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Introduction The standard treatment for caries is to apply silver diamine fluoride (SDF) to the tooth, followed by a composite resin or glass ionomer cement restoration (GIC). Tooth discolouration is an adverse effect of SDF. The aims of this study were to 1) determine whether applying a composite compared to a GIC restoration after SDF to caries-infected teeth results in less discoloration, and 2) determine whether immediate or delayed restoration application is associated with less discoloration. Methods Sixty samples of caries-infected teeth were divided into five groups: 1) control (SDF alone), 2) SDF plus immediate composite restoration, 3) SDF plus immediate GIC restoration, 4) SDF plus delayed composite restoration, and 5) SDF plus delayed GIC restoration. The delay between SDF and restoration for groups 4 and 5 was two weeks. Tooth color was measured at three sites for each sample at baseline before SDF application and at multiple times. Results When comparing the change between baseline color to the color at the last time measurement in all groups, we found that Group 4 (17.4±4.3) and Group 5 (14.4±5.3) changed the least compared to baseline and were not statistically significantly different from each other. Conclusion Under laboratory conditions, delaying application of restoration for two weeks after SDF to samples of caries-infected teeth significantly reduced discoloration, with neither composite nor GIC being superior. If these findings are confirmed in a clinical setting, delaying restoration by two weeks could provide an inexpensive oral health strategy to reduce the negative aesthetic impact associated with SDF.

Dentistry treatment is not only focused on restoring the function of mastication but also onthe aesthetic problem. Fluorosis is one of the aesthetic problems caused by excessive fluoride intakeduring email formation and produced color changes on the surface of the email. Fluorosis was notaffected by the aesthetics but also influenced the confidence of the patient. The Microabrasion techniqueis an option for fluorosis because it is conservative treatment with good results. A 20-year-old womanwho came to the Dental Conservation clinic complained that she wants to remove the brown color andwhite spots seen on the front teeth, which significantly interfere with her appearance. Based on clinicalexamination, many cavities were found in the back teeth of the upper and lower jaw. The results of thehistory and clinical study revealed that the patient had fluorosis in her teeth. Microabrasion was carriedout using Opalustre (ultradent). This material was applied to the tooth surface and rubbed using anapplicator (opal bristle) for 60 seconds. Then applied fluoride gel paste with finishing cup opal.Treatment results showed changes in tooth color, brown and white patches disappeared. Microabrasionis the first choice for aesthetic treatment in fluorosis and has shown satisfying results to restore thepatient's aesthetics problem. KEYWORDS: Fluorosis, microabrasion technique

Introduction: Dental aesthetic is an important need for many people. Tooth color is an important aspect to assess people’s perception of beauty. Teeth whitening or teeth bleaching is an aesthetic treatment to alter the color of the teeth, which is in great demand by many patients. The use of light cure is thought to be able to improve the results of bleaching treatments. Objective: the aim of this study was to conduct an integrative review with scientific evidences relating to the use of light cure to improve bleaching treatment results. Methods: analyzing journals from the Google Scholar, National Library of Indonesia, EBSCO, PubMed, Cochrane database. The results analyzed were the value of color change in tooth after the use of light cure in bleaching treatments. Conclusion: this review reveals that the use of light cure can improve the results of bleaching treatments.

Teeth are one of the important aesthetic factors for a person, including tooth color. The effect of tooth discoloration can cause a person's lack of self-confidence. The use of teeth whitening materials can cause side effects in the oral cavity so that the use of natural ingredients is chosen as a tooth whitener, one of which is activated charcoal. Activated charcoal has an absorption capacity of 25-100%. The purpose of this study was to determine the activity of coconut shell-activated charcoal toothpaste as a teeth whitener. This study used 20 dentures and then soaked them in coffee solution for 17 days to change the color of the teeth. Tooth color was measured using a classical Vitapan shade guide. Teeth whitening activity test was carried out for 14 days. Toothpaste was made in 4 formulas with different concentrations of coconut shell-activated charcoal in formula 1 (0%), formula 2 (6%), formula 3 (10%), and formula 4 (12%). The results of the observation showed that the preparation of coconut shell-activated charcoal toothpaste can give tooth discoloration. A statistical tests showed that coconut shell-activated charcoal toothpaste had a significant difference in activity as a natural ingredient for whitening teeth.

