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Effect of tooth bleaching and application of different dentifrices on enamel properties under normal and hyposalivation conditions: an in situ study

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Abstract

Objective

The purpose of this in situ study was to evaluate different dentifrices on enamel after bleaching under normal and hyposalivatory conditions.

Materials and methods

Twenty-four participants were assigned of which 12 had normal and 12 had low salivary flow. The study was conducted in 6 in situ experimental phases of 24 h duration: placebo, NaF, SnF2, F/Sn/Chitosan, F/Arginine, and F/Bioactive Glass. The specimens were previously bleached in vitro. Microhardness (SMH), roughness (Ra), and color analyses (CIELAB and ΔE00) were performed at baseline (T1), after bleaching (T2) and after in situ phase (T3). Scanning electron microscopy (SEM) and the elemental levels (wt%) of Ca, P, and Na and the proportion between Ca and P were determined using an energy-dispersive X-ray spectrometer (EDS) in T3. The SMH and Ra were analyzed by mixed models for repeated measures and Tukey Kramer. The color and Na% were analyzed by split-plot ANOVA and Tukey test. The EDS were analyzed by Mann’s Whitney nonparametric, Friedman, and Nemenyi tests (p<0.05).

Results

The dentifrices placebo and NaF in the low flow presented lower SMH and higher Ra in T3 and lower Ca% compared to the same dentifrices in normal flow. For normal flow, SnF2 resulted in greater SMH. For low flow, SnF2, F/Sn/Chitosan, and F/Bioactive Glass resulted in higher SMH in T3 and did not differ from T1. F/Bioactive Glass showed lower Ra among the dentifrices evaluated for both salivary flows, whereas SnF2 showed the highest. F/Bioactive Glass showed a statistically significant difference from placebo for Ca%, P%, Na%. For ΔE*ab and ΔE00 (T1×T3), no differences were found for the dentifrices and salivary flows.

Conclusion

The low salivary flow had less capacity for remineralization of bleached enamel compared to normal flow. Overall, the dentifrice with bioactive glass had the best performance in bleached enamel under low and normal salivary flow condition.

Clinical relevance

It is recommended to use a bioactive glass-based dentifrice after bleaching to promote tooth enamel recovery for patients with or without impaired salivary flow.

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Acknowledgements

This study was financed in part by the Coordination for the Improvement of Higher Education Personnel, Brazil (CAPES) Finance Code 001. We are grateful to the São Paulo Research Foundation (FAPESP) grant #2018/24446-1 for funding and research support. We express our gratitude to Dental Clinic and Oral Medicine Clinic (Orocentro) of Piracicaba Dental School, University of Campinas, Brazil for all the support offered for this study. We express our gratitude also to Drogal Manipulation for providing the dentifrice placebo used in this research. Thank you immensely for all the volunteers who participated in this study.

Funding

This study was financed in part by the Coordination for the Improvement of Higher Education Personnel, Brazil (CAPES) Finance Code 001 and by São Paulo Research Foundation (FAPESP) grant #2018/24446-1.

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Authors and Affiliations

  1. Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13.414-903, Brazil

    Laura Nobre Ferraz & Débora Alves Nunes Leite Lima

  2. Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13.414-903, Brazil

    Isabele Vieira

  3. Department of Social Dentistry, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13.414-903, Brazil

    Gláucia Maria Bovi Ambrosano

  4. Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13.414-903, Brazil

    Marcio Ajudarte Lopes

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  1. Laura Nobre Ferraz
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  2. Isabele Vieira
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  3. Gláucia Maria Bovi Ambrosano
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  5. Débora Alves Nunes Leite Lima
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Contributions

Laura Nobre Ferraz: project administration, conception and design of the study, data curation, acquisition of data and drafting the article, and final approval of the version to be published. Isabele Vieira: the conception and design of the study, data curation and review of the intellectual content of the article, and final approval of the version to be published. Gláucia Maria Bovi Ambrosano: statistical analysis and review of the intellectual content of the article and final approval of the version to be published. Márcio Ajudarte Lopes: the conception and design of the study review of the intellectual content of the article and final approval of the version to be published. Débora Alves Nunes Leite Lima: the conception and design of the study review of the intellectual content of the article and final approval of the version to be published.

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Correspondence to Laura Nobre Ferraz.

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Ferraz, L.N., Vieira, I., Ambrosano, G.M.B. et al. Effect of tooth bleaching and application of different dentifrices on enamel properties under normal and hyposalivation conditions: an in situ study. Clin Oral Invest 25, 5929–5944 (2021). https://doi.org/10.1007/s00784-021-03899-4

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