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PubMed1993

Enamel microabrasion: new considerations in 1993.

Enamel microabrasion is used to eliminate superficial enamel discoloration defects. This article presents a comprehensive review of the enamel microabrasion method and its results. Current technique and materials are described and six cases are used to illustrate various aspects of the procedure. The learning objective of this article is to familiarize the reader with the state-of-the-art of enamel microabrasion and to report the latest laboratory research in the field.

Adolescent↗
PubMed1982

Iron staining of the acquired enamel pellicle after exposure to tannic acid or chlorhexidine: preliminary report.

Extrinsic discoloration of teeth following a large consumption of tannin-containing beverages or a prolonged use of chlorhexidine mouthrinses is a well known observation. Tannins as well as chlorhexidine are denaturing agents. Based on preliminary studies revealing the presence of iron in chlorhexidine discolored pellicle material, the ability of iron to stain the integument after pretreatment with the two denaturants was studied in a human model. The denaturing effect of an acidic environment was also included. Enamel slabs fixed to acrylic appliances were carried in the oral cavity and alternately exposed to the test solutions in different sequences in vitro. Pretreatment with chlorhexidine or tannic acid led to marked discoloration upon iron application during 5-d tests, whereas the compounds individually had no such effect. A large content of the metal was found in the stained material. Stannous fluoride appeared to reduce the formation of the pigments, and strong oxidation completely bleached the established color. Possible mechanisms underlying the phenomena observed are discussed.

Chlorhexidine↗
PubMed2004

Color changes of dental resin composites by a salivary enzyme.

The objective of this study was to evaluate the color change (DeltaE(ab) (*)) of dental resin composites immersed in a salivary enzyme of esterase (ETE, porcine liver esterase, 400 mU/ml) compared to those immersed in phosphate-buffered saline (PBS). The colors of three brands of resin composites of 13 shades were measured after polymerization and polishing with 1500-grit SiC paper and after immersion in PBS or ETE up to 9 weeks. Color was measured according to the CIELAB color scale. DeltaE(ab) (*)after immersion was calculated by the equation DeltaE(ab) (*) = [(DeltaL(*))(2) + (Deltaa(*))(2) + (Deltab(*))(2)](1/2). Surface roughness (Ra) and Vickers hardness number (VHN) were measured. DeltaE(ab) (*)values after immersion in ETE was not higher than those in PBS. Immersion in solutions more than 3 weeks resulted in perceivable color changes (DeltaE(ab) (*) > 3.3) in one material, and immersion in solutions up to 9 weeks resulted in not-perceivable color changes in the other materials. Discoloration generally increased as the immersion period increased. For one composite, the value increased abruptly in the period of 3 days to 3 weeks of immersion. The change in Ra value after immersion was varied by the composite and shade. VHN decreased significantly after immersion in ETE for nine weeks. Immersion in PBS resulted in decreased VHN in two composites.

Animals↗
PubMed2005

Clinical performance of sealants with and without a bonding agent.

OBJECTIVES: The objective of this study was to assess the effect of a one-bottle bonding agent on sealant success after 3, 6, 12, and 24 months. METHOD AND MATERIALS: The sample group consisted of 30 schoolchildren (8 to 10 years of age) who had all their permanent first molars sound and unsealed. Occlusal sealants were placed on first molars according to a split-mouth design. Sealant scoring occurred at 3, 6, 12, and 24 months and was performed by two clinicians blinded to the treatment group. Fisher's exact test was used to analyze the data. RESULTS: The clinically acceptable marginal integrity rates for sealants with a bonding agent after 3, 6, 12, and 24 months were 93%, 93%, 83%, and 79%, respectively. For sealants without a bonding agent, the clinically acceptable marginal integrity rates after 3, 6, 12, and 24 months were 90%, 88%, 81%, and 77%. The rates for no color change in sealants with a bonding agent after 3, 6, 12, and 24 months were 96%, 93%, 81%, and 75%, respectively. For sealants without a bonding agent, the no color change rates after 3, 6, 12, and 24 months were 93%, 93%, 79%, and 72%. After 24 months, 73% of the sample group were available for recall. The retention rates for sealants with and without a bonding agent after 24 months were 79% and 75%, respectively. The results of the statistical analysis showed that there were no differences among the sealants with and without bonding agents evaluated in relation to marginal integrity, marginal discoloration, and anatomic form. CONCLUSION: The success of a sealant is related to whether the sealant is applied under optimal conditions. The results of this study show that at the 2-year mark, the placement of a bonding agent under sealants did not significantly affect the clinical success of sealants.

