Effects of dessensitizing dentifrices on the reduction of pain sensitivity caused by in-office dental whitening : double blind controlled clinical study

Orientador: Luis Alexandre Maffei Sartini PaulilloDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Introdução: A sensibilidade dolorosa associada ao clareamento dental é o principal problema relatado pelos pacientes durante esse tratamento, sendo a utilização de dentifrícios dessensibilizantes uma alternativa para o tratamento da sensibilidade. Objetivo: Avaliar clinicamente os efeitos de dentifrícios dessensibilizantes, aplicados através de moldeira plástica, na redução da sensibilidade dolorosa e variação de cor causadas pela técnica de clareamento dental em consultório, por meio de estudo clínico duplo cego controlado. Metodologia: Realizou-se um estudo longitudinal prospectivo com 48 indivíduos, entre 18 e 30 anos de idade, sem distinção de gênero, os quais foram submetidos ao clareamento dental em consultório utilizando peróxido de hidrogênio a 35% em três sessões clínicas com intervalo de uma semana entre as mesmas. Os voluntários utilizaram na noite referente a cada sessão de clareamento uma moldeira plástica por 4 horas contendo um dos dentifrícios relativos aos grupos experimentais: Grupo 1 (Controle) ¿ Sucralose (S); Grupo 2 (Controle ativo) ¿ Fluoreto de Sódio (FS) com 1450ppm de Flúor; Grupo 3 ¿ Arginina e Carbonato de Cálcio (ACC) e Monofluorfosfato de Sódio com 1450 ppm de Flúor; Grupo 4 ¿ Nitrato de Potássio (NP) a 5% e Fluoreto de Sódio com 1450 ppm de Flúor. A avaliação da sensibilidade associada aos tempos de utilização da moldeira plástica na primeira sessão (S1: sensibilidade antes da moldeira; S2: sensibilidade depois da moldeira), na segunda sessão (S3: sensibilidade antes da moldeira; S4: sensibilidade depois da moldeira) e na terceira sessão (S5: sensibilidade antes da moldeira; S6: sensibilidade depois da moldeira) utilizou a escala numérica analógica com escores de 0 a 10. A variação de cor (?E) utilizou o espectrofotômetro para obtenção dos dados (L, a, b) que foram utilizados no sistema CIELab. Os dados de sensibilidade dolorosa foram submetidos ao teste de análise de variância multifatorial (MANOVA) com medidas repetidas e Teste de Lambda Wilks (p<0.05). Para a análise da variação de cor o teste ANOVA em um critério foi aplicado (p<0.05). Resultados: Os grupos ACC e NP 5% apresentaram redução da sensibilidade em relação aos demais grupos (p<0,05). A relação da sensibilidade e tempo associados as três sessões de clareamento, mostrou que houve uma redução da sensibilidade após a colocação da moldeira com dentifrício (S2; S4; S6). A avaliação de cor associada ao fator dentifrício mostrou que não houve diferença entre os grupos experimentais após o tratamento clareador (p=0,9186). Conclusão: A utilização de dentifrício dessensibilizante ACC ou NP a 5% em moldeira plástica foi eficiente para a redução da sensibilidade dolorosa causada por clareamento dental em consultório, e ainda, o uso de dentifrício dessensibilizante não diminuiu a eficiência do tratamento clareadorAbstract: Introduction: The pain sensitivity associated with tooth whitening is the main problem reported by patients during tooth whitening and the use of desensitizing dentifrices presents an alternative for the treatment of sensitivity. Objective: To clinically evaluate the influence of desensitizing dentifrices applied through a plastic tray, reducing the pain sensitivity and color variation caused by the technique of in-office dental whitening, through a controlled double-blind clinical study. Methods: A longitudinal prospective study was conducted with 48 individuals no gender distinction with ages ranging from18 to 30 who underwent in-office dental whitening using 35% hydrogen peroxide in three clinical sessions with a one-week interval between them. In the night after each whitening session the volunteers have used for 4 hours a plastic tray containing one of the dentifrices related to the experimental groups: Group 1 (Control) - Sucralose (S) (B; Group 2 (Active Control) - Sodium Fluoride (SF) with 1450ppm of fluoride; Group 3 ¿ Arginine and Calcium Carbonate (ACC) and Sodium Monofluorophosphate with 1450 ppm fluoride; Group 4 - 5% Potassium Nitrate (PN) and Sodium Fluoride with 1450 ppm fluoride. The evaluation of the sensitivity associated with the use of the plastic tray in the first session (S1: sensitivity before the tray, S2: sensitivity after the tray), in the second session (S3: sensitivity before the tray, S4: sensitivity after the tray) in the third session (S5: sensitivity before the tray, S6: sensitivity after the tray) has used the analog numerical scale with scores from 0 to 10. The color variation (?E) was performed with the spectrophotometer and the data (L, a, b) that were used in the CIELab system. The data to pain sensitivity were submitted to the multivariate analysis of variance (MANOVA) with repeated measurements and a Lambda Wilks test (p<0.05). To analised the color variation one-way ANOVA was aplied (p<0.05). Results: The ACC and 5% PN groups showed a reduction in sensitivity in relation to the other groups (p<0.05). The relation of sensitivity and time associated with the three whitening sessions showed that there was a reduction in sensitivity after placement of the tray with dentifrice (S2, S4, S6). The color evaluation associated with the dentifrice factor showed that there was no difference between the experimental groups (p=0.9186). Conclusion: The use of desensitizing dentifrices based on ACC or 5% PN in a plastic tray was efficient for the reduction of the pain sensitivity caused by in-office dental whitening. In addition, the use of desensitizing dentifrice did not decrease the efficiency of whiteningMestradoDentísticaMestre em Clínica OdontológicaCAPE

