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Objectives To evaluate the effect of whitening toothpastes with different hydrogen peroxide (HP) concentrations on HP permeability, color change, and physicochemical properties, compared to at-home bleaching treatment. Materials and methods Forty-nine premolars were randomized into seven groups ( n  = 7): untreated (control); at-home bleaching with 10% carbamide peroxide gel (AH; 10% CP) with 14 and 28 applications of 180 min each (AH [14 × 180 min] and AH [28 × 180 min]); three whitening toothpastes (3% HP; 4% HP and 5% HP) and 10% CP brushed 28 times for 90 s each (TB [28 × 90 s]). HP permeability was measured using a UV-VIS spectrophotometer and color change by a digital spectrophotometer (ΔE ab , ΔE 00 , and ΔWI D ). Initial concentration, pH, and viscosity were measured through titration, digital pH meter, and rheometer, respectively. Statistical analysis included one-way ANOVA, Tukey’s test, and Dunnett’s test (α = 0.05). Results 4% HP group showed acidic pH, the lowest viscosity and the highest HP concentration into the pulp chamber ( p  < 0.05). The 10% CP groups had lower HP in the pulp chamber and greater color change than other groups ( p  < 0.05), except the 5% HP group in ΔE ab and ΔE 00 . For ΔWI D , the 10% CP AH groups showed greater whitening than other groups ( p  < 0.05). Conclusions Whitening toothpaste with up to 5% HP resulted in higher HP permeability and less color change compared to 10% CP. Higher HP commercial concentrations in toothpaste increased whitening effect; however, acidic pH toothpastes exhibited greater HP permeability. Clinical relevance Whitening toothpastes with high hydrogen peroxide concentrations were less effective than at-home bleaching, resulting in less color change and greater permeability of hydrogen peroxide, potentially increasing the risk of tooth sensitivity.

Objectives This study aims to assess hydrogen peroxide (HP) penetration within the pulp chamber, color change (CC), physical–chemical properties, and temperature using in-office different concentration bleaching gels with or without violet light. Materials and methods Fifty teeth were divided into five groups ( n  = 10) based on the HP concentration bleaching gels used (6% and 35%) and the used violet light (with or without). HP penetration within the pulp chamber was measured using UV–Vis. The CC was evaluated with a digital spectrophotometer. Initial and final concentration, and pH were measured through titration, and a Digital pHmeter, respectively. Temperature analyses were measured through a thermocouple. Statistical analysis included two-way ANOVA, Tukey's, and Dunnett's test (α = 0.05). Results The presence of violet light did not affect the amount of HP within the pulp chamber, or the CC ( p  > 0.05). Greater penetration of HP was observed within the pulp chamber, as well as CC when using 35% HP ( p  < 0.05). The final concentration of both gels was lower than the initial concentration, regardless of the use of violet light ( p  < 0.05). The initial and final pH levels remained neutral and stable ( p  > 0.05). The pulp temperature increased when the gels were used in conjunction with violet light ( p  < 0.05). Conclusions Using violet light in conjunction with 6% or 35% HP does not alter the physical properties of the bleaching agents, the penetration of HP or enhance color change. However, an increase in temperature was observed when violet light was applied associated with bleaching gels. Clinical relevance While the simultaneous use of violet light with hydrogen peroxide 6% or 35% does not alter the material's properties, it also does not bring benefits in reducing hydrogen peroxide penetration and improving color change. Furthermore, the use of violet light increases pulp temperature.