Child↗
PubMed2002

Five-year clinical performance of porcelain laminate veneers.

OBJECTIVE: The clinical performance of porcelain laminate veneers was evaluated at 5 years. METHOD AND MATERIALS: One hundred eighty-six porcelain laminate veneers were placed in 61 patients, aged 18 to 70 years, by a single operator following the same clinical procedure. At the 5-year recall, esthetics, marginal integrity, marginal discoloration, fracture rate, and patient satisfaction were recorded. RESULTS: At recall 98.4% of the veneers were satisfactory without intervention. The retention rate was excellent, the fracture rate was very low, and the maintenance of esthetics was superior. Patient satisfaction was very high. CONCLUSION: Porcelain laminate veneers offer a reliable and effective procedure for the conservative and esthetic treatment of anterior teeth.

Adolescent↗
PubMed1998

[Drug-induced discoloration of the teeth and gingiva].

For this article all cases of suspected drug-induced discolouration of teeth and gingiva reported between 1.1.1989 and 31.5.1997 have been collected. As far as documented all discolourations were reversible and represented exclusively undesired but not serious adverse drug effects. In the literature such events are usually not mentioned. Thus, sense and intention of this work is to draw attention to certain adverse effects that are hitherto not well known.

Adolescent↗
PubMed1980

Tetracycline discoloration, enamel defects, and dental caries in patients with cystic fibrosis.

The prevalence, distribution, and interrelationship between tetracycline discoloration, enamel defects, and dental caries was determined in 86 patients with cystic fibrosis (age 3 to 24 years). The dental caries experience was compared to control subjects matched for sex, race, exposure to optimally fluoridated water, chronologic age, and dental age. The findings indicate a high prevalence of tetracycline discolorations and enamel defects but a significantly reduced dental caries experience in these patients. However, interrelationships between these three factors were not strikingly evident. The presence of an altered oral health status in cystic fibrosis patients and the increased prevalence of this disease due to recent therapeutic and diagnostic advances in its management suggest the need for further familiarization with the dental manifestations of cystic fibrosis.

Adolescent↗
PubMed1990

[Discolorations: a new method of bleaching discolored vital teeth. (Preliminary study)].

The demand for an acceptable appearance, including a natural and attractive smile, has nowadays a great effect on clinical practice. More patients than ever are requesting various types of cosmetic dentistry in order to improve their smile. The clinical practitioner has to deal with discolorations, particularly in the anterior region of the mouth. The most severe of these problems are caused by administration of tetracycline or other medicine during the period of mineralization. The usual treatment of these cases includes full crown restorations and more recently, direct or indirect veneers (porcelain or composite-resin veneers). As an alternative, the various techniques of bleaching consist the most conservative of all above treatments. For many year, their application gives effective solutions in many cases. This article describes both clinical and laboratory procedures of a new technique for bleaching discolored vital teeth. This technique uses a warming device to apply controlled heat to the bleaching solution which is placed on both labial and lingual surfaces of the teeth to be bleached. Special thermotrays are used for the placement of the solution according to the specifications of the manufacturer. This paper presents a preliminary study of the advantages and disadvantages of this bleaching method and gives an evaluation of the results from several clinical cases.

Carbamide Peroxide↗
PubMed1994

Effectiveness, side effects and long-term status of nightguard vital bleaching.

