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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.

Background Tooth whitening is a popular cosmetic procedure; however, its perceived effectiveness and long-term psychosocial impact remain underexplored. This study investigated perceptions of tooth color change and the associated psychological and social effects over a one-year period, with particular attention to the role of individual personality traits. Methods Fifty participants aged 19 to 28 were randomly assigned to either an experimental group or a control group. The experimental group received a light-activated whitening gel, while the control group received an inactive gel. Evaluations were conducted at baseline, one week post-treatment, and one year post-treatment. Tooth color was measured using spectrophotometry. Standardized questionnaires were employed to assess psychosocial effects and personality traits. Data were analyzed using analysis of variance with Bonferroni post hoc tests and independent samples t-tests. Results The experimental group showed a significantly greater improvement in tooth color shortly after treatment compared to the control group. Although this improvement diminished over time, it remained above baseline levels at the one-year follow-up. In the short term, participants in the experimental group reported reduced psychological and social concerns, while the control group reported a decrease in psychological impact only. After one year, the experimental group experienced a return of psychosocial concerns, whereas the control group continued to report improvements. Personality traits influenced these outcomes: lower neuroticism and higher perfectionism were associated with enhanced short-term benefits, while higher conscientiousness was linked to more sustained long-term improvements. Conclusions Participants demonstrated limited ability to accurately perceive improvements in tooth color, often noticing relapse over time. The psychosocial impact of tooth whitening was influenced by personality traits, highlighting the importance of a personalized approach in cosmetic dental treatments. Practitioners should consider individual psychological profiles when managing patient expectations. Trial registration This clinical trial was prospectively registered with ClinicalTrials.gov (Identifier NCT03380702) on December 21, 2017.

Variety of treatment approaches have been proposed for esthetic management of dental fluorosis. Microabrasion, bleaching using hydrogen peroxide, and etch bleach seal are commonly used methods. Bleaching using sodium perborate has been used for intracoronal bleaching. Till now, no study has used sodium perborate for extracoronal bleaching of discolored stained teeth. Objectives: To evaluate the esthetic improvement of non-pitted fluorosis stains using sodium perborate and compare with etch bleach seal, microabrasion and in-office bleaching with 30% H2O2 on visual assessment scale VAS (primary objective) and to assess any untoward effects including staining, sensitivity, gingival problems within the course of study (secondary objectives). Study design: A randomized control trial with 6 months follow up. Methodology- Twenty children aged 8 to 12 years with non-pitted fluorosis in upper anterior teeth were divided into 4 groups with 5 patients in each group. Results and discussion: All of the techniques showed improvement in esthetics with VAS. However, microabrasion and bleaching using sodium perborate had significantly better results than other 2 techniques. Conclusion: Sodium perborate showed excellent results in extracoronal bleaching of fluorosed teeth. However a randomized study with large sample size is required to draw a definitive conclusion regarding superiority of one technique over others.

Context: Dental fluorosis is caused by successive exposure to high concentrations of fluoride during tooth development leading to enamel with lower mineral content and increased porosity. Aims: The aim of the study was to evaluate and compare the effectiveness of minimally invasive techniques for the removal of dental fluorosis stains in children in vivo. Design: Ninety children in the age group of 10-17 years were selected. Materials and Methods: The study sample was equally and randomly divided into three groups; Group 1: In-office bleaching with 35% hydrogen peroxide (HP) activated by light-emitting diode (LED) bleaching unit (35% HP), Group 2: Enamel microabrasion (EM) followed by in-office bleaching with 44% carbamide peroxide gel (EM), Group 3: In-office bleaching with 5% sodium hypochlorite (5% NaOCl). Statistical analysis was done using one-way ANOVA test. Results: Bleaching with 35% HP activated by LED bleaching unit and EM followed by bleaching with 44% carbamide peroxide were equally effective for the removal of dental fluorosis stains in children in vivo. However, bleaching with 5% NaOCl could not completely remove moderate to severe stains. It was effective in removing only mild stains. Bleaching and microabrasion procedures caused slight decrease in tooth sensitivity readings by electric pulp vitality tester which continued to increase over time. However, none of the patients reported sensitivity in their teeth at any point of time. Patients were highly satisfied with the treatment outcome postoperatively but reported slight relapse of color in the three groups. Conclusions: Bleaching and microabrasion techniques can consider as an interesting alternatives to conventional operative treatment options.

