Operative Dentistry[JOURNAL]
Sun
200 papers
Effect of Successive In-office and At-home Bleaching Protocols on the Surface Properties of CAD/CAM Materials.
Carrijo Queiroz JF, Rodrigues de Oliveira JJ, Dos Santos Nunes Reis JM … +2 more , Nordi Dovigo L, Garcia Fonseca R
Oper Dent · 2026 Feb · PMID 41371278 · Publisher ↗
Although the effects of in-office and at-home bleaching on the surface properties of CAD/CAM monolithic materials have been extensively explored, their combined effect has not yet been investigated. This study evaluated...
Although the effects of in-office and at-home bleaching on the surface properties of CAD/CAM monolithic materials have been extensively explored, their combined effect has not yet been investigated. This study evaluated the effects of different bleaching modalities, including a combination of in-office and at-home beaching in up to three sessions on the roughness, microhardness, and surface topography of five CAD/CAM materials. Disks of a resin nanoceramic (Lava Ultimate, Solventum, St. Paul, MN, USA), a polymer-infiltrated ceramic network (Vita Enamic, Vita Zahnfabrik, Bad Säckingen, Germany), a leucite-reinforced glass-ceramic (IPS Empress CAD, Ivoclar Vivadent, Schaan, Liechtenstein), a lithium disilicate glass-ceramic (IPS e.max CAD, Ivoclar Vivadent), and a zirconia-reinforced lithium silicate glass-ceramic (Vita Suprinity, Vita Zahnfabrik) were subjected to: 1) in-office bleaching with 35% hydrogen peroxide (Whiteness HP Blue, FGM Dental Group, Joinville, Santa Catarina, Brazil) (35% HP), 2) at-home bleaching with 10% carbamide peroxide (Opalescence PF, Ultradent, South Jordan, UT, USA) (10% CP), and 3) a combined protocol of in-office bleaching followed by at-home bleaching. Roughness arithmetical mean height (Sa) (n=12/group), microhardness (n=10/group), and topography (n=2/group) were evaluated before treatment and after the first, second, and third sessions. Data were submitted to mixed repeated measures analysis of variance (ANOVA) (α=0.05). Except for Lava Ultimate and Vita Suprinity, which showed progressive topographic alterations, 35% HP did not affect roughness, microhardness, or topography of any of the materials; 10% CP and the combined protocol caused topographic alterations in all materials. The 10% CP increased roughness of Vita Enamic (from the second session), IPS Empress CAD (from the first session), and IPS e.max CAD and Vita Suprinity (in the third session), and decreased microhardness of IPS Empress CAD (in the third session) and IPS e.max CAD (from the second session). The combined protocol increased roughness (from the second session) and decreased microhardness (in the third session) with IPS Empress CAD. The 35% HP affected the topography of Lava Ultimate and Vita Suprinity and was the safest bleaching protocol for the other materials, regardless of number of sessions. The 10% CP affected both roughness and microhardness of the materials most adversely and, together with the combined protocol, caused topographic changes to all materials.
Effect of Water Flow on Bond Strength of Zirconia to Tooth Structure.
Monteiro RV, Brown E, Itani J … +4 more , Bona VS, Oliveira-Santos C, Donatelli D, De Souza GM
Oper Dent · 2025 Sep · PMID 40992751 · Publisher ↗
Bond strength tests are used as predictors of the clinical longevity of dental restorations. However, the aging of bond strength specimens is often simulated with static water storage, even though the saliva flows over t...
Bond strength tests are used as predictors of the clinical longevity of dental restorations. However, the aging of bond strength specimens is often simulated with static water storage, even though the saliva flows over teeth and restorations in the mouth. This study investigated the effect of water under static and flow conditions on the bond strength between zirconia and tooth structure using different test designs. Ninety human molars with prepared flat dentin surfaces were randomly divided into three groups according to the test design: Tensile, Shear, and Crown pull-off. The Crown pull-off group received additional standard full crown preparations. Zirconia specimens milled according to the shape of each test design (n=30) were bonded to the tooth structure using resin cement. There were three subgroups (n=10) according to the artificial aging procedure: NA - no aging (24 hours); SW - static water (30 days); FW - water flow (30 days). Bond strength was assessed using a universal testing machine, and the load at failure was recorded. Data were analyzed using two-way ANOVA and Tukey post hoc tests (α=0.05), and the mode of failure was also classified. Two-way ANOVA revealed a significant effect of the test design (p<0.001). However, no effect was observed for the aging procedure (p=0.166). The interaction aging*test design was significant (p=0.019). FW significantly decreased the retention of zirconia crowns to tooth structure (p<0.05) but did not affect the other test design specimens. The mode of failure was adhesive (100%) at the zirconia/cement interface for all specimens and aging conditions, except for Crown pull-off / FW, which were predominantly mixed (60%). FW negatively affected the retention of Y-PSZ crowns to the tooth structure.
