LED, stimulates H₂O₂ degradation, increasing esthetic efficacy and reducing the trans-amelodentinal toxicity of the treatment.

Strategy for reducing cytotoxicity and obtaining esthetic efficacy with 15 min of in-office dental bleaching

OBJECTIVES

Evaluate in vitro the esthetic efficacy and cytotoxicity of a bleaching gel containing 35% hydrogen peroxide (BG-35%H₂O₂), applied for different time intervals, on enamel coated or not with polymeric biomaterials.

MATERIALS AND METHODS

Nanofiber scaffolds (NSc) and a primer catalyst (PrCa) were used to coat the bovine enamel/dentin discs before the application of BG-35%H₂O₂, according to the following groups: G1-negative control (NC, without treatment); G2, G3, and G4-BG-35%H₂O₂ applied for 3 × 15, 2 × 15, and 15 min; G5, G6, and G7-BG-35%H₂O₂ applied on enamel coated with NSc and PrCa for 3 × 15; 2 × 15, and 15 min, respectively. The culture medium with components of gel diffused through the discs was applied on MDPC-23 cells, which were evaluated regarding to viability (VB), integrity of the membrane (IM), and oxidative stress (OxS). The quantity of H₂O₂ diffused and esthetic efficacy (ΔE/ΔWI) of the dental tissues were also analyzed (ANOVA/Tukey; p < 0.05).

RESULTS

Only G7 was similar to G1 regarding VB (p > 0.05). The lowest value of H₂O₂ diffusion occurred in G4 and G7, where the cells exhibited the lowest OxS than G2 (p < 0.05). Despite G5 showing the greatest ΔE regarding other groups (p < 0.05), the esthetic efficacy observed in G7 was similar to G2 (p > 0.05). ΔWI indicated a greater bleaching effect for groups G5, G6, and G7 (p < 0.05).

CONCLUSION

Coating the dental enamel with polymeric biomaterials reduced the time and the cytotoxicity of BG-35%H₂O₂.

CLINICAL SIGNIFICANCE

Coating the dental enamel with polymeric biomaterials allows safer and faster BG-35%H₂O₂ application.

Characterization and effectiveness of a violet LED light for in-office whitening

OBJECTIVES

This study characterized a violet LED light (V-LED; bright max whitening) tooth whitening device and evaluated its efficacy on stained enamel compared to hydrogen peroxide (HP).

MATERIALS AND METHODS

Characterization of the V-LED beam profile was performed using a laser beam-profiler. The irradiance was measured throughout an exposure cycle at 0- and 8-mm distances using an integrating sphere and a spectral radiometer. Bovine enamel/dentin blocks stained with black tea (BT), cigarette smoke (CS), or without staining (CONT) were subjected to V-LED or 40% HP (n = 10/group). Color parameters (ΔL, Δa, Δb, and ΔE₀₀) were measured using a digital spectrophotometer. Light transmission was estimated through 1-mm-thick bovine enamel slices (n = 5). ΔL, Δb, ΔE₀₀, and irradiance were analyzed by two-way ANOVAs and Tukey's tests, Δa by Kruskal-Wallis and Mann-Whitney tests, and light transmission by t-test (α = 5%).

RESULTS

Heterogeneous beam distribution was observed for the emitting V-LED chips. After 20 sequential exposures, irradiance levels were reduced 25-50%, regardless of the distance from V-LED. Localized irradiance values were statistically different between beam locations and different distances from the target. V-LED produced lower ΔE_00, ΔL, Δa, and Δb values than HP for CONT and BT, with no differences for CS. Light transmittance decreased approximately 98% through 1-mm thick enamel.

CONCLUSIONS

V-LED irradiance was heterogeneous and decreased throughout the exposure cycles and was also greatly reduced with increasing tip distance. V-LED produced a significantly lower whitening effect on BT and control teeth.

CLINICAL RELEVANCE

This study contributes to the knowledge of V-LED and its clinical use.