Objectives The study aimed to compare the tooth sensitivity (TS) and bleaching efficacy of two hydrogen peroxide gels with different pHs (acid pH [Pola Office, SDI] and the neutral pH [Pola Office+, SDI]) used for in-office bleaching. Materials and methods Fifty-four patients from Brazil and Chile, with right superior incisor darker than A2, were selected for this double-blind, split-mouth randomized trial. Teeth were bleached in two sessions, with 1-week interval. Each session had three applications of 8 min each, according to the manufacturer’s instructions. The color changes were evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easy shade spectrophotometer) methods. Participants recorded TS with 0–10 visual analog scale. Color change in shade guide units (SGU) and Δ E was analyzed by Student’s t test ( α  = 0.05). The absolute risk and intensity of TS were evaluated by McNemar’s test and Wilcoxon-paired test, respectively ( α  = 0.05). Results All groups achieved the same level of whitening after 30 days of clinical evaluation. The use of a neutral in-office bleaching gel significantly decreases the absolute risk of TS (28%, 95% CI 18–41) and intensity of TS when compared to the acid bleaching gel (absolute risk of 50%, 95% CI 37–63). Conclusion The use of a neutral in-office bleaching agent gel produced the same whitening degree than an acid bleaching gel but with reduced risk and intensity of tooth sensitivity. Clinical significance Clinicians should opt to use in-office bleaching with a neutral gel than an acid product because the former causes a significant lower risk and intensity of tooth sensitivity.

To evaluate the bleaching ability, the effect on enamel surface and cytotoxicity of novel tooth-whitening formulations containing papain, ficin, or bromelain. Forty bovine dental discs (6 cm ×4 cm) were pigmentated and randomly allocated into the following groups (n = 10): Group 1, 20 wt% carbamide peroxide (control); group 2, 1% papain-based whitening; group 3, 1% ficin-based whitening; and group 4, 1% bromelain-based whitening. The whitening gels were prepared and applied on the enamel three times per day once a week, for 4 weeks. Color measurement was obtained by CIEDE2000. Enamel Knoop microhardness and roughness were evaluated. The WST-1 assay was used to evaluate the cell viability of mouse fibroblast cells (L929). Data were statistically analyzed by one-way analysis of variance (ANOVA) and Student Newman Keuls’s post hoc test at α = 0.05 significance level. Bromelain, ficin-based, and carbamide peroxide bleaching gels showed a similar color change (p < 0.001). Higher enamel hardness decrease and higher enamel roughness were caused by the carbamide peroxide (p < 0.05). The experimental whitening gels did not affect cell viability. Tooth bleaching gels containing bromelain, papain, or ficin have substantial clinical potential to be used in the development of peroxide-free tooth whitening gels.

ObjectiveDiscolouration of primary teeth, often attributed to trauma and pulpal infection, is a prevalent concern that can significantly impact the esthetics and self-esteem of children. To address this issue, bleaching techniques have emerged as a viable treatment option. This systematic review aims to provide a comprehensive summary of the effectiveness of bleaching agents in managing discoloured primary teeth.MethodsTwo reviewers independently conducted an electronic database search using PubMed, EMBASE, LILACS, CINAHL via EBSCO, Scopus, and Web of Science until September 26,2023. In vitro studies and case reports that assessed the quantifiable success were included. The present review utilized Distiller SR software for data extraction. The protocol of this study was registered in PROSPERO (International Prospective Register of Systematic Reviews) (CRD42022329831). The quality of studies was analysed with Cochrane tool and the JBI checklist.ResultsThe search retrieved 1845 references of which 14 studies were included for qualitative analysis. There were 8 in vitro studies and 6 case reports included in this systematic review. There were 299 teeth samples in the in vitro studies and 18 teeth were assessed in the case reports. All the 18 teeth (6 case reports) showed considerable shade improvement within 7–14 days. However, only 3 teeth were followed up for a period of 12–24 months. Substantial shade improvement was also observed in samples in the in vitro studies.ConclusionThis systematic review has comprehensively examined the various bleaching agents and methods for the management of discoloured primary teeth. However, it is crucial to recognize that the available evidence is from case reports and is insufficient to make a clinical recommendation.

