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Combined professional and home care nightguard bleaching of tetracycline-stained teeth.

The effectiveness of combining in-office and at-home nightguard vital bleaching on tetracycline-stained teeth was evaluated. Grade 1 and grade 2 tetracycline stains were eliminated completely in two months by this combination approach. Grade 3 stains, the most severe, were lightened significantly with a reduction in the banding effect. The most common side effect was an increase in tooth sensitivity, especially to cold, while actively in treatment. All patients reported disappearance of the sensitivity after termination of the treatment phase.

Anti-Bacterial Agents↗

Nontray whitening.

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Administration, Topical↗

Two-year clinical comparison of a microfilled and a hybrid resin-based composite in non-carious Class V lesions.

The purpose of this double-blind clinical trial was to compare the retention rate in noncarious Class V lesions of two resin-based composite restorative materials with contrasting stiffness. Isolation with retraction cord, pressed paper triangles, and cotton rolls was used to closely mimic the procedures generally used in a practice setting. Thirty pairs of restorations were placed, one using Silux Plus and one using Z100. The assignment of material was randomized, and the subjects were unaware of the material used. All restorations were placed with a fourth-generation adhesive liner, Scotchbond Multi-Purpose. Evaluations were performed at baseline, 6, 12, 18, and 24 months by two independent examiners using criteria developed by Cvar and Ryge in a forced consensus model. Examiners were unaware of the restoration's group identity. No difference between the retention rates for the two groups was found after 24 months, bringing into question the role that a material's stiffness plays in determining retention in a noncarious Class V lesion.

Adult↗

The efficacy of reservoirs in bleaching trays.

Thirty patients were selected to bleach their maxillary teeth. Vacuum-formed trays were fabricated for the maxillary arch so that only one quadrant of bleaching tray had reservoirs. Nupro Gold 10% carbamide peroxide gel was given to patients. They were instructed to place a drop of gel in each tooth area and wear the trays twice a day for two-hour periods. After 10 days the patients were evaluated for shade changes in each quadrant. No clinical difference was observed in the after-shade match of the two quadrants. It appears that the addition of blockout spacers to create reservoirs does not increase the success of home bleaching.

Administration, Topical↗

One-year clinical evaluation of compomer restorations placed in general practice.

OBJECTIVE: This study evaluated the in-service performance, after 1 year, of a sample of F2000 compomer restorations placed by 10 general dental practitioners as part of handling evaluation of this material. METHOD AND MATERIALS: Five general dental practitioners who participated in the handling evaluation were asked to cooperate in the 1-year assessment of the restorations. The practitioners were requested to contact patients and inquire if they were willing to attend at a specified time for examination of their restorations by a trained evaluator who would travel to the various practice locations. A total of 84 restorations were presented for examination. The mean age of the restorations at examination was 14 months. The restorations were assessed for anatomic form, marginal adaptation, surface roughness, sensitivity or discomfort, gingival condition, and presence or absence of secondary caries. RESULTS: Eighty-two restorations were intact. No secondary caries was detected. Optimal scores were obtained in a high proportion of the assessments. All patients reported satisfaction with the restorations, both in appearance and surface texture, and no symptoms were reported. CONCLUSION: The F2000 compomer restorations, placed in conjunction with its bonding system in general practice conditions, were found to be performing satisfactorily after 1 year.

Adult↗

Clinical evaluation of bleaching agents of different concentrations.

OBJECTIVE: The purpose of this study was to evaluate the degree of color change, any rebound effect, and sensitivities associated with using 2 different concentrations of carbamide peroxide in vivo. METHOD AND MATERIALS: Twenty-five subjects used 10% and 15% agents in trays for 14 days on different sides of their maxillary arches. Subjects returned in 3 days and at 1, 2, 3, and 6 weeks for evaluation of color change and rebound effect. Shade matching, photographic means, and a colorimeter were used for evaluation. Subjects self-reported gingival and tooth sensitivity on a scale of 1 (no sensitivity) to 5 (severe sensitivity). RESULTS: After 2 weeks, delta L*, delta a*, delta b*, delta E* and delta shade guide rank means for the 10% whitening agent were 6.50, -1.37, -4.63, 8.79, and -15.40, respectively; for the 15% agent, they were 8.72, -1.63, -5.90, 11.03, and -16.59, respectively. After 6 weeks, delta L*, delta a*, delta b*, delta E*, and delta shade guide rank means for the 10% whitening agent were 3.04, -0.99, -3.19, 5.13, and -13.13, respectively; for the 15% agent, they were 3.48, -1.01, -3.60, 5.58, and -13.65, respectively. Means for gingival sensitivity were 1.18 and 1.21 for the 10% and 15% agents, respectively; means for tooth sensitivity were 1.21 and 1.26 for the 10% and 15% agents, respectively. CONCLUSION: All 3 methods of evaluation revealed a significant difference in the tooth lightness achieved by 10% and 15% products at 2 weeks but no significant difference at 6 weeks. No statistically significant difference was found in gingival or tooth sensitivity.

Adult↗

Direct resin composite veneers: masking the dark prepared enamel surface.

