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Hydrogen peroxide (H 2 O 2 )-based products are effective in tooth whitening; however, their safety is controversial as they may harm patient tissues/cells. These effects are suggested to be concentration-dependent; nonetheless, to date, there are no reports on H 2 O 2 -mediated oxidative damage in the gingival tissue, and neither whether this can be detected in gingival crevicular fluid (GCF) samples. We hypothesize that H 2 O 2 whitening products may cause collateral oxidative tissue damage following in office application. Therefore, H 2 O 2 and nitric oxide (NO) levels were investigated in GCF samples obtained from patients undergoing dental bleaching with H 2 O 2 at different concentrations, in a randomized, double-blind, split-mouth clinical trial. A proteomic analysis of these samples was also performed. H 2 O 2 -based whitening products promoted inflammation which was detected in GCF samples and lasted for longer following 35% H 2 O 2 bleaching. This included time-dependent changes in NO levels and in the abundance of proteins associated with NO synthesis, oxidative stress, neutrophil regulation, nucleic acid damage, cell survival and/or tissue regeneration. Overall, H 2 O 2 -based products used in office promote inflammation irrespective of their concentration. As the inflammation caused by 35% H 2 O 2 is longer , patients may benefit better from using lower concentrations of this bleaching product, as they may result in less tissue damage.

Introduction The primary objective of this study was to determine the efficiency of hydrogen peroxide (H 2 O 2 ) techniques in disinfection of ICU rooms contaminated with multidrug-resistant organisms (MDRO) after patient discharge. Secondary objectives included comparison of the efficiency of a vaporizator (HPV, Bioquell®) and an aerosolizer using H 2 O 2 , and peracetic acid (aHPP, Anios®) in MDRO environmental disinfection, and assessment of toxicity of these techniques. Methods This prospective cross-over study was conducted in five medical and surgical ICUs located in one University hospital, during a 12-week period. Routine terminal cleaning was followed by H 2 O 2 disinfection. A total of 24 environmental bacteriological samplings were collected per room, from eight frequently touched surfaces, at three time-points: after patient discharge (T0), after terminal cleaning (T1) and after H 2 O 2 disinfection (T2). Results In total 182 rooms were studied, including 89 (49%) disinfected with aHPP and 93 (51%) with HPV. At T0, 15/182 (8%) rooms were contaminated with at least 1 MDRO (extended spectrum β–lactamase-producing Gram-negative bacilli 50%, imipenem resistant Acinetobacter baumannii 29%, methicillin-resistant Staphylococcus aureus 17%, and Pseudomonas aeruginosa resistant to ceftazidime or imipenem 4%). Routine terminal cleaning reduced environmental bacterial load ( P <0.001) without efficiency on MDRO (15/182 (8%) rooms at T0 versus 11/182 (6%) at T1; P  = 0.371). H 2 O 2 technologies were efficient for environmental MDRO decontamination (6% of rooms contaminated with MDRO at T1 versus 0.5% at T2, P  = 0.004). Patient characteristics were similar in aHPP and HPV groups. No significant difference was found between aHPP and HPV regarding the rate of rooms contaminated with MDRO at T2 ( P  = 0.313). 42% of room occupants were MDRO carriers. The highest rate of rooms contaminated with MDRO was found in rooms where patients stayed for a longer period of time, and where a patient with MDRO was hospitalized. The residual concentration of H 2 O 2 appears to be higher using aHPP, compared with HPV. Conclusions H 2 O 2 treatment is efficient in reducing MDRO contaminated rooms in the ICU. No significant difference was found between aHPP and HPV regarding their disinfection efficiency.

