Análisis de los sistemas adhesivos autograbantes sobre dientes sometidos a blanqueamiento.

RESUMEN Introducción: El aumento de tratamientos blanqueadores en la consulta dental y la aparición de distintos sistemas adhesivos obligan a hacer nuevos estudios para establecer las características de la interfase entre los materiales y el diente cuando estos se han sometido a un tratamiento blanqueador. Objetivos: Analizar la adaptación marginal de los adhesivos autograbantes de última generación cuando los dientes se han sometido a un tratamiento con agentes blanqueadores. Material y método: Se seleccionaron 80 dientes (16 grupos de 5 dientes con dos cavidades en cada uno). Los grupos A-B-C-D (bloque 1) fueron blanqueados con peróxido de carbamida al 22% (PC); E-F-G-H (bloque 2) con peróxido de hidrógeno al 37,5 % (PH); Los I-J-K-L y M-N-Ñ-O (bloque 3 y 4) no se blanquearon. A su vez, todos los grupos excepto los del bloque 4 se obturaron conectados a un dispositivo de presión intrapulpar (DPI). Todos los grupos fueron obturados respectivamente con 2 adhesivos autograbantes (Xeno V y AdheSE One) y dos monocomponentes (Exice y XP Bond). Las obturaciones se efectuaron a las dos semanas de finalizar los tratamientos blanqueadores. Para evaluar el blanqueamiento se calcularon los porcentajes de modificación de color y estos se analizaron con el test U de Mann-Whitney.; los datos del MCL con test de Tukey y para el MEB la χ2. Resultados: Bloque 1 obtuvo un porcentaje de blanqueamiento de 47% al final del tratamiento y un 65% a la semana frente a un 20% al final y 17% a la semana con PH (p= 0,003 final y p=0,012 semana). La ausencia de adhesivo a lo largo del perímetro de la cavidad medido con el MCL fue: Grupo A: 25%; B: 25%; C: 30%; D: 29%; E: 12%; F: 1%, G: 5%; H: 10%; I: 16%; J: 22%; K: 9%; L: 10%; M: 0%; N: 2%; Ñ: 0%; O: 0%. La buena adaptación marginal observada con MEB: En el esmalte: Bloque 1: 83%; Bloque 2: 74%; Bloque 3: 86%; Bloque 4: 94%. En la pared axial: 47%-75%-88%-80% En la pared cervical: 41%-45%-78%-60%. p=0,157 para el esmalte y p= 0,001 y 0,009 para la axial y la cervical. Conclusiones: Ambos peróxidos blanquearon los elementos muestrales utilizados en este estudio, siendo el PC el que significativamente mejor resultados obtuvo. La adaptación marginal de los adhesivos estudiados fue significativamente mejor en los grupos en los que no se aplicó una presión intrapulpar simulada. La adaptación marginal en el esmalte fue significativamente mejor para los adhesivos de grabado total y en la dentina para los autograbantes. Se encontraron diferencias significativas en la adaptación marginal entre los grupos blanqueados y los controles (no blanqueados) y obturados a las dos semanas de haber finalizado los tratamientos blanqueadores. __________________________________________________________________________________________________Objectives: Analyze the marginal adaptation of the newest self-etching bonding systems when on teeth under a bleaching treatment. Materials and Methodology: 80 teeth were selected (16 groups of 5 teeth with 2 cavities each). Groups A-B-C-D (block 1) were bleached with 22% carbamide peroxide (CP); Groups E-F-G-H (block 2) with 37.5% hydrogen peroxide (HP); Groups I-J-K-L and M-N-Ñ-O (blocks 3 and 4) were not bleached. Every group except block 4 were filled connected to an intrapulpar pressure device. 2 Self-etching bonding systems (XenoV and AdheSE One) and 2 microcomponents (Excite and XP Bond) were used in every group. The fillings were done two weeks after the bleaching treatment. The Test U from Mann-Whitney was used to evaluate the results; Data from the confocal laser microscopy was analyzed using Tukey´s test; SEMs data using χ2. Results: Block 1 had a bleaching percentage of 47% at the end of the treatment and 65% one week after, while Block 2 had 20% and 17% (p=0,003 for CP, p=0,012 for HP). The lack of adhesive along the cavity perimeter was measured with the confocal laser microscopy: Group A: 25%; B: 25%; C: 30%; D: 29%; E: 12%; F: 1%, G: 5%; H: 10%; I: 16%; J: 22%; K: 9%; L: 10%; M: 0%; N: 2%; Ñ: 0%; O: 0%. The marginal adaptation measured with the SEM: In enamel: Block 1: 83%; Block 2: 74%; Block 3: 86%; Block 4: 94%. In axial wall: 47%-75%-88%-80%. Gingival wall: 41%-45%-78%-60%. p=0,157 for the enamel and p=0.001 and 0.009 for the axial and gingival wall respectively. Conclusions: Both peroxide bleached the samples used in the study, being the CP the one which obtained significantly better results. The marginal adaptation of the adhesives under study was better in the groups without intrapulpar pressure. The marginal adaptation in the enamel was better for total-etching bonding systems, while the results were better for self-etching in dentin. There were notorious differences between bleached and non bleached groups and those filled two weeks after the bleaching treatment was over