Objectives: To assess the whitening efficiency and patient satisfaction after usage of commercially available toothpastes with the different whitening ingredients. Materials and methods: This randomized controlled trial study comprised 161 participants who were randomly divided into eight groups based on used whitening or control/conventional toothpaste (Colgate Max Expert White [CMEW], n = 20 ; Signal Daily White [SDW], n = 20 ; Himalaya Sparkly White Herbalis [HSWH], n = 20 ; Signal White System [SWS], n = 20 ; Rembrandt Deeply White + Peroxide [RDWP], n = 20 ; Splat Extreme White [SEW], n = 20 ; Splat White Plus [SWP], n = 21 ; and Kalodont Multi Repair [control], n = 20). Tooth color and color change were evaluated using a spectrophotometer (CIELAB coordinates, ΔEab*, ΔE00, whiteness index change [ΔWID]). Measurements were performed at baseline, 30 days and 60 days after the beginning of treatment, and 30 days after completing treatment - follow-up. Side effects and satisfaction with the whitening outcome were reported throughout the questionnaire. Results: The results for ΔL*, Δa*, and Δb* showed an increase in lightness and decrease in yellowness for all tested whitening toothpastes compared to the control group after 30 days of use (p ≤ 0.05). Also, significant tooth color difference (ΔEab*, ΔE00) and whiteness index change (ΔWID) were recorded for all tested whitening toothpastes 30 days and 60 days from the beginning of use (p ≤ 0.05). Toothpaste containing a combination of urea peroxide and enzyme ingredients (SEW) demonstrated the highest and the longest whitening effect. Conclusions: Whitening toothpastes can show perceptibly whitening effect after a short time of usage, but without a long- lasting impact. Clinical relevance: Toothpaste containing a combination of enzymes and peroxides showed the best whitening performance compared to those containing only enzymes, peroxides, or abrasives.

Amelogenesis imperfecta (AI) is an inherited disease that expresses a disorder in the development of enamel structure. In its mildest form, it promotes tooth color change; and in more severe cases, it presents a loss of enamel structure initiated during the eruption phase. Different AI manifestations can coexist in the same patient or in the same tooth, both in the primary and permanent dentures. In addition, several subtypes are described, characterized according to the variety of phenotype and genotype. Successful treatment requires early diagnosis and therapeutic solutions involving different dental specialties. Although some professionals prefer to postpone permanent rehabilitation until the development of complete permanent dentures, the aesthetic and functional impact of this disease in childhood and adolescence requires that restorative treatment be started as soon as possible. The proposed therapies demonstrate numerous challenges such as extreme dentinal sensitivity, difficulties installing and maintaining the orthodontic appliance and the need for restorative and prosthetic intervention in malformed teeth. This work aims to demonstrate the interaction between Orthodontics, Restorative Dentistry and Prosthesis in the treatment of a patient with AI, reporting the success of treatment involving aesthetics, function and well-being and the long-term benefit of this interdisciplinary approach for patients with this disease. Keywords: Orthodontics. Amelogenesis Imperfecta. Mouth Rehabilitation. ResumoA amelogênese imperfeita (AI) é uma doença hereditária que expressa uma desordem no desenvolvimento da estrutura do esmalte. Na sua forma mais branda, promove alteração na cor dos dentes; e em casos mais severos, apresenta perda de estrutura do esmalte iniciada durante a fase de irrupção. Diferentes manifestações da AI podem coexistir no mesmo paciente ou no mesmo dente, tanto na dentadura decídua quanto na permanente. Além disso, são descritos diversos subtipos, caracterizados de acordo com a variedade do fenótipo e genótipo. O sucesso do tratamento requer diagnóstico precoce e soluções terapêuticas que envolvam diversas especialidades odontológicas. Embora alguns profissionais prefiram adiar a reabilitação definitiva até o desenvolvimento da dentadura permanente completa, o impacto estético e funcional desta doença na infância e adolescência exige que o tratamento restaurador seja iniciado o mais cedo possível. As terapias propostas demonstram inúmeros desafios como a sensibilidade dentinária extrema, as dificuldades para instalação e manutenção do aparelho ortodôntico e a necessidade de intervenção restauradora e protética em dentes com má formação. O presente trabalho tem como finalidade demonstrar a interação entre a Ortodontia, a Dentística Restauradora e a Prótese no tratamento de um paciente com AI, relatando o sucesso do tratamento envolvendo estética, função, bem estar e o benefício em longo prazo desta abordagem interdisciplinar para os portadores desta doença. Palavras-chave: Ortodontia. Amelogênese Imperfeita. Reabilitação Bucal.

