Evaluation of reservoirs in bleaching trays for at-home bleaching: a split-mouth single-blind randomized controlled equivalence trial

Objectives: This randomized, split-mouth, single-blinded trial assessed whether the use of reservoirs in at-home bleaching trays is equivalent to non-reservoir trays. Our choice of an equivalence trial was based on the expectation that a non-reservoir tray is sufficient to produce a color change. Secondary outcomes such as tooth sensitivity (TS) and gingival irritation (GI) were also assessed. Methodology: Forty-six patients were selected with canines shade A2 or darker. In half of the patient’s arch, bleaching trays were made with reservoirs and the other half, without reservoirs. At-home bleaching was performed with carbamide peroxide (CP) 10% (3 h daily; 21 days). Color change was evaluated with a digital spectrophotometer (ΔE, ΔE00, and Whiteness Index) and shade guide units (ΔSGU) at baseline, during and one-month post-bleaching. TS and GI were assessed with a numeric scale (NRS) and a visual analog scale (VAS). Results: After one month, the equivalence of reservoir and non-reservoir groups were observed in all color instruments (p>0.05). Fifteen and sixteen patients presented pain (absolute risk: 33% and 35%, 95%, confidence interval (CI) 21-46% and 23-49%) in the reservoir and non-reservoir side, respectively. The odds ratio for pain was 0.8 (95%CI 0.2-3.0) and the p-value was non-significant (p=1.0). TS intensity was similar between both groups in any of the pain scales (p>0.05). No difference in the GI was observed (p>0.05). Conclusions: The protocol with reservoirs is equivalent in color change to the non-reservoir, although no superiority of the latter was observed in terms of reduced TS and GI with at-home 10% carbamide peroxide bleaching. Clinical Relevance: The presence of reservoirs in a bleaching tray did not improve color change or affect tooth sensitivity and gingival irritation

Osteonecrosis associated with bisphosphonates and its relationship with dental implants - literature review

Bisphosphonates are drugs used to treat diseases such as osteoporosis, Paget's disease, and bone metabolism changes that might be associated with neoplasms. These drugs have some side effects, one of them is a new complication of great interest to the dental class, namely, osteonecrosis of the jaws associated with bisphosphonates (OAB). How bisphosphonates develop such a disease is still unknown. However, the type of bisphosphonate, the treatment duration and the route of administration may have a direct relationship with the occurrence of OAB. Due to the care required by patients who use bisphosphonates and the risk of developing osteonecrosis after implant surgery, this study aims to conduct a literature review about the context of bisphosphonates in implant dentistry, as well as their mechanism of action and most common complications. As this is a recently discovered disease, there is still no consensus on the installation of dental implants in patients who have taken or are taking bisphosphonates, therefore, communication between the dental surgeon and the patient's physician is vital, so that all preventive measures are taken always aiming at the patient's well-being.&nbsp

Amlodipine-induced gingival overgrowth – Review and Case Report / Crescimento gengival induzido por Amlodipina - Revisão e Relato de Caso

Gingival overgrowth or enlargement is among one of the most important clinical features of gingival pathology frequently seen in periodontal clinic. Gingival overgrowth is a serious side e?ect that accompanies the use of amlodipine. Amlodipine is a comparatively new calcium channel blocker and is being used with increasing frequency in the management of hypertension and angina pectoris. Pertinent management depends on precisely diagnosing the origin of overgrowth. Cessation or change of drug and meticulous plaque control often leads to regression of the lesion, which however might need surgical correction for optimal maintenance of gingival health. The purpose of this article is to present a case report and highlight significant aspects of Amlodipine-Induced Gingival Overgrowth (AIGO)

Influence of simplified, higher-concentrated sodium ascorbate application protocols on bond strength of bleached enamel

Bleaching procedures performed before restorative procedures, due to the oxygen released, affects the quality of bonding restorations. The application of an lower-concentrated antioxidant for one-hour or more can reversal the compromised bonding to bleached enamel, but it was not effective according to the bleaching concentrations applied. The aim of the present study was to evaluate simplified protocol of higher-concentrated sodium ascorbate (35%SA) in bond strength values of enamel bleached with 10%, 16%, 22% carbamide peroxide (CP) or 35% hydrogen peroxide (HP). Three hundred and forty enamel surfaces of 85 human third molars were used, divided into 17 groups (n=20), according to the following groups: control = no bleaching and no ascorbic acid application; bleaching (CP10%, CP16%, CP22% at-home and HP 35% in-office) and 35%SA application (no application; 35%SA applied twice for 1-min each [SA2×1], twice for 5-min each [SA2×5] and; twice for 10-min each [SA2×10]). After that, adhesive was applied and composite cylinders were made with Filtek Z350 composite. Microshear test was performed in a universal testing machine. BS values were statistically evaluated using ANOVA and Tukey?s and Dunnet?s (against control) tests, with 5% level of significance. All bleaching concentrations significantly decrease the enamel bond strength results when compared to control group (p<0.05). More concentrated PC (PC22% and PH35%) showed lower enamel bond strength results when compared to lower concentrated PC (PC10% and PC16%; p<0.05). A significant increase of the enamel bond strength results were only observed when SA2×5 and SA2×10 were applied (p<0.05). The application of 35% sodium ascorbate for twice 5- and 10-min each was an efficient protocol to reverse the bond strength in bleached enamel at the same level as the no bleaching enamel, independently of the bleaching concentration used

