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PubMed2003

[Clinical evaluation of 546 tetracycline-stained teeth treated with Cerinate laminate veneers].

OBJECTIVE: The purpose of this study was to evaluate the clinical result of 546 tetracycline-stained teeth corrected with Cerinate porcelain laminate veneer system for esthetic purpose. METHODS: 546 tetracycline-stained teeth were corrected with Cerinate porcelain veneer system, and bonded with Ultra Bond resin cement. The restorations were recalled after 0.5 year, 1.5 years and 2.5 years, respectively. modified Ryge criteria were used to evaluate the veneers marginal adaptation, interfacial staining, secondary caries, postoperative sensitivity and the patients' satisfaction with the shade of the restorations. RESULTS: this study found that 99% veneers had excellent marginal adaptations; and less than 1% veneers were rebonded after debond in the first half year application; the color of the veneers was stable and no evident staining was found. Almost all patients were satisfied with their restoration color after 1 year's application. CONCLUSION: The research indicated that Cerinate porcelain veneer restoration system is a reliable and ideal choice for the correction of tetracycline-stained teeth.

Anti-Bacterial Agents↗
PubMed1992

Bleaching the natural dentition to match the color of existing restorations: case reports.

Vital tooth bleaching has become a popular and successful treatment. This treatment may be performed under controlled conditions in the dental office or it may be used under monitored, prescribed conditions with a 10% or 15% carbamide peroxide solution, applied by the patient at home. This paper presents the use of both types of systems in a unique application to modify the color of the natural dentition to match that of existing restorations.

Adult↗
PubMedDate not supplied

Clinical effects of a stannous fluoride mouthrinse on plaque.

The purpose of this 3-week, double-blind study was to determine the effect of a stannous fluoride-containing mouthrinse on existing and developing dental plaque. A total of 55 subjects (mean age = 31.42 yrs.) received a professional prophylaxis in randomly assigned contralateral quadrants and were then stratified into two balanced groups based on screening plaque scores: one group (27 subjects) used the placebo rinse, the second group (28 subjects) used the test mouthrinse (0.63% diluted to 0.1% stannous fluoride). Plaque index (PI) and stain index (SI) were scored at baseline, week 1 and week 3. Gingival inflammation (GI) was monitored as a measure of product irritancy potential. The PI for the stannous fluoride rinse was significantly lower than the placebo, (p < 0.0001), for both prophied and unprophied sites with an average reduction of 29% at week 1 and 28% at week 3. There was no statistically significant difference between the presence or absence of prophylaxis. Plaque indexes for both stannous fluoride and placebo showed significant reduction (p < 0.0001) compared to baseline in all sites. Differences in staining potential between stannous fluoride and placebo were not significant (p > 0.05) at any time during the study. The stain index for both stannous fluoride and placebo showed a non-significant increase from baseline in the prophied and unprophied sites. No irritancy was noted, although a trend towards lower GI scores was observed at 3 weeks for the stannous fluoride group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Oral rehabilitation of young adults with amelogenesis imperfecta.

PURPOSE: This article describes the restorative management of two patients in whom the diagnosis of amelogenesis imperfecta was not made until young adulthood. MATERIALS AND METHODS: Amelogenesis imperfecta is a variable developmental abnormality of the tooth enamel that affects relatively few persons. Previous case reports have focused largely on the early management of children and young adolescents. However, some patients may not be diagnosed correctly or may not request dental treatment until they are older, as with the two cases presented. In some instances, parents fail to appreciate the importance of early intervention. RESULTS: Both patients required intensive preventive therapy and extensive restorative treatment over several years. The correct sequencing of treatment phases was required to achieve relief of pain and provide satisfactory function and esthetics. CONCLUSION: The two cases presented illustrate the degree of complexity that extended restorative treatments can involve, especially following severe tooth wear and poor bonding of restorations to the affected enamel.

Adolescent↗
PubMed2003

Clinical evaluation of a novel liquid tooth whitening gel.

PURPOSE: To clinically evaluate a new system for at-home tooth whitening (Colgate Simply-White Whitening Gel), by comparing tooth color improvement and adverse event incidence after 14-days treatment. MATERIALS AND METHODS: 22 subjects (aged 21-46 years) were enrolled into the study. Tooth color and safety assessments were conducted at baseline and following a 2-week at-home treatment. Efficacy was assessed using VITA shade scores. Safety evaluations were performed including the examination of plaque index (PI), bleeding index (BOP), gingival recession and dentin hypersensitivity. Statistical analysis was performed to determine the mean change from baseline. RESULTS: The new whitening gel releasing 5.9% hydrogen peroxide was significantly effective in lightening tooth shade. After only 2 weeks, patients enrolled in the study exhibited an overall mean 3.56-shade improvement from baseline, far superior than minimum values established in ADA Guidelines for the acceptance of peroxide-containing oral hygiene products. Periodontal health (PI and BOP) improved with time overall. Dentin hypersensitivity slightly increased, but it was very well tolerated. No patient discontinued study participation due to such an adverse event. Therefore, it was concluded that the new Colgate Simply White Clear Whitening Gel provided clinically proven, safe and effective at-home tooth whitening.

