This randomized clinical trial evaluated the whitening potential of commercially available toothpastes. Sixty patients were selected and randomly divided into 4 groups (n=15), according to the dentifrice used: GI (control) - Colgate Total 12, GII - Close-up White Now, GIII: Oral-B 3D White, GIV: Colgate Luminous White. Three daily brushings were performed for 2 to 3 min each, during a period of 15 days. Patients had the color of their teeth evaluated before and after the treatment by means of a spectrophotometer (Vita EasyShade - CIE L*a*b*). Data obtained from L values were analyzed by one-way ANOVA and t test. ∆E was also evaluated to calculate color alteration, by NBS criteria. Mean (standard deviation) of initial values were GI: 82.9 (4.9); GII: 83.9 (5.8); GIII: 83.9 (7.2); GIV: 86.4 (3.4) and final values were GI: 84.1 (6.3); GII: 84.6 (6.1); GIII: 84.2 (7.1); GIV: 88.2 (2.8). In conclusion, the dentifrices showed no lightening action on vital teeth, except for Colgate Luminous White; but according to NBS criteria, there was no noticeable visible change to the patients in any group.

The overall risk of immediate postoperative sensitivity was 20.3% and was not affected by either the adhesive strategy (etch-and-rinse/self-etch) or the filling technique (incremental/ bulk).

This study evaluated the effects on human enamel after two bleaching procedures: with a fluoridated bleaching agent and with topical fluoride application postbleaching. It used 43 enamel blocks (3 mm(2) ) that were ground flat (600-2,000 grit) and polished with polishing paste (one and one-fourth). Specimens were randomly divided into three groups according to the bleaching procedure: (1) control group, (2) hydrogen peroxide 35% (HPF) and topical application of fluoride 1.23%, and (3) HP 38% (OP) with fluoride in its composition. Bleaching agents were used according to the manufacturer's instructions. Three methodologies were used: nanoindentation, to observe surface hardness and elastic modulus; atomic force microscopy, to observe surface roughness (R(a) - R(z)); and scanning electron microscopy, to observe the enamel surface effects. Group OP had a decrease in the elastic modulus after bleaching, which was recovered at 14 days. An increased roughness (R(a); 32%) was observed on group HPF and had an increased erosion on enamel surface (67%). It was concluded that topical application of fluoride, after using the nonfluoridated whitening agent, increased the roughness values and erosion of enamel.

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BackgroundBleaching procedures performed before restorative procedures, due to the oxygen released, affects the quality of bonding restorations. The application of an lower-concentrated antioxidant for one-hour or more can reversal the compromised bonding to bleached enamel, but it was not effective according to the bleaching concentrations applied. The aim of the present study was to evaluate simplified protocol of higher-concentrated sodium ascorbate (35%SA) in bond strength values of enamel bleached with 10%, 16%, 22% carbamide peroxide (CP) or 35% hydrogen peroxide (HP).Material and MethodsThree hundred and forty enamel surfaces of 85 human third molars were used, divided into 17 groups (n=20), according to the following groups: control = no bleaching and no ascorbic acid application; bleaching (CP10%, CP16%, CP22% at-home and HP 35% in-office) and 35%SA application (no application; 35%SA applied twice for 1-min each [SA2×1], twice for 5-min each [SA2×5] and; twice for 10-min each [SA2×10]). After that, adhesive was applied and composite cylinders were made with Filtek Z350 composite. Microshear test was performed in a universal testing machine. BS values were statistically evaluated using ANOVA and Tukey’s and Dunnet’s (against control) tests, with 5% level of significance.ResultsAll bleaching concentrations significantly decrease the enamel bond strength results when compared to control group (p<0.05). More concentrated PC (PC22% and PH35%) showed lower enamel bond strength results when compared to lower concentrated PC (PC10% and PC16%; p<0.05). A significant increase of the enamel bond strength results were only observed when SA2×5 and SA2×10 were applied (p<0.05).ConclusionsThe application of 35% sodium ascorbate for twice 5- and 10-min each was an efficient protocol to reverse the bond strength in bleached enamel at the same level as the no bleaching enamel, independently of the bleaching concentration used. Key words:Tooth bleaching, hydrogen peroxide, sodium ascorbate, bond strength.