Purpose To assess patient self-perception of overall dental appearance and of potentially localized dyschromic teeth and to compare them to the perception of the treating dentist. Materials and methods A sample of 160 patients from Cluj-Napoca, Romania, answered a questionnaire regarding the self-perception of their dental appearance and of potential localized dental discolorations. The same questions were answered by their dentist, without knowing their answers, after clinical examination of each patient. Each patient and the dentist were asked to indicate a tooth with a pleasant color to be considered as reference. Color measurements of teeth indicated as dyschromic and of the reference teeth were performed using a spectrophotometer. Color differences were calculated using the ΔE00 formula. Results Tooth color was considered the most disturbing factor of their dental appearance by 41.25% of patients. Most patients (58.12%) acknowledged localized dyschromic teeth in their dental arches. Agreement between patients and dentist regarding the identification of dyschromic teeth was found in 61.87% of cases. The DE00 between the reference teeth and the teeth considered dyschromic by both patients and dentist ranged between 0.8 and 23.1. Disagreement between patients and dentist was found in 38.12% of situations. For teeth considered dyschromic only by patients, the ΔE00 ranged between 0.8 and 23.1. For teeth considered dyschromic only by the dentist, the ΔE00 ranged between 0.8 and 25. Conclusion Most patients expressed concerns regarding their overall dental color and perceived themselves as having teeth with localized dyschromia. More than a third of the investigated patients had different perceptions regarding dyschromic teeth compared to their dentist. The majority of ΔE00 values calculated between dyschromic and reference teeth exceeded the perceptibility and acceptability thresholds.

Aim: This study assessed the validity and reliability of color selection by smartphone photography using two smartphone applications and Adobe Photoshop software. Settings and Design: In vitro comparative study. Materials and Methods: The validity and reliability of dental tooth shade recognition (DTSR), Chromatcher, and Adobe Photoshop were evaluated for color selection of shade tabs. The iPhone 7 camera in automatic mode was used for photography. Images were captured using Smile Lite with/without polarized filter and with camera flash. To assess the reliability, nine Vita Lumin Vacuum shade tabs were chosen and each was photographed for 10 times using Smile Lite. The reliability of DTSR, Chromatcher, and Photoshop in shade-taking was calculated. To assess their validity, 16 shade tabs of Vita Lumin Vacuum and 26 shade tabs of Vita 3D Master were photographed using the aforementioned lighting conditions. The color of photographs was calibrated and shade-taking was performed and compared with the shade suggested by SpectroShade as reference. Statistical Analysis Used: Data were analyzed using Two-way analysis of variance and Bonferroni post hoc test. Results: The reliability of Photoshop, DTSR, and Chromatcher was 98.88%, 63.3%, and 100%, respectively. The validity of Photoshop was significantly higher than other software programs (P < 0.05). Chromatcher had higher validity than DTSR (P < 0.05). Conclusion: Shade-taking by calibrated smartphone pictures and Adobe Photoshop has high validity and reliability.

Background/Purpose Mineral trioxide aggregate (MTA) was widely used in endodontic therapy as bioceramic material. Although MTA has high biocompatibility, it may lead to tooth discoloration. The aim of this study was to investigate the discoloration of two different bioceramic materials and the effects of internal bleaching. Methods Thirty single-canal mandibular premolars were extracted and randomly assigned to three groups (n = 10), white ProRoot® MTA, SavDen® MTA and a control group. Endodontic access opening, cleaning and shaping were performed, then the teeth were obturated using the two bioceramic materials. Tooth color was recorded at baseline, day 1, and 1, 2, 4, 6, 8, 12, 16, and 24 weeks after treatment. At the end of 24 weeks, sodium perborate was used to perform internal bleaching. Tooth color was recorded at 1, 2, and 6 weeks subsequently. Teeth were measured using a DeguDent® spectrophotometer, and data were transformed into Commission Internationale de l'Eclairage (CIE) L∗a∗b∗ system. Results Teeth treated with white ProRoot® MTA showed significant color change and decrease in L∗ value. Internal bleaching leaded to decrease of the ΔE∗ value for all three groups and increase in the L∗ value. There was no difference in tooth discoloration between SavDen® MTA and the control group after obturation and internal bleaching. Conclusion In terms of visual perception, white ProRoot® MTA tends to cause black and blue discoloration. SavDen® MTA, formulated with calcium lactate gluconate, could be used to reduce tooth discoloration in endodontic treatment.

Shade matching is a challenging step and the major objective in esthetic and restorative dentistry. On many occasions, the production of the accurate target color will not be achieved due to errors in the registration of the target color, or errors in composing the appropriate color of the restoration in the dental laboratory. Thus, the accurate and correct shade matching of tooth and restoration is one of the most important quality criteria for the patient and the key to successful results for the dentist. Conclusion: Spectrophotometers, colorimeters, intraoral scanners, and imaging systems are useful and relevant tools for tooth color measurement and analysis, and for the quality control of color reproduction. The combination of visual and instrumental methods of tooth color determination will complement each other, leading toward predictable esthetic results.

