Influence of enamel/dentin thickness on the toxic and esthetic effects of experimental in-office bleaching protocols
Influence of enamel/dentin thickness on the toxic and esthetic effects of experimental in-office bleaching protocols
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DOI：
10.1007/s00784-017-2049-7
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发表时间：
2017-11-01
影响因子：
3.4
通讯作者：
de Souza Costa, C. A.
中科院分区：
文献类型：
--
作者：
de Oliveira Duque, C. C.;Soares, D. G.;de Souza Costa, C. A.
本文旨在评估牙齿漂白方案应用于模拟下颌切牙（IC）和前磨牙（PMs）的釉质/牙本质盘的美白效果和毒性。将10%过氧化氢（H2 O2）凝胶应用于模拟下颌IC和PMs的釉质/牙本质盘3 x 15、1 x 15或1 x 5 min，并将跨釉质和跨牙本质扩散产物应用于人牙髓细胞（1小时）。专业治疗（35%H2O2 -3 x 15 min）用作阳性对照，未漂白样品用作阴性对照。评估细胞活力和形态、氧化应激生成和成牙本质细胞标记物表达。H2 O2扩散和釉质颜色变化（Δ E）也进行了分析。10%H2O2凝胶仅在应用3 × 15 min时诱导显著的细胞活力降低，IC组中氧化应激强度和成牙本质细胞标志物的下调更高。其他实验性漂白方案引起关于所评价的细胞参数的轻微改变，其中强度与釉质/牙本质厚度相关。这些效应也与IC组中较高的H2 O2扩散相关。IC组的10% 3 x 15和1 x 15方案的Δ E值与阳性对照相似，在第4和第6次会议后。应用10% H2 O2漂白凝胶15或45分钟，可使牙齿基质变薄，与高浓度凝胶相比，通过增加漂白次数，可显著降低细胞毒性，从而获得相似的美学效果。使用10%H2O2在小牙齿中短期应用可能是一种有趣的替代方法，可以获得美白效果，而不会对牙髓细胞造成毒性，这可能能够减少患者声称的牙齿过敏症。
This paper aims to assess the whitening effectiveness and toxicity of tooth-bleaching protocols applied to enamel/dentin disks simulating mandibular incisors (ICs) and premolars (PMs).A 10% hydrogen peroxide (H2O2) gel was applied for 3 x 15, 1 x 15, or 1 x 5 min to enamel/dentin disks simulating mandibular ICs and PMs, and the trans-enamel and trans-dentinal diffusion products were applied to human dental pulp cells (1 h). Professional therapy (35% H2O2-3 x 15 min) was used as positive control, and non-bleached samples were used as negative control. Cell viability and morphology, oxidative stress generation, and odontoblastic marker expression were assessed. The H2O2 diffusion and enamel color change (Delta E) were also analyzed.The 10% H2O2 gel induced significant cell viability reduction only when applied 3 x 15 min, with the intensity of oxidative stress and down-regulation of odontoblastic markers being higher in the IC group. The other experimental bleaching protocols caused slight alterations regarding the cell parameters evaluated, with intensity being related to enamel/dentin thickness. These effects were also correlated with higher H2O2 diffusion in the IC group. Delta E values similar as positive control were found for the 10% 3 x 15 and 1 x 15 protocols on IC group, after 4 and 6 sessions.Application of a 10% H2O2 bleaching gel for 15 or 45 min to thin dental substrate significantly minimizes cell toxicity in comparison with highly concentrated gels associated with similar esthetic outcomes by increasing the number of bleaching sessions.Bleaching gels with 10% H2O2 applied in small teeth for short periods may be an interesting alternative to obtain whitening effectiveness without causing toxicity to pulp cells, which may be able to reduce the tooth hypersensitivity claimed by patients.