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A commercially available nano-filled composite resin was used. Specimens were stained using a coffee-based solution and a 10% carbamide peroxide-based gel was employed as the whitening agent. The pigment’s penetration and the effect of the bleaching gel were evaluated by measuring color (CieLab values) from the outer edge to the inner part of the specimens. Color measurements were taken at 14 points, starting from 0.1 mm from the external perimeter up to 3.0 mm.
Analysis of variance tests showed a statistically significant difference between the Control Group (CG), Pigmentation Group, and Whitening Group. The whitening agent was effective up to 1.5 mm in depth, with Whiteness index (W) values not statistically different from those of CG up to 0.5 mm in depth.
Whitening agents on nano-filled resin composite previously pigmented appear effective in restoring the W to values similar to the original, particularly in the superficial layers of the sample.
This study aimed to answer the question through a systematic review: Can carbamide peroxide be as effective as hydrogen peroxide and cause less in-office bleaching sensitivity? A literature survey was performed in PubMed/MEDLINE, Embase, Scopus, ISI Web of Science, and gray literature. Primary clinical trials that compared the efficacy or the in-office bleaching sensitivity between carbamide and hydrogen peroxides were included. The risk of bias was evaluated using the RoB2. The certainty of the evidence was assessed using the GRADE approach. DPI training significantly improved the mean scores of the dental undergraduates from 7.53 in the pre-DPI-training test to 9.01 in the post-DPI-training test (
Citations
This study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells.
Electronic searches were performed in July 2023.
Out of 1,112 articles, 27 were included. Nine animal studies evaluated remineralizing/anti-inflammatories agents in rat molars subjected to bleaching with 35%–38% hydrogen peroxide (HP). Five of these studies demonstrated a significant reduction in inflammation caused by HP when combined with bioglass or MI Paste Plus (GC America), or following KF-desensitizing or Otosporin treatment (
Few
PROSPERO Identifier:
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This study aimed to evaluate the bleaching efficacy and hydrogen peroxide permeability in the pulp chamber by the at-home bleaching gel in protocols applied on different dental surfaces.
Forty premolars were randomly into 4 groups: control group no bleaching, only application on the buccal surface (OB), only application on the lingual surface (OL) and application in buccal and lingual surfaces, simultaneously (BL). At-home bleaching gel (White Class 7.5%) was used for the procedure. The bleaching efficacy was evaluated with a digital spectrophotometer (color change in CIELAB [Δ
All groups submitted to bleaching procedure showed bleaching efficacy when measured with Δ
The application of bleaching gel exclusively on the OB is sufficient to achieve bleaching efficacy, when compared to BL. Although the OL protocol demonstrated lower bleaching efficacy based on the ΔWID values, it may still be of interest and relevant in certain clinical scenarios based on individual needs, requiring clinical trials to better understand its specificities.
Citations
The present study evaluated the pulp response of human mandibular incisors subjected to in-office dental bleaching using gels with medium or high concentrations of hydrogen peroxide (HP).
The following groups were compared: 35% HP (HP35;
The CC and TS of the HP35 group were significantly higher than those of the CONT group (
In-office bleaching therapies using bleaching gels with 20% or 35% HP caused similar pulp damage to the mandibular incisors, characterized by partial necrosis, tertiary dentin deposition, and mild inflammation.
Citations
This study evaluated the bleaching efficacy of different in-office protocols associated with violet light emitting diode (V-LED), and measured the pulpal temperature rise caused by V-LED with or without gel application.
Bovine incisors were distributed in 4 groups (
VL exhibited lower color (
HPLV was more efficient than HYB. The 2 protocols with VL showed similar results to control. Gel application combined with VL promoted higher pulpal temperature than to the no gel group.
Citations
This study aimed to use a laboratory model to evaluate the efficacy of an experimental bleaching agent.