Adult↗
PubMed1992

Chlorhexidine solutions, gels and varnishes in caries prevention.

To combat dental caries, a chemical has been sought that possesses stronger antimicrobial properties than fluoride in support of its physicochemical tooth-protecting properties. These searches have led to several agents, of which chlorhexidine (CH) appears most effective. To reduce local side effects of the well-known 0.2% CH mouthwash, a 0.05% CH gluconate + 0.04% NaF solution, pH 5.9, has been developed. Use of this combination over a 2-year period resulted in a 53% reduction in caries increment and a 75% reduction in gingival bleeding, i.e. a clear duality of prevention of oral disease (Luoma et al. 1978). Staining of teeth was minimal and easily removable in about one third of the subjects. To lessen the contribution of patients, chlorhexidine gels, without but more especially with fluoride have been professionally administered. Reductions in salivary mutans streptococci after short periods of gel applications have been found to persist longer than reductions after brief periods of mouthwashing. Reductions of approximal caries increment by about 50% in children, and root surface caries in adults have been obtained through use of CH gels. The effect on root surface caries in adults was equal to that obtained through use of local fluoride applications. Dental CH varnish seems promising, especially because a very short contact time with a tooth may be sufficient to reduce mutans streptococci. No simultaneous effects against caries and gingivitis of CH gels or varnishes has been reported. Comparisons of CH solutions, gels and varnishes, with or without fluoride, in relation to their potentials for preventing oral disease in subjects at risk remain to be accomplished.

Chlorhexidine↗
PubMed1992

History, safety, and effectiveness of current bleaching techniques and applications of the nightguard vital bleaching technique.

This article reviews the literature on the use of hydrogen peroxide in three professionally administered bleaching techniques from historical, technique, and safety viewpoints. Safety over time, absolute safety, and relative safety of nonvital bleaching, in-office vital bleaching, nightguard vital bleaching, and over-the-counter bleaching kits are compared. The advantages and disadvantages of different bleaching options, as well as indications for individual or combined use of the techniques, are discussed. In addition, specific indications for the use of the nightguard vital bleaching technique are presented.

Carbamide Peroxide↗
PubMedDate not supplied

Orthodontic decalcification management with microabrasion.

Patient home care during orthodontic treatment is often less than ideal. For those patients who routinely let plaque accumulate around orthodontic appliances, there can be white or stained areas of decalcification around the bonded appliances. Management of this esthetic problem can be accomplished in several ways depending on the severity of the defect. This paper describes the very conservative technique of microabrasion which works well in removing superficial markings caused by decalcification. In a sample of 98 decalcified teeth from 20 patients with orthodontic decalcifications and various other unesthetic stains, microabrasion removed most or all of the disfiguring marks on 78.5 percent of the teeth evaluated. At least some improvement was noted 96.9 percent of the time. These results were statistically significant (P > .01). It seems appropriate to employ this technique prior to initiating more aggressive cosmetic dentistry such as resin bonding, Class V restorations, or labial veneers.

Dental Enamel↗
PubMed2003

Clinical response of two brush-applied peroxide whitening systems.

OBJECTIVE: A randomized, examiner-blind parallel design study was conducted to evaluate the clinical efficacy and tolerability of two brush-applied, peroxide-based tooth whiteners. METHODOLOGY: A total of 38 subjects were randomized to Colgate Simply White, an 18% carbamide peroxide paint-on liquid in an applicator bottle, or Crest Night Effects, a 19% sodium percarbonate system in unit dose sachets that dries to form an adherent film. Treatment was for 14 days. The 18% carbamide peroxide gel was applied twice daily, while the 19% sodium percarbonate film was applied for overnight use. Subjects were evaluated at baseline, and again after 7 and 14 days of treatment using digital images to assess tooth color, and oral examinations to establish safety. Whitening efficacy was determined by evaluating the reduction in tooth yellowness (delta b*), increase in tooth brightness (delta L*), reduction in tooth redness (delta a*) and overall tooth color change relative to pure white (delta W*). RESULTS: After 14 days, the mean change in yellowness (delta b*) was -1.43 +/- 0.20 for the 19% sodium percarbonate film, and -0.44 +/- 0.06 for the 18% carbamide peroxide gel. Mean change in brightness (delta L*) was 1.13 +/- 0.13 and 0.55 +/- 0.13 in the film and gel groups, respectively. Between-group comparisons showed highly significant (p < or = 0.003) whitening for the 19% sodium percarbonate film compared to the 18% carbamide peroxide gel for all 14-day color measurements (delta b*, delta L*, delta a* or delta W). Both products were well-tolerated, with no subjects discontinuing treatment early due to a causal adverse event. CONCLUSION: In a direct clinical comparison of two brush-applied products over 14 days, Crest Night Effects provided significant and meaningful improvement in tooth color, representing more than double the whitening measured for the Colgate Simply White.