A technique for manufacturing direct resin composite veneers is presented. Described are the advantages of using an acrylic resin matrix, made before the preparation is begun, to copy anatomic details. An additional step to mask previously prepared dark enamel with opaquers is also described. The advantages and limitations of the procedures are discussed.

Composite Resins↗

Dental findings in Morquio syndrome (mucopolysaccharidoses type IVa).

Morquio syndrome is a disorder of mucopolysaccharide metabolism with specific skeletal features. The clinical and radiographic appearance of the teeth resembles hypoplastic amelogenesis imperfecta with thin enamel of normal radiodensity. The dental practitioner has a part to play in collaboration with medical colleagues in the recognition and diagnosis of this condition.

Amelogenesis Imperfecta↗

Adjunctive use of chlorhexidine in oral candidoses: a review.

Oral candidosis is by far the commonest human fungal infection and manifests in a variety of clinical guises. The main reason for its high incidence appears to be the multiplicity of predisposing factors, which facilitate the conversion of oral commensal Candida to a parasitic existence. Despite the availability of a number of effective antimycotics for the treatment of oral candidoses, failure of therapy is not uncommon owing to the unique environment of the oral cavity where the flushing effect of saliva and the cleansing action of the oral musculature tend to reduce the drug concentration to sub-therapeutic levels. For these and other reasons chlorhexidine is widely prescribed in dentistry both as an antiseptic mouthwash and a denture disinfectant in order to supplement other antifungals. Chlorhexidine has a broad spectrum of antimicrobial activity including Candida albicans and other common non-albicans yeast species. In this review we outline the utility of chlorhexidine as an adjunct to conventional antimycotic therapy in the management of oral Candida infections.

Anti-Infective Agents, Local↗

An innovative chairside bleaching protocol for treating stained dentition: initial results.

For years, investigators have attempted to develop a predictable means of bleaching pathologically and nonpathologically stained dentition. While previous efforts have modified the concentration of the bleaching material, the duration of the procedure, and the manner by which the bleaching agent is activated, the ability to affect a significant shade improvement remains an elusive objective. This article demonstrates an innovative technique used to influence the penetration of oxygen ions into the tooth enamel, which may resolve this clinical dilemma.

Adult↗

Influences of directed research and clinical observations on the development of a tartar control whitening dentifrice.

Early literature described the benefits of cleaning the mouth and teeth to prevent tartar accumulation and tooth loss. For more than a century, the need for meticulous tooth scaling and regular brushing to maintain oral health has been recorded. More recently, because of innovative research into the chemical and biological activity of saliva, dentifrices have been formulated which specifically interrupt the mineralization of plaque and food debris to stain and calculus. Proof of efficacy of these dentifrices are obtained with well-designed clinical tests which quantify stain and calculus by using reliable scoring systems.

Clinical Trials as Topic↗

A six-week clinical tooth whitening study of a new calculus-inhibiting dentifrice formulation.

This six-week double-blind clinical study compared the toothwhitening effects of a new calculus-inhibiting dentifrice containing pyrophosphate, tripolyphosphate and copolymer in a 0.243 sodium fluoride/silica base (Test Dentifrice) with two commercially available dentifrices: Aquafresh Whitening Toothpaste with Fluoride and Crest Regular Fluoride Toothpaste. After a baseline examination for extrinsic tooth stain, qualifying adult males and females from Manchester, United Kingdom and from Mississauga, Ontario, Canada were randomly assigned into three test groups. Each group was balanced for gender, tobacco habits and levels of tooth stain. Subjects were to brush their teeth twice daily with a soft-bristled toothbrush using the assigned toothpaste. One-hundred and twenty-eight (128) subjects complied with instructions and completed the trial. Subjects using the Test Dentifrice exhibited statistically less stain area and less stain intensity than did either the Aquafresh or Crest groups. Crest Regular Fluoride toothpaste was statistically less effective than Aquafresh Whitening toothpaste in removing stain. Results in this trial support the conclusion that a new dentifrice formulation containing pyrophosphate, tripolyphosphate and a copolymer, in a 0.243% sodium fluoride/silica base, effectively removes extrinsic tooth stain.

Adolescent↗

Laboratory stain removal and abrasion characteristics of a dentifrice based upon a novel silica technology.

These laboratory studies examined the stain removal efficacy and hard tissue abrasivity of a new dentifrice formulation--Crest Extra Whitening--based on the incorporation of elevated concentrations of a proprietary silica. Cleaning power assessments were made using a modification of the laboratory test method developed by Stookey and associates at Indiana University Oral Health Research Institute. Abrasion assessments were made using Radioactive Enamel and Radioactive Dentin Abrasivity (REA and RDA) measures. Results show that Crest Extra Whitening dentifrice produced statistically significantly improved stain removal when compared to a number of conventional dentifrices, including Crest Cavity Protection and Crest Tartar Protection, and a number of recently marketed cleaning and whitening dentifrices. Laboratory studies further demonstrated that the Crest Extra Whitening dentifrice produces dentin and enamel abrasivity similar to conventional silica dentifrices.

Aluminum Oxide↗