American journal of dentistry最新文献

Summary: This article critically examines the most recent developments in peroxide-based and non-peroxide bleaching agents, with a focus on phthalimido-peroxy-caproic acid (a peroxyl derivative), cysteine proteases and sodium dithionites (non-peroxide agents). The rationale for seeking non-peroxide agents, elucidating their mechanisms of action, and potential safety concerns are addressed. While newer non-peroxide agents show promise in laboratory studies, clinical studies are essential to determine their safety and efficacy in a real-world setting.

Clinical significance: Both peroxide-based and non-peroxide-based agents have their merits and side effects. It is crucial that practitioners and patients choose whitening products based on sound scientific evidence.

Summary: Long term clinical studies are needed to confirm the usefulness of LEDs. Charcoal toothpaste with whitening power is a product that defies logic. One must fight discoloration by incorporating an ingredient that is dark in color. Again, controversies exist, and we are just introducing the readers to the possibility. One major US oral health product company has aggressively marketed such a product so there must be some magic behind the concept. One important issue concerning dental bleaching is that of public safety. To add to the confusion, the European Union regulations are much stricter than those in the USA. FDA classified dental bleaching as a cosmetic procedure and not under its supervision. We often see advertisements on cruise ships and shopping kiosks recruiting clients for "teeth whitening". They are careful with the terminology since according to the FDA, whitening restores natural tooth color and bleaching whitens beyond the natural color. Currently, there are multiple ongoing clinical studies and we will wait for conclusive clinical data to help guide us. Lastly, I would like to thank all the contributors and the editorial staff at the American Journal of Dentistry who were so patient with us through this process. Without them, the issue would not be possible.

Purpose: To evaluate the laboratory color change, intrapulpal temperature variation and enamel surface roughness after tooth bleaching using violet LED light (LED), with or without high concentration bleaching gels.

Methods: Dental crowns of bovine incisors were submitted to whitening protocols: Control (without treatment), 35% hydrogen peroxide (HP) and 37% carbamide peroxide (CP) associated or not with LED (LED/HP and LED/CP) or only LED. The whitening protocol consisted of three sessions of bleaching gels application for 30 minutes every 7 days or eight sessions with LED protocol. Groups (n= 10) were assessed for color (ΔE₀ ₀) and whiteness index changes (ΔWID), temperature variation (Δ°C) and surface roughness (Ra), prior to the beginning of the whitening treatment, in the last session and 14 days later. Data were analyzed by generalized linear models, Kruskal Wallis, Dunn and Mann Whitney tests (α= 0.05).

Results: HP and CP, with or without LED, promoted greater color change than LED. LED/CP promoted higher color change than CP. LED significantly increased intrapulpal temperature compared to non-irradiated groups. No protocol promoted a significant increase in surface roughness.

Clinical significance: The use of violet LED light could potentiate 37% carbamide peroxide effect; however, light increased the intrapulpal temperature in laboratory conditions.

Purpose: To determine how effective plant-based natural teeth whiteners are in comparison to the gold standard of at-home teeth whiteners.

Methods: Human molars (N= 64) were embedded and placed in artificial saliva. Experimental groups consisted of NC: Negative control consisting of immersion in water for 5 minutes; PA: Rubbing teeth with pineapple core for 5 minutes; BA: Rubbing teeth with a banana peel for 5 minutes; HW: 10% carbamide peroxide in custom-fitted tray for 8 hours. All groups were treated for 10 days and consisted of 16 specimens each. The Kruskal-Wallis test was used to assess the difference in overall color change among groups at alpha= 0.05.

Results: Lightness and chroma measured at 1 day and 1 week post whitening showed a statistically significant difference among the groups (P< 0.001). Only HW and PA showed an increase in lightness and a decrease in chroma. Overall color change was highest for HW followed by PA, BA, and NC.

Clinical significance: The use of at-home whitening with 10% carbamide peroxide showed greater efficacy compared to natural whitening options. Yet, the utilization of pineapple as a potential whitening remedy demonstrated encouraging prospects, warranting further exploration.