Efficacy of In-office Bleaching Gel One Week After Mixing: A Randomized Clinical Trial.
de Freitas IM, Carneiro TS, Forville H … +6 more , Favoreto MW, Wendlinger M, Ñaupari-Villasante R, Gonçalves S, Vallejo-Izquierdo L, Loguercio AD
Oper Dent · 2025 Sep · PMID 40992750 · Publisher ↗
OBJECTIVE: This randomized clinical trial aimed to evaluate the efficacy, risk and intensity of tooth sensitivity (TS) and gingival irritation (GI), and esthetic self-perception of in-office dental bleaching using a blea...
OBJECTIVE: This randomized clinical trial aimed to evaluate the efficacy, risk and intensity of tooth sensitivity (TS) and gingival irritation (GI), and esthetic self-perception of in-office dental bleaching using a bleaching gel 1 week after mixing. METHODS AND MATERIALS: Forty subjects underwent in-office bleaching with 40% hydrogen peroxide (Opalescence Boost PF, Ultradent). In a splitmouth design, each maxillary hemiarch received bleaching gel that was mixed during, or 1 week before, the treatment session. The bleaching procedure was performed in two sessions of 40 minutes with a 7-day interval. Tooth color was assessed before treatment, and 1 week, 2 weeks, and 1 month after the end of bleaching, using a digital spectrophotometer (Vita Easyshade; ΔEab, ΔE00, and ΔWID) and subjective scales (Vita Classical and Vita Bleachedguide; ΔSGU). The risk and intensity of TS and GI were recorded using a Visual Analogue Scale (0-10). Esthetic self-perception was assessed using the Orofacial Esthetic Scale (0-10). RESULTS: Satisfactory bleaching was achieved in both groups, with no significant differences for objective (ΔEab, ΔE00, and ΔWID; p>0.72) or subjective (ΔSGU [shade guide units], p>0.84) color assessments. No significant differences were found in the risk and intensity of TS (p=0.79; p=0.67) or GI (p=1.0; p=0.85). Patients' esthetic self-perceptions changed after the procedure (p<0.009), mainly on the tooth color question (p<0.001). CONCLUSION: In-office dental bleaching with Opalescence Boost PF 40% remained effective, without differences in risk and intensity of TS and GI, even 1 week after mixing.
Are New Dentists Prepared for Clinical Practice? A Survey of Recent Graduates and Their Supervisors.
Chiodo K, Capin O, Diefenderfer K … +3 more , Eckert G, Adcook R, Cook NB
Oper Dent · 2025 Sep · PMID 40992749 · Publisher ↗
OBJECTIVE: The purpose of this study was to measure clinical competence in preventive and restorative dental procedures among recently graduated dentists entering US military service. METHODS: An anonymous, electronic su...
OBJECTIVE: The purpose of this study was to measure clinical competence in preventive and restorative dental procedures among recently graduated dentists entering US military service. METHODS: An anonymous, electronic survey was sent to 201 new dentists and 32 clinical supervisors in the US Air Force, Army, and Navy in 2022. Using a modified Dreyfus model of skill acquisition, new dentists, during their first year following graduation, completed self-assessments of their ability to perform 20 preventive and restorative procedures, and supervisors evaluated the proficiency of the new dentists under their supervision. RESULTS: A total of 59 (29.3%) new dentists and 25 (78.1%) supervisors responded. The proportion of ratings of competent or higher was calculated, along with a 95% confidence interval, and one-sample chi-square tests were used to compare the proportion against 50%. Supervisor ratings of competent or higher were significantly greater than 50% in caries diagnosis and treatment planning, caries risk assessment, Class III anterior resin composites, and posterior resin composites. Significant discrepancies between new dentist and supervisor ratings occurred with Class I and II amalgam restorations, restoring endodontically treated teeth not requiring a post, and crown preparation and delivery skill levels. When rating new dentists overall, supervisors assessed 71.3% of new dentists at novice or beginner skill level. CONCLUSIONS: Supervisor ratings of new dentists' skill levels were significantly lower than the new dentists' self-assessments for the majority of procedures. Fewer than one-third (28.7%) of new dentists were evaluated as overall competent in preventive and restorative procedures during their first year following graduation.
Opportunities Lost.
Eichmiller F
Oper Dent · 2025 Sep · PMID 40992748 · Publisher ↗
Abstract loading — click title to view on PubMed.