Adolescent↗
PubMed2003

Comparative clinical investigation of the tooth whitening efficacy of two tooth whitening gels.

OBJECTIVE: The objective of this randomized, double-blind, parallel-group clinical study was to compare the tooth whitening efficacy of two tooth whitening gel products--Colgate Simply White Night Clear Whitening Gel containing either 25% carbamide peroxide, or 8.7% hydrogen peroxide--when used once daily at night. METHODOLOGY: Following a baseline tooth shade evaluation using the Vita Shade Guide, qualifying adult male and female subjects from the Central New Jersey area were randomized into two treatment groups, which were balanced for baseline Vita Shade Guide scores, gender and age. The treatment groups were: 1) a tooth whitening gel containing 25% carbamide peroxide; or 2) a tooth whitening gel containing 8.7% hydrogen peroxide. All subjects were given a commercially available, non-whitening dentifrice and a soft-bristled toothbrush at the beginning of the study. In addition, they were also given one of the two tooth whitening gel products. All subjects were instructed to brush their teeth for one minute twice daily (morning and evening) with the non-whitening toothpaste. The subjects were further instructed to apply their assigned tooth whitening gel product once daily at night, per the instructions provided. Evaluations of tooth shade for each subject were repeated after two weeks, and again after three weeks of product use. RESULTS: Fifty-nine (59) subjects complied with the protocol and completed the three-week study. At both the two-week and three-week examinations, all subjects exhibited statistically significant (p < 0.05) tooth shade lightening relative to baseline tooth shade. Further, there was no statistically significant difference in tooth shade lightening between the two tooth whitening gel products. CONCLUSION: The results of this clinical study indicate that after once daily use at night for two or three weeks, a tooth whitening gel containing 25% carbamide peroxide and a tooth whitening gel containing 8.7% hydrogen peroxide both provided statistically significant tooth shade lightening relative to baseline tooth shade. The results also showed that there was no statistical difference in tooth whitening efficacy between the two tooth whitening gel products.

Adolescent↗
PubMed2003

Plaque removal and oral health promotion potential for the elmex interX medium toothbrush: clinical efficacy and safety evaluation.

OBJECTIVE: This study was designed to assess a newly developed toothbrush for efficacy in plaque removal, reduction of gingivitis and soft tissue bleeding, and retardation of stain formation over 30 days. METHODOLOGY: Healthy adult subjects (N = 112) were admitted to the study, and randomly given a test toothbrush, (the elmex interX medium) or the control toothbrush, an ADA-Accepted flat-bristle profile toothbrush. Additionally, the subjects were randomly assigned to be given oral hygiene instruction, or no formal oral hygiene instruction. Examinations and assessments were performed at baseline, 15 and 30 days, and included gingivitis levels, stain levels, bleeding on probing, and plaque levels before and after brushing. RESULTS: No significant statistical differences were found between the two toothbrushes on gingivitis, nor on the stain index; however, over the course of the study the gingivitis decreased significantly (p = 0.012) for the test toothbrush group. For the bleeding index, a significant statistical difference (p = 0.027) was found at 30 days favoring the test toothbrush. There was also a significant decrease for the test toothbrush on bleeding over time (p = 0.004). Following overnight plaque formation, the before-brushing plaque levels were significantly different in favor of the test toothbrush at 15 days (p = 0.002), and again at 30 days (p = 0.001). Immediately after brushing, there was a significant statistical difference (p = 0.015) favoring the test toothbrush at 30 days. CONCLUSION: These results clearly indicate improved plaque removal and reduction of bleeding and gingivitis for the new elmex interX medium toothbrush compared to the ADA-Accepted control toothbrush.

Adult↗
PubMedDate not supplied

A clinical evaluation of two in-office bleaching products.

