Effectiveness and safety of biosilicate-enhanced bleaching gels on enamel with early erosion lesion

IF 3.2 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Esthetic and Restorative Dentistry Pub Date : 2024-06-09 DOI:10.1111/jerd.13271

Rafael Dascanio DDS, MS, Rafael Antonio de Oliveira Ribeiro DDS, MS, Camila Siqueira Silva Coelho DDS, MS, PhD, Marina Trevelin Souza DDS, MS, PhD, Matheus Kury DDS, MS, PhD, Edgar Dutra Zanotto Eng, MS, PhD, Carlos Alberto de Souza Costa DDS, MS, PhD, Vanessa Cavalli DDS, MS, PhD

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Abstract

Aim

This study evaluated the efficacy and cytotoxicity of 35% hydrogen peroxide (HP) gel incorporated with 10% (w/w) biosilicate (BioS) on sound enamel and early-stage enamel erosion lesions.

Methods

Discs of enamel/dentin were selected, subjected to erosive cycles (0.3% citric acid, pH 2.6), and treated with (n = 8): HP (35% HP, positive control); HP_BioS [carboxymethyl cellulose (CMC) + HP + BioS]; BioS (CMC + BioS); CMC (negative control). The discs were adapted to artificial pulp chambers with the enamel exposed for bleaching, and the dentin facing toward the culture medium (Dulbecco's modified Eagle's medium [DMEM]). Bleaching was performed in three 30-min sessions at 7-day intervals. After bleaching, the diffusion product (DMEM extract + diffused HP) was pipetted onto MDPC-23 odontoblastic cell line and inoculated. Color parameters (ΔL, Δa, Δb), color change (ΔE₀₀), and changes in whiteness index (ΔWI_D) were determined before (T₀) and after the last bleaching session (T₃). Cell viability (MTT, %), H₂O₂ diffusion (μg/mL), oxidative cell stress (OxS), and cell fluorescence (live/dead assay, in confocal microscopy) were assessed (ANOVA/Tukey; α = 0.05).

Results

No difference in ΔL, Δa, Δb, ΔE₀₀, and ΔWI_D were found between HP and HP_BioS (p > 0.05). The incorporation of BioS decreased the HP diffusion into the substrates and mitigated oxidative stress in early-stage eroded enamel (p < 0.05). HP_BioS presented significantly higher cell viability compared with HP under erosion conditions. Live/dead assay indicated that BioS_HP maintained viability with larger clusters of viable cells.

Conclusion

Incorporating BioS into HP maintained bleaching effectiveness, favored cell viability, reduced the oxidative stress, and the cytotoxicity in teeth with early-stage erosion.

Clinical Significance

BioS formulation showed promising results for reducing cytotoxicity in patients seeking tooth bleaching and presenting undetectable early-stage erosion.

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生物硅酸盐强化漂白凝胶对早期侵蚀病变珐琅质的有效性和安全性。

目的：本研究评估了含10%（重量比）生物硅酸盐（BioS）的35%过氧化氢（HP）凝胶对健全釉质和早期釉质侵蚀病变的疗效和细胞毒性：选取珐琅质/牙本质圆片，对其进行侵蚀循环（0.3% 柠檬酸，pH 值为 2.6），并用（n = 8）进行处理：HP（35% HP，阳性对照）；HP_BioS [羧甲基纤维素（CMC）+ HP + BioS]；BioS（CMC + BioS）；CMC（阴性对照）。将圆盘放入人工牙髓腔，釉质暴露在外进行漂白，牙本质朝向培养基（杜氏改良老鹰培养基 [DMEM]）。漂白分三次进行，每次 30 分钟，间隔 7 天。漂白后，用移液管将扩散产物（DMEM 提取物 + 扩散的 HP）滴入 MDPC-23 牙本质细胞系并接种。在漂白前（T0）和最后一次漂白后（T3）测定颜色参数（ΔL、Δa、Δb）、颜色变化（ΔE00）和白度指数变化（ΔWID）。对细胞活力（MTT，%）、H2O2 扩散（μg/mL）、细胞氧化应激（OxS）和细胞荧光（共聚焦显微镜下的活/死检测）进行了评估（方差分析/Tukey；α = 0.05）：HP 和 HP_BioS 的 ΔL、Δa、Δb、ΔE00 和 ΔWID 均无差异（p > 0.05）。BioS 的加入减少了 HP 向基质中的扩散，减轻了早期侵蚀釉质中的氧化应激（p 结论：BioS 的加入减少了 HP 向基质中的扩散，减轻了早期侵蚀釉质中的氧化应激：在 HP 中加入 BioS 可保持漂白效果、提高细胞活力、减少氧化应激和早期腐蚀牙齿的细胞毒性：BioS配方在降低寻求牙齿漂白并出现无法检测到的早期腐蚀的患者的细胞毒性方面显示出良好的效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Esthetic and Restorative Dentistry 医学-牙科与口腔外科

CiteScore

6.30

自引率

6.20%

发文量

124

审稿时长

>12 weeks

期刊介绍： The Journal of Esthetic and Restorative Dentistry (JERD) is the longest standing peer-reviewed journal devoted solely to advancing the knowledge and practice of esthetic dentistry. Its goal is to provide the very latest evidence-based information in the realm of contemporary interdisciplinary esthetic dentistry through high quality clinical papers, sound research reports and educational features. The range of topics covered in the journal includes: - Interdisciplinary esthetic concepts - Implants - Conservative adhesive restorations - Tooth Whitening - Prosthodontic materials and techniques - Dental materials - Orthodontic, periodontal and endodontic esthetics - Esthetics related research - Innovations in esthetics