Effect of Polishing Systems on Surface Roughness of Universal Resin Composites.
Maghaireh GA, Alzraikat H, Hameed R
Oper Dent · 2025 Sep · PMID 40992747 · Publisher ↗
RATIONALE: Polishing of resin composites ensures optimal esthetics and longevity. Effective polishing techniques for conventional multi-shade resin composites are well documented. However, less is known regarding accepta...
RATIONALE: Polishing of resin composites ensures optimal esthetics and longevity. Effective polishing techniques for conventional multi-shade resin composites are well documented. However, less is known regarding acceptable polishing for newer single-shade universal resin composites. OBJECTIVE: This study compared the surface roughness of five universal resin composites (Omnichroma, Neo Spectra, Charisma Diamond One, One Shade) and one conventional multi-shade resin composite (Palfique Asteria) following the use of three polishing systems (one-step, Enhance PoGo; two-step, EVE Diacomp Plus Twist; three-step, Sof-Lex) and Mylar strip (without polishing). METHODS: A total of 240 specimens were prepared (n=40 for each resin composite). The specimens were grouped into four subgroups (n=10) based on the polishing system applied. The surface roughness of all specimens was evaluated using a non-contact three-dimensional optical profilometer. One randomly selected specimen from each subgroup underwent scanning electron microscope examination. RESULTS: Surface roughness was significantly affected by the resin composite type and the polishing system used (p<0.05). The study groups were ranked by surface roughness, from lowest to highest, across all tested materials as follows: Mylar strip < Enhance PoGo < Sof-Lex < EVE Diacomp. The surface roughness values of the universal resin composites were comparable to the multi-shade nanofilled resin composite in all polishing systems.
Margin Integrity of Experimental and Commercial Ion-releasing Restorative Materials.
Burrer P, Costermani A, Par M … +2 more , Attin T, Tauböck TT
Oper Dent · 2025 Sep · PMID 40992746 · Publisher ↗
OBJECTIVE: To investigate marginal integrity of experimental and commercial ion-releasing restorative materials before and after thermomechanical loading (TML). METHODS: Standardized mesio-occlusal-distal (MOD) cavities...
OBJECTIVE: To investigate marginal integrity of experimental and commercial ion-releasing restorative materials before and after thermomechanical loading (TML). METHODS: Standardized mesio-occlusal-distal (MOD) cavities (mesial margins 1 mm below the CEJ, distal margins 1 mm above the CEJ) were restored using six materials, following the manufacturer-recommended adhesive pretreatment, if applicable. One conventional, non-ion-releasing restorative material, Ceram.x Spectra ST (HV) (Dentsply Sirona, Charlotte, NC, USA), and five ion-releasing restorative materials were used (n=8 per group). Four of the ion-releasing materials were commercially available: Cention Forte (Ivoclar Vivadent, Schaan, Liechtenstein), Beautifil II LS (Shofu, Kyoto, Japan), ACTIVA BioACTIVE-RESTORATIVE (Pulpdent, Watertown, MA, USA), and Surefil one (Dentsply Sirona). In addition, an experimental resin composite restorative material with a fluoride-modified bioactive glass was specially produced for use in this study. TML was applied (1.2 M loading cycles, 1.7 Hz, 49 Newtons; 3000 thermal cycles, 5°C-50°C). Restoration margins were assessed before and after TML using scanning electron microscopy (200× magnification) and classified as continuous, noncontinuous, or nonjudgeable. Margin integrity was quantitatively expressed as the percentage of continuous margins in relation to the total measurable margin length. Data were analyzed using Wilcoxon signed-rank and Kruskal-Wallis tests, followed by Dunn post hoc tests and Bonferroni correction and Mann-Whitney U tests (α=0.05). RESULTS: Each group exhibited significantly reduced marginal integrity after TML. The experimental resin composite showed the significantly highest continuous enamel margins before TML, whereas Surefil one had the lowest (p<0.001). Margin integrity in dentin did not differ significantly among groups (all p=0.236). CONCLUSIONS: The experimental resin composite with a fluoride-modified bioactive glass exhibited marginal integrity similar or superior to a conventional resin composite, while the self-adhesive resin composite Surefil one displayed the lowest marginal adaptation of all groups in enamel.
Biophysical Properties of Three Light-cured Pulp Capping Materials.
Fraga M, Janini A, Nobre MM … +4 more , Dos Santos V, da Silva NA, Marciano MA, Correr AB
Oper Dent · 2025 Sep · PMID 40992745 · Publisher ↗
This study assessed photoactivated dentin-pulp complex materials concerning cell viability, degree of conversion, compressive strength, and bioactive potential. The materials Theracal, Hidrox-cal, and Ultra-Blend underwe...
