Darlon Martins Lima

Evaluation of several clinical parameters after bleaching with hydrogen peroxide at different concentrations: A randomized clinical trial

OBJECTIVE This randomized double-blind clinical trial compared tooth sensitivity (TS), bleaching efficacy, and cytokine levels after applying in-office bleaching treatments containing 15% and 35% hydrogen peroxide (HP15% and HP35%, respectively). METHODS Twenty-five volunteers were randomly assigned to receive HP15% or HP35% treatment. The bleaching agent was applied in three 15-min applications per session. Two bleaching sessions were separated by a 1-week interval. The participants scored TS using a visual analog scale and numerical rating scale. Bleaching efficacy was determined by subjective and objective methods. Gingival crevicular fluid was collected from three jaws sites per patient for the analysis of fluid volume. Flow cytometry was used to analyze gingival crevicular fluid levels of interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-10, tumor necrosis factor, and interferon-gamma. All measurements were obtained before and after bleaching. All data were statistically analyzed (α=0.05). RESULTS The absolute risk and intensity of TS was higher for HP35% than for HP15% (p>0.002). One month post-bleaching, HP35% produced more bleaching than HP15% (p=0.02). However patient perception (p=0.06) and patient satisfaction (p=0.53) with regard to bleaching were not significantly different. No significant differences existed in the gingival fluid volume (p>0.38) or in any cytokine level (p>0.05) for either HP concentration. CONCLUSION Treatment: with HP35% is more effective than HP15%, but generates a greater risk and intensity of TS. No inflammatory changes occurred despite the difference in the HP concentrations. CLINICAL SIGNIFICANCE Hydrogen peroxide at a lower concentration (e.g., 15%) should be considered a good treatment alternative for in-office bleaching because the higher concentration for in-office bleaching generates a greater risk and intensity of TS for patients.

Polymerization Shrinkage of Bulk Fill Composites and its Correlation with Bond Strength

The present study aimed to evaluates polymerization shrinkage (PS) using microcomputed tomography (μCT) and microtensile bond strength (μTBS) in bulk fill composites (BFC) and conventional class I restorations as well as the correlation between these factors. Class I cavities (4 x 5 x 4 mm), factor-C = 4.2, were created in third molars that were free of caries, which were randomly divided in 4 groups (n = 6): XTI (Filtek Supreme XTE: incremental technique); XTB (Filtek Supreme XTE: single fill technique); TBF (Tetric Bulk Fill); and SF (SonicFill). Each tooth was scanned twice in μCT: T0 was after filling the cavity with composite, and T1 was after light curing. The data were analyzed by subtracting the composite volume for each time (T1 - T0). After 1 week, the teeth were sectioned crosswise in the buccolingual and mesiodistal directions to obtain specimens with approximately 1 mm² thickness and fixed in a universal testing machine to perform μTBS. The Kruskal-Wallis and Dunn tests showed a statistically significant difference for shrinkage in µCT among the XTI and XTB and between the SF and XTB. Regarding the μTBS, all the groups differed from XTB. Bulk fill composites type presents a PS similar to that of the conventional nanoparticulate composite inserted using the incremental technique, but the bond strength was higher for the incremental group, which presented a lower number of pre-test failures when compared to BFC. No correlation was observed between the polymerization shrinkage and bond strength in the studied composites.

Is there correlation between polymerization shrinkage, gap formation, and void in bulk fill composites? A μCT study

This in vitro study aimed to evaluate the volume of polymerization shrinkage (VS), gap (VG), and void (VV) using computerized microtomography (μCT) in bulk fill resin composites and conventional class I restorations, and to establish a correlation between these factors. Class I cavities (4 x 5 x 4 mm), C-factor = 4.2, were performed on caries-free human third molars and randomly divided into five groups (n = 6): FSI (Filtek Supreme XTE incremental insertion); FSS [(Filtek Supreme XTE single insertion(SI)]; TBF [(Tetric Bulk Fill: SI and manual filling (MF)]; SFM (Sonic Fill: SI/MF); and SFS (SonicFill: SI and sonic filling). The teeth were scanned and analyzed by μCT at T0, after filling the cavity with resin, and at T1, after polymerization for VG and VV, and for VS (T1-T0). There was statistically significant difference in VS in μCT for the FSI and FSS groups and between SFS and FSS as well as some difference in VV for FSI and bulk fill resin composites and no difference in VG between the conventional technique and bulk fill composites. Bulk fill resin composites presented similar VS and gap formation to those of incrementally inserted conventional resin composites. There is a moderate and weak positive correlation between polymerization shrinkage and gap formation and void, respectively. The final gap formation was more dependent on the initial gap than on polymerization shrinkage or void volume.