• Restorative Dentistry and Endodontics
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• v.44 no.4
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• pp.39.1-39.8
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• 2019

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.1 no.1
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• pp.50-57
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• 1992

Intrinsic discoloration of permanent anterior teeth is a continuing esthetic problem. Tetracycline ingested during amelogenesis has long been recognized as predisposing factor in intrinsic staining. Methods for restoring original tooth color have included (1) complete PFM crown coverage (2) porcelain laminate veneers (3) direct bonding of composite resin, and (4) bleaching. In the case of tetracycline-stained upper anterior teeth, We authors, obtained the satisfactory results by means of gingivectomy, preliminary bleaching and porcelain laminate veneer restoration.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.656-669
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• 1998

Hydrogen peroxide at high concentration during walking bleaching may cause damage to the tooth structure and to the surrounding periodontal tissues and may develop external root resorption. Clinically, It is so important to find a method of prevention or minimization of these complications. The efficacy of various chamber-irrigating agents to eliminate residual hydrogen peroxide after walking bleaching was examined and compared with water rinse in this study. Extracted human 46 premolars without any cementoenamel junction defects were treated endodontically and based with IRM to 1 mm below CEJ and totally bleached 3 times for each tooth with 30% hydrogen peroxide and sodium perborate. Upon completion of the 3rd walking bleaching procedure, the cervical portion and pulp chamber of each group of teeth were irrigated with catalase, 70% ethylalcohol, acetone, and distilled water. And then, a radicular hydrogen peroxide penetration was measured with spectrophotometer immediately after each bleaching and following treatment with each chamber-irrigating agents, and the significance of their eliminating efficacy of residual hydrogen peroxide was analyzed by Kruskal-Wallis test. The results were obtained as follows. 1. Cervical root penetration of hydrogen peroxide was increased as the bleaching procedure was repeated(P<.01). 2. The most effective irrigant that removed residual hydrogen peroxide was the catalase, and the least effective one was water rinsing (P<.01).; there was no significant difference between the acetone and ethanol group. 3. The Irrigation with antioxidant enzyme or water-displacement solutions can eliminate residual oxygen radicals from the pulp chamber effectively after walking bleaching. So, these agents can reduce adverse effects such as cervical external resorption and periapical inflammation and prevent residual $O_2$ from impeding composite resin polymerization, thus increase the bonding strength of composite resin. This, in turn reduces microleakage and discoloration of the esthetic restoration, extending its service-life.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.174-181
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• 2009

Statement of problem: There is a reduction of dentin bonding strength when the bonding procedure is carried out immediately after bleaching with peroxides. Purpose: The aim of this study is to evaluate a proper time interval for in-office bleaching technique using 35% hydrogen peroxide. Material and methods: Fifty extracted non-caries human third molars were used in this study. Buccal enamel of each tooth was removed and polished by 600 grits silicone carbide paper. They were randomly divided into five groups and bleached 35% hydrogen peroxide except control group. All groups were bonded with Single Bond/Z 350 after each time intervals ; Group-A: control, no bleaching treatment. Group-B: resin bonding immediately after bleaching. Group-C: resin bonding 1day after bleaching. Group-D: resin bonding 2 days after bleaching. Group-E: resin bonding 7days after bleaching. Shear bond strengths were measured with a cross-head speed of 1.0 mm/min using an Instron machine. The data of results were statistically analyzed by analysis of variance(ANOVA) and Tukey multiple comparison test.(P=.05) Results: There were significant decreases in mean shear strength in immediately bonding group after bleaching. The reduction of bond strengths was 78% compared with the group of no bleaching treatment. Group C showed the recovery of 51%, and Group D showed recovery of 63%. Both of them have no statistical difference with non-bleaching group. Group E showed no statistical difference with no bleaching treatment group. Conclusion: Dentin bonding strength is significantly reduced when bonding is performed immediately after bleaching for in-office bleaching regimens using 35% hydrogen peroxide, and increases as time goes by. One week of elapsed time between bleaching and resin bonding significantly increases bonding strengths for the in-office bleaching technique.