This study assessed photoactivated dentin-pulp complex materials concerning cell viability, degree of conversion, compressive strength, and bioactive potential. The materials Theracal, Hidrox-cal, and Ultra-Blend underwent cell viability testing using the MTT assay (n = 6), degree of conversion analysis via Raman spectroscopy (n = 5), and compressive strength testing on a universal testing machine (n = 5). Bioactive potential (n = 3) was determined through scanning electron microscopy and Raman spectroscopy after 30 days of immersion in simulated body fluid. For cell viability, the Kruskal-Wallis test was employed, followed by Dunn's post hoc test. Degree of conversion, compressive strength, and bioactivity data were analyzed by one-way ANOVA, followed by Tukey's post hoc tests. For all analyses, α = 0.05 was considered. Cell viability was similar between Hidrox-cal and Ultra-Blend, while Theracal exhibited the lowest cell viability values. The degree of conversion was also higher in the Hidrox-cal group, which did not differ from Ultra-Blend. No differences were observed in compressive strength. The bioactive potential demonstrated a greater formation of crystalline structures in Theracal and Ultra-Blend, however limited. Light-cured pulp capping materials, despite demonstrating good mechanical properties, showed limited performance in terms of bioactivity and cytotoxicity ranging from slight to high.
Influence of a Combination of Catalysts to Improve the Outcomes of In-office Bleaching.
Esteves L, de Souza Costa CA, da Fonseca Leopoldo JA … +5 more , Silva Bezerra JK, de Oliveira Ribeiro RA, Aidar K, Fagundes TC, Briso A
Oper Dent · 2025 Sep · PMID 40992744 · Publisher ↗
OBJECTIVES: The aims of this study were to investigate (1) whether the addition of catalytic enzymes and violet LED light to the conventional in-office hydrogen peroxide (H2O2) bleaching protocol could improve esthetic r...
OBJECTIVES: The aims of this study were to investigate (1) whether the addition of catalytic enzymes and violet LED light to the conventional in-office hydrogen peroxide (H2O2) bleaching protocol could improve esthetic results in a shorter time and (2) whether these strategies could minimize adverse effects on the enamel surface and the diffusion of H2O2 through the tooth structure. METHODS: 120 bovine dental discs were divided into two study phases. In phase I, 60 sectioned specimens were pigmented with black tea for analysis of chromatic change, bleaching index, and trans-amelodentinal diffusion. In phase II, 60 unpigmented specimens were evaluated for enamel roughness and microhardness. In both phases, the specimens were divided into four groups (n=15): NC (negative control): no treatment; G45: 35% H2O2 bleaching gel for 45 minutes; GT: 35% H2O2 bleaching gel with peroxidase enzyme for 15 minutes on enamel previously covered with a polycaprolactone nanofiber mesh scaffold; GTL: Same procedure as GT, irradiated with violet LED light for 15 minutes. Esthetic efficacy (ΔE00 and WID) was analyzed in three sessions (T1, T2, T3) and 7 days (T4) after treatment, and H2O2 diffusion was evaluated at T1 (phase I). In phase II, the specimens were evaluated for microhardness and surface roughness at T0 and T4. For the analysis of microhardness, roughness and chromatic alteration, a Two-Factor ANOVA with Repeated Measures was used to evaluate the groups over time, while H2O2 diffusion was analyzed by One-Way ANOVA. RESULTS: GTL promoted the greatest change in ΔE00 in all sessions; however, ΔWID in GTL did not differ from G45 at T3 and T4. The diffusion of H2O2 in GT was 69% lower than G45. The enamel microhardness and roughness of the GT and NC groups were not altered by treatments, but were significantly worse in G45. CONCLUSION: When compared with conventional in-office whitening alone, the strategies tested achieved the same esthetic results in two-thirds less time, reduced alterations to the enamel surface, and reduced the trans-amelodentinal diffusion of H2O2.
Influence of Delayed Material Placement on In Vivo Intrapulpal Temperature Rise in Class V Resin Composite Restorations.
Maucoski C, Guarneri J, Runnacles P … +4 more , Zarpellon DC, Coelho U, Rueggeberg FA, Arrais C
Oper Dent · 2025 Sep · PMID 40992743 · Publisher ↗
OBJECTIVE: This study evaluated the effect of delay of the etch-and-rinse bonding procedure on in vivo real-time intrapulpal temperature during restoration of Class V preparations on human premolars. METHODS AND MATERIAL...