In vitro evaluation of the efficacy of two bleaching procedures

Objective: In vitro comparison of the efficacy of two bleaching procedures, one based on carbamide peroxide (CP) and the other on hydrogen peroxide (HP), simulating clinical conditions. Study Design: Two groups of 20 teeth in each group were selected. Group A: 22% CP, one hour a day for 21 consecutive days. Group B: 37.5% HP, in 2 treatment sessions with an one week interval between each session. At each session the product was applied three successive times for eight minutes. Colour was recorded before treatment, when it was finished and one week after finishing it, with the Vita EasyShade spectrophotometer. CIEL*a*b* and ?E were established at each moment in the study. Intra-group data was compared using the paired t-test and inter-group data with the independent groups t-test. Scores from the Vita Classical guide provided with the device were recorded and the colour improvement percentage was calculated. Results: In both groups significant whitening was achieved by the end of treatment. Lightness remained significantly high when treatment was finished and one week after in both groups. The percentage of bleaching was significantly higher in group A. Conclusions: Both 22% CP and 37.5% HP were effective for bleaching teeth. Bleaching effect was greater in CP group. © Medicina Oral S. L

Med Oral Patol Oral Cir Bucal

Abstract Objective: In vitro comparison of the efficacy of two bleaching procedures, one based on carbamide peroxide (CP) and the other on hydrogen peroxide (HP), simulating clinical conditions. Study Design: Two groups of 20 teeth in each group were selected. Group A: 22% CP, one hour a day for 21 consecutive days. Group B: 37.5% HP, in 2 treatment sessions with an one week interval between each session. At each session the product was applied three successive times for eight minutes. Colour was recorded before treatment, when it was finished and one week after finishing it, with the Vita EasyShade spectrophotometer. CIEL*a*b* and ∆E were established at each moment in the study. Intra-group data was compared using the paired t-test and intergroup data with the independent groups t-test. Scores from the Vita Classical guide provided with the device were recorded and the colour improvement percentage was calculated. Results: In both groups significant whitening was achieved by the end of treatment. Lightness remained significantly high when treatment was finished and one week after in both groups. The percentage of bleaching was significantly higher in group A. Conclusions: Both 22% CP and 37.5% HP were effective for bleaching teeth. Bleaching effect was greater in CP group

Caries dental en diabéticos tipo 1: Influencia de factores sistémicos de la enfermedad en la instauración de la caries dental

Objetivos: La diabetes mellitus es una de las enfermedades crónicas más prevalentes en población general. Se presenta un estudio que pretende evaluar la presencia de caries en los pacientes diabéticos tipo 1. El objetivo específico era comprobar si había o no mayor incidencia de caries en diabéticos tipo 1 comparándolos con un grupo de individuos no diabéticos. También, se comprobó la relación con las tasas de flujo salival y con los factores propios de la enfermedad como el grado de control metabólico, el tiempo de evolución de la enfermedad y la existencia de complicaciones crónicas. Diseño del estudio: Se estudiaron 90 diabéticos tipo 1 de edades comprendidas entre los 18 y los 50 años de edad y un grupo de pacientes controles no diabéticos pareados por edad y sexo. Se realizó una exploración visual y táctil, en todos los dientes de los sujetos explorados. Se tuvo en cuenta el grado de la higiene oral mediante el índice de placa de O'Leary, y se estudiaron las tasas de saliva basal y estimulada en ambos grupos. En el grupo diabético se relaciono con el control de la enfermedad mediante la obtención de la media de la hemoglobina glicosilada (HbA1c) de los dos años previos a la exploración, así como la evolución de su enfermedad en años y la existencia de complicaciones como neuropatía diabética o retinopatía. Resultados: Bajo similares condiciones de higiene oral y de flujo salival, el grupo diabético resultó tener una incidencia de caries mayor que el grupo control (p<0.05). Asimismo, al estudiar específicamente al grupo diabético, ni el control metabólico de la enfermedad, ni la evolución de la enfermedad, ni la existencia de complicaciones de la diabetes tenían influencia en la instauración de caries dental. Conclusiones: Se sugiere que habría que estudiar factores cualitativos salivales que explicasen esta mayor incidencia de caries en los diabéticos.Objectives: Diabetes mellitus is one of the most common chronic diseases in the general population. A study is made of the presence of caries in type 1 diabetic patients. The specific aim was to determine whether such patients present a greater incidence of dental caries than non-diabetic individuals. An evaluation was also made of the relationship of caries to salivary flow and to factors inherent to the disease such as the degree of metabolic control, the duration of diabetes, and the existence of chronic complications. Study design: The study comprised 90 type 1 diabetics between 18 and 50 years of age, and a group of non-diabetic controls matched for age and sex. Visual and tactile exploration of the dentition was carried out in all cases. Oral hygiene was rated based on the O'Leary plaque index, and basal (unstimulated) and stimulated salivary flow were evaluated in both groups. In the diabetic group, correlations were established with disease control based on the mean glycosylated hemoglobin (HbA1c) value corresponding to the two years prior to examination; evolution of the disease in years; and the existence of complications such as diabetic neuropathy or retinopathy. Results: Under similar conditions of oral hygiene and salivary flow, the diabetic group showed a higher incidence of caries than the control group (p<0.05). Likewise, on specifically analyzing the diabetic group, metabolic control of the disease, the duration of diabetes, and the existence of complications of the disease exerted an influence upon the development of dental caries. Conclusions: Qualitative salivary studies are advised to better account for this increased incidence of caries in the diabetic population