Abstract To mitigate the deleterious effects of salt stress, substances capable of acting as mitigators and/or inducers of tolerance to stress have been used, enabling the use of saline waters and contributing to the development of irrigated agriculture. In this context, the aim of the present study was to evaluate the effect of foliar spraying with hydrogen peroxide as an attenuator of salt stress effects on soursop morphophysiology. The experiment was conducted under greenhouse conditions in Campina Grande - PB, Brazil, using a randomized block design, in a 4 × 4 factorial arrangement, whose treatments resulted from the combination of four levels of electrical conductivity of irrigation water - ECw (0.8 – control, 1.6, 2.4, and 3.2 dS m-1) and four concentrations of hydrogen peroxide - H2O2 (0, 10, 20, and 30 μM), with three replicates. Foliar application of hydrogen peroxide at a concentration of 10 µM increased growth, chlorophyll synthesis, and relative water content in the leaves and consequently reduced the foliar water saturation deficit of soursop irrigated with ECw up to 1.6 dS m-1. The concentration of hydrogen peroxide of 30 µM intensified the salt stress on the electrolyte leakage in the leaf blade and the photosynthetic pigments of soursop, 270 days after transplanting. Resumo Para mitigar os efeitos deletérios do estresse salino, tem se utilizado substâncias capazes de atuar como atenuantes e/ou indutoras de tolerância ao estresse, viabilizando o uso de águas salinas e contribuindo para desenvolvimento da agricultura irrigada. Neste contexto, objetivou-se com presente estudo, avaliar o efeito da pulverização foliar com peróxido de hidrogênio como atenuante do estresse salino sobre a morfofisiologia da gravioleira. O estudo foi conduzido sob condições de casa de vegetação, em Campina Grande - PB, utilizando-se o delineamento de blocos casualizados, no arranjo fatorial 4 × 4, cujos tratamentos resultaram da combinação de quatro níveis de condutividade elétrica da água de irrigação - CEa (0,8 – controle; 1,6; 2,4 e 3,2 dS m-1) e quatro concentrações de peróxido de hidrogênio - H2O2 (0; 10; 20 e 30 µM), com três repetições. A aplicação foliar de peróxido de hidrogênio na concentração de 10 µM aumentou o crescimento, a síntese de clorofila e o teor relativo de água nas folhas e consequentemente reduziu o déficit de saturação hídrica foliar da gravioleira irrigada com CEa de até 1,6 dS m-1. A concentração de peroxido de hidrogênio de 30 µM intensificou o estresse salino sobre o extravasamento de eletrólitos no limbo foliar e os pigmentos fotossintéticos da gravioleira, aos 270 dias após o transplantio.

ObjectiveTo investigate the effect of fluoride-containing whitening products on sound enamel and on artificial caries lesions during a cariogenic challenge.Materials and methodsBovine enamel specimens (n = 120) with three areas [non-treated sound enamel (NSE), treated sound enamel (TSE), and treated artificial caries lesion (TACL)] were randomly assigned to the four groups: whitening mouthrinse (WM: 2.5% hydrogen peroxide-100 ppm F−), placebo mouthrinse (PM: 0% hydrogen peroxide-100 ppm F−), whitening gel (WG: 10% carbamide peroxide-1130 ppm F−), and deionized water (negative control; NC). The treatments (2 min for WM, PM, and NC, and 2 h for WG) were carried out during a 28-day pH-cycling model (6 × 60 min demineralization/day). Relative surface reflection intensity (rSRI) and transversal microradiography (TMR) analyses were performed. Fluoride uptake (surface and subsurface) was measured in additional enamel specimens.ResultsFor TSE, a higher value of rSRI was observed in WM (89.99% ± 6.94), and a greater decrease in rSRI was observed for WG and NC, and no sign of mineral loss was verified for all groups (p > 0.05). For TACL, rSRI significantly decreased after pH-cycling for all experimental groups with no difference between them (p < 0.05). Higher amounts of fluoride were found in WG. WG and WM exhibited intermediate values of mineral loss, similar to PM.ConclusionsThe whitening products did not potentialize the enamel demineralization under a severe cariogenic challenge, and they did not exacerbate mineral loss of the artificial caries lesions.Clinical relevanceLow concentrated hydrogen peroxide whitening gel and mouthrinse containing fluoride do not intensify the progression of caries lesions.