The model used human extracted molars that were treated and measured for bleaching efficacy. Teeth (
There was no significant difference in color parameters (L1, a1, b1, and shade guide units [SGU]) at baseline (
The laboratory model was successful in screening an experimental bleaching agent.
Citations
To minimize the tooth sensitivity caused by in-office bleaching, many dentists use non-steroidal anti-inflammatory drugs and topical desensitizing gels containing potassium nitrate and sodium fluoride. This study aimed to evaluate the influence of these substances on inflammation and the expression of substance P and calcitonin gene-related peptide in pulp nerve fibers.
Seventy-two rats were divided into 6 groups as follows: GI, control; GII, only dental bleaching; GIII, only ibuprofen; GIV, ibuprofen administered 30 minutes before and after the bleaching treatment and every 12 hours until the analysis; GV, only topical application of a desensitizing agent; and GVI, topical application of a desensitizing agent before dental bleaching. Placebo gel was applied to the upper left jaw and the bleaching agent was applied to the upper right jaw in all groups. Subsequently, the groups were divided into 3 subgroups based on the time of analysis: 0, 24, and 48 hours after bleaching (
In the bleaching groups, the inflammatory process and expression of neuropeptides decreased over time. The animals in which a desensitizing agent was applied showed better results within 24 hours.
The use of a desensitizing agent had positive effects on inflammation and pain-related neuropeptide expression, minimizing the painful effects of dental bleaching treatment.
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The aim of this
Sixty specimens were prepared of each composite resin (Filtek Supreme XT and Opallis), and BisCover LV surface sealant was applied to half of the specimens. Thirty enamel samples were obtained from the buccal and lingual surfaces of human molars for use as the control group. The surface roughness and microhardness were measured before and after bleaching procedures with 35% hydrogen peroxide or 16% carbamide (
Neither hydrogen peroxide nor carbamide peroxide treatment significantly altered the hardness of the composite resins, regardless of surface sealant application; however, both treatments significantly decreased the hardness of the tooth samples (
The microhardness and surface roughness of enamel and Opallis composite resin were influenced by bleaching procedures.
Citations
The aim of the present study was to evaluate the effect of whitening mouth rinses alone and in combination with conventional whitening treatments on color, microhardness, and surface roughness changes in enamel specimens.
A total of 108 enamel specimens were collected from human third molars and divided into 9 groups (
Statistically significant color change was observed in all groups compared to the CG. All groups, except the LW group, showed statistically significant decreases in microhardness. Roughness showed a statistically significant increase after the treatments, except for the 38% HP group.
Whitening mouth rinses led to a whitening effect when they were used after conventional treatments; however, this process caused major changes on the surface of the enamel specimens.
Citations
The aim of this
Extracted 160 sound human incisors were used for the study. Teeth were divided into 4 treatment groups: No treatment, 35% hydrogen peroxide, 16% carbamid peroxide, 7.5% carbamid peroxide. After bleaching treatments, groups were divided into subgroups according to the adhesive systems used and application modes (
No significant difference were found among bleaching groups (35% hydrogen peroxide, 16% carbamid peroxide, 7.5% carbamid peroxide, and no treatment groups) in the mean SBS values. There was also no difference in SBS values between Single Bond Universal and Gluma Universal at same application modes, whereas self-etch mode showed significantly lower SBS values than etch and rinse mode (
The bonding performance of the universal adhesives was enhanced with the etch and rinse mode application to bleached enamel and non-bleached enamel.
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The aim of this
The crowns of 24 extracted sound human molars were sectioned. Sixty enamel specimens (2 × 3 × 4 mm) were selected and divided into five groups (
Significant differences were observed between the study groups. The enamel microhardness changes in Groups 1, 3, 4, and 5 were significantly lower than that of Group 2 (
Within the limitations of this study, it can be concluded that incorporation of each one of the three tested biomaterials as remineralizing agents might be effective in decreasing enamel microhardness changes subsequent to in-office bleaching.