In this clinical trial of nightguard vital bleaching for six weeks, 92 percent of the patients experienced some lightening of treated teeth. About 97 percent of patients with teeth stained through aging, inherent discoloration, brown fluorosis or trauma experienced lightening, as did 75 percent with tetracycline-stained teeth. Sixty-six percent experienced side effects, which resolved in 24 to 48 hours. Earliest re-treatment was done after one year in less time. Minimal color change occurred for 74 percent after 1 1/2 years and 62 percent after three years.

Adult↗
PubMed2003

Clinical evaluation of different posterior resin composite materials: a 7-year report.

OBJECTIVES: The aim of this study was to investigate the clinical performance of 120 posterior composite restorations placed in 38 patients after a period of 7 years. METHOD AND MATERIALS: Eighty-eight Class I and 32 Class II restorations were made (93 molars and 27 premolars) using three different resin composite materials: Z100, Clearfil Ray-Posterior, and Prisma TPH. The restorations were evaluated using Ryge's criteria for color match, marginal discoloration, marginal adaptation, secondary caries, surface texture, and anatomic form at baseline, 1,2, 5, and 7 years. Photographs and radiographs were taken at each recall period. RESULTS: At 7-year recalls, 70 restorations were available for examination. Four restorations had failed due to secondary caries. Saliva sampling was performed to determine the level of mutans streptococci and lactobacilli for the four failed restorations at the last recall. No statistically significant differences were found among the materials in regard to color match, anatomic form, and secondary caries. Clearfil Ray-Posterior had statistically significantly rougher surface texture than the surrounding enamel compared to the other resin composites. Z100 showed more cavosurface margin discoloration after 5 years than the other two resin composites. All materials had slight marginal adaptation problems at the 7-year recall. There was no apparent relationship between the levels of mutans streptococci and lactobacilli in saliva and the failed restorations. CONCLUSION: The three posterior composites tested had acceptable clinical performance after 7 years.

Adult↗
PubMed1997

In-office bleaching: where we came from, where we are today.

Discolored teeth are the primary aesthetic concern among dental patients. While many seek professional advice and treatment, an alarming number opt for non-professional quick-fix solutions. The in-office bleaching modality often is overlooked in favor of at-home vital bleaching. But this option has been proven to be effective, quick and safe-either alone or in combination with other aesthetic treatments-as a method of brightening and enhancing a patient's smile.

Anti-Bacterial Agents↗
PubMed1981

Changes in dental development in paediatric patients with chronic kidney disease.

Dental examination of 73 paediatric patients with nephrotic syndrome and 49 with chronic renal failure revealed enamel changes of permanent teeth in about 50%. They consisted usually of white discolorations and hypoplasia of enamel. In nephrotic patients they were observed particularly after the administration of high doses of corticosteroids. In patients with renal failure enamel changes occur very early. Their location was usually compatible with an insult on enamelisation at the time of manifestation of kidney disease. The prevalence of caries was almost twice as high in patients with nephrotic syndrome than in those with renal failure.

Adolescent↗
PubMed1992

Modified internal bleaching of severe tetracycline discoloration: a 6-year clinical evaluation.

Since 1985, 534 severely discolored teeth have been treated with intentional endodontics and internal bleaching; of these, 258 were treated with the conventional technique and 276 were treated with the modified technique. Six years of clinical and radiographic evaluation revealed that the results obtained with the first group (conventional technique) remain stable and that a very noticeable improvement has been achieved with the second group of teeth, treated with the modified technique.

Adolescent↗
PubMedDate not supplied

Performance of some diagnostic systems in the prediction of occlusal caries in permanent molars in 6- and 11-year-old children.

