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The bleaching depth of a 35% hydrogen peroxide based in-office product: a study in vitro.

OBJECTIVES: The aim of the present study was to quantify the penetration of 35% hydrogen peroxide into enamel and dentine and to relate this to the resultant shade change of the tooth. METHOD: The crowns of 24 caries and developmental defect free human maxillary incisors were stained internally with a standardised tea solution. Twelve specimens were power bleached with light activated 35% hydrogen peroxide and 12 placed in water; both exposure times were 30min. Three different shade assessment methods (Vita shade guide [SG], shade vision system [SVS] and a chromometer) were employed prior to, after tea staining and after power bleaching/water treatments. Twelve specimens each from the bleach group and the water control water group were sectioned mesio-distally. An additional 12 specimens from the bleach and the control group were sectioned labio-palatally. The stain area for each specimen was measured using image analysis software. RESULTS: With tea staining, the mean changes in Vita shade guide units (SGU) ranged from 3.66 to 8.33. With the SVS system changes of 3.66-9 units were seen. Chromometer readings showed that following bleaching the L* values moved in the direction of black (3.8-6.7) and a* and b* values were in the red (0.3) and yellow (1.5) direction, respectively. Samples bleached and sectioned mesio-distally showed stain coverage of 28.6-39.4%, while palatal sections showed stain coverage of 58-72%. Control samples, whether sectioned mesio-distally or labio-palatally, showed staining throughout the dentine (97-100% coverage). CONCLUSION: A 35% hydrogen peroxide in-office bleaching gel demonstrated bleaching into dentine of uniform depth.

Analysis of Variance↗

In vitro studies on the effect of sodium tripolyphosphate on the interactions of stain and salivary protein with hydroxyapatite.

OBJECTIVES: To study properties of sodium tripolyphosphate (STP) relevant to inhibition or removal of dental stain in vitro. METHODS: The effects of STP and other phosphates on adsorption of a dietary chromogen (black tea polyphenol) and salivary protein to hydroxyapatite (HA) powder were studied by analysing loss of protein or tea stain from solutions mixed with HA or HA pre-treated with the test agents. The effects on desorption of protein and stain from HA were studied by analysis of water or solutions of test agents mixed with HA or HA pre-treated with saliva or tea solution. RESULTS: At concentrations and pH representative of those likely to occur in the mouth, STP inhibited adsorption of salivary protein and black tea polyphenol to, and desorbed these substances from, HA surfaces. Adsorption and desorption of protein and stain were not influenced by pH of the STP solutions but adsorption varied with concentration. STP showed equivalent effectiveness with respect to salivary protein adsorption and desorption as a longer-chain condensed phosphate. The inhibitory activity of HA-bound STP on adsorption of salivary protein and stain resisted extensive washing. CONCLUSIONS: STP is likely to be an effective agent for inhibiting and removing dental stain, whether bound directly to mineralised surfaces or indirectly via salivary pellicle.

Adsorption↗

Clinical evaluation of the stain removing ability of a whitening dentifrice and stain controlling system.

OBJECTIVES: This study aimed to evaluate the stain removing/controlling properties of a whitening dentifrice and a stain controlling system, in a parallel group, multiple use study. METHODS: Subjects (63), were stratified according to baseline stain scores and randomly allocated to a group, A (standard dentifrice), B (whitening/stain removing dentifrice) or C (whitening/stain removing dentifrice, tooth polish, tooth polisher and whitening/stain removing mouthwash). At each attendance, extrinsic stain was scored blind by a trained and calibrated examiner using the Shaw and Murray Stain Index, under constant lighting conditions. In addition, whiteness was measured using a colorimeter. RESULTS: The toothpaste regimens were well balanced at baseline (p=0.811). At 4 weeks, Regimens B and C had significantly less stain than A (p<0.05). Lower stain values were maintained/reduced for regimens B and C by week 6, with changes from baseline significantly greater than for Regimen A. When lightness was assessed by colorimeter, Regimen C was also found to be significantly whiter than Regimen A (p<0.05). CONCLUSIONS: It was concluded that both whitening regimens had a significant effect on reducing tooth staining and improving whiteness over the 6 week time period.

Adult↗

Comparison of quantitative light-induced fluorescence (QLF) and digital imaging applied for the detection and quantification of staining and stain removal on teeth.

