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This study evaluated the photoactivation of hydrogen peroxide gels at different concentrations using blue or violet LED in terms of whitening efficacy and tooth sensitivity. Forty patients were randomly divided into 4 groups: HP6V (violet LED and 6% hydrogen peroxide), HP6B (blue LED and 6% hydrogen peroxide), HP35V (violet LED and 35% hydrogen peroxide), and HP35B (blue LED and 35% hydrogen peroxide). The L*, a* and b* values were measured before, 1 week and 3 months after treatment, and the ΔE and ΔWID values were calculated. Tooth sensitivity was measured using a visual analogue scale (VAS) before, immediately after, and 24 h after bleaching. The ΔE, ΔWID and bleaching sensitivity values were subjected to the ANOVA test and Bonferroni post-test. HP35V and HP35B showed higher whitening efficacy than HP6VL, while HP6V did not show statistical differences compared to the other groups. Regarding bleaching-related sensitivity, the HP6V and HP6B groups presented the lowest values when compared to HP35V and HP35B. HP6V showed whitening efficacy comparable to HP35V and HP35B but with reduced tooth sensitivity. TRIAL REGISTRATION NUMBER: NCT06165458; registration date: 12/09/2023.

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CASE REPORT: This case report describes the multidisciplinary approach performed in a 9-year-old male patient with dental agenesia affecting teeth 21 and 22. Autotransplantation of the right upper second premolar with incomplete rhizogenesis to the missing area was combined with coronary reshaping with resin composite and orthodontic therapy. The treatment began with the extraction of the deciduous upper left central incisor, bone preparation for the recipient site of the donor tooth, atraumatic extraction of the right upper second premolar and immediate autotransplantation in the surgically prepared recipient site. Subsequently, sutures to reposition the flap and a rigid splint were performed. After 12 months, coronary reshaping of the autotransplanted tooth with resin composite was carried out. Orthodontic treatment involving the use of a fixed appliance was used to correct the interdental spaces and achieve adequate occlusion. Clinical and radiographic follow-up 10 years after tooth autotransplantation and 9 years after reshaping revealed partial obliteration of the pulp chamber, root resorption, ankylosis and the presence of endodontic treatment. CONCLUSIONS: The long-term outcomes highlighted that tooth autotransplantation represents a biologically and cost-effective procedure for replacing missing teeth in young patients, particularly in cases of incomplete rhizogenesis of the autotransplanted tooth. CLINICAL SIGNIFICANCE: This case report discusses tooth autotransplantation and resin composite reshaping as viable and long-term clinical options for treating young patients with dental agenesis.

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Context: Seal the dentin of the pulp chamber during endodontic treatment to avoid interfering with the restorative treatment performed afterward. Aims: The aim was to evaluate the effect of three adhesive systems applied in different bonding strategies (etch-and-rinse, self-etch, and universal adhesive) and time-point application (immediately after the cavity access preparation or after endodontic obturation) on the hybrid layer formation and dentinal penetrability. Materials and Methods: Forty-eight sound molars were randomly distributed into six groups (n = 10) according to the adhesive system used: Forty-eight sound molars were randomly distributed into six groups (n = 10) according to the adhesive system used and the time-point application: Adper Scotchbond Multi-purpose (AS), Clearfil SE (CF) and Scotchbond Universal (SU) in strategy of immediate endodontic sealing (IES) or delayed endodontic sealing (DES). In IES-AS, IES-CF, and IES-SU groups, dentin sealing was performed immediately after the cavity access, while in DES-AS, DES-CF, and DES-SU, after root canal obturation. The specimens were sectioned in the long axis, in a buccal-lingual direction, and the dentinal penetrability of the adhesive systems was evaluated using confocal microscopy images. Hybrid layer formation was analyzed by scanning electron microscopy images. Statistical Analysis Used: Dentinal penetrability data were analyzed with the ANOVA test and the Kruskal-Wallis test was performed for hybrid layer data (α = 0.05). Results: IES-CF showed the lowest dentinal penetrability (P < 0.05), while the other protocols were similar to each other (P > 0.05). No significant differences were found between groups regarding the hybrid layer formation (P > 0.05). Immediate and DES protocols do not influence the hybrid layer formation, regardless of the bond strategy used. Conclusions: Sealing the pulp chamber dentin before endodontic treatment can improve the bond strength of the final restoration but the formation of the hybrid layer was not influenced by the bond strategy.