Summary: Dental bleaching, a popular cosmetic procedure projected to drive a global industry worth USD 10.6 billion by 2030, necessitates thorough ethical consideration, including patient rights, informed consent, and professional responsibility. Dentistry's commitment to patient well-being requires balancing esthetic goals with ethical principles of beneficence, non-maleficence, autonomy, and justice. Ethical frameworks, rooted in documents like the Nuremberg Code and the Declaration of Helsinki, guide dental practice. Bleaching agents such as hydrogen peroxide and carbamide peroxide break down chromogenic molecules to whiten teeth. Despite general safety under professional supervision, ethical concerns include ensuring informed consent, managing expectations, and preventing overuse. Access and equity issues reveal disparities in dental bleaching availability, influenced by socioeconomic status and insurance coverage, affecting self-esteem and well-being. Addressing these requires systemic interventions, expanded coverage, and promoting acceptance of diverse dental appearances. For minors and vulnerable populations, careful assessment of bleaching appropriateness is necessary, considering dental maturity and psychological implications. Responsible disposal of bleaching agents is crucial to mitigate environmental risks.

Clinical significance: This paper highlights the ethical considerations in dental bleaching, including patient rights, informed consent, professional responsibility, access, equity, and environmental impact. Dentists must prioritize patient health and uphold ethical principles to navigate dental bleaching complexities, ensuring safe, effective, and equitable care.

Results: This article has two aims: (1) To review the role of artificial intelligence (AI) in dentistry and teeth whitening. This is completed via discussion of technical descriptions, accuracy of AI, patients' trust in AI, teledentistry, benefits and risks of AI, and teeth whitening color and interpretation; and (2) To introduce a new project developed by the School of Dentistry, University of Washington (UW), one which enables access to datasets of images acquired through clinical treatment with patients, to those individuals and organizations interested in research and development of AI systems in teeth whitening. Access to the data repository is publicly available as a global online service, free of charge. A detailed synopsis of the 70-year history of AI is provided for comprehensive technical, social and clinical context of technologies and innovations previously and currently available commercially, and for those reported in dental and health care scientific literature. The UW project is relevant during this time where unprecedented levels of interest exist in esthetic dentistry, the technological progress and social impacts of artificial intelligence, and readily available datasets of actual patient outcomes.

Clinical significance: A detailed synopsis of the 70-year history of artificial intelligence is provided for comprehensive technical, social and clinical context of technologies and innovations previously and currently available commercially, and for those reported in dental and health care scientific literature.

Purpose: To compare the inconsistencies of press-fit and screw-retained digital implant replicas in models obtained from different 3D printers using intraoral and extraoral digital impression techniques with the conventional method.

Methods: An all-on-four concept edentulous maxillary model was fabricated. Two models were prepared with two manufacturing methods: conventional group (CNV group) and additive manufacturing group (AM group). The AM group was fabricated in two different technologies (SLA and LCD) 3D printers from impressions taken with an intraoral scanner and a model scanner. The AM group was further subdivided into press fit replicas and screw-retained replicas. The position of each abutment replica was measured with a coordinate measuring machine (CMM).

Results: Models produced with the Anycubic printer gave inconsistent results in the z-axis (10.449 µm for group AM-5, 10.407 µm for group AM-6, 10.454 µm for group AM-7 and 10.43 µm for group AM-8). The other groups showed similar results in x-, y- and z-axis. The CNV group showed significant differences from some groups for XZ angle and YZ angle. IOS, EOS and conventional impression techniques showed similar accuracy. The screw-retained digital replica group showed better results than the press-fit digital replica group, but no significant difference was found. The Anycubic printer provided the least accurate values for implant replica positions, as it showed the highest discrepancy values on the vertical axis.

Clinical significance: The Anycubic printer provided the least accurate values for implant replica positions, as it showed the highest discrepancy values on the vertical axis.

Purpose: To investigate the influence of immediate dentin sealing (IDS) on the shear bond strength (SBS) and wettability of both sound and eroded dentin.

Methods: Dentin specimens were divided into four groups (n= 21): sound dentin with and without IDS and eroded dentin with and without IDS. Erosive cycling was performed using 1% citric acid solution, and lithium disilicate discs were cemented onto the dentin. The samples underwent thermocycling and SBS testing (n= 10), with failure modes analyzed by stereomicroscopy. Scanning electron microscopy (SEM) (n= 3) was used to examine the hybrid layer and resin tags, while wettability (n= 8) was measured by contact angle analysis.

