To the moment, there is no sound evidence in dental literature to suggest that the ADA-recommended whitening technique based on 10 % carbamide peroxide gel could be substituted by the whitening strips. The existing studies, with their limitations, revealed similar tooth whitening and tooth and gingival sensitivity for both whitening techniques.

SUMMARY Whitening dentifrices (WDs) are widespread and accessible worldwide, claiming to whiten teeth. Therefore, this systematic review aimed to assess the extrinsic stain removal (ESR), the whitening potential, and the adverse effects of WDs. Randomized controlled trials comparing WDs with regular dentifrices (RDs) and other home-based whitening products were searched at NCBI-PubMed, Cochrane-CENTRAL, EBSCO-Host, and clinicaltrials.gov. The studies were screened and had data extracted by two independent researchers. Eligible studies presented outcomes of ESR, color change, and adverse effects, with no restriction of publication date. Data were meta-analyzed using RevMan 5.3, and the level of evidence was rated according to GRADE criteria. Eleven studies (n=1962) assessed reduction of stain area and intensity through Lobene Stain index, with a mean difference (MD) of −0.33 ([−0.41;−0.25]; p=0.00001) and −0.34 ([−0.44;−0.25]; p=0.00001), respectively. When the modified Lobene Stain index was used (six studies; n=2576), MD was −0.42 ([−0.58;−0.25]; p=0.00001) and −0.30 ([−0.39;−0.21]; p=0.00001), respectively. Mean color change through shade guide tabs (three studies; n=1322) was −1.80 ([−2.33;−1.26]; p=0.00001). All differences were in favor of the WDs, which also produced a risk of adverse effects (RR=1.74; [1.20, 2.52]; p=0.003; four studies; n=1322). The comparison of WDs with paint-on gel (two studies; n=58) yielded similar efficacy and adverse effects (p>0.05), whereas the comparison of WDs with white strips (two studies; n=87) yielded higher efficacy of the latter (p=0.00001) and similar adverse effects (p=0.52). The quality of evidence varied from low to moderate. WDs are more effective in reducing extrinsic stain and producing a whitening-like effect in teeth than RDs, although they also produce more adverse effects. Whitening efficacy of WDs is similar to paint-on gel and lower than white strips. Higher-quality evidence demands larger, well-conducted, independent studies.

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Denture use may aggravate the occurrence of oral infections, considering it enhances microbial adherence. Aim: This study assessed the reduction of microbial loads of Candida albicans, Staphylococcus aureus, and Klebsiella oxytoca by disinfecting the polymethylmethacrylate (PMMA) of complete dentures with hydroalcoholic extract of Salvia officinalis. Additionally, the effect of such extract on the properties of PMMA was examined. Methods: Microorganisms were isolated from saliva samples collected from complete denture wearers. The hydroalcoholic extract of S. officinalis was produced according to the Brazilian Pharmacopoeia 5. The PMMA specimens (n=188) were immersed in microbial inoculum and incubated at 37°C for 16 hours per day. Then, they were subjected to a disinfection protocol for 30 days. The specimens were divided into five treatment groups: sterile saline solution (0.85%; control), 0.2% chlorhexidine digluconate, and hydroalcoholic extract of S. officinalis (0.2%, 0.8%, and 1.16%). Microorganism adherence to the PMMA surface was also assessed, as well as surface roughness (Ra in µm) and color stability of the PMMA (mean ΔE). Changes in microbial load and surface roughness after the disinfection protocol were verified with paired t-test. Substances at day 10, adherence, and color stability were compared by the Kruskall-Wallis and Mann-Whitney tests, and one-way ANOVA was used to compare substances at the beginning and end of the experiment (α=0.05). Results: The 1.16% S. officinalis extract significantly reduced the microbial load of all the microorganisms after 30 days of disinfection (p<0.05). The microbial load of K. oxytoca was also reduced at lower concentrations of the S. officinalis extract (0.2% and 0.8%) (p<0.02). Antimicrobial and anti-adherent effects against microorganisms isolated from the oral cavity were observed. There was no significant change in surface roughness (p>0.05) and color stability was significantly higher in the control group (p<0.0001). Conclusions: The hydroalcoholic extract of S. officinalis may be used as a disinfectant solution for dentures.

To the moment, there is no ideal substance for home-based denture disinfection. This study assessed in vitro the antimicrobial effect of the hydroalcoholic extract of Eugenia uniflora and the effect on the physical properties of denture polymethylmethacrylate (PMMA). Candida albicans, Staphylococcus aureus, and Klebsiella oxytoca were isolated from samples of saliva collected from denture wearers. The extracts were produced in three concentrations, according to the Brazilian Pharmacopeia. One hundred eighty-eight disc-shaped specimens of thermopolymerizable PMMA were prepared and randomly allocated to five treatment groups: sterile saline solution (0.85%; control); chlorhexidine digluconate (0.2%); and hydroalcoholic extract of E. uniflora (0.2%, 0.8%, and 1.16%). The specimens were disinfected for 8 HIGHLIGHTS  The hydroalcoholic extract of Eugenia uniflora presents antimicrobial potential  Microbial adherence is affected by the hydroalcoholic extract of Eugenia uniflora  Surface roughness of the PMMA is not affected by the extract of Eugenia uniflora  Color change may require different application of the extract of Eugenia uniflora. 2 Ferrari, D.O.; et al.