Citations
The purpose of this study was to evaluate the histopathological effects of an antioxidant therapy on the pulp tissue of rat teeth exposed to a bleaching gel with 35% hydrogen peroxide.
Forty rats were subjected to oral ingestion by gavage of distilled water (DW) or ascorbic acid (AA) 90 min before the bleaching therapy. For the bleaching treatment, the agent was applied twice for 5 min each to buccal surfaces of the first right mandibular molars. Then, the animals were sacrificed at 6 hr, 24 hr, 3 day, or 7 day post-bleaching, and the teeth were processed for microscopic evaluation of the pulp tissue.
At 6 hr, the pulp tissue showed moderate inflammatory reactions in all teeth of both groups. In the DW and AA groups, 100% and 80% of teeth exhibited pulp tissue with significant necrosis and intense tissue disorganization, respectively. At 24 hr, the AA-treated group demonstrated a greater regenerative capability than the DW group, with less intense inflammatory reaction and new odontoblast layer formation in 60% of the teeth. For up to the 7 day period, the areas of pulpal necrosis were replaced by viable connective tissue, and the dentin was underlined by differentiated odontoblast-like cells in most teeth of both groups.
A slight reduction in initial pulpal damage during post-bleaching was promoted by AA therapy. However, the pulp tissue of AA-treated animals featured faster regenerative potential over time.
Citations
Some antioxidants are believed to restore dentin bond strength after dental bleaching. This study was done to evaluate the influence of antioxidants on the bond strength of bleached bovine dentin.
Thirty incisors were randomly assigned to 10 groups (two unbleached control and eight bleached groups: immediate bonding IB, 4 wk delayed bonding DB, 10% sodium ascorbate treated SA, 10% α-tocopherol treated TP groups). Teeth in half of groups were subjected to thermal stress, whereas the remaining groups were not. Resin-dentin rods with a cross-sectional area of 2.25 mm2 were obtained and microtensile bond strength was determined at a crosshead speed of 1 mm/min. Fifteen specimens were prepared for SEM to compare the surface characteristics of each group. The change in dentin bond strength from thermal stress and antioxidant treatment was evaluated using two-way analysis of variance (ANOVA) and Sheffe's
The control group exhibited the highest bond strength values, whereas IB group showed the lowest value before and after thermocycling. The DB group recovered its bond strength similar to that of the control group. The SA and TP groups exhibited similar bond strength values with those of the control and DB groups before thermocycling. However, The TP group did not maintain bond strength with thermal stress, whereas the SA group did.
Applying a 10% sodium ascorbate solution rather than 10% α-tocopherol solution for 60 sec is recommended to maintain dentin bond strength when restoring non-vitally bleached teeth.
Citations
This study aimed to assess the effect of 38% carbamide peroxide on the microleakage of class V cavities restored with either a silorane-based composite or two methacrylate-based composites.
A total of 96 class V cavities were prepared on the buccal surface of extracted human teeth with both enamel and dentin margins and were randomly assigned into three groups of Filtek P90 (3M-ESPE) + P90 system adhesive (3M-ESPE)(group A), Filtek Z250 (3M-ESPE) + Adper Prompt L-Pop (3M-ESPE)(group B) and Filtek Z350XT (3M-ESPE) + Adper Prompt L-Pop (group C). Half of the teeth were randomly underwent bleaching (38% carbamide peroxide, Day White, Discus Dental, applying for 15 min, twice a day for 14 day) while the remaining half (control) were not bleached. Dye penetration was measured following immersion in basic fuchsine. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests at a level of 0.05.
No significant differences were found between composites in the control groups in enamel (
No significant differences were noted between the bleached and control subgroups of two methacrylate-based composites in enamel or dentin margins. Microleakage of silorane-based composite significantly increased after bleaching.
The aim of this study was to determine the effect of epigallocatechin gallate (EGCG) on the shear bond strength of composite resin to bleached enamel.