OBJECTIVE: This study evaluated the effect of delay of the etch-and-rinse bonding procedure on in vivo real-time intrapulpal temperature during restoration of Class V preparations on human premolars. METHODS AND MATERIALS: Intact premolars planned for orthodontic extraction from 11 volunteers received infiltrative anesthesia and were isolated using a dental dam. An occlusal preparation was performed using a high-speed diamond bur with air-water spray until obtaining minimal pulp exposure, followed by insertion of a sterile thermocouple probe. A buccal Class V preparation was made using a high-speed diamond bur cooled using air-water spray. To simulate the time spent on caries removal, material placement was delayed 15 minutes until physiologic pulpal temperature (PT) was reestablished (approximately 35°C). Preparations were acid etched and rinsed. A two-step etch-and-rinse bonding agent, Single Bond Universal (Solventum, St. Paul, MN, USA) or Tetric Nano Bond (Ivoclar Vivadent, Schaan, Lichtenstein), was applied and photocured following manufacturers' instructions. The teeth were restored using conventional (Filtek Z250 or Filtek Z350, Solventum) or bulk-fill (Tetric N Ceram Bulk-fill, Ivoclar Vivadent) resin composites, which were photocured with a dual-peak LED light-curing unit (Bluephase 20i, Ivoclar Vivadent). Peak PT and ΔT values were analyzed using two-way repeated measures ANOVA and Bonferroni post hoc tests. RESULTS: Etch-and-rinse and solvent evaporation procedures reduced PT, despite restoration starting at physiologic PT. Only the 40-second exposure of Filtek Z350 resulted in significantly higher peak PT values compared to baseline (38.2°C ± 2.4°C). ΔT values for Z250 were not significantly different from those for Tetric N-Ceram Bulk-fill. CONCLUSION: Even when etch-and-rinse bonding procedures started at physiologic PT, PT decreased, preventing harmful levels of temperature rise in the pulp.
Looking Back, Looking Forward.
Diefenderfer K
Oper Dent · 2025 Jan · PMID 40962333 · Publisher ↗
Abstract loading — click title to view on PubMed.
Clinical Use of Modeling Resins in Minimally Invasive Restorative Dentistry: A Case Report and Brief Review.
Ceinos R, Attal JP, Dursun E … +1 more , François P
Oper Dent · 2025 Sep · PMID 40653668 · Publisher ↗
OBJECTIVE: Although the use of modeling resins for sculpting resin composites is not a recent development, it is still not widely practiced, either because of a lack of knowledge or because of concerns about the potentia...
OBJECTIVE: Although the use of modeling resins for sculpting resin composites is not a recent development, it is still not widely practiced, either because of a lack of knowledge or because of concerns about the potential deleterious effects induced by its use. This study presents a clinical case illustrating how the use of modeling resins, in conjunction with minimally invasive techniques, can achieve satisfactory clinical outcomes in the treatment of deep, unsightly enamel stains. METHODS: A case of severe fluorosis affecting the maxillary anterior segment was treated using a minimally invasive approach. Techniques included microabrasion, macroabrasion, resin infiltration, and resin composite layering with modeling resin. Once discussed, this case will also serve as the basis for a review on the use of modeling resins in restorative dentistry. RESULTS: This clinical case was successful. The use of modeling resin made it easier to carry out the resin composite layering, thereby helping the clinician to achieve a highly esthetic clinical outcome. CONCLUSIONS: A minimally invasive approach combining microabrasion, macroabrasion, resin infiltration, and resin composite layering can achieve very good esthetic results. Modeling resins appear to be useful in facilitating resin composite placement, although clinical and in vitro studies still seem necessary.
Influence of Specimen Pre-staining on In Vitro Whitening Efficacy of Hydrogen Peroxide Gels.
Borges AB, Dos Santos KC, da Silva DF … +3 more , Bottesini VC, Torres C, Mailart MC
Oper Dent · 2025 Sep · PMID 40653663 · Publisher ↗
OBJECTIVES: Various in vitro approaches have been used to evaluate whitening efficacy, utilizing both stained and non-stained tooth substrates, which may influence the outcomes. This study aimed to assess the effect of p...