ObjectiveThe objective of the study is to evaluate through a randomized clinical trial the best method to preheat a composite resin, if using a Caps dispenser device associated with Caps Warmer (CD) or with a VisCalor Caps dispenser/warmer (VD) for restorations in non-carious cervical lesions (NCCLs).Material and MethodsOne hundred and twenty restorations were distributed to two groups (n = 60) according to the pre-heating way of thermoviscous bulk-fill composite resin. For the CD group, pre-heating was carried at 68 °C using a heating bench for 3 min. For the VD group, pre-heating was performed at 68 °C using a heating gun for 30 s. After that, pre-heated bulk-fill composites were directly inserted in the NCCLs. The total working time was recorded. The restorations were evaluated after 6 and 12 months of clinical performance according to the FDI criteria. Statistical analysis was performed using the Student’s t test for unpaired samples for working time, and the Chi-square test for restoration clinical performance (α = 0.05).ResultsWorking time was shorter for VD with a statistically significant difference compared to CD (p = 0.01). Few restorations were lost or fractured after 12 months of clinical evaluation (p > 0.05). The retention rates were 96.7% (CI 95 %: 88.6–99.1%) for CD and 98.3% (CI 95 %: 91.1–99.7%) for VD. The other FDI parameters were considered clinically acceptable.ConclusionsThe different pre-heating ways did not influence the clinical performance of thermoviscous bulk-fill composite restorations in NCCLs after 12 months.Clinical relevanceRegardless of the bulk-fill thermoviscous composite resin pre-heating ways, the restorations are clinically acceptable after 12 months.

Background Light-cured resins are widely used as gingival barriers to protect the gums from highly concentrated peroxides used in tooth bleaching. The impact of barrier brand on clinical outcomes is typically considered negligible. However, there is limited evidence on the effects of different brands on operator experience, barrier adaptation, and patient comfort. Objective This clinical trial assessed the impact of four commercial gingival barrier brands (Opaldam, Topdam, Lysadam, and Maxdam) on operator perception, adaptation quality, and patient comfort. Methods Twenty-one undergraduate students placed gingival barriers in a randomized sequence using blinded syringes. Photographs of the barriers were taken from frontal and incisal perspectives. After bleaching procedures, operators rated handling features and safety using Likert scale forms. Two experienced evaluators independently assessed barrier adaptation quality on a scale from 1 (perfect) to 5 (unacceptable). The absolute risk of barrier-induced discomfort was recorded. Data were analyzed using Friedman and Chi-square tests (α = 0.05). Results Opaldam and Topdam received the highest scores in most handling features, except for removal, which was similar among all brands. No significant difference was observed in barrier adaptation quality between the evaluated brands. Discomforts were mainly reported in the upper dental arch, with Maxdam having the highest absolute risk (35% for this arch and 24% overall). Conclusions This study suggests that gingival barrier brands can influence operator perception and patient comfort. Opaldam and Topdam were preferred by operators, but all brands demonstrated comparable adaptation quality. Clinical trial registration The study was nested in a randomized clinical trial registered in the Brazilian Clinical Trials Registry under identification number RBR-9gtr9sc.

Objective This randomized controlled trial aimed to evaluate the equivalence in the color change, adverse effects, self-perception (AS) and the impact on oral condition (IO) of participants submitted to different application protocols of in-office dental bleaching. Materials and methods 165 participants were bleached with a 35% hydrogen peroxide gel (Total Blanc Office One-Step, DFL), according to the following protocols: (1) 2 applications of 20-min each (2 × 20 min); (2) 1 × 40-min and; (3) 1 × 30-min. The color change was evaluated with the Vita Easyshade spectrophotometer, Vita Classical and Vita Bleachedguide scales. The intensity and risk of tooth sensitivity (TS) and gingival irritation (GI) were recorded using a 0–10 visual analogue scale (VAS). AS and IO was assessed before and after the bleaching procedure using the Orofacial Aesthetic Scale and Oral Health Impact Profile-14, respectively. Results Equivalent color change were observed ( p  < 0.001), with no significant difference between groups. The group 2 × 20 min presented the highest risk of TS (76%, 95% CI 63 to 85), compared to the 1 × 30 min ( p  < 0.04). The intensity of TS and GI and the risk of GI was similar between groups ( p  > 0.31). Irrespectively of the group ( p  = 0.32), significant improvements were observed for all items of AS and IO after bleaching ( p  < 0.02). Conclusions The 1 × 30 min protocol produced equivalent color change to the other bleaching protocols with reduced risk of TS and shorter application time. Clinical relevance A more simplified application regimen of a single application of 30 min yields effective bleaching and patient satisfaction while minimizing undesirable side effects and improving patient satisfaction.