INTRODUÇÃO: Atualmente, os pacientes almejam um sorriso harmônico e natural, e procedimentos minimamente invasivos devem ser priorizados. Dentre esses, o clareamento dental associado às restaurações diretas com resina composta são tratamentos indicados para alteração de cor e forma dental, devolvendo estética e função. OBJETIVO: O presente trabalho tem como objetivo apresentar, através de um relato de caso clínico, o restabelecimento de um sorriso possibilitado pelo clareamento dental e restaurações diretas em resina composta. RELATO DE CASO: Paciente do sexo feminino, 33 anos, compareceu em consulta clínica se queixando da estética do seu sorriso após a remoção do aparelho ortodôntico. Os dentes apresentavam alteração de cor e forma, e assim, foram planejados clareamento dental e restaurações diretas em resina composta. O clareamento dental foi realizado pela técnica combinada e após 14 dias, as restaurações em resina composta nos incisivos, caninos e pré-molares superiores foram confeccionadas. CONCLUSÃO: O tratamento clareador e as restaurações em resina composta são abordagens conservadoras que possibilitaram o restabelecimento estético do sorriso.

Objectives: this study was aimed to assess any tooth color change resulting from dehydration due to rubber dam application and the required time for any change to recover to baseline. Materials and methods: Ten Participants with intact maxillary central incisors were recruited. with age ranging from 20 to 55 years according to inclusion and exclusion criteria. Patients were randomized. The spectrophotometer was used for evaluating tooth shade at A baseline, 10 min and 30 min. Further measurements were done at,40 min and 60 min during rehydration. Data was collected. For statistical analysis, ANOVA was used at the significance level P ≤ 0.05. Results: Color change (ΔE): there was a statistically significant change in mean (ΔE) values (P-value

Purpose The aim of the present study was to assess the perceptibility and acceptability threshold values for color differentiation at the restoration and mucosa levels. Materials and methods One restored single-tooth implant and the contralateral reference tooth were spectrophotometrically assessed in 20 patients. Perceptibility and acceptability were evaluated by dentists, dental technicians, and laypeople. Results Dental technicians had the highest sensitivity in the perception of tooth color differences (ΔE = 2.7), followed by dentists (ΔE = 3.3) and laypeople (ΔE = 4.4). Acceptability threshold values were generally higher than perceptibility threshold in all groups. Dental technicians exhibited the highest sensitivity in the perception of mucosa color differences (50% perceptibility at ΔE = 2.65), followed by dentists (ΔE > 3.7) and laypeople (ΔE > 6). Conclusion Color differences were tolerated with varying degrees among the three groups. Laypeople accepted higher color differences at the mucosa level.

Nothing could be more desirable than a sparkling white smile. A shining, beautiful smile has been a symbol of health & vitality since the centenary. Discoloration of a tooth is a common esthetic problem caused by either extrinsic or intrinsic factor. The normal color of tooth can be re-established by decolorizing the stain with the powerful oxidizing agent such as 35 percent hydrogen peroxide, which is directly placed on the labial surface of the tooth to be treated. Dental bleaching offers a conservative & simplified approach to change the color of discolored teeth. This case report reflects the remarkable change of tooth color by in-office bleaching.

Background YouTube™ is the world’s second most popular website after Google on the Internet. The aim of this study was to assess the quality and content of information YouTube™ videos for patients seeking information about teeth whitening. Methods The keyword ‘teeth whitening’ was searched on YouTube™. YouTube™ was filtered by the relevance, and the first 100 videos that met the inclusion criteria were evaluated. The included videos were analyzed for views, duration, time since video upload, likes/dislikes, number of comments, source, material types (dental, natural, and other). Also, video purpose was analyzed under nine categories (definition, material preparation, the procedure of application, material comparison, before/after comparison, symptoms, post-op experience, commercial, educational). Each video was classified according to the quality of information content as ‘good’, ‘moderate’, or ‘poor’. The Kruskal-Wallis test, Fischer’s Exact test and Spearman correlation analyses were performed. Results Most videos were uploaded by laypersons (60.0%). The definition of teeth whitening was the most commonly covered topic (74.0%), followed by the procedure of application (54.0%), and post-op experience (36.0%). Only 12% of videos were classified as having good information quality content, 53% moderate, and 35% were rated as poor information content. Poor-information content videos had a significantly higher number of viewing rates than the other groups (P = 0.002), besides the duration was significantly higher in poor-information content videos (P =0.002). There was a significant relationship between the quality of video information and material types (P Conclusions YouTube™ should not be used as a thoroughly reliable and accurate source for patient information about teeth whitening. More informative and reliable content YouTube™ videos about teeth whitening should be uploaded by professionals.