OBJECTIVES: Various in vitro approaches have been used to evaluate whitening efficacy, utilizing both stained and non-stained tooth substrates, which may influence the outcomes. This study aimed to assess the effect of previous in vitro staining on whitening efficacy and the enamel surface using hydrogen peroxide (HP) gels with different concentrations. METHODS: Bovine enamel/dentin specimens (n=16) were randomly allocated into groups according to the HP concentration [20% (HP20), 30% (HP30), 40% (HP40), and deionized water (negative control)]; and substrate condition (non-stained or stained). Tooth color was measured using a spectrophotometer, and the color difference (ΔE00) and whiteness index (WID and ΔWID) were calculated. Knoop surface microhardness (SMH) and roughness (Ra) of enamel were assessed at different times. Data from both non-stained and stained substrates were analyzed using ANOVA and Tukey post hoc tests (α<0.05). RESULTS: Significant differences were observed in ΔE00 for different HP concentrations and substrate conditions (p<0.001). Greater tooth color change was found for HP 40, followed by HP30 and HP20. Stained groups exhibited higher ΔE00 values than non-stained ones, except for HP20. Higher values of ΔWID were observed in stained/bleached groups. The staining process reduced SMH and increased Ra. CONCLUSIONS: The bleaching patterns were similar for both non-stained and stained substrates, with higher concentrations of HP bleaching gels resulting in greater tooth color difference. Previous staining increased the variation in whiteness values (ΔWID) following bleaching, but specimens maintained a lower whiteness index after bleaching compared to the non-stained substrate. Staining induced alterations on the enamel surface. These factors indicate that pre-staining of specimens is not essential to evaluate the whitening efficacy of bleaching gels.
Depicting Errors in Clinical Decisions for Posterior Proximal Enamel Caries Lesions in Permanent Teeth Using the Fact Box Format.
Hashim Nainar SM
Oper Dent · 2025 May · PMID 40587898 · Publisher ↗
OBJECTIVES: To depict restorative treatment recommendations of US dentists for posterior proximal enamel caries lesions detected with bitewing radiographs in permanent teeth. METHODS: The Fact Box format was utilized to...
OBJECTIVES: To depict restorative treatment recommendations of US dentists for posterior proximal enamel caries lesions detected with bitewing radiographs in permanent teeth. METHODS: The Fact Box format was utilized to depict the probabilities of restorative treatment recommendations made by US dentists for posterior proximal enamel caries lesions detected with bitewing radiographs in permanent teeth. Four case scenarios were considered, including patients at low caries risk versus those at high caries risk for two proportions (10% versus 38%) of proximal enamel caries lesions with external surface cavitation. RESULTS: The Fact Box showed that the decision to restore posterior proximal enamel caries lesion was more likely to be an incorrect decision (61-91%) in the four case scenarios considered. Meanwhile, the decision to not provide restorative treatment for posterior proximal enamel caries lesion was less likely to be erroneous (9-37%) in the four case scenarios considered. CONCLUSION: Using the Fact Box to depict restorative decision-making for posterior proximal enamel caries lesions in permanent teeth may improve communication of decisional probabilities and reduce restorative overtreatment.
Lest We Lose Sight: A Reprint with Foreword.
Diefenderfer K
Oper Dent · 2025 May · PMID 40587896 · Publisher ↗
Abstract loading — click title to view on PubMed.
At-home vs In-office Bleaching: An Updated Systematic Review and Meta-analysis.
de Geus JL, Martins A, Reis A … +1 more , Rezende M
Oper Dent · 2025 Sep · PMID 40485133 · Publisher ↗
OBJECTIVE: To conduct a systematic review and meta-analysis to compare the efficacy, risk, and intensity of tooth sensitivity of at-home and in-office bleaching. This is an update of a systematic review first published i...
OBJECTIVE: To conduct a systematic review and meta-analysis to compare the efficacy, risk, and intensity of tooth sensitivity of at-home and in-office bleaching. This is an update of a systematic review first published in 2016, adding new evidence. METHODS AND MATERIALS: A comprehensive search was performed in seven databases, including MEDLINE, EMBASE, and Cochrane Library. Additionally, other sources were screened manually for any additional trials, and the reference lists and citation lists of included trials and relevant reviews were manually searched. WE included randomized clinical trials that compared the risk intensity of tooth sensitivity or bleaching efficacy of in-office and at-home treatments in adult patients. After data extraction and risk of bias assessment, mean differences or relative risks and the corresponding 95% confidence intervals were calculated and assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS: A total of 910 articles were identified via databases and registers. After title and abstract screening, 11 studies remained. In addition, another 11 records were identified through websites, organizations, and citation searches. Including the previous studies from the earlier systematic review, 26 studies remained for qualitative analyses and 23 for meta-analysis. In 2024, six studies were added, totaling 32 studies included for qualitative analysis. The intensity of tooth sensitivity was significantly lower for at-home bleaching (standardized mean difference [SMD] -0.78; 95% confidence interval [CI] -1.53 to -0.03; p=0.04). There was no significant difference in the risk of tooth sensitivity (relative risk [RR] 0.82; 95% CI 0.61 to 1.10; p=0.19) or bleaching efficacy in ΔSGU (SMD 0.04; 95% CI -0.17 to 0.25; p=0.68). The color change in ΔE was significantly higher for at-home bleaching (SMD 0.49; 95% CI 0.14 to 0.84; p=0.006). CONCLUSION: Although there was a difference in the intensity of tooth sensitivity and color change in ΔE favoring at-home bleaching, the quality of the evidence was considered low. Neither the risk of tooth sensitivity nor the color change in shade guide units (ΔSGU) was influenced by the bleaching technique.
