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使用高浓度漂白凝胶后的漂白和牙釉质表面相互作用。

Bleaching and enamel surface interactions resulting from the use of highly-concentrated bleaching gels.

机构信息

Department of Dental Materials, School of Dentistry, University of the Republic, Gl. las Heras 1925, Montevideo, 11600, Uruguay; Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPel), Rua Gonçalves Chaves, 457, Pelotas, RS, 96015-560, Brazil.

Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPel), Rua Gonçalves Chaves, 457, Pelotas, RS, 96015-560, Brazil.

出版信息

Arch Oral Biol. 2018 Mar;87:157-162. doi: 10.1016/j.archoralbio.2017.12.026. Epub 2017 Dec 28.

Abstract

Tooth bleaching is considered a non-invasive treatment, although the use of highly-concentrated products may provoke increased surface roughness and enamel demineralization, as well as postoperative sensitivity. Thus, the aim of this study was to investigate whether hydrogen peroxide (HO) concentration would affect tooth bleaching effectiveness and the enamel surface properties. Enamel/dentin bovine specimens (6 × 4 mm) were immersed in coffee solution for 7 days and evaluated with a spectrophotometer (Easyshade; baseline), using the CIELab color parameters. Hardness was measured using a hardness tester. The specimens were randomly assigned into four groups: one negative control, in which the specimens were not bleached, but they were irradiated with a laser-light source (Whitening Lase II, DMC Equipments); and three groups using distinct HO concentration, namely LP15% (15% Lase Peroxide Lite), LP25% (25% Lase Peroxide Sensy), and LP35% (35% Lase Peroxide Sensy), all products from DMC. The bleached specimens were also irradiated with the laser-light source. After bleaching, all specimens were evaluated using scanning electron microscopy (SEM). pH kinetics and rate was monitored during bleaching. The data were analyzed using ANOVA and Tukey's test (p < 0.05). All bleaching gels produced similar color change (p > 0.05). Concerning hardness, only the LP25% and LP35% significantly reduced hardness after bleaching; also, there was a progressive tendency for a greater percentage reduction in hardness with increased HO concentration of the gel (R = 0.9973, p < 0.001). SEM showed that LP25% and LP35% produced an etching pattern on enamel with prism rods exposure. In conclusion, HO concentration above the 15% level does not increase bleaching effectiveness, and may increase the possibility for alteration of enamel hardness, surface morphology, and acidity of the medium. When using HO-based bleaching agents, dental practitioners should choose for less concentrated gels, e.g., around the 15% level.

摘要

牙齿漂白被认为是一种非侵入性的治疗方法,尽管使用高浓度的产品可能会导致表面粗糙度增加和牙釉质脱矿,以及术后敏感。因此,本研究旨在探讨过氧化氢(HO)浓度是否会影响牙齿漂白效果和牙釉质表面特性。将牙本质/牙釉质牛标本(6×4mm)浸入咖啡溶液中 7 天,并使用分光光度计(Easyshade;基线),使用 CIELab 颜色参数进行评估。使用硬度测试仪测量硬度。将标本随机分为四组:一组为阴性对照组,标本未漂白,但用激光光源(Whitening Lase II,DMC 设备)照射;三组使用不同浓度的 HO,即 LP15%(15% Lase Peroxide Lite)、LP25%(25% Lase Peroxide Sensy)和 LP35%(35% Lase Peroxide Sensy),均为 DMC 产品。漂白后的标本也用激光光源照射。漂白后,用扫描电子显微镜(SEM)对所有标本进行评估。在漂白过程中监测 pH 动力学和速率。使用方差分析和 Tukey 检验(p<0.05)对数据进行分析。所有漂白凝胶均产生相似的颜色变化(p>0.05)。关于硬度,只有 LP25%和 LP35%在漂白后显著降低了硬度;此外,随着凝胶 HO 浓度的增加,硬度降低的百分比呈逐渐增加的趋势(R=0.9973,p<0.001)。SEM 显示 LP25%和 LP35%在牙釉质上产生了一个蚀刻图案,暴露了棱柱体。综上所述,HO 浓度超过 15%并不会增加漂白效果,反而可能增加牙釉质硬度、表面形态和介质酸度改变的可能性。当使用基于 HO 的漂白剂时,牙科医生应选择浓度较低的凝胶,例如 15%左右。

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