Michael C. Floros

Low Concentration H2O2/TiO_N in Office Bleaching: A Randomized Clinical Trial

Objectives: The purpose of this randomized double-blinded clinical trial was to test the efficacy and tooth sensitivity promoted by the use of an in-office 15% H2O2 bleaching agent containing nanoparticles of TiO_N photocatalyzed with LED/laser light (HP15) and a control of 35% H2O2 (HP35). Methods: Forty healthy volunteers, both sexes, aged 18 to 25 yr, were randomly distributed in 2 groups: HP15 (n = 20) was treated in 3 sessions of 48 min each, and HP35 (n = 20) was treated in 3 sessions of 45 min each. The efficacy (E) was evaluated by ΔE values measured via reflectance spectroscopy. The tooth sensitivity (S) was analyzed by visual analog scale (low, average, high, very high). The absolute risk reduction and the number needed to treat index were calculated. The data were analyzed by mixed repeated measures analysis of variance with Bonferroni-correction t test (α = 0.05). Results: For the efficacy, significant differences were found for number of bleaching sessions (p = .0001; η p 2 = 0.73 and π = 1.000) and for the interaction of number of sessions and bleaching protocols (p = .0001; η p 2 = 0.319 and π = 1.000. The tooth sensitivity level showed significant differences only between the bleaching protocols. Absolute risk reduction calculated was 52% and number needed to treat, 1.92. Conclusions: The bleaching agent with the lower concentration (HP15) promoted lower levels of tooth sensitivity and presented greater efficacy compared to the control (HP35) in patients between 18 and 25 yr old. The limitation of short-term evaluation did not provide information about the longevity of the tooth bleaching (Brazilian Clinical Trials Registry Re Bec no. U1111-1150-4466).OBJECTIVES The purpose of this randomized double-blinded clinical trial was to test the efficacy and tooth sensitivity promoted by the use of an in-office 15% H(2)O(2) bleaching agent containing nanoparticles of TiO_N photocatalyzed with LED/laser light (HP15) and a control of 35% H2O2 (HP35). METHODS Forty healthy volunteers, both sexes, aged 18 to 25 yr, were randomly distributed in 2 groups: HP15 (n = 20) was treated in 3 sessions of 48 min each, and HP35 (n = 20) was treated in 3 sessions of 45 min each. The efficacy (E) was evaluated by ΔE values measured via reflectance spectroscopy. The tooth sensitivity (S) was analyzed by visual analog scale (low, average, high, very high). The absolute risk reduction and the number needed to treat index were calculated. The data were analyzed by mixed repeated measures analysis of variance with Bonferroni-correction t test (α = 0.05). RESULTS For the efficacy, significant differences were found for number of bleaching sessions (p = .0001; [Formula: see text] = 0.73 and π = 1.000) and for the interaction of number of sessions and bleaching protocols (p = .0001; [Formula: see text] = 0.319 and π = 1.000. The tooth sensitivity level showed significant differences only between the bleaching protocols. Absolute risk reduction calculated was 52% and number needed to treat, 1.92. CONCLUSIONS The bleaching agent with the lower concentration (HP15) promoted lower levels of tooth sensitivity and presented greater efficacy compared to the control (HP35) in patients between 18 and 25 yr old. The limitation of short-term evaluation did not provide information about the longevity of the tooth bleaching (Brazilian Clinical Trials Registry Re Bec no. U1111-1150-4466).

Vegetable Oil Derived Solvent, and Catalyst Free “Click Chemistry” Thermoplastic Polytriazoles

Azide-alkyne Huisgen “click” chemistry provides new synthetic routes for making thermoplastic polytriazole polymers—without solvent or catalyst. This method was used to polymerize three diester dialkyne monomers with a lipid derived 18 carbon diazide to produce a series of polymers (labelled C18C18, C18C9, and C18C4 based on monomer chain lengths) free of residual solvent and catalyst. Three diester dialkyne monomers were synthesized with ester chain lengths of 4, 9, and 18 carbons from renewable sources. Significant differences in thermal and mechanical properties were observed between C18C9 and the two other polymers. C18C9 presented a lower melting temperature, higher elongation at break, and reduced Youngs modulus compared to C18C4 and C18C18. This was due to the “odd-even” effect induced by the number of carbon atoms in the monomers which resulted in orientation of the ester linkages of C18C9 in the same direction, thereby reducing hydrogen bonding. The thermoplastic polytriazoles presented are novel polymers derived from vegetable oil with favourable mechanical and thermal properties suitable for a large range of applications where no residual solvent or catalyst can be tolerated. Their added potential biocompatibility and biodegradability make them ideal for applications in the medical and pharmaceutical industries.