Dental caries in type 1 diabetics : influence of systemic factors of the disease upon the development of dental caries

Objectives: Diabetes mellitus is one of the most common chronic diseases in the general population. A study is made of the presence of caries in type 1 diabetic patients. The specific aim was to determine whether such patients present a greater incidence of dental caries than non-diabetic individuals. An evaluation was also made of the relationship of caries to salivary flow and to factors inherent to the disease such as the degree of metabolic control, the duration of diabetes, and the existence of chronic complications. Study design: The study comprised 90 type 1 diabetics between 18 and 50 years of age, and a group of non-diabetic controls matched for age and sex. Visual and tactile exploration of the dentition was carried out in all cases. Oral hygiene was rated based on the O?Leary plaque index, and basal (unstimulated) and stimulated salivary flow were evaluated in both groups. In the diabetic group, correlations were established with disease control based on the mean glycosylated hemoglobin (HbA1c) value corresponding to the two years prior to examination; evolution of the disease in years; and the existence of complications such as diabetic neuropathy or retinopathy. Results: Under similar conditions of oral hygiene and salivary flow, the diabetic group showed a higher incidence of caries than the control group (p<0.05). Likewise, on specifically analyzing the diabetic group, metabolic control of the disease, the duration of diabetes, and the existence of complications of the disease exerted an influence upon the development of dental caries. Conclusions: Qualitative salivary studies are advised to better account for this increased incidence of caries in the diabetic population

Efect of periodontal disease and non surgical periodontal treatment on C-reactive protein. Evaluation of type 1 diabetic patient.

Objectives: The purpose of this study was to analyze how anti-infectious periodontal treatment affects C reactive protein (CRP) values in patients with type 1 diabetes, and correlate baseline CRP levels with periodontal disease severity. Study Design: A cohort of fifty three subjects with type 1 diabetes and moderate to severe periodontitis were recruited. Periodontal parameters were measured, and blood samples were obtained to evaluate high-sensitivity C-reactive protein (hs-CRP). Group 1 was treated with scaling, root planning, and systemic administration of doxycycline. Group 2 received only scaling and root planning. Results: Hs-CRP was reduced after periodontal treatment in group 1 (-0.22 mg/l) and 2 (-0.21 mg/l ) but this reduction was not statistically significant, even in the patients with the best response to periodontal treatment. However, significant correlation appeared between hs-CRP and mean probing pocket depth (PPD) (p=0, 01) and mean clinical attachment level (CAL) (p=0,03). Conclusions: Non-surgical periodontal treatment couldn¿t reduce hs-CRP values, however, it was found an asso- ciation between advanced periodontitis and elevated blood hs-CRP levels in patients with type 1 diabetes. It can be speculated that periodontal disease increases production of pro-inflammatory mediators in patients with type 1 diabetes, but other producing sources of these pro-inflammatory substances may exist

Type 1 diabetes mellitus and periodontal disease : relationship to different clinical variables

Objective: This study is designed to evaluate the frequency of periodontal disease in a group of patients with type 1 diabetes mellitus and how this relates with diabetes metabolic control, duration of diabetes, and presence of diabetic complications. Methods: A comparison was made of periodontal parameters (plaque index, bleeding index, pocket depth and attachment loss) in a group of diabetic patients (n=90) versus a group of non-diabetics (n=90). Logistic regression analysis was performed to evaluate relationship between periodontal parameters and degree of metabolic control, the duration of the disease, and the appearance of complications. Results: Diabetics had greater bleeding index (p<0.01), deeper periodontal pockets (p<0.01) and more periodontal attachment loss (p<0.01) than non-diabetics. Deficient metabolic control and presence of diabetic complication were associated with higher bleeding index and pocket depth (p?0.02). Conclusions: Patients with type 1 diabetes appear to show increased periodontal disease susceptibility, particularly those with poorer metabolic control or with diabetic complications