Aim: To evaluate the human enamel permeability after different external bleaching techniques. Methods: The coronal portions of 20 maxillary human incisors were covered with an acid resistant varnish, except the labial surface, to prevent dye penetration of silver nitrate. The specimens were divided randomly into four groups (n=5) according to the bleaching treatments: Group 1 (G1)-without bleaching agent (control group), Group 2 (G2)-35% hydrogen peroxide (HP)-one session of three 10-min applications, Group 3 (G3)-35% HP-2 sessions of three 10-min applications, and Group 4 (G4)-6% HP-14 days (1h/day). G1 was exposed to artificial saliva only and in the other groups the bleaching agents were applied following the manufacturers' recommendations. After bleaching, teeth were immersed in a 50% silver nitrate solution for 2 h and photodeveloped for 16 h. Then, three longitudinal slices of each tooth were photographed by an optical microscope (100x). The degree of dye penetration was analyzed in the middle third of the dental crowns using a 0 to 4 score system (0= no dye penetration, 1= less than half the enamel thickness, 2= half of the enamel thickness, 3= full extent of enamel without reaching the dentin, and 4= tracer agent reaching dentin). The data were analyzed statistically by the Kruskal-Wallis and Dunn tests (α=0.05). Results: The median (1 st /3 rd interquartiles) ranges were: G1: 0(0/0), G2: 2(2/3), G3: 3(3/3) and G4: 3(3/3). G2, G3 and G4 showed significantly higher dye penetration compared with G1 (p=0.0017). Conclusions: The use of bleaching agents increased dental enamel permeability, regardless of the bleaching technique.

Aim: To evaluate the effect of different in-office bleaching agents on the permeability, roughness and surface microhardness of human enamel. Methods: For evaluation of roughness and microhardness, 40 hemi-faces of 20 premolars were subjected to initial roughness (Ra parameter) and microhardness (VHN) measurements. Thirty-two premolar's crowns were used for permeability test. Then, all specimens were randomly divided into four groups: C -without bleaching (control), HP35 -bleaching with 35% hydrogen peroxide (HP), HPF38 -38% HP+fluoride, HPC35 -35% HP+calcium. Final roughness (FR) and microhardness (FM) measurements were evaluated. For permeability, the 32 crowns were immersed in 1% sodium hypochlorite (20 min) and silver nitrate solutions (2 h) and subjected to developing solution under fluorescent light (16 h). Three sections from the crowns were analyzed in light microscope (100x) to evaluate the scores of permeability: Score 0 -no tracer agent penetration; Score 1 -less than half the thickness of enamel penetration; Score 2 -tracer agent reaching half the enamel thickness; Score 3 -entire enamel depth penetration, without reaching dentin and Score 4 -tracer agent reaching dentin. For roughness and microhardness evaluation were used one-way ANOVA and Dunnet post-test for independent samples, and t test for paired samples. For permeability, the data were analyzed by Kruskal Wallis and Dunn tests. Results: A significantly higher permeability and surface roughness were observed in groups HP35, HPF38 and HPC35 compared to the C group, as well as decreased microhardness (p<0.05). Conclusions: All bleaching agents increased permeability and surface roughness, and decreased microhardness of human enamel; thus, the addition of fluoride or calcium was not beneficial.

The objective of this study was to evaluate the effect of passive or active phosphoric acid (PA) application after hydrofluoric acid (HA) treatment on the microshear bond strength of lithium disilicate. Thirty ceramic discs were made with IPS Emax 2 (10 mm thick and 10 mm diameter). The specimens were divided into 3 groups, A: 9.6% HA application; AF: 9.6% HA application + cleaning with 37% PA in passive mode and AFF: 9.6% HA application + cleaning with 37% PA in active mode. For the microshear test, four tygons (0.9 mm diameter and 0.2 mm high) were filled with resin cement (RelyX Ultimate) and placed on the ceramic disks. After testing, the fracture modes were examined under scanning electron microscopy. Data were analyzed by one-way ANOVA and Tukey's post test (α=0.05). The bond strength values were significantly higher in Group AFF (11.0±2.5 MPa) compared with group A (8.1±2.6 MPa) (p<0.002). AF group was not statistically different (9.4±2.5 MPa) from Group A. It was concluded that the active application of 37% PA after 9.6% HA increases the microshear bond strength values between the resin cement and lithium disilicate ceramic.