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Comparative efficacy of In-office and walking bleach techniques in whitening of non-vital teeth
Objectives
This study aimed to compare the efficacy of two non vital whitening techniques, In-office and Walking Bleach, using 35% hydrogen peroxide. The primary research question was to determine which technique achieves greater tooth color improvement.
Materials and methods
Fifty non-vital anterior teeth with discoloration were randomly assigned to either the In-office (
n
= 25) or Walking Bleach (
n
= 25) groups. Tooth color was measured using a Vita EasyShade V
®
spectrophotometer and visual scales (Vita Classical and Bleachguide) before treatment, after each bleaching session, and at a one-month follow-up. ΔE00, Whiteness Index (WID), and Shade Guide Unit (ΔSGU) values were calculated. Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney tests.
Results
Both techniques improved tooth color, with final ΔE00 values of 10.08 for In-office and 8.12 for Walking Bleach. WID values were significantly higher in the In-office group, indicating greater whitening efficacy. Significant differences favoring the In-office method were seen after the first bleaching (
p
= 0.0337), and one-month follow-up (
p
= 0.0327).
Conclusions
Both the In-office and Walking Bleach techniques effectively improve the color of non-vital teeth, with the In-office method showing slight advantages at certain times. Clinicians can choose either technique based on safety, patient needs, and clinical context to achieve optimal results.
Clinical relevance
This study provides evidence that both bleaching techniques are viable options for non-vital teeth whitening. The findings help clinicians choose the most appropriate technique based on biological safety and patient needs and desired outcomes, with the In-office technique being preferable for faster results.
Journal Article
My tooth is loose!
When Georgie announces he has a loose tooth, all of his friends have advice to offer him, but none of it is appealing.
Book
Whitening efficacy and removal of extrinsic tooth stain of sodium phytate-containing whitening toothpaste: a randomized controlled trial
Objective
The study aimed to evaluate the whitening efficacy and removal of extrinsic tooth stain of sodium phytate-containing whitening toothpaste, as well as to evaluate participant satisfaction.
Methods
A total of eighty participants were recruited for this randomized, triple-blind controlled trial and were randomly assigned to either the test group (toothpaste containing 0.875% sodium phytate, ST) or the control group (toothpaste without sodium phytate, CT). Tooth color was assessed using a VITA spectrophotometer and changes in exogenous tooth stains were evaluated using the Lobene Index, which were conducted at baseline, as well as at 2, 3, and 4 weeks. Additionally, participants’ self-assessment of tooth color were evaluated through an aesthetic numerical analogue scale. Statistical tests were conducted appropriately, and the significance level was established at α = 0.05.
Results
This study demonstrates that the b-value of the index teeth in the ST group was significantly lower (
p
< 0.05) than that of the CT group, while the △WI
D
values were significantly higher (
p
< 0.05) at both the 3-week and 4-week time points. Additionally, the a-value of the index teeth in the ST group was significantly lower (
p
< 0.05) compared to the CT group, and the L-value of the index teeth in the ST group was significantly higher (
p
< 0.05) than that of the CT group after 4 weeks. The differences in color between the two treatments, as analyzed by the CIELAB (ΔE), were not statistically significant. Similarly, no significant differences were observed in the changes of the Lobene Index or in participant satisfaction regarding tooth color between the two groups. A comparative analysis of the subjects in the ST group at the 3-week and 4-week marks revealed that the L-value of the index tooth at 4 weeks was significantly higher than that at 3 weeks (
p
< 0.001), while the b-value was significantly lower at 4 weeks compared to 3 weeks (
p
< 0.001).
Conclusion
Brushing teeth with sodium phytate-containing whitening toothpaste for a duration of three weeks demonstrates notable whitening effects, which significantly increase over time. However, after four weeks, the sodium phytate-containing toothpaste shows minimal efficacy in removing extrinsic tooth stains.
Clinical significance
Sodium phytate may be incorporated into toothpaste as a whitening agent.
