The purpose of this study was to evaluate bleaching methods containing hydrogen peroxide (HP) or carbamide peroxide (CP), dispensed in customized or prefilled trays, in terms of color change, tooth sensitivity, gingival irritation, acceptance, and comfort. Seventy-five volunteers were randomly selected and distributed according to the whitening agent (n=25): 10% HP dispensed in prefilled trays (Opalescence Go 10%) and 9.5% HP (Pola Day) and 10% CP both delivered in customized trays (Opalescence PF 10%). HP was applied for 30 min/d for 14 days (d), and CP for 8 h/d for 14 days. Evaluations were performed at baseline and at 7 days and 14 days of treatment. Color change was measured with Commission internationale de l'éclairage color coordinates (L*, a*, b*), Vita Classical, and 3D Master scales. A visual analog scale was used to assess tooth sensitivity, acceptance of the method and degree of comfort of the tray. Gingival irritation was evaluated as present or absent and localized or generalized. Regarding gingival irritation, tray acceptance, and tooth sensitivity, no differences were observed among the groups at any time (p>0.05). As for degree of comfort, 10% HP showed lower scores (comfortable) than 10% CP, with significant differences (p<0.05) from the other groups (comfortable to very comfortable). In terms of ΔL, Δa, and ΔE, no difference was observed among the groups or between the time periods (p>0.05). The Δb average was higher at 14 days (p<0.05), and there was no difference among the groups (p>0.05). Localized gingival irritation was observed in both tray methods. Mild tooth sensitivity was observed with time, regardless of the bleaching agent concentration or the application time. Color change was similar for all the groups at 7 days and 14 days, but there was a greater reduction in the yellow hue at 14 days. All the bleaching methods were highly accepted and effective in promoting whitening. Although prefilled trays are generally comfortable, they proved less comfortable than customized trays.

Lubrication plays a role in friction forces between self-ligating brackets and CuNiTi wires, with mucin- and CMC-based artificial saliva providing a reliable alternative to human natural saliva.

The purpose of this study was to evaluate the calcium (Ca) and phosphorous (P) content in enamel bleached with high and low concentrations of hydrogen peroxide (HP) using Total Reflection X-Ray Fluorescence (TXRF) and colorimetric spectrophotometry (SPEC). Forty-eight sound human third molars were used. Their roots were embedded in polystyrene resin and immersed for seven days in an artificial saliva solution. Then they were distributed into six groups to receive the bleaching treatments. The agents of high HP concentration (for in-office use) evaluated were Whiteness HP Maxx/FGM (35% HP), Whiteness HP Blue/FGM (35% HP, 2% calcium gluconate), Pola Office+/SDI (37.5% HP, 5% potassium nitrate), and Opalescence Boost/Ultradent (38% HP, 1.1% ion fluoride, 3% potassium nitrate); these agents were applied to enamel in three sessions. The agents of low HP concentration (for home use) evaluated were Pola Day/SDI (9.5% HP) and White Class 10%/FGM (10% HP, potassium nitrate, calcium, fluoride), and these agents were applied for 14 days. Enamel microbiopsies were evaluated by TXRF and SPEC analysis before the bleaching treatment (baseline), during the treatment, and 14 days after the end of the treatment. For TXRF, the Kruskal-Wallis test showed that Ca and P were not influenced by agent (p>0.05). For SPEC, Pola Office+, Opalescence Boost, Pola Day, and White Class 10% caused a decrease of Ca over time; there was a significant decrease of P over time to Pola Office+ and White Class 10%. The Spearman test showed no correlation between the Ca (p=0.987; r=-0.020) and P (p=0.728, r=0.038) obtained by SPEC and TXRF. For TXRF and SPEC, changes in Ca and P during bleaching occurred independently of the HP concentration used.

The aim of this in vitro study was to evaluate the effect of bleaching protocols on the surface roughness (Ra), color change and surface micromorphology of a low-viscosity bulk-fill composite (Filtek Bulk Fill Flow, 3M ESPE), a highviscosity bulk-fill composite (Filtek Bulk Fill, 3M ESPE) and a conventional nanoparticulate composite resin (control) (Filtek Z350 XT, 3M ESPE). Forty samples of each composite (disks 5 mm in diameter and 2 mm thick) were randomly divided into four groups (n=10), according to bleaching protocol: a) 10% carbamide peroxide gel (Opalescence, Ultradent Products) (2 h/ day, for 14 days); b) 40% hydrogen peroxide gel (Opalescence Boost, Ultradent Products) (three bleaching sessions, once a week, 45 min/session); c) whitening rinse (Listerine Whitening Extreme, Johnson & Johnson) (2 min/day, for 14 days); and d) distilled water (control). The samples were submitted to triplicate readings (Ra and color [CIELAB parameters]) before and after contact with bleaching protocols. Micromorphology was analyzed in a scanning electron microscope (SEM). Ra and color parameters (ΔL, Δa, Δb and ΔE) were analyzed by generalized linear models (α=0.05). The Ra of the high-viscosity bulk-fill was significantly higher than that of the other composites (p<0.05). Ra increased significantly (p<0.05) and surface became more irregular (SEM analysis) in all the composite resins, regardless of the bleaching protocol (p<0.05). The high-viscosity bulk-fill composite resin group had significantly lower ΔE (p<0.05) than the nanoparticulate composite resin group immersed in distilled water. It was concluded that the characteristics of each resin significantly influenced the Ra more than the bleaching protocol. The high-viscosity bulk-fill resin presented minor color change.

The aim of this study was to compare low- and high-viscosity bulk-fill composites for Knoop microhardness (KHN), microtensile bond strength (MTBS) to dentin in occlusal cavities, and fracture strength (FS) in molars with mesialocclusal-distal restoration. Disk-shaped samples with different thicknesses (2 or 4 mm) of low-viscosity (SDR Flow, Dentsply) and high-viscosity bulk-fill composites (Filtek BulkFill, 3M ESPE; and Tetric-N Ceram Bulk Fill, Ivoclar Vivadent) were prepared for top and bottom KHN analysis (n=10). MTBS to dentin and fracture pattern was evaluated in human molars with occlusal cavities restored with (n=10): conventional nanocomposite (Z350XT, 3M ESPE), low-viscosity (Filtek Bulk-fill Flow, 3M ESPE) or high-viscosity bulk-fill composites (Filtek BulkFill). The FS and fracture pattern of human molar with mesial-occlusal-distal restorations submitted or not to thermomechanical cycling were investigated (n=10) using: intact tooth (control), and restoration based on conventional microhybrid composite (Z250, 3M ESPE), low-viscosity (SDR Flow) or high-viscosity bulk-fill composites (Filtek BulkFill). The data were submitted to split-plot ANOVA (KHN), one-way ANOVA (MTBS), two-way ANOVA (FS) followed by Tukey’s test (α=0.05). For KHN, there was no significant difference for the resin composites between the top and bottom. For MTBS, no significant differences among the materials were detected; however, the low-viscosity composite presented lower frequency of adhesive failures. For FS, there was no significant difference between composites and intact tooth regardless of thermomechanical cycling. Low- and high-viscosity bulk-fill composites have comparable microhardness and microtensile bond strength when used in occlusal restorations. Likewise, the bulk-fill composites present similar fracture strength in molars with mesio-occlusal-distal restorations.