Ninety enamel surfaces of maxillary incisors were randomly divided into 9 groups as follows: G1: control (no bleaching); G2: bleaching; G3: bleaching and storage for seven days; G4 - 6: bleaching and application of 600, 800 and 1,000 µmol of EGCG-containing solution for 10 minutes, respectively; G7 - 9: bleaching and application of 600, 800 and 1,000 µmol of EGCG-containing solution for 20 minutes, respectively. The specimens were bleached with 30% hydrogen peroxide gel and a composite resin cylinder was bonded on each specimen using a bonding agent. Shear bond strength of the samples were measured in MPa. Data was analyzed using the two-way ANOVA and Tukey HSD tests (α = 0.05).
The maximum and minimum mean shear bond strength values were observed in G1 and G2, respectively. Time and concentration of EGCG showed no significant effects on bond strength of the groups (
There is a significant decrease in bond strength of composite resin to enamel immediately after bleaching. A delay of one week before bonding and the use of EGCG increased bond strength of composite resin to bleached enamel.
Citations
The aim of this study was to determine an appropriate application duration of sodium ascorbate (SA) antioxidant gel in reducing microleakage of bonded composite restoration in intracoronally-bleached teeth.
Eighty endodontically-treated human incisors were randomly divided into eight groups: control, no bleaching; IB and DB, immediate and delayed bonding after bleaching, respectively; S10m, S60m, S24h, S3d and S7d, bleaching + SA gel for 10 min, 60 min, 24 hr, 3 day and 7 day, respectively. For bleaching, a mixture of 30% hydrogen peroxide and sodium perborate was applied for 7 day. All access cavities were restored using One-Step adhesive (Bisco Inc.) and then Aelite LS Packable composite (Bisco Inc.). The bonded specimens were subjected to 500 thermal cycles, immersed in 1% methylene blue for 8 hr, and longitudinally sectioned. Microleakage was assessed with a 0 - 4 scoring system and analyzed using nonparametric statistical methods (α = 0.05).
Group IB showed a significantly higher microleakge than the control group (
Application of SA gel for 3 day after nonvital bleaching was effective in reducing microleakage of composite restoration in intracoronally-bleached teeth.
Citations
Invasive cervical resorption is a relatively uncommon form of external root resorption. It is characterized by invasion of cervical region of the root by fibrovascular tissue derived from the periodontal ligament. This case presents an invasive cervical resorption occurring in maxillary lateral incisor, following damage in cervical cementum from avulsion and intracoronal bleaching procedure. Flap reflection, debridement and restoration with glass ionomer cement were performed in an attempt to repair the defect. But after 2 mon, more resorption extended apically. Considering root stability and recurrence potential, we decided to extract the tooth. Invasive cervical resorption in advanced stages may present great challenges for clinicians. Therefore, prevention and early detection must be stressed when dealing with patients presenting history of potential predisposing factors.
Citations
This clinical study evaluated the effect of light activation on the whitening efficacy and safety of in-office bleaching system containing 15% hydrogen peroxide gel.
Thirty-three volunteers were randomly treated with (n = 17, experimental group) or without light activation (n = 16, control group), using Zoom2 white gel (15% H2O2, Discus Dental) for a total treatment time of 45 min. Visual and instrumental color measurements were obtained using Vitapan Classical shade guide and Shadepilot (DeguDent) at screening test, after bleaching, and 1 month and 3 month after bleaching. Data were analyzed using
Zoom2 white gel produced significant shade changes in both experimental and control group when pre-treatment shade was compared with that after bleaching. However, shade difference between two groups was not statistically significant (
The application of light activation with Zoom2 white gel system neither achieved additional whitening effects nor showed more detrimental influences.
Citations
The purpose of this study was to evaluate the whitening efficacy and longevity of home bleaching.