This half-mouth design, two-week treatment phase, combined with an 11-week evaluation double-blinded randomized clinical trial was conducted to compare two in-office bleaching products, StarBrite (35% hydrogen peroxide) with Opalescence Xtra Boost (38% hydrogen peroxide), for degree of color change of teeth, any relapse effect (darkening) associated with discontinued use and gingival irritation and tooth sensitivity associated with use. The degree of color change and relapse was evaluated by using a colorimeter, shade guide and color slide photographs. Participants self-evaluated their gingival irritation and tooth sensitivity. They recorded daily the level of gingival irritation and tooth sensitivity experienced during the first three weeks of the study. The results of this study showed no statistical difference between products during active treatment periods and any follow-up visits using the three-color evaluation methods. Color relapse began after the bleaching treatments were finished and continued until the fifth week, after which no further significant changes appeared. Also, there was no statistical difference in gingival irritation and tooth sensitivity between the products.

Adult↗
PubMed2003

The prevention of induced stain using two levels of sodium hexametaphosphate in chewing gum.

OBJECTIVE: This study was a randomized, controlled, examiner-blind, four-period crossover design that examined the prevention of induced stain deposition through the use of chewing gums containing either 2.0% or 3.0% sodium hexametaphosphate (Na Hex). METHODOLOGY: The test treatments were an experimental chewing gum containing 2.0% Na Hex, a second experimental chewing gum containing 3.0% Na Hex, a placebo chewing gum (0.0% Na Hex) and no chewing gum. The study was carried out over a four-week period, with each treatment period lasting two days. Treatment periods were separated by a washout period of three to five days. Twelve subjects who met the inclusion and exclusion criteria were given a thorough dental prophylaxis limited to the anterior twelve teeth, and then underwent a baseline digital imaging assessment (DIA) procedure. Each treatment period involved two days of stain induction, which consisted of rinsing for 60 seconds with 10 ml of 0.12% chlorhexidine, followed by chewing with two pellets of the assigned chewing gum for five minutes or by no gum chewing, followed by rinsing with 10 ml of cold tea solution for 60 seconds. This regimen was repeated eight times throughout the day, approximately once an hour. Imaging was completed at baseline and at the end of day 2 of the induced stain regimen. Subjects refrained from any oral hygiene during the two-day stain induction periods. RESULTS: Average baseline L* scores ranged from 76.30 to 76.57. At the end of the two-day stain induction regimen (eight hourly cycles per day) when no gum was chewed ("no gum"), subjects' teeth were 5.18 units darker on average than they were at baseline. At the end of the two-day regimen when the placebo gum was chewed, subjects' teeth were 4.54 units darker on average than they were at baseline. The difference between "no gum" and placebo gum was statistically significant (p = 0.017), and represented a 12.4% reduction in tooth darkness for the placebo gum treatment. Use of the 2.0% Na Hex gum resulted in teeth 3.64 units darker on average versus baseline, and the 3.0% Na Hex gum resulted in teeth 4.02 units darker. Both the 2.0% and 3.0% Na Hex gums resulted in teeth that were statistically significantly less dark (p < or = 0.042) than both the "no gum" and placebo gum treatments. On average, the reduction in tooth darkness for the 2.0% Na Hex gum was 29.7% versus "no gum" and 19.8% versus the placebo gum. The 2.0% Na Hex and 3.0% Na Hex gum treatments did not differ significantly (p = 0.114). CONCLUSION: This study demonstrated that 2.0% and 3.0% levels of Na Hex in a chewing gum prevented the deposition of extrinsic dental stain better than a chewing gum without Na Hex, which in turn prevented the deposition of stain better than no chewing gum.

Adult↗
PubMed2004

Professional vital bleaching using a thin and concentrated peroxide gel on whitening strips: an integrated clinical summary.

Rapid innovation in vital bleaching continues to expand the number of treatment options available to patients, particularly in the area of at-home whitening. The development of bleaching strips represented a new paradigm in the delivery of peroxide. The efficacy and safety of bleaching strip systems delivering up to 6.5% hydrogen peroxide has been established in numerous randomized clinical trials. In 2003, a novel bleaching strip with 14% hydrogen peroxide (Crest Whitestrips Supreme) was introduced. This advanced system carries a thinner but more concentrated gel on each strip, resulting in a relatively similar total amount of peroxide as compared to other strip systems. This 2-variable change, higher concentration gel with lowered gel volume translates to improved whitening without adversely affecting oral soft tissue tolerability and irritation. This paper provides an integrated review of 9 comparative clinical trials evaluating the whitening response (six trials) and safety (nine trials) of this novel vital bleaching system. Efficacy results for the 14% hydrogen peroxide strips were significantly (p<0.05) better than the placebo or pooled positive controls evaluated in the clinical trials assessing tooth color or shade. Adverse events were similar in type to the other vital bleaching systems. Overall, the research of 408 patients showed generally better efficacy and similar to or better tolerability for the 14% hydrogen peroxide strips compared to a selected group of marketed positive bleaching controls.

Adolescent↗