Entries by Pamela Ramos

Myths and facts about teeth whitening

March 18, 2021 /0 Comments/in /by

When it comes to teeth whitening, many questions arise and we have plenty of information available out there. However, what is myth and fact about whitening?

We have listed below the main myths and facts for you to have no more doubts. Check out!

1: Coffee, wine, soft drinks and food coloring must be avoided during/after treatment.

Myth! Studies indicated that there are no reasons for dietary restrictions during and/or after whitening if a quality product is used and the treatment is done appropriately.

  • Rezende M, Loguercio AD, Reis A, Kossatz S. Clinical effects of exposure to coffee during at-home vital bleaching. Oper Dent. 2013 Nov-Dec;38(6):E229-36. doi: 10.2341/12-188-C. Epub 2013 Apr 9. PMID: 23570297.
  • Mori AA, Lima FF, Benetti AR, Terada RS, Fujimaki M, Pascotto RC. Susceptibility to Coffee Staining during Enamel Remineralization Following the In-Office Bleaching Technique: An In Situ Assessment. J Esthet Restor Dent. 2016 Mar;28 Suppl 1:S23-31. doi: 10.1111/jerd.12134. Epub 2015 Jan 30. PMID: 25640880.
  • Hass V, Carvalhal ST, Lima SNL, Viteri-Garcia AA, Maia Filho EM, Bandeca MC, Reis A, Loguercio AD, Tavarez RRJ. Effects of Exposure to Cola-Based Soft Drink on Bleaching Effectiveness and Tooth Sensitivity of In-Office Bleaching: A Blind Clinical Trial. Clin Cosmet Investig Dent. 2019 Dec 20;11:383-392. doi: 10.2147/CCIDE.S227059. PMID: 31908538; PMCID: PMC6930015.
  • Matis BA, Wang G, Matis JI, Cook NB, Eckert GJ. White diet: is it necessary during tooth whitening? Oper Dent. 2015 May-Jun;40(3):235-40. doi: 10.2341/14-019-LIT. Epub 2015 Mar 6. PMID: 25748208.

 

2: It is possible to treat patients that smoke.

Fact! Smokers or non-smokers reach the same dental whitening results according to studies. The habit, however, affects the results in the long term, since it tends to make teeth yellower. Correct prophylaxis and oral hygiene help to maintain the good results.

  • Ness L, Rosekrans Dde L, Welford JF. An epidemiologic study of factors affecting extrinsic staining of teeth in an English population. Community Dent Oral Epidemiol. 1977 Jan;5(1):55-60. doi: 10.1111/j.1600-0528.1977.tb01617.x. PMID: 264419.
  • de Geus JL, Fernández E, Kossatz S, Loguercio AD, Reis A. Effects of At-home Bleaching in Smokers: 30-month Follow-up. Oper Dent. 2017 Nov/Dec;42(6):572-580. doi: 10.2341/16-126-C. PMID: 29144876.
  • de Geus JL, Rezende M, Margraf LS, Bortoluzzi MC, Fernández E, Loguercio AD, Reis A, Kossatz S. Evaluation of genotoxicity and efficacy of at-home bleaching in smokers: a single-blind controlled clinical trial. Oper Dent. 2015 Mar-Apr;40(2):E47-55. doi: 10.2341/14-121-C. Epub 2014 Dec 23. PMID: 25535783.
  • de Geus JL, de Lara MB, Hanzen TA, Fernández E, Loguercio AD, Kossatz S, Reis A. One-year follow-up of at-home bleaching in smokers before and after dental prophylaxis. J Dent. 2015 Nov;43(11):1346-51. doi: 10.1016/j.jdent.2015.08.009. Epub 2015 Aug 21. PMID: 26303401.

 

3: It is necessary to use light for whitening treatments.

Myth! The use of light during whitening treatments in the clinic does not improve results and does not lead to color change, independently from the concentration of hydrogen peroxide used and type of light. Also, the light increases the risk of sensitivity and pain during whitening treatments. Therefore, dentists must use the light-activated systems very carefully or completely avoid it during treatment.

  • He LB, Shao MY, Tan K, Xu X, Li JY. The effects of light on bleaching and tooth sensitivity during in-office vital bleaching: a systematic review and meta-analysis. J Dent. 2012 Aug;40(8):644-53. doi: 10.1016/j.jdent.2012.04.010. Epub 2012 Apr 21. PMID: 22525016.
  • Maran BM, Burey A, de Paris Matos T, Loguercio AD, Reis A. In-office dental bleaching with light vs. without light: A systematic review and meta-analysis. J Dent. 2018 Mar;70:1-13. doi: 10.1016/j.jdent.2017.11.007. Epub 2017 Dec 29. PMID: 29289725.
  • Maran BM, Ziegelmann PK, Burey A, de Paris Matos T, Loguercio AD, Reis A. Different light-activation systems associated with dental bleaching: a systematic review and a network meta-analysis. Clin Oral Investig. 2019 Apr;23(4):1499-1512. doi: 10.1007/s00784-019-02835-x. Epub 2019 Feb 14. PMID: 30767069.

 

4: Coal, dental pastes, mouth wash and whitening stripes are efficient to whiten teeth.

Myth! Toothpaste, mouth wash, chewing gum, among others, are not whitening products, therefore, they do not whiten teeth. Those items may help just the maintenance of results for acting in the dental hygiene and prophylaxis. Products with coal are just dental abrasives, and do not whiten teeth either and, according to studies, may be prejudicial to the dental structure.