A total of 28 patients were divided into either experimental group (Opalescence F; 15% carbamide peroxide) or control group randomly. The patients in experimental group were instructed to wear individual trays applied with bleaching gel for 2 hours a day for 4 weeks. Any treatments weren't applied to the patients in control group. The color measurements of central incisors, lateral incisors & canines of upper and lower arch were recorded at base line, immediately after the finishment of treatmemt (4 weeks), 8 weeks and 12 weeks using Colorimeter (Chroma Meter, 2600d Konica Minolta co.) and Vitapan classical shade guide (Vita Zahnfabrik).
A significantly stronger color change was observed for overall teeth samples in experimental group immediately after treatment (at 4 weeks) compared to ones in control group (
The clinical effecacy and longevity of home bleaching without combined application of in-office bleaching was observed through this experiment.
Citations
This study evaluated the safety of an office bleaching gel (RemeWhite, Remedent Inc., Deurle, Belgium) containing 30% hydrogen peroxide. 37 volunteers were recieved office bleaching with the RemeWhite for 3 times at one visit, total 2 visits. As control group, the same gel in which hydrogen peroxide was not included was applied to 34 volunteers with the same protocol.
There was no difference between experimental group and control group using electric pulp test. In the result of gingival inflammation index and tooth sensitivity test, there was mild pain response in experimental group but it disappeared as time went by. Therefore, safety of the office bleaching gel containing 30% hydrogen peroxide was confirmed.
Citations
This study evaluated the efficacy of an office bleaching gel (RemeWhite, Remedent Inc., Deurle, Belgium) containing 30% hydrogen peroxide. 31 volunteers were recieved office bleaching with the RemeWhite for 3 times at one visit, total 2 visits. As control group, the same gel in which hydrogen peroxide was not included was applied to 31 volunteers with the same protocol. The shade change (ΔE*, color difference) of 12 anterior teeth was measured using Colorimerter and Vitapan classical shade guide. The shade change of overall teeth in the experimental group was significantly greater than that in the control group which was measured using Colorimeter. There was also a significant difference between baseline and 14 weeks or 26 weeks though color rebounding phenomenon occurred as time went by. Small shade change difference can be measured accurately using Colorimeter than using Vitapan classical shade guide.
Citations
The aim of this study was to evaluate the influence of light energy on the tooth whitening effect of bleaching agent in vitro. Extracted human mandibular molars were sectioned to 2 fragments(mesial, distal) and lingual portions of crown were used in this study. All specimens were stained using a red wine for 24 hours and immersed in artificial saliva. Specimens divided into four groups, group 1 and 2 light-activated by LumaCool (LED, LumaLite, Inc., Spring Valley, USA), group 3 and 4 light-activated by FlipoWhite2 (Plasma acr lamp, Lokki, Australia). Group 1 and 3 bleached with LumaWhite(LumaLite, Inc., Spring Valley, USA), group 2 and 4 bleached with Polaoffice(SDI, Victoria, Australia). Bleaching treatment performed during 10 minutes every 24 hours and repeated 6 times. During bleaching treatment , distal fragments was light-activated(L) but mesial fragments was not(NL). Shade assessment employed before and after bleaching treatment using spectrophotometer. The results of the change in shade was compared and analysed between NL and L by using paired-sample T test with 95% level of confidence.
There were no significant differences between NL and L with a few exceptions. In group 2, a* value more change in L, in group 3, b* value more change in L, in group 4, a* value less change in L. After bleaching, L* value and ΔE increased in all groups and the value of a* and b* decreased in all groups.
Within the limitation of this test conditions, the results of this study indicate that the light energy has no obvious improving impact on the tooth whitening effect of a bleaching agent.