Results: Erosion significantly reduced the SBS (P< 0.001), while IDS increased it for both sound and eroded dentin (P< 0.001). The most common failure mode was adhesive. SEM revealed a thicker hybrid layer and more resin tags in eroded dentin with IDS. Erosion did not affect wettability (P= 0.186), but IDS increased it (P< 0.001). IDS improved both SBS and wettability in sound and eroded dentin, suggesting it may be an effective technique for enhancing adhesion in restorative dentistry.

Clinical significance: Immediate dentin sealing (IDS) improves bond strength and wettability in both sound and eroded dentin, making it a valuable technique for enhancing adhesion in restorative procedures, especially in cases with compromised dentin. This could contribute to the durability and success of restorations.

Purpose: To evaluate the laboratory shear bond strength of four different adhesive systems and to determine the effect of Universal adhesive when bonded to two CAD-CAM ceramics (IPS e.max CAD and Vita Suprinity) to tooth surfaces (enamel and dentin).

Methods: 80 human teeth were sectioned to obtain enamel and dentin substrates and embedded into acrylic molds (N= 160). Two CAD-CAM ceramics, including lithium-disilicate glass-ceramic (IPS e.max CAD) and zirconia-reinforced lithium-silicate glass-ceramic (Vita Suprinity), were milled into 2 mm diameter and 2.5 mm height specimens (N= 160). Four adhesive systems were tested: esthetic cement with universal adhesive in total-etch mode (Variolink Esthetic DC with Adhese Universal), total-etch (Variolink II), self-etch (Panavia F 2.0), and self-adhesive (Rely X U200) (n=10/subgroups). Cementation was performed according to the manufacturers' instructions, and shear bond strength test was applied (1mm/minute). Data were statistically analyzed using three-way ANOVA and independent t-tests. Fractured surfaces were also examined.

Results: For enamel, the statistically highest values were observed in Variolink Esthetic DC with Adhese Universal and Variolink II, while Rely X U200 showed the lowest values for both ceramics. For dentin, no significant differences were found among most adhesive system groups. Shear bond strength values between IPS e.max CAD and Vita Suprinity were statistically similar for all adhesive systems. Cementation to enamel resulted in higher bond strengths than to dentin, except in the Rely X U200 group, where adhesive failures predominated for both ceramics. Variolink Esthetic DC with Universal Adhesive in total-etch mode produced numerically higher bond strength values for all groups, with a higher incidence of mixed failure types.

Clinical significance: Variolink Esthetic DC with Universal Adhesive in total-etch mode, followed by Variolink II, provided stronger and more durable bonds, with enamel generally resulting in higher shear bond strengths than dentin for both IPS e.max CAD and Vita Suprinity. These findings can guide clinicians in selecting the most appropriate adhesive systems to optimize the longevity and effectiveness of IPS e.max CAD or Vita Suprinity depending on the type of tooth tissue.

Purpose: To visually analyze the chromatic behavior of single-shade resin composite in non-carious cervical lesions (NCCLs) and assess its acceptability among undergraduate and graduate students, dentistry professors, and patients.

Methods: Restorations were performed on NCCLs using the single-shade resin composites Omnichroma (OC) and Vittra APS Unique (VT), with Filtek Z350 XT (FT) as the control. Patients with three or more NCCLs in consecutive teeth were included, and 22 restorations were visually analyzed by 20 evaluators who were tested for color vision deficiency. The restorations were evaluated based on World Dental Federation (FDI) criteria after 6 months, and a survey was completed by patients after 6 months. Data were analyzed using the Kruskal-Wallis test.

Results: OC performed significantly better than VT (P= 0.020), but with no significant difference compared to FT (P= 0.441). OC had a 96.43% success rate in terms of color and translucency, compared to FT (92.50%) and VT (77.22%). Single-shade resin composites showed satisfactory compatibility in terms of color, translucency, and shine for NCCLs, as evaluated by both professionals and patients.

Clinical significance: Single-shade resin can be used with promising results for NCCLs, with Omnichroma being recommended as it had the best performance.