New Parameter for In-Office Dental Bleaching

Dental bleaching is considered a conservative and biologically safe treatment for discolored teeth. Despite this, one of the major undesirable effects of bleaching is dentin sensitivity which may occur during and after treatment. To address these sensitivity issues, new dental bleaching preparations with lower concentrations of hydrogen peroxide (H2O2) have recently been introduced to the market. This paper presents a clinical case report of a 20-year-old female patient admitted to the Araraquara Dental School, UNESP, Brazil. The patient underwent dental bleaching using one of the new products with reduced hydrogen peroxide concentration, Lase Peroxide Lite 6%, a 6% H2O2 gel containing titanium oxide nanoparticles doped with nitrogen (6% H2O2/N-doped TiO2).

Can a bleaching toothpaste containing Blue Covarine demonstrate the same bleaching as conventional techniques? An in vitro, randomized and blinded study

ABSTRACT Objective The purpose of this in vitro study was to compare the efficacy of a bleaching toothpaste containing Blue Covarine vs. conventional tooth bleaching techniques using peroxides (both in-office and at-home). Material and Methods Samples were randomly distributed into five experimental groups (n=15): C - Control; BC – Bleaching toothpaste containing Blue Covarine; WBC – Bleaching toothpaste without Blue Covarine; HP35 - In-office bleaching using 35% hydrogen peroxide; and CP10 – At-home bleaching with 10% carbamide peroxide. The dental bleaching efficacy was determined by the color difference (ΔE), luminosity (ΔL), green-red axis (Δa), and blue-yellow axis (Δb). The CIELab coordinates were recorded with reflectance spectroscopy at different times: T0 - baseline, T1 – immediately after bleaching, T2 - 7 days, T3 - 14 days, and T4 - 21 days after the end of treatments. Data were analyzed by a repeated measures mixed ANOVA and post hoc Bonferroni test, with a significance level of 5%. Results No significant differences were found between the treatment groups C, BC, and WBC. The groups HP35 and CP10 showed significantly higher whitening efficacy than groups C, BC, and WBC. Conclusions There were no significant differences in the whitening efficacy between a Blue Covarine containing toothpaste, a standard whitening toothpaste, and a control. Neither of the whitening toothpastes tested were as effective as in-office or at-home bleaching treatments.

Does a toothpaste containing blue covarine have any effect on bleached teeth? An in vitro, randomized and blinded study

The objective of this study was to analyze the effect of bleaching toothpastes, both conventional and those containing the new whitening agent Blue Covarine, on teeth previously bleached by conventional techniques (in-office and at-home). Squared bovine enamel/dentin blocks (6.0 x 6.0 x 2.0 mm) were randomly distributed in 6 groups (n = 15), according to the technique used to bleach them (in-office: HP35%; at-home: PC10%) and the type of bleaching toothpaste (none: control; Blue Covarine containing: BC; and without Blue Covarine: NBC). Experimental groups denominated HP35%, HP35%BC and HP35%NBC received in-office tooth bleaching before toothbrushing, and groups PC10%, PC10%BC and PC10%NBC were subjected to at-home tooth bleaching prior to toothbrushing. After bleaching treatment, groups HP35%BC, PC10%BC, HP35%NBC and PC10%NBC underwent daily tooth brushing in a brushing machine for 3 minutes (150 strokes/min, with a load of 375 g). Tooth color alteration was measured by reflectance spectroscopy (Vita EasyShade, Vident, Brea, CA, USA) at: T0 (baseline) - after in-office or at-home bleaching treatment; T1 - immediately after tooth brushing; T2 - 7 days and T3 - 14 days after tooth brushing. Data was analyzed by repeated measures mixed ANOVA and the Bonferroni post hoc test, with a significance level of 5%. Statistically significant differences were found between different experimental groups, evaluation times and for the interaction between them (p < 0.001). Tooth brushing using either bleaching toothpaste (conventional or with Blue Covarine) showed no color alteration on teeth previously bleached by in-office and at-home tooth bleaching. The use of bleaching toothpastes on previously bleached teeth did not produce a color alteration.