Citations
This study investigated the clinical effectiveness and safety of sealed bleaching compared to conventional in-office bleaching using a randomized clinical trial of split arch design. Ten participants received a chairside bleaching treatment on the upper anterior teeth, and each side was randomly designated as sealed or control side. A mixture of Brite powder (PacDent, Walnut, USA), 3% hydrogen peroxide and carbamide peroxide (KoolWhite, PacDent, Walnut, USA) were used as bleaching agent. The control side was unwrapped and the experimental side was covered with a linear low density polyethylene (LLDPE) wrap for sealed bleaching. The bleaching gel was light activated for 1 hour. The tooth shades were evaluated before treatment, after treatment, and at one week check up by means of a visual shade (VS) assessment using a value oriented shade guide and a computer assisted shade assessment using a spectrophotometer (SP). The data were analyzed by paired t-test.
In the control and sealed groups, the visual shade scores after bleaching treatment and at check up showed statistically significant difference from the preoperative shade scores (p < .05). The shade scores of the sealed group were significantly lighter than the control immediately after bleaching and at the check-up appointment (p < 0.05). Compared to prebleaching status, the ΔE values at post-bleaching condition were 4.35 ± 1.38 and 5.08 ± 1.34 for the control and sealed groups, respectively. The ΔE values at check up were 3.73 ± 1.95 and 4.38 ± 2.08 for the control and sealed groups. ΔE values were greater for the sealed group both after bleaching (p < .05) and at check up (p < .05).
In conclusion, both ΔE and shade score changes were greater for the sealed bleaching group than the conventional bleaching group, effectively demonstrating the improvement of effectiveness through sealing.
This study evaluated the effectiveness and safety of an experimental bleaching strip (Medison dental whitening strip, Samsung medical Co., Anyang, Korea) containing 2.9% hydrogen peroxide. Twenty-three volunteers used the bleaching strips for one and a half hour daily for 2 weeks. As control group, the same strips in which hydrogen peroxide was not included were used by 24 volunteers with the same protocol. The shade change (ΔE*, color difference) of twelve anterior teeth was measured using Shade Vision (X-Rite Inc., S.W. Grandville, MI, USA), Chroma Meter (Minolta Co., Ltd. Osaka, Japan) and Vitapan classical shade guide (Vita Zahnfabrik, Germany). The shade change of overall teeth in the experimental group was significantly greater than that in the control group (p < 0.05) and was easily perceivable. The change resulted from the increase of lightness (CIE L* value) and the decrease of redness (CIE a* value) and yellowness (CIE b* value). The shade change of individual tooth was greatest in canine, and smallest in central incisor. The safety of the bleaching strip was also confirmed.
Citations
To evaluate the effect of vital tooth bleaching agent and alcohol pretreatment on dentin bonding, flat dentin windows were produced on the buccal side of the crowns of fifty-five extracted, human premolars. A bleaching gel, Opalescence® with 10% of carbamide peroxide (Ultradent Product, USA) was daily applied on the teeth of three experimental groups for six hours for 10 consecutive days, while teeth of a control group were not bleached. After 6 hours of bleaching gel application, the specimens were washed and stored in saline until the next day application. After application of One-step® dentin bonding agent (Bisco, USA), Z-250® resin (3M-ESPE, USA) was bonded to dentin with a mount jig. Shear bond strength was measured with an Instron machine (Type 4202, Instron Corp., USA) after 24 hours. The results were analyzed using one-way ANOVA and Duncan's multiple range test at
Immediate bonding group showed significantly lower bond strength than un-bleached control group (
Ethanol-treated group showed significantly higher bond strength compared to immediate bonding group (
There were no significant difference in shear bond strength between the 2-week delayed bonding group and the ethanol-treated group (
In the condition of the present study, it seems that alcohol pretreatment after bleaching procedure can reduce the adverse effect of vital bleaching agent on dentin bonding.