• Restorative Dentistry and Endodontics
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• v.44 no.1
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• pp.6.1-6.11
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• 2019

Objectives: The aim of the present study was to evaluate the effect of whitening mouth rinses alone and in combination with conventional whitening treatments on color, microhardness, and surface roughness changes in enamel specimens. Materials and Methods: A total of 108 enamel specimens were collected from human third molars and divided into 9 groups (n = 12): 38% hydrogen peroxide (HP), 10% carbamide peroxide (CP), 38% HP + Listerine Whitening (LW), 10% CP + LW, 38% HP + Colgate Plax Whitening (CPW), 10% CP + CPW, LW, CPW, and the control group (CG). The initial color of the specimens was measured, followed by microhardness and roughness tests. Next, the samples were bleached, and their color, microhardness, and roughness were assessed. Data were analyzed through 2-way analysis of variance (ANOVA; microhardness and roughness) and 1-way ANOVA (color change), followed by the Tukey post hoc test. The Dunnett test was used to compare the roughness and microhardness data of the CG to those of the treated groups. Results: Statistically significant color change was observed in all groups compared to the CG. All groups, except the LW group, showed statistically significant decreases in microhardness. Roughness showed a statistically significant increase after the treatments, except for the 38% HP group. Conclusions: Whitening mouth rinses led to a whitening effect when they were used after conventional treatments; however, this process caused major changes on the surface of the enamel specimens.

• Restorative Dentistry and Endodontics
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• v.33 no.5
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• pp.463-471
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• 2008

This study investigated the clinical effectiveness and safety of sealed bleaching compared to conventional in-office bleaching using a randomized clinical trial of split arch design. Ten participants received a chairside bleaching treatment on the upper anterior teeth, and each side was randomly designated as sealed or control side. A mixture of Brite powder (PacDent, Walnut, USA), 3% hydrogen peroxide and carbamide peroxide (KoolWhite, PacDent, Walnut, USA) were used as bleaching agent. The control side was unwrapped and the experimental side was covered with a linear low density polyethylene (LLDPE) wrap for sealed bleaching. The bleaching gel was light activated for 1 hour. The tooth shades were evaluated before treatment, after treatment, and at one week check up by means of a visual shade (VS) assessment using a value oriented shade guide and a computer assisted shade assessment using a spectrophotometer (SP). The data were analyzed by paired t-test. In the control and sealed groups, the visual shade scores after bleaching treatment and at check up showed statistically significant difference from the preoperative shade scores (p<.05). The shade scores of the sealed group were significantly lighter than the control immediately after bleaching and at the check-up appointment (p<0.05). Compared to prebleaching status, the ${\Delta}E$ values at post bleaching condition were $4.35{\pm}1.38\;and\;5.08{\pm}1.34$ for the control and sealed groups, respectively. The ${\Delta}E$ values at check up were $3.73{\pm}1.95\;and\;4.38{\pm}2.08$ for the control and sealed groups. ${\Delta}E$ values were greater for the sealed group both after bleaching (p<.05) and at check up (p<.05). In conclusion, both ${\Delta}E$ and shade score changes were greater for the sealed bleaching group than the conventional bleaching group, effectively demonstrating the improvement of effectiveness through sealing.

• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.47.1-47.9
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• 2021

Objectives: This study aimed to use a laboratory model to evaluate the efficacy of an experimental bleaching agent. Materials and Methods: The model used human extracted molars that were treated and measured for bleaching efficacy. Teeth (n = 50) were distributed into 5 groups: Negative control (NC): immersion in water for 8 hours; Nanofibers (NFs): Experimental titanium dioxide nanofibers with stirring and light activation for 8 hours; Whitestrips (WS): Crest 3D White Glamorous White Whitestrips, 2 applications daily for 30 minutes, 14 days; 1% hydrogen peroxide (HP) standard: 1% hydrogen peroxide for 8 hours; and 30% HP standard: 30% hydrogen peroxide for 8 hours. Instrumental measurements were performed using a spectrophotometer. Results were recorded at baseline, 1-day post-bleaching, and 1-week post-bleaching. Kruskal-Wallis procedure was used to determine differences in color change. Pearson correlation was used to evaluate the relationship between visual and instrumental measurements. Tests of hypotheses were 2-sided with alpha = 0.05. Results: There was no significant difference in color parameters (L1, a1, b1, and shade guide units [SGU]) at baseline (p > 0.05). There was a significant difference among the groups for overall color change (ΔE^*ab) and change in shade guide units (ΔSGU) at 1-day and 1-week post-bleaching (p < 0.05). The higher the HP concentration, the higher the color change as expressed in ΔSGU and ΔE^*ab. The negative control exceeded the perceptibility threshold of ΔE^* = 1.2 regardless of time point. NFs showed a decrease in chroma, but were not statistically different compared to the negative control. Conclusions: The laboratory model was successful in screening an experimental bleaching agent.

