Laser Doppler flowmetry (LDF) is a noninvasive method capable of evaluating variations in pulp blood flow (PBF) and pulp vitality. This method has thus far not been used to assess changes in blood flow after in-office bleaching. The aim of this case series report was to measure changes in PBF by LDF in the upper central incisor of three patients submitted to in-office bleaching. The buccal surfaces of the upper arch were bleached with a single session of 35% hydrogen peroxide gel with three 15-min applications. The color was recorded using a value-oriented Vita shade guide before in-office bleaching and one week after the procedure. The tooth sensitivity (TS) in a verbal scale was reported, and PBF was assessed by LDF before, immediately, and one week after the bleaching session. The lower arch was submitted to dental bleaching but not used for data assessment. A whitening degree of 3 to 4 shade guide units was detected. All participants experienced moderate to considerable TS after the procedure. The PBF readings reduced 20% to 40% immediately after bleaching. One week postbleaching, TS and PBF were shown to be equal to baseline values. A reversible decrease of PBF was detected immediately after bleaching, which recovered to the baseline values or showed a slight increase sooner than one week post-bleaching. The LDF method allows detection of pulp blood changes in teeth submitted to in-office bleaching, but further studies are still required.
Objectives
To evaluate the influence of the sonic device on the clinical performance of one‐step self‐etch adhesive systems in non‐carious cervical lesions (NCCLs) after 18 months.
Materials and methods
Forty patients participated in this study. Eighty restorations were assigned to two groups (n = 40): Sonic application and Manual application. After the adhesive application (iBond Self‐Etch, Kulzer, Hanau, Germany), NCCLs were restored using composite resin (Charisma, Kulzer, Hanau, Germany). The restorations were evaluated at baseline and after 18 months both according to the Word Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Friedman repeated measures analysis of variance by rank and Wilcoxon test for significance in each pair were applied (α = 0.05).
Results
After 18 months, 38 patients were evaluated. Twenty‐three restorations were lost (19 for manual vs. 4 for sonic application). The retention rates (95% confidence interval) were 50% (CI 34.8%–65.1%) for manual application and 84.2% (CI 69.6%–92.6%) for sonic application (p < 0.05). Twelve restorations showed marginal staining (nine for manual vs. three for sonic application; FDI, p < 0.05) and nine some marginal discrepancy (seven for manual vs. two for sonic application; FDI, p < 0.05). No restorations showed postoperative sensitivity and caries recurrence at the time.
Conclusion
The sonic application increases the retention rate of iBond Self‐Etch after 18 months of clinical evaluation in NCCLs.
Clinical relevance
The application of a simplified self‐etch adhesive (iBond Self‐Etch) associated to a sonic device seems to be an alternative to improve the clinical behavior in NCCLs.
ResumoObjetivos: avaliar a concentração de Peróxido de Hidrogênio (PH) que alcança a câmara pulpar, utilizando géis clareadores de mesma marca comercial. Métodos: 90 pré-molares foram divididos em 9 grupos de acordo com o tratamento: Controle (sem tratamento tampão de acetato na câmara pulpar. Os géis clareadores foram aplicados de acordo com as recomendações dos fabricantes. A solução de tampão foi removida e adicionada a esta, soluções de leucocristal violeta e enzima peroxidase.
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