Citations
This study was done to evaluate whether vital bleaching agents could influence on the translucency of the bovine enamel. The anterior bovine teeth that were extracted one day before and without any gross discoloration were obtained and then were preserved in physiologic saline. 6 mm cylindrical tooth specimens were fabricated with diamond puncher perpendicularly on labial surface of bovine tooth. After embedded in transparent acrylic resin with labial surface being exposed, they were cut to a thickness of 1.2 mm with low speed diamond saw (Isomat, Buehler Co., Lake Bluff, IL, USA). They were smoothly ground to 1 mm thickness of enamel with sandpaper. 24 specimens were randomly divided into 3 groups and control group respectively. Opalescence (10% carbamide peroxide, Ultradent, South Jordan, USA), Rembrandt (10% carbamide peroxide, DenMat, USA) and Opalescence F (15% carbamide peroxide with fluoride, Ultradent, USA) were applied on labial sides of the bovine enamel for 7 days (bleaching agents were reapplied every 24 hours) and the opposite surface was contacted to cotton that soaked in distilled water. The control group was soaked in distilled water. Three stimulus value X, Y and Z were evaluated with colorimeter (Color & Color Differencemeter, Model TC-6FX, Tokyo Denshoku Co., Japan) on the labial surface of all specimen three times on white and black background plate before the bleaching agents were applied and on 3rd, 5th and 7th day after applied. The degree of translucency was normally assessed by measuring the inverse property, opacity (contrast ratio).
10% Opalescence, 15% Opalescence-F, and control group showed no significant variation in the translucency of bovine enamel, However Rembrandt decreased the translucency of it (p < 0.01).
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The purpose of the present study were to evaluate microleakage of a fourth generation dentin-bonding agent following a walking bleaching treatment, to determine the effect of temporary postbleaching dressing with calcium hydroxide on microleakage and to investigate the effect of delayed intracoronal restoration on microleakage.
The results of this study were as follows:
1. Bleached groups showed more microleakage than unbleached group.
2. Immediately restored group following bleaching procedure showed the highest microleakage score.
3. One-week delayed restorations showed less microleakage but there were no statistically significant difference between group II and III.
4. Provisional dressing with calcium hydroxide had no influence on microleakage.
It is necessary to know the time that has elapsed from the bleaching treatment to the restoration procedure to achieve optimal seal, as well as to reduce the risk of microleakage in adhesive restoration.
The bleaching of discolored nonvital teeth is conservative treatment that satisfy the cosmetic desire. The most common method for this treatment, walking bleaching, is using 30% hydrogen peroxide and sodium perborate.
Many alternatives are suggested for preventing the external cervical root resorption that is the common complication of the nonvital teeth bleaching with 30% hydrogen peroxide.
The same extent of oxidation reactions as that resulted by the bleaching with the application of 30% hydrogen peroxide and sodium perborate can also be acquired more safely by materials that contain 10% carbamide peroxide, used primarily for the bleaching of vital teeth. Therefore, this study was performed to evaluate the efficacy of 10% and 15% carbamide peroxide bleaching gel in nonvatal teeth bleaching.
The internal bleaching of intentionally discolored teeth was performed in vitro with 10% carbamide peroxide (Group 1), 15% carbamide peroxide (Group 2), mixture of distilled water and sodium perborate (Group 3), and mixture of 30% hydrogen peroxide and sodium perborate (Group 4). The bleaching materials were refreshed following 3, 6, 9 and 12 days. To evaluate the bleaching effect, the color change of the crowns was measured at 1, 2, 3, 4, 7 and 15 days of bleaching using the colorimeter.
The results were as follows :
1. L* and ΔE* values were increased with time in all bleaching agents(p<0.01).
2. There was no significant difference in L* and ΔE* value among bleaching agents.
3. ΔE* value higher than 3 was shown after 3 days of bleaching with 10% carbamide peroxide gel, 1 day with 15% carbamide peroxide gel, 4 days with mixture sodium perborate and distilled water and 4 days with mixture sodium perborate and 30% hydrogen peroxide, respectively.
These results revealed that the use of 10% and 15% carbamide peroxide bleaching gel in non-vital teeth bleaching is as effective as mixture of distilled water and sodium perborate and mixture of 30% hydrogen peroxide and sodium perborate. Accordingly, carbamide peroxide could be used clinically to bleach discolored non-vital teeth.