Effect of different adhesive strategies on the microtensile bond strength of dentin to indirect resin-based composite

To evaluate the microtensile bond strength of indirect resin composite bonded to dentin using five different adhesives strategies. Forty specimens (Solidex) were produced and randomly into five groups with different adhesives strategies: (G1)- Single Bond Universal + etch + silane + RelyX Ultimate, (G2)- Single Bond Universal + silane + RelyX Ultimate, (G3)- Single Bond Universal + etch + RelyX Ultimate, (G4)- Single Bond Universal + RelyX Ultimate, and (G5)-Scotchbond Multi-purpose + RelyX ARC. After cementation the specimens were stored in 100% humidity for 24hours at 37°C. The specimens were sectioned perpendicular to the adhesive interface to obtain beams and submitted to microtensile test. Microtensile values were expressed in MPa and analyzed by one-way ANOVA and multiple comparison Tukey tests (?=0.05). The mean bond strength in MPa groups were: G1=11,48, G2=14,15, G3=16,95, G4=17,03 and G5=16,80. Statistical analysis showed that the bond strength values were not significantly affected by the different adhesive strategies. Cementation of dentin to indirect resin composite cannot be significantly affected by different adhesive strategies used. The specimens treated with silane, etch associated with Single bond universal did not increase bond strength values

Influence of different photoinitiators on the resistance of union in bovine dentin : experimental and microscopic study

To evaluate in vitro the influence of photoinitiators on the microtensile strength of adhesive systems and composite resins in bovine dentin. Forty dentin obtained from bovine teeth were randomly distributed in four groups (n = 10) according to the dif

Desensitizing Agent Previously Applied During In-Office Bleaching: A Double-Blind Randomized Clinical Trial

Objective:&nbsp;To compare the clinical effect of two desensitizing agents used before the application of a bleaching gel based on 35% hydrogen peroxide (HP).&nbsp;Material and Methods:&nbsp;30 patients were selected, and two desensitizing agents with different mechanisms of action were applied: Fluorine Neutral 2% (FN), which acts by blocking dentinal canaliculi while Potassium Nitrate 5% with 2% Sodium Fluoride (PN/SF) that acts in nerve transmission and blockade. Desensitizers were used before the application of 35% HP. For whitening, three clinical sessions were performed, with an interval of seven days, with three applications of the bleaching gel for 15 minutes, totaling 45 minutes/session. Tooth sensitivity (TS) was assessed with the numerical analog scale, and a spectrophotometer was used to obtain the color variation (ΔE).ΔE were submitted to ANOVA and Tukey test (p&lt;0.05), and TS data were submitted to a two-way ANOVA analysis.&nbsp;Results:&nbsp;For sensitivity experience, the Tukey test indicated differences between PN/SF and the placebo I, but there was no statistically significant difference between FN and the placebo II. The TS was lower when the desensitizing gel was used during the bleaching procedure compared to after treatment, regardless of the desensitizing agents.&nbsp;Conclusion:&nbsp;PN/SF before in-office tooth bleaching can reduce TS intensity, and the use of desensitizing gel before bleaching did not affect the bleaching efficacy