Objective This study compares the effects of Nanosil ® mouthwash, a multi-component formulation containing hydrogen peroxide, silver ions, eugenol, and menthol and chlorhexidine on healing, pain, and complications following impacted mandibular third molar surgery. Impacted mandibular third molars extraction, often accompanied by complications like pain, dry socket, swelling, trismus, and infection. Mouthwashes are used to reduce infection risk and promote healing by eliminating oral microorganisms. Methodology : This double-blind, randomized clinical trial involved 62 patients (aged 18–50 years) with Pell and Gregory A and B impacted third molars. Participants were allocated to two groups: 15 cc of Nanosil ® mouthwash and 250 ml of 0.2% chlorhexidine mouthwash (Najo ® ) before and after surgery. Pain was assessed with the Visual Analog Scale (VAS), swelling was measured on days 1, 3, and 7, and wound healing was evaluated. Data were analyzed using t-tests and Mann-Whitney tests. Results Healing on day 3 was significantly better in the Nanosil group ( p  = 0.001). No infections or discharge were observed. A dry socket occurred in one patient in the Nanosil group, but it was not statistically significant. Swelling was significantly lower in the Nanosil group on day 3 ( p  < 0.001). Pain levels were similar in both groups. Conclusion Nanosil promoted better healing and reduced swelling compared to chlorhexidine on the third day post-surgery. No significant differences were found regarding pain, infection, discharge, or dry socket. Trial registration: The study was registered in the Iranian Clinical Trials Center with the code IRCT20171216037893N6 on 16/12/2021. https://irct.behdasht.gov.ir/trial/60568 .

Aim This study aimed to compare the efficacy of mouth rinsing with chlorhexidine, essential oil, and hydrogen peroxide mouthwashes in reducing bacterial infection in aerosols produced during dental scaling. Materials and methods Eighty subjects were randomly assigned to four groups. Ten minutes before treatment, participants rinsed for 1 min with 10 mL of either chlorhexidine, essential oil, hydrogen peroxide, or water. Blood agar plates were used to collect aerosols during the scaling procedure, with plates placed at the patient’s chest, dentist’s chest, and assistant’s chest. Plates were exposed for 30 min during and after treatment, incubated at 37 °C for 48 h, and the total number of colony-forming units (CFUs) was counted and analyzed using SPSS-24 software. Results The mean age of participants was 35.01 years, with 57.5% female and 42.5% male. A statistically significant difference was observed in the number of bacterial colonies on the patient’s chest plates (882.56 CFUs), dentist’s chest (99.84 CFUs), and assistant’s chest (48.49 CFUs) (p value < 0.001). Chlorhexidine mouthwash significantly reduced bacterial growth compared to the other groups. Conclusion Rinsing with chlorhexidine mouthwash before dental treatment effectively reduces bacterial contamination in aerosols, thereby lowering the risk of infection for dental personnel and patients. Clinical trial number Not applicable

Exposure to intense physical exercise increases reactive oxygen and nitrogen species production. The process can be modulated by dipeptide bioavailability with antioxidant scavenger properties. The effects of dipeptide intake in combination with physical exercise on the oxi-antioxidant response were examined in a randomized and placebo-controlled trial. Blood samples were collected from 20 males aged 21.2 ± 1.8 years before and after 14-day intake of chicken breast extract (4 g/day), which is a good source of bioactive dipeptides. A significant increase in the NO/H2O2 ratio was observed in the 1st and 30th minute after intense incremental exercise in dipeptides compared to the placebo group. Total antioxidant and thiol redox status were significantly higher in the dipeptide group both before and after exercise; η2 ≥ 0.64 showed a large effect of dipeptides on antioxidant and glutathione status. The level of 8-isoprostanes, markers of oxidative damage, did not change under the influence of dipeptides. By contrast, reduced C-reactive protein levels were found during the post-exercise period in the dipeptide group, which indicates the anti-inflammatory properties of dipeptides. High pre-exercise dipeptide intake enhances antioxidant status and thus reduces the oxi-inflammatory response to intense exercise. Therefore, the application of dipeptides seems to have favourable potential for modulating oxidative stress and inflammation in physically active individuals following a strenuous exercise schedule.

This study aimed to evaluate color longevity after 2 years of whitening gel (6% hydrogen peroxide (HP), blue LED/infrared laser activation system) in comparison to a control 35% concentration in a split-mouth study and investigate the long-term effect on quality of life (QOL).Thirty-one patients were treated. Whitening using 6% or 35% HP gel was performed on half of the upper jaw in each patient. The color was measured at baseline and 1 week, 1 month, 1 and 2 years after treatment using the Easyshade Vita spectrophotometer and the Vita Bleached and Vita Classical Shade Guides organized by value. During 2 years of follow-up, color was evaluated before and after dental prophylaxis. Oral Health of Impact Profile (OHIP 14) and Psychosocial Impact Dental Aesthetics Questionnaire (PIDAQ) surveys measured QOL. Nineteen patients were evaluated at the 2-year follow-up. Significant differences in ΔE were measured between the two groups at all time points (p < 0.05). No significant differences in ΔSGU were observed at any time point (p > 0.05). The positive effect of bleaching on QOL was maintained in patients treated with a low concentration of the whitening gel. The two compounds remained effective after 2 years. An objective color difference was found between the groups, but no difference was observed in subjective reports. The positive effect on QOL remained after 2 years of follow-up in this cohort of patients.ClinicalTrials.gov identifier NCT02353611.