Journal Article
Microdont Developing Outside the Alveolar Process and Within Oral Diffuse and Plexiform Neurofibroma in Neurofibromatosis Type 1
Numerical aberrations of permanent dentition and dystopic tooth eruption are part of the phenotype of the tumor predisposition syndrome neurofibromatosis type 1 (NF1). In these cases, surplus tooth germs usually develop in the alveolar processes of the jaw. This report attests to the dystopic development of a dysplastic supernumerary tooth in NF1 arising outside the jaw.
The 8-year-old male patient developed a microdont outside the bone and above the occlusal plane of the retained maxillary right second molar. The supernumerary tooth was completely embedded in oral soft tissue. Hyperplastic oral soft tissue in the molar region and microdont were excised. Specimen of the mucosa surrounding the teeth was interspersed with diffuse and plexiform neurofibroma. The retained upper right first molar emerged spontaneously within a few months after surgery. The upper right second molar did not change position.
Odontogenesis can take place within tumorous oral mucosa in NF1. Surgical removal of the tumorous mucous membrane facilitates tooth eruption in some cases.
Journal Article
Why do my teeth fall out?
How teeth work, loss of baby teeth and loss of teeth through injury are explained.
Book
Epidemiology, aetiology and prevention of tooth wear
Tooth wear is a commonly reported finding globally; however, many patients are unaware of having tooth wear. Identifying early signs of erosion, abrasion or attrition and determining the risk factors contributing to a patient's tooth wear may help to prevent further loss of enamel and dentine in the future. Appropriate prevention should be instigated, or appropriate referral made to other health professionals, when conditions such as gastroesophageal reflux or eating disorders are suspected. This paper presents the epidemiology and aetiological factors for tooth wear, as well as identifying the common clinical presentations of tooth wear. Patient perspectives on tooth wear and preventive techniques that can be utilised are also discussed.Key pointsThis paper summarises the clinical presentation of erosion, attrition and abrasion.Prevalence of tooth wear and aetiological factors are discussed in detail.Strategies for prevention of tooth wear are described.
Journal Article
How do my braces work?
Dicusses the physiology and functions of your teeth and how best to keep them in optimum condition.
Book
Surface-Specific Efficacy of Fluoride Varnish in Caries Prevention in the Primary Dentition: Results of a Community Randomized Clinical Trial
Objectives: Fluoride varnish (FV) is efficacious in caries prevention although its effects among different tooth surfaces are poorly understood. This study sought to determine the extent to which caries-preventive effects of a community intervention that included FV application among preschool-aged children varied according to primary tooth anatomy and baseline tooth pathology. Methods: Secondary analysis was undertaken of data from a community-randomized controlled trial among 543 3- to 5-year-old Aboriginal children in 30 Northern Territory Australian communities. Children in intervention communities received community health promotion and FV application once every 6 months. Net caries (d 3 mfs) risk and 95% confidence limits (CL) were estimated for the control and intervention arms, and stratified according to tooth anatomy/location and baseline pathology (sound, enamel opacity, hypoplastic defect or precavitated carious lesion). The intervention’s efficacy was quantified using generalized estimating equation modeling accounting for study design and clustering. The assumption of efficacy homogeneity was tested using a Wald χ 2 test with a p < 0.2 criterion and post hoc pairwise comparisons. Results: The intervention resulted in a 25% reduction (relative risk, RR = 0.75; 95% CL = 0.71, 0.80) in the 2-year surface-level caries risk. There was substantial heterogeneity in FV efficacy by baseline surface pathology: RRs were 0.73 for sound, 0.77 for opaque, 0.90 for precavitated, and 0.92 for hypoplastic surfaces. Among sound surfaces, maxillary anterior facials received significantly more benefit (RR = 0.62) compared to pits and fissures (RR = 0.78). Conclusion: The intervention had greatest efficacy on surfaces that were sound at baseline. Among those sound surfaces, maxillary anterior facials received most caries-preventive benefit.
Journal Article