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BACKGROUND: The photo-acceleration of bleaching gels by lights has been extensively researched. However, the induced temperature increase during this process needs to be further evaluated to prevent damage to the dental pulp. Therefore, the objective of this study was to evaluate the surface and intrapulpal temperature kinetics of different concentrations of hydrogen peroxide (HP) gels photo-accelerated by blue or violet light and infrared laser. METHODS: The whitening gels at concentrations of HP35, HP15, and HP6 % were irradiated with blue and violet LED/laser on the surface of a human canine tooth. The surface temperature variation (∆Ts) was evaluated using a pH meter, while the intrapulpal temperature variation (∆Ti) was assessed using a digital thermometer at intervals of 1, 15, and 30 min. Statistical analysis was conducted using a Two-way repeated measures ANOVA test, and Bonferroni post-test was applied at a significance level of 5 %. RESULTS: All violet LED photo-accelerated groups showed a higher increase in ∆Ts compared to the blue LED/laser groups. However, there were no significant differences between the groups for ∆Ti. CONCLUSION: Although the photo-acceleration of HP35 and HP15 % gels with violet LED/laser has a greater increase in surface temperature compared to HP6 % gel, the different light systems do not significantly increase the intrapulpal temperature.

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This study evaluated the effect of different concentrations of alpha-tocopherol in gel form on fracture strength, hybrid layer formation, and microtensile bond strength of endodontically treated teeth bleached with 40% hydrogen peroxide (H2 O2 ). Sixty bovine incisors were randomized into one of six groups (n = 10 incisors per group) defined by the interventions carried out after endodontic treatment. In the control group, no additional intervention was carried out, while all teeth in the five intervention groups were bleached with 40% H2 O2 and subsequently treated with alpha-tocopherol at concentrations of 15% (15AT), 20% (20AT), or 25% (25AT), with 10% sodium ascorbate (10SA), or with nothing (40HP). Fracture strength was evaluated in a mechanical testing machine, hybrid layer formation was assessed using scanning electron microscopy, and bond strength was determined using microtensile bond-strength testing. Data were analyzed using Kruskal-Wallis and Dunn's tests. No statistically significant difference regarding fracture strength was observed among groups. Hybrid layer formation was greater in the 15AT group than in groups 40HP and 10SA. Teeth in groups 15AT, 20AT, and 25AT demonstrated higher bond strength than teeth in groups 40HP and 10SA. Alpha-tocopherol, preferably at 15%, effectively reverses the deleterious effects, of bleaching, on hybrid layer formation and bond strength to dentin.

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OBJECTIVE: To evaluate in vitro the effect of dental bleaching using high concentration hydrogen peroxide (HP) photoactivated with violet LED on fracture strength and hybrid layer formation. METHODS: forty endodontically-treated bovine teeth were randomized into four groups (n = 10): C - Control, HP - 35% hydrogen peroxide, HP-BL - 35% hydrogen peroxide photoactivated with blue LED, HP-VL - 35% hydrogen peroxide photoactivated with violet LED. Three bleaching sessions with an interval of 7 days between them were performed. After 10 days of the last bleaching session, the dental crowns were restored and submitted to the fracture strength test. Five specimens from each group were used to evaluate the hybrid layer formation by scanning electron microscope (SEM) images. One-way ANOVA and Kruskal-Wallis test were used for parametric and non-parametric data, respectively. Significance level of 5% was adopted to all the tests. RESULTS: No differences on fracture strength among the groups were observed (p > 0.05). HP and HP-BL showed alterations on hybrid layer formation compared to C group (p < 0.05), but not for HP-VL (p > 0.05). No differences on hybrid layer formation were observed among HP, HP-VL and HP-BL groups (p > 0.05). CONCLUSION: Dental bleaching, photoactivated or not, did not affect the fracture strength of endodontically-treated teeth. Regardless of the protocol used, hydrogen peroxide altered the hybrid layer formation at some level when the restoration was placed after 10 days of the last bleaching session.

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Novel approaches for caries lesion removal and treatment have been proposed. This study evaluates the combined use of an experimental ultrasound, aPDT (antimicrobial photodynamic therapy) and bioactive glasses on the removal, decontamination and remineralization of dentin caries lesions. A biological model created with a duo species biofilm (Streptococcus mutans and Lactobacillus acidophilus) was used for the development of a caries-like lesion over the dentin for 7 days. Bovine dentin specimens (4 × 4 × 2 mm) were randomized according to the following caries removal techniques: bur (BUR) or ultrasound (ULT), decontamination (with or without aPDT) and remineralization materials (45S5 or F18 bioactive glasses). The following different groups were investigated: caries lesion (control); sound dentin (control); BUR; BUR + aPDT; ULT; ULT + aPDT; BUR + 45S5, BUR + F18; ULT + 45S5; ULT + F18; BUR + aPDT + 45S5; BUR + aPDT + F18; ULT + aPDT + 45S5; and ULT + aPDT + F18. Transverse microradiography (TMR), cross-sectional microhardness (CSH), FT-Raman spectroscopy and confocal microscopy (CLSM) were performed. A two-way ANOVA and Tukey's test were used (α = 0.05). (3) Results: The TMR revealed a lesion depth of 213.9 ± 49.5 µm and a mineral loss of 4929.3% vol.µm. The CSH increases as a function of depth, regardless of the group (p < 0.05). Removal with BUR (24.40-63.03 KHN) has a greater CSH than ULT (20.01-47.53 KHN; p < 0.05). aPDT did not affect the CSH (p > 0.05). No difference was observed between 45S5 or F18 (p > 0.05), but a change was observed for ULT (p > 0.05). The FT-Raman shows no differences for the phosphate (p > 0.05), but a difference is observed for the carbonate and C-H bonds. The CLSM images show that aPDT effectively inactivates residual bacteria. A combination of ULT, aPDT and bioactive glasses can be a promising minimally invasive treatment.

