The aim of this study was to compare the effectiveness of and tooth sensitivity to 10% and 20% carbamide peroxide (CP) home-use bleaching agents and 35% and 38% hydrogen peroxide (HP) in-office bleaching agents, all of which contain desensitizing agents, in a clinical trial. Four agents were evaluated: 10% CP and 20% CP (Opalescence PF 10% and Opalescence PF 20%, Ultradent, both with 0.5% potassium nitrate and 0.11% fluoride ions), 38% HP (Opalescence Boost PF, Ultradent, with 3% potassium nitrate and 1.1% fluoride ions), and 35% HP (Pola Office, SDI, with potassium nitrate). The initial screening procedure included 100 volunteers, aged 18 to 42, with no previous sensitivity or bleaching treatment and with any tooth shade. Volunteers were randomly assigned among the technique/bleaching agent groups. A run-in period was performed 1 week before the beginning of the bleaching treatment. For the home-use bleaching technique, each volunteer was instructed to dispense gel (10% CP or 20% CP) into the trays and then insert them into his or her mouth for at least two hours per night for three weeks. For the in-office bleaching technique, the bleaching agents (38% HP or 35% HP) were prepared and used following the manufacturer's instructions, with three applications performed in each session. Three sessions were carried out with an interval of seven days between each session. The participants were evaluated before, at one week, two weeks, and three weeks after the beginning of the bleaching treatment, and again one and two weeks after the bleaching treatment ended. A shade guide (Vita Classical, Vita) was used by a blinded examiner to perform shade evaluations before bleaching and two weeks after the end of bleaching. At the time of the shade evaluations, tooth sensitivity was also recorded by asking the volunteers to classify the sensitivity during bleaching treatment as absent, mild, moderate, or severe. The present study found that 13.8% of the volunteers withdrew from the study due to tooth sensitivity, and 43.2% of the participants experienced some type of sensitivity during bleaching treatment. The χ(2) test showed that there was a significant prevalence of tooth sensitivity during bleaching treatment using the home-use 20% CP agent, with 71.4% of volunteers reporting any level of tooth sensitivity (p=0.0032). A low prevalence of tooth sensitivity was observed for volunteers who used the in-office 38% HP agent (15.0%). The Wilcoxon test (p<0.05) showed that all of the bleaching treatments were effective in bleaching teeth and that there were no differences between the final color shade results among the treatments (Kruskal-Wallis, p<0.05). This study showed that 43.2% of all the volunteers experienced mild or moderate tooth sensitivity during the treatment with bleaching agents. A higher prevalence of tooth sensitivity was observed for 71.4% of the volunteers who used the 20% CP home-use bleaching agent, which may be ascribed to the peroxide concentration and/or the time/length the agent was in contact with the denta...
This in vitro study assessed the shear bond strength of human enamel and dentin submitted to a bleaching treatment with 10% carbamide peroxide and treatment with antioxidant agents containing 10% α α-tocopherol and 10% sodium ascorbate formulated in solution and gel. Sixty human dental enamel slabs (E) and 60 human dental dentin slabs (D) were randomly divided into six groups (n=10). Groups E1 and D1 were negative control groups and the bleaching agent was not applied. The bleaching agent was applied daily for two-hours on the dental slabs of all the other groups and, during the remaining 22 hours, the specimens were stored in an artificial saliva solution for a total of 14 days. Groups E2 and D2 were positive control groups and they only received application of the bleaching agents. Antioxidant agents were applied in Groups E3 and D3 (10% sodium ascorbate solution), E4 and D4 (10% α α-tocopherol solution), E5 and D5 (10% sodium ascorbate gel) and E6 and D6 (10% α α-tocopherol gel) for two hours. RT Sasaki • FM Flório • RT Basting Clinical RelevanceA significant reduction in bond strength of restorative materials to dentin and enamel after home-use bleaching treatment has been reported. Antioxidizing agents may be a procedure to increase bond strength values. Although no reversal of bond strength values was found for sodium ascorbate, alpha-tocopherol formulated in solution resulted in a significant increase in bond strength of bleached enamel. 747Sasaki, Flório & Basting: Effects of 10% Sodium Ascorbate and 10% α-tocopherol on SBS After Bleaching Cylinders were made with microhybrid resin composite and a total-etch adhesive system for shear bond strength tests. These tests were performed in a universal testing machine at a speed of 0.5 mm/minute to obtain the values in MPa. ANOVA (p>0.05) showed no significant differences among groups E4, E5, E6 and E1. However, groups E3, E5 and E6 presented statistically similar values to group E2. The Kruskal-Wallis test showed no significant differences among D1 and all the other experimental groups; the same values occurred with D2, which did not differ from the experimental groups. Antioxidant treatment with 10% α α-tocopherol solution was the only effective agent to revert the oxidizing effects of the bleaching treatment on enamel.
Garlic and tea tree oil might be an alternative to chlorhexidine.
The aim of this study was to perform a follow-up evaluation of the Streptococcus mutans and Streptococcus sobrinus colonization profile of children's oral cavities, which included the pattern of vertical transmission from mother to child, genotypic diversity, and stability of the strains. The subjects were 16 mother-child pairs, who were monitored for 20 months. Samples of saliva, tongue dorsum, alveolar ridge mucosa, and dental plaque from the children were collected bimonthly. Saliva samples from the mothers were also collected. After isolation and identification, the arbitrarily primed PCR method was performed for the genotypic characterization of S. mutans (968 isolates) and S. sobrinus (111 isolates). At the time the strains were acquired, the children harbored one to four distinct genotypes of S. mutans and only one genotype of S. sobrinus. Although S. mutans prevalence and genotypic diversity were greater than those of S. sobrinus, the presence of matching genotypes of S. mutans and S. sobrinus was similar (in 81.25 and 83.33% of mother-child pairs, respectively), suggesting vertical transmission for both species. This longitudinal study showed an increase in genotypic diversity of S. mutans in the oral cavity during the follow-up period: most of the initially acquired genotypes persisted, normally those genotypes transmitted by the mother, and some were lost during follow-up; new strains were also acquired. In conclusion, S. mutans and S. sobrinus genotypes acquired from maternal or alternative sources may show effective persistence in the oral cavity and/or transitory detection in the children's mouths, reflecting the continuous development of oral microbiota in children.
Among the three types evaluated, the customized MG (type III) presented better results in the athletes' physical performance evaluation, even taking into account physical tests performed without the use of mouthguards.
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