The Use of Intraoral Camera, Quantitative Light Fluorescence, and Visual Examinations for the Detection and Assessment of Enamel Fluorosis.
Abogazalah N, Al Dehailan L, Soto-Rojas AE … +5 more , Ando M, Martignon S, Eggertsson H, Shone D, Martinez-Mier EA
Oper Dent · 2025 May · PMID 40485090 · Publisher ↗
PURPOSE: To evaluate the in vivo and in vitro performance of an intraoral camera (IC), visual examination using the Thylstrup and Fejerskov Index (TFI), and quantitative light-induced fluorescence (QLF) to detect and qua...
PURPOSE: To evaluate the in vivo and in vitro performance of an intraoral camera (IC), visual examination using the Thylstrup and Fejerskov Index (TFI), and quantitative light-induced fluorescence (QLF) to detect and quantify enamel fluorosis (EF). METHODS AND MATERIALS: Calibrated examiners performed IC-qualitative (ICQual), TFI, IC-quantitative (ICQuant), and QLF (Area, Fluorescence loss [ΔF], and ΔQ: Area×ΔF) on 150 extracted teeth in vitro and 150 children in vivo. Polarized light microscopy (PLM) was the gold standard for the in vitro phase. Cross tabulation, agreement, correlation, comparison of means from quantitative measures, sensitivity, and specificity were calculated for TFI, QLF, ICQual, and ICQuant. For the in vivo phase, TFI scores were cross tabulated with ICQuant and ICQual, and Kendall's Tau was used to measure correlation. RESULTS: Agreements of TFI and ICQual with PLM were 53.77% and 47.17%, respectively. Correlation coefficients for QLF (area, ΔF, ΔQ) and ICQuant with PLM scores were 0.47, 0.56, 0.51, 0.46, respectively. Sensitivity/specificity for TFI, ICQual, ICQuant, and ΔQ were 0.86/0.58, 0.86/0.62, 0.86/0.58, and 1.00/0.13, respectively. For the in vivo phase, correlations of ICQual and ICQuant with TFI were 0.55 and 0.52, respectively. Quantitative measurements of ICQuant by TFI scores showed consistent separation in means, while those for QLF were neither as clear nor as consistent. CONCLUSION: All methods were able to detect and quantify enamel fluorosis. However, there were consistent and significant differences among them.
Esthetic Outcome of a Universal Shade Resin Composite Placed Before Nonvital Tooth Bleaching.
Ruaydee T, Saikaew P, Panpisut P … +3 more , Kawamoto C, Tomokiyo A, Sano H
Oper Dent · 2025 May · PMID 40485085 · Publisher ↗
OBJECTIVE: In this case report, we describe the use of a universal shade resin composite to restore a discolored tooth before nonvital tooth bleaching. The intent of this procedure is to maintain an acceptable color matc...
OBJECTIVE: In this case report, we describe the use of a universal shade resin composite to restore a discolored tooth before nonvital tooth bleaching. The intent of this procedure is to maintain an acceptable color match, eliminating the need for subsequent replacement of the restoration after bleaching. METHODS: A substantial defective Class IV resin composite was removed from a discolored, endodontically treated tooth #8. The existing gutta percha was sealed with glass ionomer, and 35% Thanawat Ruaydee, DDS MSc, Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Nahon Pathom, Thailand hydrogen peroxide gel was applied in the access chamber. The access cavity was temporarily sealed with a flowable resin composite and the entire tooth was restored with a group-shade universal resin composite. After a two-week bleaching period, the bleaching gel and temporary filling in the access cavity were replaced with the same universal shade resin composite, without necessitating the complete replacement of the entire restoration. RESULTS: A favorable outcome was noted during a one-year follow-up period, with the bleached tooth maintaining a harmonious color and the resin composite restoration exhibiting a stable and satisfactory condition. CONCLUSION: The clinical use of a universal shade resin composite before bleaching exhibited significant promise in facilitating an effective color match in a discolored tooth after bleaching. This method may substantially diminish the need for restoration replacement due to challenges associated with color discrepancies.
Variations in Microstructural, Thermal, and Mechanical Properties of Different CAD/CAM Lithium Disilicate Reinforced Glass Ceramics.