  • Jiang N, Zhang C, Agingu C, Attin T, Cheng H, Yu H. Comparison of Whitening Dentifrices on the Effectiveness of In-office Tooth Bleaching: A Double-blind Randomized Controlled Clinical Trial. Oper Dent. 2019 Mar/Apr;44(2):138-145. doi: 10.2341/17-333-C. Epub 2018 Aug 14. PMID: 30106335.
  • Brooks JK, Bashirelahi N, Reynolds MA. Charcoal and charcoal-based dentifrices: A literature review. J Am Dent Assoc. 2017 Sep;148(9):661-670. doi: 10.1016/j.adaj.2017.05.001. Epub 2017 Jun 7. PMID: 28599961.
  • Franco MC, Uehara J, Meroni BM, Zuttion GS, Cenci MS. The Effect of a Charcoal-based Powder for Enamel Dental Bleaching. Oper Dent. 2020 Nov 1;45(6):618-623. doi: 10.2341/19-122-L. PMID: 32243248.

 

5: Dental whitening treatments carried out in the clinic are not stable.

Myth! Currently available whiteners, even with a high concentration of hydrogen peroxide, are more alkaline and maintain the pH stable, specially those which do not require the substitution of the gel. That characteristic minimizes the demineralization of the enamel which, besides preventing sensitivity, resulting in more longevity of the whitening.

  • Pinto A, Bridi EC, Amaral F, França F, Turssi CP, Pérez CA, Martinez EF, Flório FM, Basting RT. Enamel Mineral Content Changes After Bleaching With High and Low Hydrogen Peroxide Concentrations: Colorimetric Spectrophotometry and Total Reflection X-ray Fluorescence Analyses. Oper Dent. 2017 May/Jun;42(3):308-318. doi: 10.2341/16-032-L. PMID: 28467252.
  • Torres CR, Crastechini E, Feitosa FA, Pucci CR, Borges AB. Influence of pH on the effectiveness of hydrogen peroxide whitening. Oper Dent. 2014 Nov-Dec;39(6):E261-8. doi: 10.2341/13-214-L. Epub 2014 Aug 19. PMID: 25136903.
  • Mena-Serrano AP, Parreiras SO, do Nascimento EM, Borges CP, Berger SB, Loguercio AD, Reis A. Effects of the concentration and composition of in-office bleaching gels on hydrogen peroxide penetration into the pulp chamber. Oper Dent. 2015 Mar-Apr;40(2):E76-82. doi: 10.2341/13-352-L. Epub 2014 Dec 23. PMID: 25535786.
  • Tay LY, Kose C, Herrera DR, Reis A, Loguercio AD. Long-term efficacy of in-office and at-home bleaching: a 2-year double-blind randomized clinical trial. Am J Dent. 2012 Aug;25(4):199-204. PMID: 23082382.

 

Content based on the lesson by Prof. Alessandro Loguércio and Prof. Alessandra Reis.

Want to know more? Watch a class by Prof. Alessandra Reis on our channel: https://youtu.be/W6V4JA30M60

Case with extensive coronary destruction of the cervical region

November 4, 2020 in /by

Author: Dr. Fabio Lorenzoni

CASE REPORT

The patient came to the dental office, reporting the frequent falling out of the provisional crown of tooth 21, which had a provisional post cemented inside the root canal.

 

TREATMENT

A Whitepost DCE 2.0 fiberglass post was used, cemented with Allcem Core and Ambar Universal APS as the adhesive system. The fiberglass post sleeve was reconstructed with Vittra APS composite in shade DA2 .

Subsequently, the patient requested tooth whitening.

Then, a treatment plan was established involving the cementation of a lithium disilicate crown on tooth 21, with teeth 13, 12, 11, 22, and 23 received the cementation of veneers.

The veneers were cemented with Allcem Veneer APS and the crown was cemented with Allcem Core. The adhesive used was Ambar Universal APS in both cases.

 

STEP BY STEP

Initial aspect

Initial image. Note the lack of finishing and polishing of the buccal surfaces of the anterior teeth (the patient had removed the orthodontic brackets a few days ago) and quality of the provisional crown

Periapical image

Periapical X-ray image where it is possible to observe that this tooth had a temporary metallic post cemented in the root canal, which needed to be replaced.

Coronary remnant

Frontal image of the coronary remnant (quite darkened) after the removal of the provisional crown and the provisional metallic post.

Coronary remnant

Incisal image of the coronary remnant. Note that the root canal (especially in the cervical third) was quite wide. The prosthetic preparation of the coronary remnant was performed before cementation of the fiberglass post.

Depth of the root canal

Periapical X-ray image showing the unobstructed depth of the root canal.

Incisal image

Incisal image where it is possible to observe that the thickness of the cement line will be reduced due to the larger diameter of this fiberglass post, since the Whitepost DC-E posts have a larger diameter in their cervical portion.

Front image

Front image where it is possible to see the relationship between the fiberglass post and the coronary remnant.

Cement application

After acid etching, the root dentin was treated with the Ambar Universal APS adhesive. After that, the cement AllCem Core was applied inside the root canal through its applicator tip. Then, the fiberglass post Whitepost was inserted into the root canal and, after excesses removal, it was photoactivated.

Composite abutment

An abutment was created with Vittra APS composite in shade DA2. This abutment followed the principles of retention and stability of prosthetic preparations.

Incisal view

Incisal view showing the palatal face of the prosthetic preparation.

Post adaptation

Periapical X-ray image after cementation of the fiberglass post.

Teeth prepared for veneer

Frontal image showing teeth 13, 12, 11, 22 and 23 prepared for veneer and tooth 21 prepared for full crown. The preparations fot veneers were minimally invasive.

Initial aspect

Final aspect

Initial and final appearance of the case.