OBJECTIVES: This study compares the use of QLF with digital imaging in the detection and quantification of the development and removal of stain on teeth. METHODS: Two experimental phases, tooth staining and tooth whitening, conducted in vitro on labial 12 mm(2) enamel windows made on ten extracted bovine teeth, developed stains in 6-min cycles (2 min in each solution) using artificial saliva, chlorhexidine and tea solutions and removed them using sodium perborate monohydrate in 2-min cycle monitored at the end of each cycle with QLF (Inspektor Research Systems, NL) and digital photography (Fuji, Japan). The stain values were quantified as DeltaQ derived from QLF and DeltaE from digital imaging. This was observed by the two methods correlated with Pearson correlation coefficient (r). Regression equations (R(2)) were also obtained. RESULTS: For both staining and stain removal there was a statistically significant (p<0.01) reverse correlation between DeltaQ values for QLF (r=-0.924, R(2)=85.4%) and DeltaE values for digital imaging (r=-0.994, R(2)=98.8%), respectively. CONCLUSION: QLF showed a high correlation with digital imaging as a technique for detecting and monitoring tooth stains and tooth whitening in vitro. The potential for QLF with further development as a tool for monitoring staining and whitening of teeth may be possible in vivo in addition to the diagnostic ability for caries detection.

Animals↗

The bleaching of teeth: a review of the literature.

OBJECTIVES: To review current knowledge of tooth whitening with respect to external bleaching methods. DATA: The scope is the external bleaching of vital teeth and focuses on mechanisms; in vivo and in vitro measurement methods, and factors influencing the efficacy of the whitening process. SOURCES: "Medline" and "ISI Web of Science" databases from 1966 and 1974, respectively were searched electronically with key words tooth, teeth, colo*r, white*, bleach* and peroxide. CONCLUSIONS: The importance of tooth whitening for patients and consumers has seen a dramatic increase in the number of products and procedures over recent years, with a concomitant rise in publications on this topic. Literature suggests that the mechanisms of tooth whitening by peroxide occur by the diffusion of peroxide through enamel to cause oxidation and hence lightening of coloured species, particularly within the dentinal regions. A number of approaches are available for measuring changes in tooth colour. These include visual measurements by trained clinicians and instrumental measurements using spectrophotometry, chromameters and digital image analysis. The key factors that affect tooth whitening efficacy by peroxide containing products are concentration and time. In general, higher concentrations are faster than lower concentrations. However, lower concentrations can approach the efficacy of higher concentrations with extended treatment times. Alternative bleach systems to peroxide have received only minor attention. The efficacy of light activated systems versus non-light activated controls in clinical studies is limited and conflicting. Other factors which can influence tooth bleaching outcome include type of stain, initial tooth colour and subject age.

Age Factors↗

Home-use bleaching.

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Carbamide Peroxide↗

The safety of lincomycin in pregnancy.

The progeny of mothers treated with lincomycin during the first, second, or third trimester of their pregnancy were extensively evaluated at various periods extending to 7 years after birth. As compared to a control group (mothers not receiving lincomycin), the study group did not show any more developmental anomalies of the teeth, specific physical defects, general developmental anomalties, or late developing abnormalities in speech, emotional and mental make-up, or ability to adjust to schooling, than would occur in the normal population. The relationship to clindamycin, a closely related derivative, and to antibiotic therapy during pregnancy is discussed.

Abnormalities, Drug-Induced↗

Effects of iron salts in sucrose on dental caries and plaque in rats.

Anaemia caused by iron deficiency and dental caries are still among the most prevalent diseases in some developing countries. Anaemia can be prevented by iron fortification of food. Previous studies demonstrated that iron-sucrose, which has been used for prevention of anaemia, reduces the incidence of caries in rats. The aim of the present study was to compare the influence of ferrous sulphate and ferric glycerophosphate co-crystallized with sucrose on the incidence of dental caries in rats. Forty-eight desalivated rats were caged in a programmed feeder and received their essential nutrition by gavage. The animals were fed 17 meals per day at hourly intervals of 88 parts/10(6) Fe++ or Fe co-crystallized with sucrose. Plain sucrose and calcium glycerophosphate with sucrose were used as control groups. Both ferric- and ferrous-sucrose meals reduced the incidence of smooth-surface and sulcal caries in rats. Stain formation, organic acid production and acidogenic activity of dental plaque in animals receiving iron-sucrose meals were also investigated. Ferric glycerophosphate did not induce extrinsic staining on the tooth surface. The concentration of organic acids did not differ significantly among the groups. The acidogenic activity of plaque in animals receiving either of the iron-sucrose meals tended to be lower than that of the control groups. The possibility that iron-sucrose might reduce the prevalence of two major public health problems, dental caries and anaemia, makes this preventive approach extremely attractive for additional investigation.

Acids↗

Calcification of the urinary bladder in the wild cotton rat (Sigmodon hispidus).

Calcification of the urinary bladder epithelium was observed in 19 of 30 and 18 of 30 wild cotton rats from control and petrochemical-contaminated sites, respectively. The rats in the two sites did not differ significantly in respect of serum calcium and phosphorus concentrations. The calcification was considered to be dystrophic in nature. An unidentified factor common to both control and petrochemical-contaminated sites was considered to be responsible for this syndrome.

Animals↗