OBJECTIVES: Attempts have been made to develop diagnostic methods which enable an early diagnosis of occlusal lesions which are not detectable by visual inspection. The aim of this study was to compare the performance of visual inspection focused on finding signs of fissure decalcification and discoloration, visual inspection upon fibre-optic transillumination (FOTI), and electrical conductance measurements (ECMs) in predicting the onset of occlusal caries in 6- and 11-year-old children. METHODS: Fifty children aged 5-7 and 11-15 years, having first or second permanent molar teeth that were not exposed to the oral environment for more than half a year, participated in the study. Following baseline data recording, the diagnostic measurements were repeated six times at 6-month intervals over a period of 2.5 years. RESULTS: Data were collected at predefined sites in the fissures. During the study, 220 of the 652 sites, i.e. 75 of 197 molars in 31 of the 50 children were judged to require a sealant or a sealant restoration. Two examiners jointly decided on the decay status at the sites. Survival plots showed that ECMs were superior to FOTI and fissure discoloration in predicting the onset of occlusal caries, although the differences were small. CONCLUSION: ECM is a better predictor of occlusal caries than fissure discoloration and FOTI, although the differences among the performance of the three methods in this study were very small. A cost-effective analysis is envisaged to obtain insight into the practical value of ECMs in the prediction of occlusal caries and, thus, into the effectiveness of sealant application.

Adolescent↗
PubMed2003

Long-term treatment results with nightguard vital bleaching.

Since its introduction into dentistry in 1989, nightguard vital bleaching has been proven to be a simple and safe procedure to lighten discolored teeth. Efficacy of the technique is 98% for nontetracycline-stained teeth, and with extended treatment time, tetracycline-stained teeth can be expected to lighten in at least 86% of cases. Satisfactory retention of the shade change without re-treatment can be expected in at least 43% at 10 years posttreatment. Side effects are usually mild and transient, disappearing within days of treatment completion with no long-term sequelae. Participants report that they are glad they went through the procedure, and wild recommend the procedure to a friend.

Humans↗
PubMed1987

Salivary lactoferrin in a selected group of subjects with exceptional extrinsic dental staining.

Some people exhibit an exceptional tendency to develop brownish extrinsic staining on their teeth and previous studies indicate that iron may be involved in certain types. The object of this investigation was to find out whether the level of salivary lactoferrin, which is an ironbinding glycoprotein, is elevated in persons exhibiting extreme staining tendency. Subjects who developed dark brownish discoloration on the facial surfaces of their anterior teeth during a 3-week period following professional cleaning of the teeth were selected for study. Salivary lactoferrin was measured by the enzyme-linked immunosorbent assay (ELISA). The results showed that this group of persons exhibited a markedly higher concentration of salivary lactoferrin compared with non-stainers. It was also demonstrated in an in vitro study that combinations of lactoferrin, iron, and tannic acid produced stain on slabs of enamel and dentin.

Dental Enamel↗
PubMedDate not supplied

The dental status of children with chronic renal failure.

We evaluated the dental status of thirty children with chronic renal failure (CRF): 15 managed conservatively, 9 on dialysis replacement therapy and 6 after kidney transplant. Dental age was delayed, but to a lesser extent than bone age; this delay was most marked where CRF occurred before 7 years of age. Eruption age was only minimally delayed. Eighteen patients (60%) showed enamel defects, mainly hypoplasia, the location of which was related to the age at which major metabolic changes of uremia appeared. In 9 children (30%) there was intrinsic discoloration of the teeth--this was also related to the severity and duration of CRF. Compared to normal Israeli children our patients showed poor oral hygiene and gingival condition, but a significantly lower prevalence of caries. Seven patients (23%) showed mild radiologic changes in the jawbones (mainly loss of lamina dura), the severity of which was related to the severity and duration of CRF. None of the above findings could be related to specific metabolic disturbances.

Adolescent↗
PubMed1998

Efficacy, longevity, side effects, and patient perceptions of nightguard vital bleaching.

Since its introduction into dentistry in 1989, nightguard vital bleaching has been proven to be a simple and safe procedure to whiten discolored teeth. Efficacy of the technique is 95% for nontetracycline-stained teeth, and with extended treatment time, tetracycline-stained teeth can be expected to lighten in 90% of cases. Satisfactory retention of the shade change can be expected in 63% of patients 3 years posttreatment and at least 35% at 7 years. Side effects are usually mild and transient, disappearing within days of treatment completion. Patients report that they are glad they went through the procedure, and 97% recommend the procedure to a friend.

Anti-Bacterial Agents↗