ObjectiveThe study evaluated the longevity, effectiveness, safety, and impact on the oral health-related quality of life of in-office dental bleaching using low-concentration hydrogen peroxides.Materials and methodsRandomized, parallel, and double-blinded clinical trial was performed with 54 participants using 6% or 15% hydrogen peroxide (HP) in-office bleaching activated via hybrid LED/laser light. Tooth color was evaluated at baseline (T1), 1 week of bleaching (T2), 2 weeks of bleaching (T3) and 1 week (T4) and 6 months (T5) after finishing the bleaching using the Classical Vita™ scale and spectrophotometer. Tooth sensitivity and gingival irritation were measured with Visual Numeric Scale and Modified Gingival Index. The impact on quality of life was evaluated using the Oral Impact on Daily Performance. The data were analyzed using the Friedman, Mann-Whitney, and McNemar tests (p < 0.05).ResultsThe group HP15% presented significant color change (ΔE) from T1 to T4 (p = 0.002) and T1 to T5 (p < 0.001). Parameters L, a*, and b* differed significantly at T3, T4, and T5 compared T1 for both groups. At 6-month follow-up, 57.1% of HP6 and 43.7% of HP15% participants migrated from B1 to a darker color. No significant differences were observed between the groups in tooth sensitivity, gingival irritation, or impact on quality of life.ConclusionsBoth agents showed bleaching effectiveness, but HP15% presented greater color stability than HP6%, at 6-month follow-up. The agents showed low levels of tooth sensitivity, gingival irritation, and did not affect the oral health-related quality of life of the participants.Clinical relevanceDespite the greater presence of sensitivity during treatment compared with 6% hydrogen peroxide, 15% hydrogen peroxide demonstrated better bleaching effectiveness, and greater color stability at the end of bleaching and at 6-month follow-up. The use of 15% hydrogen peroxide presents more suitable results.

This study examined the effects of zinc chloride (ZnCl 2 ) and sodium selenite (Na 2 SeO 3 ) supplementation in maturation medium on in vitro maturation (IVM) rate, oxidative biomarkers and gene expression in buffalo oocytes. Ovaries from a slaughterhouse were aspirated and good quality cumulus–oocyte complexes (COCs) with at least four layers of compact cumulus cells and evenly granulated dark ooplasm were selected. COCs were randomly allocated during IVM (22 h) to one of four treatment groups: (1) control maturation medium (basic medium), or basic medium supplemented with (2) ZnCl 2 (1.5 µg/ml), (3) Na 2 SeO 3 (5 µg/l), or (4) ZnCl 2 + Na 2 SeO 3 (1.5 µg/ml + 5 µg/l, respectively). Oocytes were denuded after 22 h of IVM in the first four replicates. Specimens were fixed and stained to evaluate the stage of nuclear maturation. The spent medium was collected for biochemical assays of total antioxidant capacity (TAC), malondialdehyde (MDA) and hydrogen peroxide concentrations. A second four replicates were used for COCs for RNA extraction. The expression levels of antioxidant ( SOD1 , GPX4 , CAT and PRDX1 ), antiapoptotic ( BCL2 and BCL-XL ) and proapoptotic ( BAX and BID ) genes were measured. Supplementation with ZnCl 2 and Na 2 SeO 3 during IVM increased the ratio of oocytes reaching metaphase II at 22 h, increased TAC and decreased MDA and H 2 O 2 concentrations in the maturation medium ( P < 0.05). Moreover, beneficial effects were associated with complementary changes in expression patterns of antioxidative, antiapoptotic and proapoptotic genes, suggesting lower oxidative stress and apoptosis. Supplementation medium with zinc chloride and sodium selenite improves the maturation rate, reduces oxidative stress and increases expression levels of antioxidative and antiapoptotic genes.