• The Journal of Korean Academy of Prosthodontics
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• v.40 no.5
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• pp.451-469
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• 2002

The purpose of this study was to estimate the effect of a bleaching agent on tooth surfaces and to evaluate the resin bond strength according to different surface treatments on bleached teeth. To prepare for the experimental samples, first, extracted human third molars were used and the body portions of the crowns were cut into four equal-sized specimens. Next, each specimen was mounted in an plastic bottle with self-cured resin and highly polished to have them reveal the enamel or dentin surfaces. Then, the enamel(E) and dentin(D) specimens were divided into four ; 1) non-bleached, laser-treated(NBLA) group 2) bleached, laser-treated(BLLA) group 3) non-bleached, acid-treated(NBAC) group and 4) bleached, acid-treated(BLAC) group. Here, $opalescence^{(R)}$ (10% carbamide peroxide) was used for bleaching agent. The treated specimens were observed by confocal laser scanning microscopy and bonded with composite resin for shear bond test. The following results were obtained from this experiment : 1. Compared with the ENB group, the EBL group was shown be dyed about $20{\mu}m$ deeper with rhodamine B. The DBL group appeared to be caved in at the entry part of the dentinal tubules, was dyed about $20{\mu}m$ deeper and $5{\mu}m$ wider in diameter, compared with the DNB group. 2. In comparison with the EBLAC group, the ENBAC group looked evenly bonded with the resin, while the DNBAC group, compared to DBLAC group, was observed to have its resin tags penetrated about $50{\mu}m$ deeper. Other than those, however, no observable differences between ENBLA and EBLLA group or between DNBLA and DBLLA group were found. 3, At the shear bond test, the ENBAC group was shown to have statistically significant higher shear bond strength than the EBLAC group(p<0.05). No statistically significant differences between the ENBLA and the EBLLA groups were observed(p>0.05). 4. At the shear bond test, the DNBAC group was shown to have statistically significant higher shear bond strength than the DBLAC group(p<0.05). No statistically significant differences between the DNBLA and the DBLLA groups were observed(p>0.05). The in vitro observations above suggest that tooth-bleaching procedure brings a certain change on enamel and dentin surfaces and it weakens the shear bond strength with composite resin when the bleached tooth was acid-treated.

• Restorative Dentistry and Endodontics
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• v.31 no.2
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• pp.79-85
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• 2006

To evaluate the effect of vital tooth bleaching agent and alcohol pretreatment on dentin bonding, flat dentin windows were produced on the buccal side of the crowns of fifty-five extracted, human premolars. A bleaching gel, $Opalescence^{(R)}$ with 10% of carbamide peroxide (Ultradent Product, USA) was daily applied on the teeth of three experimental groups for six hours for 10 consecutive days, while teeth of a control group were not bleached. After 6 hours of bleaching gel application the specimens were washed and stored in saline until the next day application. After application of $One-step^{(R)}$ dentin bonding agent (Bisco, USA), $Z-250^{(R)}$ resin (3M-ESPE, USA) was bonded to dentin with a mount jig. Shear bond strength was measured with an Instron machine (Type 4202, Instron Corp., USA) after 24 hours. The results were analyzed using one-way ANOVA and Duncan's multiple range test at p < 0.05. Immediate bonding group showed significantly lower bond strength than un-bleached control group (p < 0.05). Ethanol-treated group showed significantly higher bond strength compared to immediate bonding group (p < 0.05). However, the bond strength of the ethanol treatment group was lower than that of the un-bleached control group (p < 0.05). There were no significant difference in shear bond strength between the 2-week delayed bonding group and the ethanol-treated group (p > 0.05) and between delayed bonding group and un-bleached control group (p > 0.05). In the condition of the present study. it seems that alcohol pretreatment after bleaching procedure can reduce the adverse effect of vital bleaching agent on dentin bonding.

• Journal of dental hygiene science
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• v.12 no.4
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• pp.320-328
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• 2012

The purpose of this study was to evaluate the tooth whitening and properties of an enamel surface after treatments with tooth bleaching agents that contained dicalcium phosphate dihydrate (DCPD) and hydrogen peroxide (HP). Thirty specimens were obtained from fifteen premolar and were randomly divided into three groups (n=10): 1, 3.5% HP + 0 g DCPD; 2, 3.5% HP + 0.1 g DCPD; 3. 3.5% HP + 1 g DCPD. All groups were bleached 8 hours per day for 14 days. With increasing DCPD concentration, the pH values in the agents increased, making it less acidic. However, there was no statistically significant difference (p>.05). As the concentration of DCPD was increased, the concentration of Ca and P was also increased. In all groups, after the tooth whitening, the tooth color was found to have a value of $L^*$ (p<.05). All groups showed significantly decreased enamel microhardness compared to their baseline (p<.05). The percentage microhardness loss (PML) of the group A1 and A2 were significantly lower than that of group A3. The obvious variation of morphology was observed on enamel surfaces in group A1. Following an analysis of the constituents of enamel surface after bleaching, as DCPD content was increased, the amount of Ca and P was increased. In this study, the experimental results suggest that DCPD/HP agent less demineralization changes such as the erosion morphology and hardness loss without compromising whitening efficiency.