Background Technological innovations in dental materials have been fueled by the desire of patients to improve the esthetics of their teeth. This emphasis on esthetics has led dentists to seek resources that respect the standards established by society, but without compromising the integrity of the teeth. Methods/design The aim of the proposed controlled clinical trial will be to assess colorimetric changes and increased dental sensitivity in adolescent patients submitted to tooth whitening with 6% and 7.5% hydrogen peroxide using home kits with whitening strips. Adolescents aged 12 to 20 years will be allocated to different groups based on treatment ( n = 16 per group): (1) placebo; (2) 6.0% hydrogen peroxide (White Class with Calcium, FGM); (3) 7.5% hydrogen peroxide (White Class with Calcium, FGM); and (4) 7.5% hydrogen peroxide (Oral B 3D White, Oral-B). After the whitening procedures, the participants will be evaluated using a visual analog scale for tooth sensitivity and digital spectrophotometry to measure changes in color. Descriptive analysis of the data will be performed. Either the chi-squared test or Fisher’s exact test will be used for the determination of associations among the categorical variables. Student’s t -test and analysis of variance will be used to compare mean colorimetric data. Pearson’s correlation coefficients will be calculated to determine the strength of correlations among the continuous variables. Discussion This randomized trial will provide an opportunity to evaluate products such as whitening strips in comparison to other self-administered methods, especially in adolescents. Trial registration The protocol for this study was submitted to Clinical Trials in November 2013 with registration number NCT01998386 .

Objectives This in vitro study aimed to assess the influence of a calcium hydroxide dressing regarding the relative color change (Δ E ) of enamel–dentin specimens previously exposed to antibiotic/corticosteroid pastes. Materials and methods Eighty bovine enamel–dentin specimens with a cylindrical central cavity were randomly allocated to four groups: NEG (empty), POS (blood), LED (Ledermix), and ODO (Odontopaste) ( n  = 20 each). The materials were applied and sealed with self-adhesive resin luting material. After 3 weeks, the materials were removed and a calcium hydroxide (Ca(OH) 2 ) dressing was placed in all cavities. After a further 3-week storage period, the cavities were restored with resin-based composite. Spectrophotometric color measurements were taken over 6 months, and Δ E values were calculated. A Tukey’s multiple comparison test was performed to assess significant differences within the treatment groups ( p  < 0.05). Results Tooth discolorations were present after 3 weeks in LED (Δ E 29.14 ± 6.55) and POS (Δ E 18.05 ± 7.03); NEG and ODO remained color stable (Δ E 3.2 ± 1.36 and Δ E 2.3 ± 1.16). The 3-week Ca(OH) 2 dressing decreased discolorations of POS (Δ E 15.93 ± 6.63; p  = 0.37), whereas LED showed a further significant increase (Δ E 39.55; p  < 0.0001). Between the end of the Ca(OH) 2 dressing and the final restoration no significant color changes were observed in any group ( p  > 0.9). Conclusions Discolorations induced by LED progressed during the Ca(OH) 2 dressing despite careful removal of all residues. Clinical relevance Calcium hydroxide might negatively affect the discoloring potential of Ledermix. This highlights the need for direct intracanal application methods of Ledermix ensuring a material-free access cavity or alternative antibiotic/corticosteroid pastes such as Odontopaste should be used.

Objective To assess the effects for controlling extrinsic tooth stain of a whitening toothpaste containing 10% high cleaning silica, 0.5% sodium phytate and 0.5% sodium pyrophosphate, in comparison with a negative control toothpaste. Methods A total of 86 adults who met with the inclusion and exclusion criteria were invited to take part in the study. They were distributed into test and control groups randomly. At baseline, 4 weeks and 8 weeks, the same examiner provided the clinical examinations, including evaluations of oral soft and hard tissues and measurements of tooth stain of the anterior teeth using the Lobene Stain Index. Adverse events and any changes in general health conditions of the patients were monitored. Results When the study was completed, comparisons between patients in test and control groups yielded statistically significant differences in Lobene stain adjusted mean area score [0.83 (0.05) vs. 1.13 (0.05)], Lobene stain adjusted mean intensity score [0.99 (0.06) vs. 1.32 (0.06)] and Lobene stain adjusted mean composite score [1.45 (0.13) vs. 2.50 (0.13)] (All, P  < 0.001). Patients in the test group exhibited reductions of 26.55%, 25% and 42%, respectively in Lobene stain area, intensity and composite scores, relative to patients in the control group. Comparisons within groups showed that all three Lobene scores at 8 weeks in both groups were lower than those at baseline (All, P  < 0.001). Conclusion This study demonstrates that 8-week use of a toothpaste containing 10% high cleaning silica, 0.5% sodium phytate and 0.5% sodium pyrophosphate can effectively reduce extrinsic tooth stain. Trial registration NCT04238429 (before enrollment of the first participant). Data register: March 4, 2018.