Effect of simplified chemical moisture control protocols on the bond durability of fiber posts cemented to root dentin / Efeito de protocolos simplificados de controle químico de umidade na durabilidade da união de pinos de fibra cimentados à dentina radicular

Objective: Investigate the influence of simplified chemical moisture control protocols on the bond durability of fiber posts through an evaluation of push-out bond strength.  Materials and methods: Forty-eight roots from single-rooted human teeth were treated endodontically and randomly distributed among groups with different dehydration protocols (n = 8): simplified ethanol wet bonding/100 (100G) – irrigation with 100% ethanol; simplified ethanol wet bonding/50 (50G) – irrigation with 50% ethanol; wet bonding (WG) – removal of excess water with paper. Fiber posts were cemented with the Ambar/Allcem (FGM) luting system, following the manufacturer's instructions. The bonded roots were cut cross-sectionally, producing slices 1 mm in thickness. The specimens were tested for push-out bond strength after 24 h (T1) and 12 months (T2) of storage. Specimens from each group were also processed for the nanoleakage analysis. The statistical analysis was performed considering a 5% significance level. Results: Significant differences were found among groups at T1 (p = 0.01) and T2 (p = 0.007). Bond stability in 100G was maintained after one year of aging, demonstrating greater bond strength (9.51 ± 3.28) in comparison to the other groups, with no significant differences in the analysis of the roots by thirds. The nanoleakage results confirmed that the simplified 100% ethanol wet bonding method improved the quality of the interface. Conclusions: Simplified 100% ethanol wet bonding contributes to the bond stability of the fiberglass posts on root dentin. 

Analysis of self-etch adhesives behavior in class I composite restorations with different treatment of enamel margins and light-activation sources/ Análise do comportamento de adesivos autocondicionantes em restaurações de resina composta classe I com diferentes tratamentos das margens de esmalte e fontes de ativação de luz

Objective: To evaluate the microtensile bond strength (MTBS), knoop microhardness (KHN) and gap formation of class I restorations restored with self-etching adhesives and resin composites light-activated by either halogen or LED light curing units. Materials and Methods: Class I cavities were prepared in one hundred and forty-four human third molars. Three self-etching adhesives (Clearfil S3 Bond - S3, Clearfil Protect Bond – ProtectB and One-Up Bond F Plus - OneUp) were applied to the cavities, which had the enamel margins either etched with 35% phosphoric acid or left unecthed. The cavities were incrementally restored with TPH3 restorative composite, which was light-activated using Light Emitted by Diode (Hadii-Cal) or Halogen Lamp (Optilux 501). Epoxy resin replicas were obtained from the restored teeth, which were then submitted to thermal cycling. Afterwards, new replicas were obtained and the gaps at the resin composite/enamel margin interface were analyzed by Scanning Electronic Microscopy. Half sample was randomly tested for microtensile bond strength test (n=6) while the other half had the composite tested for KHN (n=6). Results: The etched enamel contributed to avoid gap formation only when OneUp adhesive system was used. No significant difference in MTBS values was found among groups. For KHN analysis, all restorations light-activated with LED showed higher KHN values than those light-activated with halogen lamps. In addition, the resin composites used to restore cavities with acid etched enamel margins showed higher KHN means than those used in cavities having unteched enamel margins. Conclusion: The resin composite bonded to cavities with S3 showed the lowest KHN values at the intermediate and bottom. ProtectB showed no significant differences for the different surface depths

Scaffold based on castor oil as an osteoconductive matrix in bone repair: biocompatibility analysis

