Response of human pulps after professionally applied vital tooth bleaching

Kina, Juliana; Huck, Cláudia; Riehl, Heraldo; Martinez, Tais Cruz; Sacono, Nancy Tomoko; Ribeiro, Ana Paula Dias; Costa, Carlos Alberto de Souza

doi:10.1111/j.1365-2591.2010.01713.x

Cited by 52 publications

(71 citation statements)

References 31 publications

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“…The data obtained in this study corroborate those of previous investigations [6,20,21]. However, superficial zones of coronal pulp necrosis occurred in young human mandibular incisors even after a single clinical session of in-office bleaching [6].…”

Section: Discussionsupporting

confidence: 90%

“…Based on the data obtained in this investigation as well as in previous in vivo studies [6,[20][21][22], new strategies for in-office bleaching therapy should be focused on preventing pulp damage and improving pulp cell regenerative potential. It was recently demonstrated that reducing the contact time of a 35%-HP gel (5-15 min) with enamel led to decreases in about 60% the transenamel and transdentinal diffusion of HP [26].…”

Section: Discussionmentioning

confidence: 78%

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Histopathological Features of Dental Pulp Tissue from Bleached Mandibular Incisors

Roderjan¹,

Stanislawczuk²,

Hebling³

et al. 2014

JMSE-B

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Mandibular incisors scheduled for extraction were subjected or not to three 15-minute applications of a 35% hydrogen peroxide gel. Two days thereafter, bleaching effectiveness (according to a value-oriented shade guide) was evaluated, and histological analysis of pulp tissue was performed. Immediately and two days after bleaching, tooth sensitivity (TS) experience was recorded. Bleached teeth of both groups showed significant color improvement (Mann-Whitney; p < 0.05). However, these teeth presented significant pulp alterations when compared with non-bleached teeth (Mann-Whitney; p < 0.05), including areas of superficial necrosis associated with mild inflammatory reactions. These data were achieved by recordings of TS immediately after bleaching (Fisher's exact test; p<0.05), which was reduced with time. Instead of 'no significant difference' being observed between young and old teeth (Mann-Whitney; p<0.05), necrosis occurred in 60% of old bleached teeth in comparison with 100% of young teeth, associated with underlying tertiary dentin deposition. It was concluded that, regardless of the age of patients, the application of a 35%-HP bleaching gel to mandibular incisors causes pulp damage, which was related to initial TS; however, superficial necrosis was more prevalent in young teeth.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 78%

Histopathological Features of Dental Pulp Tissue from Bleached Mandibular Incisors

Roderjan¹,

Stanislawczuk²,

Hebling³

et al. 2014

JMSE-B

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“…Since the tooth-bleaching process is mediated by ROS, which can diffuse through the enamel and dentin, reaching the pulp space [2], these aesthetic procedures can promote pulp alterations, such as mild inflammation or even partial necrosis [3][4][5]. Due to the deleterious effects caused by components of bleaching agents, which have been demonstrated in both in vitro [6][7][8][9][10] and in vivo studies [3,5,11], the evaluation of other bleaching techniques that can prevent or reduce pulp damage is needed.…”

Section: Introductionmentioning

confidence: 99%

“…Due to the deleterious effects caused by components of bleaching agents, which have been demonstrated in both in vitro [6][7][8][9][10] and in vivo studies [3,5,11], the evaluation of other bleaching techniques that can prevent or reduce pulp damage is needed. Thus, laser is promising coadjutant treatment that can be used in the photodynamic therapy [12,13], stimulate cell differentiation, reduction of inflammation, and tissue repair [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Effect of low-level laser therapy on odontoblast-like cells exposed to bleaching agent

et al. 2013

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The aim of the present study was to evaluate the effect of low-level laser therapy (LLLT) on odontoblast-like MDPC-23 cells exposed to carbamide peroxide (CP 0. 01 %-2.21 μg/mL of H 2 O 2 ). The cells were seeded in sterile 24-well plates for 72 h. Eight groups were established according to the exposure or not to the bleaching agents and the laser energy doses tested (0, 4, 10, and 15 J/cm 2 ). After exposing the cells to 0.01 % CP for 1 h, this bleaching solution was replaced by fresh culture medium. The cells were then irradiated (three sections) with a near-infrared diode laser (InGaAsP-780±3 nm, 40 mW), with intervals of 24 h. The 0.01 % CP solution caused statistically significant reductions in cell metabolism and alkaline phosphate (ALP) activity when compared with those of the groups not exposed to the bleaching agent. The LLLT did not modulate cell metabolism; however, the dose of 4 J/cm 2 increased the ALP activity. It was concluded that 0.01 % CP reduces the MDPC-23 cell metabolism and ALP activity. The LLLT in the parameters tested did not influence the cell metabolism of the cultured cells; nevertheless, the laser dose of 4 J/cm 2 increases the ALP activity in groups both with and without exposure to the bleaching agent.

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“…7,8,9 While laboratory testing is a very useful method to study the diffusion of the components of bleaching gels, such H 2 O 2 , into dental pulp, 10,11 clinical trials can provide reliable and direct evidence to guide clinicians in their choice of materials for in-office and at-home bleaching. 12,13,14,15 Hence, randomized controlled trials (RCTs) are considered the standard research design for the evaluation of health interventions.…”

Section: Introductionmentioning

confidence: 99%

Randomized clinical trials of dental bleaching – Compliance with the CONSORT Statement: a systematic review

et al. 2017

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We reviewed the literature to evaluate: a) The compliance of randomized clinical trials (RCTs) on bleaching with the CONSORT; and b) the risk of bias of these studies using the Cochrane Collaboration risk of bias tool (CCRT). We searched the Cochrane Library, PubMed and other electronic databases, to find RCTs focused on bleaching (or whitening). The articles were evaluated in compliance with CONSORT in a scale: 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the number of studies by journal, follow-up period, country and quality assessments were performed with CCRT for assessing risk of bias in RCTs. 185 RCTs were included for assessment. More than 30% of the studies received score 0 or 1. Protocol, flow chart, allocation concealment and sample size were more critical items, as 80% of the studies scored 0. The overall CONSORT score for the included studies was 16.7 ± 5.4 points, which represents 52.2% of the maximum CONSORT score. A significant difference among journal, country and period of time was observed (p < 0.02). Only 7.6% of the studies were judged at "low" risk; 62.1% were classified as "unclear"; and 30.3% as "high" risk of bias. The adherence of RCTs evaluating bleaching materials and techniques to the CONSORT is still low with unclear/high risk of bias.

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Response of human pulps after professionally applied vital tooth bleaching

Abstract: Professionally applied vital tooth bleaching with a 38% H(2)O(2) gel with or without activation by a halogen light source did not cause damage to the pulp tissue of sound human premolar teeth.

Cited by 52 publications

References 31 publications

Histopathological Features of Dental Pulp Tissue from Bleached Mandibular Incisors

Histopathological Features of Dental Pulp Tissue from Bleached Mandibular Incisors

Effect of low-level laser therapy on odontoblast-like cells exposed to bleaching agent

Randomized clinical trials of dental bleaching – Compliance with the CONSORT Statement: a systematic review

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