Tavares LN, Ferraz DC, Dolenkei KK … +3 more , Zancopé K, Almeida Silva AC, Raposo LH
Oper Dent · 2025 May · PMID 40458920 · Publisher ↗
PURPOSE: This study compared four CAD/CAM lithium disilicate-reinforced glass ceramic systems (IPS e.max CAD, Rosetta SM CAD, T-lithium CAD, and IRIS CAD) regarding their crystalline and microstructural characteristics,...
PURPOSE: This study compared four CAD/CAM lithium disilicate-reinforced glass ceramic systems (IPS e.max CAD, Rosetta SM CAD, T-lithium CAD, and IRIS CAD) regarding their crystalline and microstructural characteristics, thermal properties, mechanical strength, and bonding to a resin cement. METHODS AND MATERIALS: The crystalline and morphological characteristics of the ceramic microstructure were investigated by X-ray diffraction (XRD) and scanning electron microscopy (SEM), thermal behavior was assessed via differential thermal analysis (DTA). Mechanical properties were evaluated using a biaxial flexural strength test, and bonding to a resin cement was measured with a microshear strength test at distinct storage times. Data were evaluated using analysis of variance and Tukey HSD tests (α = 0.05). RESULTS: High peak positions corresponding to standard lithium metasilicate and lithium disilicate with similar intensities were observed for all ceramics in the XRD analysis. SEM morphological analysis showed differences in crystal characteristics among the ceramics after HF etching. The DTA thermograms showed a crystallization process ranging from 812-872°C among the different ceramic systems. The IRIS system showed the lowest flexural strength values, while bond strengths to resin cement remained comparable among materials, regardless of storage time. CONCLUSIONS: Most lithium disilicate ceramic systems demonstrated acceptable characteristics in the tests performed, except for IRIS, which showed shortcomings in crystal morphology and mechanical strength, along with inconsistent thermal behavior. These findings underscore the importance of careful material selection to ensure durable dental restorations.
Dental Adhesive Protection Against Development of Noncarious Cervical Lesions.
Denucci GC, Lima LC, Ekert GJ … +4 more , Silva F, Scaramucci T, Sochacki S, Hara AT
Oper Dent · 2025 May · PMID 40458918 · Publisher ↗
OBJECTIVE: This study aimed to verify whether dental adhesives prevent noncarious cervical lesion (NCCL) development in an in vitro simulation model based on abrasive/erosive challenges. METHODS AND MATERIALS: Extracted...
OBJECTIVE: This study aimed to verify whether dental adhesives prevent noncarious cervical lesion (NCCL) development in an in vitro simulation model based on abrasive/erosive challenges. METHODS AND MATERIALS: Extracted human premolars were randomly assigned to one of three treatments (n=16): 1. reference adhesive (Clearfil SE, Kuraray Co., Ltd., Chiyoda City, Tokyo, Japan); 2. experimental adhesive (10 wt% [percentage by weight] beta-tricalcium phosphate nanoparticles); 3. negative control (no treatment). After treatment, specimens were submitted to 11 episodes of 18 hours of acid exposure (1% citric acid solution-0.052 molar (M), pH ~2.5) interspersed by toothbrushing abrasion. Three-dimensional images of teeth were captured at baseline and after 5000, 10,000, 15,000, 35,000, and 55,000 toothbrushing strokes using an intraoral scanner. Tooth wear (mm3) was calculated after each toothbrushing period by scan superimposition. Lesion angle was measured, and shape classified. Data were analyzed using analysis of variance (ANOVA) and Fisher Protected Least Significant Difference (PLSD) tests (α=0.05). RESULTS: Tooth wear increased with toothbrushing strokes overall (p<0.001) and within each treatment (p<0.05) except between 10,000 and 15,000 strokes (p=0.24). Reference had less tooth wear than control overall (mean difference [95% CI]: 0.68 [0.20,1.15], p=0.008) and for all toothbrushing periods (p<0.05) except at 55,000 strokes (0.54 [-0.38,1.46], p=0.25). Reference had less tooth wear than experimental overall (0.54 [0.01,1.07], p=0.046) and for 35,000 strokes (0.80 [0.13,1.46], p=0.019). Experimental had less tooth wear than negative control at 5000 and 10,000 strokes (p<0.05). Treatments had no effect on lesion angle (p=0.52). At 55,000 strokes, reference had more flat-shaped lesions than experimental (p<0.001) and negative control (p<0.001), but experimental and negative control were not different from each other (p=1.00) having more striated lesions. CONCLUSION: Adhesives showed some degree of protection against NCCL development at early stages; however, reference had longer-lasting protection than experimental.
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