Evaluation of the color stability of different temporary restorative materials

This study aimed to evaluate the color stability of different temporary restorative materials in contact with staining solutions, as well as to verify which one presents the highest resistance to staining. In this laboratory study, five types of temporary restorative materials were evaluated: self-curing acrylic resin, bis-acrylic resin, light-curing acrylic resin, CAD/CAM machinable, and 3D printed resin. Thirty samples of each material were produced in a circular mold measuring 10 mm diameter and 2 mm thickness. The materials were divided into subgroups (n=10) and immersed in solutions: Coffee, Coca-cola®, and distilled water (control). Color measurements were carried out at baseline, 1, 7, and 14 days using a digital spectrophotometer and the color parameters were calculated according to the CIEDE00 system. The color change data were subjected to two-way ANOVA (temporary material vs time) and post-hoc Tukey test (α = 0.05). The materials showed a color change only comparing baseline vs. one day, according to acceptability standard ΔE00 &gt; 1.8. Thus, we concluded that there was a difference in color stability already on the first day of immersion. In addition, the coffee solution showed the highest color variation when compared to the other solutions. Clinical applicability: Temporary restorations are widely used in prosthetic treatments and can remain in the mouth for a considerable period. They are responsible for aesthetic and function maintenance along the rehabilitation process. In addition, they provide data for the definitive prosthesis and should assure comfort and confidence to the patient.&nbsp; Thus, it is necessary that these materials are resistant and present such color stability that does not compromise the aesthetics during the treatment phase

Análise da capacidade de remoção de pigmentos da resina composta pelo peróxido de hidrogênio 35%

Resumo Objetivo Avaliar in vitro a capacidade de remoção de pigmentos ocasionados em resina composta após aplicação de peróxido de hidrogênio 35%. Material e método Confeccionaram-se 20 amostras de resina composta Opallis (FGM), cor A1, em matriz metálica circular. As amostras foram divididas em quatro grupos (n=5) dos seguintes agentes corantes: água destilada (controle), café, vinho tinto e Coca-Cola®. No manchamento, as amostras ficaram imersas nas soluções durante 72 horas, com troca diária das bebidas. Procedeu-se à aplicação do gel de peróxido de hidrogênio 35% (Whiteness HP Blue Calcium, FGM) em três sessões, sendo uma aplicação do gel por sessão, o qual permaneceu nas amostras durante 40 minutos. Medidas de cor foram feitas inicialmente, após manchamento, após aplicação do peróxido e por mais 21 dias, usando espectrofotômetro Vita Easyshade. Os dados foram submetidos à análise de variância de dois fatores (tempo vs. corante) e ao teste de Tukey, para o contraste das médias (α=0,05). Resultado Apresentaram alteração de cor (ΔE - média/desvio padrão de L*) o café (15,7 ± 2,0) e o vinho (15,2 ± 4,6), quando comparados à Coca-Cola® (4,8 ± 1,9). O peróxido de hidrogênio removeu a pigmentação das amostras, porém, para nenhum dos corantes, houve retorno à coloração inicial, principalmente no grupo manchado por café (12,9 ± 1,5); este mostrou diferença significativa quando comparado ao controle (1,6 ± 0,6), diferentemente do vinho (3,3 ± 0,6) e da Coca-Cola® (2,1 ± 0,9), que se aproximaram do grupo controle. Conclusão As soluções corantes pigmentaram a resina composta, principalmente o café. A aplicação do peróxido de hidrogênio 35% foi eficaz na remoção de pigmentos das amostras, porém, em nenhum dos grupos, com diferentes corantes, houve retorno à coloração inicial (p>0,005)

Nasolabial Cyst Associated with Odontogenic Infection

The nasolabial cyst or Klestadt cyst is a relatively uncommon nonodontogenic cyst that develops in the nasal alar region; it has uncertain pathogenesis. This lesion has slow growth and variable dimensions and is characterized clinically by a floating tumefaction in the nasolabial fold area around the bridge of the nose, causing an elevation of the upper lip and relative facial asymmetry. Diagnosis is primarily made clinically; if necessary, this is complemented by imaging. This paper reports the case of a 39-year-old male patient who complained of pain in the right upper premolar region and poor aesthetics due to a firm tumor in the right wing of the nose. Initially, this was thought to be due to an odontogenic abscess; however, the differential diagnosis was that a nasolabial cyst was communicating with the apex of teeth 14 and 15. Surgical treatment was carried out, followed by histopathological examination and concomitant endodontic treatment of the teeth involved