To analyze the biocompatibility of the scaffold produced from a natural polymer derived from castor oil through hemolytic activity and antimicrobial activity, to enable the clinical application. Three in vitro tests were performed: Hemolytic activity test - Polymer partially dissolved in contact with blood agar; Hemolytic activity test in sheep's blood - Polymer extract with red blood cells solution; Antimicrobial activity test - Solid polymer in direct contact with E. Coli and S. Aureus. For hemolytic tests, none of the samples showed hemolysis. Negative hemolytic activity is a good indicator, as the maintenance of the blood clot in the area of the lesion is essential for the formation of new tissue. For the antimicrobial activity test, no significant activity was observed against the bacteria used. The polymer is not toxic to red blood cells, being viable for clinical application as a matrix for tissue regeneration.info:eu-repo/semantics/publishedVersio

Effects of desensitizing products on the reduction of pain sensitivity caused by in-office tooth bleaching: a 24-week follow-up

Objective: To clinically assess the effect of desensitizing gels and dentifrices on the reduction in pain sensitivity and color variation during tooth bleaching. Methodology: A total of 108 volunteers were randomly separated into the following groups of n=12: GT/S-glycerine and thickener/sucralose; NF/S-potassium nitrate and sodium fluoride/sucralose; NA/S-potassium nitrate and arginine/sucralose; GT/AC-glycerine and thickener/arginine and calcium carbonate; NF/AC-potassium nitrate and sodium fluoride/arginine and calcium carbonate; NA/AC-potassium nitrate and arginine/arginine and calcium carbonate; GT/PN-glycerine and thickener/potassium nitrate; NF/PN-potassium nitrate and sodium fluoride/potassium nitrate; and NA/PN-potassium nitrate and arginine/potassium nitrate. Sensitivity was assessed with the numerical analogue scale, and color variation (ΔE) was measured with a spectrophotometer. The sensitivity values obtained were subjected to a multivariate analysis of variance (MANOVA) and color variation values were subjected to a randomized analysis of variance (p&lt;0.05). Results: The NF/AC, NA/AC, NF/PN, and NA/PN groups presented lower sensitivity values and reduced sensitivity compared to those of the other groups throughout the clinical sessions. None of the groups showed sensitivity at the 24-week assessment. Statistically, no significant difference were observed in the color values among the groups four weeks after the beginning of bleaching (p=0.074). Additionally, the color assessment of all groups was statistically similar four weeks (p=0.084) and 24 weeks (p=0.118) after the beginning. Conclusion: Our results indicate that adding NF/S, NA/S, NF/AC, and NA/AC desensitizers to tooth bleaching protocols reduces pain sensitivity without affecting its effectiveness

Influence of the volume of restorative material on the concentration of stresses in the restorative interface

To evaluate the microtensile strength in the adhesive interface depending on the volume of the composite resin used to restore class I cavities. Forty-eight human third molars received a standardized class I cavity preparation and they were separated i

Comparison between dmf/DMF and ICDAS in Brazilian schoolchildren: a cross-sectional study / Comparação entre ceo/CPO e ICDAS em escolares brasileiros: um estudo transversal

The objective was to compare the use of the International Caries Detection and Assessment System (ICDAS-II) and the dmft/DMFT (WHO) indexes in epidemiological surveys in schools. Two calibrated examiners analyzed 402 public school children aged 5-12 years, in the city of Mesquita, Rio de Janeiro, Brazil, using ICDAS-II and WHO criteria. The schools are located in areas covered by the Family Health Strategy. The DMF-DMF-S, dmf-t, dmf-s, the prevalence of decayed teeth, and examination time were calculated using both systems. The research subjects participated in health education and prevention activities and oral hygiene training. Data were statistically analyzed and the mean dmf-t / DMF-T was 2.35 (sd ± 2.15) and 3.18 (sd ± 2.31), respectively, using the WHO criteria. When considering the score of the three-ICDASII the average was 2.64 (sd ± 1.89) and 3.45 (sd ± 2.48). With the score-2 ICDASII, 4386 surfaces with lesions were identified, 2795 (63.7%) were not considered when we used the dmf-t / DMF-T. The average examination time was almost twice as long to ICDAS-II (3.2 ± 1.9 min) and WHO (1.8 ± 0.9 min). Conclusion: The ICDAS-II, and provide information on non-cavitated lesions of caries, shows significant experience of dental caries in schoolchildren from the city, and can generate data comparable with previous research that used the WHO criteria