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OBJECTIVE: This study evaluated the effects of antioxidants, 10% sodium ascorbate (SA) or 20% alpha-tocopherol (AT), after post-space irrigation with 2.5% sodium hypochlorite +17% EDTA (SH) or 1% peracetic acid (PA) on the adhesive interface after glass fiber post cementation. MATERIALS AND METHODS: Sixty bovine roots were endodontically treated. After preparation, the post-space was irrigated with SH or PA followed or not by the use of antioxidants (SA or AT) (n = 10). Push-out bond strength test, failure mode, and dentin penetrability analysis using confocal laser microscope were performed in the cervical, middle, and apical thirds. Data from bond strength and dentinal penetrability were evaluated by one-way ANOVA and Tukey post hoc test (p < 0.05). RESULTS: SH showed the lowest bond strength regardless of the third (p < 0.05). In apical third, mixed failure was the most incident in all groups. Only in the cervical third of the post-space, SH-AT provided the greatest tag extension of the cementation system into dentin (p < 0.05). However, in the middle and apical thirds, SH-AT, SH-SA, and PA-SA provided the largest tag extensions (p < 0.05), but similar to each other (p > 0.05). CONCLUSIONS: The use of antioxidants only favored bond strength when SH was used and dentin penetrability of the adhesive and conventional resin cementation, regardless of the solution used to irrigate the post-space. CLINICAL SIGNIFICANCE: The use of antioxidants (10% sodium ascorbate and 20% alpha-tocopherol) after post-space irrigation with sodium hypochlorite appears to increase the bond strength favoring the glass fiber post-cementation.

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This study evaluated the effect of aging and cementation of fiber posts using glass ionomer and resin cements on push-out bond strength, failure mode, and resin tag formation. One hundred and twenty bovine incisors were used. After post-space preparation, the specimens were randomly allocated into 12 groups (n = 10) according to the cementation system used: GC - GC Gold Label Luting & Lining); RL - RelyX Luting 2; MC - MaxCem Elite; RU - RelyX U200 and the aging periods (24 hours, 6 months, and 12 months). Slices from the cervical, middle, and apical thirds were obtained and analyzed by push-out bond strength test and confocal laser scanning microscopy. One-way ANOVA and Tukey's post-hoc test was used at a significance level of 5%. For the push-out bond strength test, no differences among GC, RU, and MC in the cervical and middle thirds were observed, regardless of the period of storage (P > 0.05). In the apical third, GC and RU showed similar bond strength but higher than other groups (P > 0.05). After 12 months, GC showed the highest bond strength (P < 0.05). Bond strength to post-space dentin decreased over time, regardless of the cementation system used. Cohesive failure was the most frequent, regardless of the period of storage, cementation system, and post-space third. Tag formation was similar among all groups. After 12 months, GC showed the highest bond strength values.

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BACKGROUND: Few studies have investigated the effect of violet LED irradiation associated or not with bleaching agents on blood-stained teeth. This in vitro study aimed to evaluate the whitening efficacy and color stability of non-vital dental bleaching using 35% hydrogen peroxide (HP) photoactivated with violet LED (VL) compared to 35% HP alone and 35% HP photoactivated with blue LED (BL). METHODS: Fifty bovine dental crowns were used to obtain specimens of 5 × 5 × 2 mm. After selection based on a previous colorimetric analysis, the specimens were blood-stained and randomly assigned into five groups (n = 10): control (no treatment); 35% HP, 35% HP/BL; 35% HP/VL; and VL. Three bleaching sessions were performed and the colorimetric analysis (∆Eab, ∆L, and ∆WID) was recorded after 7 days, 30 days, and 9 months of the last bleaching session. Two-way repeated measures ANOVA followed by Bonferroni post-hoc test was used at a significance level of 5%. RESULTS: 35% HP, 35% HP/BL, and 35% HP/VL showed higher values of ∆Eab, ∆L, e ∆WID (P < 0.05), without intra- and intergroup differences (P > 0.05). C and VL were similar in all the evaluation times (P > 0.05), showing lower values of ∆Eab, ∆L, and ∆WID (P < 0.05). CONCLUSIONS: 35% HP/VL can be a viable alternative for dental bleaching in endodontically-treated teeth, showing bleaching efficacy similar to 35% HP solely used, even after a 9-month follow-up. VL used alone was not effective to bleach blood-stained teeth.

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