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BACKGROUND: Dental bleaching in traditional concentrations generates greater sensitivity. In this respect, new systems of lower concentration of hydrogen peroxide for tooth bleaching appeared, with color stability unknown over time. The aim of this study was to compare the change and stability of color with low-concentration (6%) hydrogen peroxide gel in an in-office bleaching setting relative to conventional 37.5% gel, including their effects on psychosocial and esthetic self-perception, after 1 year. METHODS: Patients (n = 25) were assessed at 12 months post bleaching treatment (whitening with 6% chemo-activated alkaline formula gel versus 37.5% traditional concentration gel). Color changes were measured objectively using total variation in color (ΔE), and subjectively using Vita Classical and Vita Bleached scale (ΔSGU) by calibrated evaluators (Kappa = 0.85). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Oral Health Impact Profile (OHIP-14) aesthetic questionnaires were used to measure the self-perception and the psychosocial impact of the bleaching protocols. RESULTS: The effect (ΔE) of 37.5% HP (8.37 ± 2.73) was significantly better than that of 6% HP (5.27 ± 2.53) in terms of color rebound after 1 year of follow-up. There were significant differences in psychosocial impact and esthetic self-perception measurements prior to bleaching versus one-year post-whitening time points; positive effects were maintained. CONCLUSIONS: Low concentration (6%) achieved effective bleaching with good stability after 1 year, accompanied by a positive psychosocial impact and enhanced self-perception at follow-up. TRIAL REGISTRATION: NCT03217994 (before enrollment of the first participant). Data register: July 14, 2017.

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Single-drop microextraction (SDME) was coupled with surface-enhanced Raman scattering (SERS) to provide sample extraction and pre-concentration for detection of analyte at low concentrations. A gold nanohole array substrate (AuNHAS), fabricated by interference lithography, was used as SERS substrate and para-mercaptobenzoic acid (p-MBA) was tested as a probe molecule, in the concentration range 10-8-10-4 mol L-1. With this approach, a limit of 10-7 mol L-1 was clearly detected. To improve the detection to lower p-MBA concentration, as 10-8 mol L-1, the SDME technique was applied. The p-MBA Raman signature was detected in two performed extractions and its new concentration was determined to be ~4.6 × 10-5 mol L-1. This work showed that coupling SDME with SERS allowed a rapid (5 min) and efficient pre-concentration (from 10-8 mol L-1 to 10-5 mol L-1), detection, and quantification of the analyte of interest, proving to be an interesting analytical tool for SERS applications.

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OBJECTIVES: The aim of this study was to evaluate color longevity after a year of in-office bleaching with gel (6% hydrogen peroxide HP, LED blue/laser infrared activation system) compared to a 35% control concentration in a split-mouth study model. MATERIALS AND METHODS: Thirty-one patients were initially treated. The bleaching procedure with 6% or 35% gel HP was performed randomly in the upper half arcade of each patient. The color was measured at baseline and at 1 week, 1 month, and 1 year using the spectrophotometer Vita Easyshade, Vita Bleached, and Vita classical Shade guide organized by value. During the 1-year recall, the color was assessed before and after dental prophylaxis. RESULTS: Only 27 patients were assessed in the 1-year recall. There was a significant difference in the ΔE between the two groups at all times assessed (P < .011). The ΔL, Δa, and Δb showed significant difference between both groups at all assessed times (P < .038). There was no significant difference between the ΔSGU at all times (P > .05) except for the Vita bleachedguide postprophylaxis comparison (P < .05). CONCLUSION: The two compounds remained effective at 1 year. When objectively evaluated, color difference between groups was found, not seen when subjectively determined. CLINICAL SIGNIFICANCE: A low concentration hydrogen peroxide bleaching agent can reach good clinical results at 1 year of follow-up.

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Phthalates are a class of plasticizing chemicals produced in high volume and widely found in consumer products. Evidence suggests that phthalates may have non-monotonic effects on reproductive hormone activity. With exposure to phthalates virtually ubiquitous among industrialized populations, identifying unexposed and/or minimally exposed human populations is essential for understanding the effects of low level exposures. Our primary objective was to quantify urinary phthalate metabolite concentrations in the Tsimane', a remote population of Bolivian forager-horticulturalists. Our secondary objectives were to determine if phthalate metabolite concentrations vary in relation to access to market goods; and to explore relationships between phthalate and reproductive hormone metabolite concentrations. Given that phthalate exposure is of particular concern during fetal development, we focused on reproductive age women in the current analyses. Phthalate metabolites were assayed in urine samples from 59 naturally cycling, reproductive age Tsimane' women. Market access was assessed as: (1) distance from residence to the largest nearby town (San Borja, Bolivia) and (2) Spanish fluency. Urinary reproductive hormone metabolite concentrations were quantified using enzyme immunoassays. We fit linear models to examine: (1) predictors of phthalate exposure; and (2) relationships between urinary phthalate and reproductive hormone metabolite concentrations. Eight phthalate metabolites were detectable in at least 75% of samples. Median concentrations were up to an order of magnitude lower than industrialized populations. Proximity to San Borja and Spanish fluency were strong predictors of exposure. In exploratory analyses, the sum of the di-2-ethylhexyl phthalate metabolites (∑DEHP) and Mono-isobutyl phthalate (MiBP) were significantly associated with altered concentrations of urinary reproductive hormone metabolites. Remote, subsistence populations, like the Tsimane', offer a unique window into the health effects of endocrine active compounds because: (1) exposures are low and likely to be first generation; (2) a natural fertility lifestyle allows for exploration of reproductive effects; and (3) ever-increasing globalization will result in increasing exposure in the next decade.

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OBJECTIVE: The aim of this clinical randomized double-blind split-mouth study was to assess the effectiveness of a 6% hydrogen peroxide with nitrogen-doped titanium dioxide light activated bleaching agent. METHOD: 31 patients were treated with: one upper hemiarcade with a 35% hydrogen peroxide bleaching agent and the other hemiarcade with a 6% hydrogen peroxide. Two applications were completed each treatment session and three sessions were appointed, with one week interval between them. Tooth colour was registered each session and 1 week and 1 months after completing the treatment by spectrophotometer, registering parameters L*, a* and b*, and subjectively using VITA Classic guide. Tooth sensitivity was registered by VAS and patient satisfaction and self-perception result was determined using OHIP-14. Tooth colour variation and sensitivity were compared between both bleaching agents. RESULTS: Both treatment showed a change between baseline colour and all check-points with a ΔE=5.57 for 6% and of ΔE=7.98 for the 35% one month after completing the (p<0.05). No statistical differences were seen when subjective evaluations were compared. Also, no differences were seen in tooth sensitivity between bleaching agents. OHIP-14 questionnaire demonstrated a significant change for all patients after bleaching. CONCLUSIONS: A 6% hydrogen peroxide with nitrogen-doped titanium dioxide light activated agent is effective for tooth bleaching, reaching a ΔE of 5.57 one month after completing the treatment, with no clinical differences to a 35% agent neither in colour change or in tooth sensitivity. CLINICAL SIGNIFICANCE: A low concentration hydrogen peroxide bleaching agent may reach good clinical results with less adverse effects.

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