Objectives Visual shade selection is the most commonly used method in dentistry and a challenge for every dentist. However, differences to natural tooth color and the differences of each shade guide are well known. The aim of this paper is to investigate the suitability of two different color scales for determining the color of no‐match templates. Materials and methods Volunteers (N = 76) selected a shade color of a no‐match template with two shade guides (VITA Classical shade guide (VC) and VITA Linearguide 3D‐Master (V3D LG), both Vita Zahnfabrik). The neutral grey background was laterally illuminated with a color differentiation lamp (Dialite, Eickhorst GmbH). For the volunteers’ accuracy, the triangle's area was used which are emerge by the color coordinates of a template (LTaTbT) and the color coordinates of the two decisions (L1a1b1 and L2a2b2). Statistical software was used to evaluate the differences in ΔE00 with α = .01. Results A deviation in the median of ΔE00 of 7.6 (V3D LG, first choice) to 6.6 (VC, second choice) was detected, while U test showed no significant differences in the median for both color scales. But the triangle's area generated by both shade decisions and tooth color with V3D LG was significant smaller (14.2) then VC (19.2) (P ≤ .001). Conclusions When comparing both results no significant difference in the subject's shade selection and the shade guides was detected. The new evaluation strategy using the size of the triangle's areas proves the superiority of the V3D LG due to a better distribution of the tooth color shades within the color space.

Objective To record in detail, the long-term success of a bleaching treatment employing hydrogen peroxide in a severely darkened tooth. Clinical considerations Tooth discoloration is an important aesthetic complain of patients. Because it is a relatively common condition, different materials and techniques capable of restoring the tooth color in a minimally invasive, conservative, and longstanding manner were developed. In this case, it was used the association between mediate (walking bleach) and immediate (internal/external) bleaching techniques using hydrogen peroxide as the main agent. Conclusion The association of techniques was a conservative therapeutic solution to restore the natural color of the right upper central incisor, which was darkened after an endodontic treatment performed more than twenty years ago. The bleaching protocol used presented no risk to the patient, such as cervical resorption and the color was stable over a 48 months period, showing the success of the protocol proposed for this case. Clinical significance There is a possibility to severely darkened teeth receive an adequate bleaching treatment protocol, which can successfully restore the aesthetics and natural color in a conservative and long lasting way.

Objective To evaluate dental prophylaxis influence in tooth color assessment with the use of different methods. Materials and methods Volunteers were consecutively recruited and screened according to appropriate inclusion/exclusion criteria. Each participant's upper right central incisive and canine color was measured before and after dental prophylaxis with a one-week interval. Tooth color assessment was performed by calibrated operators and the patient using a VITA Classical shade guide and by spectrophotometric methods with a proper device (SpectroShade). Color was reported as mean with SD of Commission Internationale De l'Eclairage (CIE) L*a*b* values, ΔEab and ΔE00. One-way analysis of variance and Tukey post hoc were performed to assess differences between methods and paired t test for assessing differences in tooth color coordinates after dental prophylaxis. Values of P < .05 were taken as significant. Results Fifty patients were included. Self-assessed dental prophylaxis effects equated to a significantly different mean ΔE00 value of 2.3 ± 1.7 (P < .01), when compared to the calibrated operator reported 0.8 ± 1.1 and the spectrophotometer 1.0 ± 0.5. Half of volunteer's ΔE00 values surpassed the acceptability threshold, when compared to 28% from investigator and 10% from spectrophotometer. Conclusion Performing a dental prophylaxis did have an influence in tooth color perception with a higher self-perceived effect in the patient assessment. Clinical significance The results of this study suggest that performing professional dental prophylaxis presented a perceived effect in tooth color regardless of the method used being that patients precepted whiter and less yellowish teeth. Since extrinsic stain is considered as one of the factors that could influence tooth color assessment, performing professional dental prophylaxis prior to composite or ceramic color selection in anterior teeth restorations could consequently increase treatment predictability.

Objective: To clinically evaluate the effect of the violet light-emitted diode (LED) light (405–410 nm) associated to in-office dental bleaching with 35% carbamide peroxide, on tooth color change a...

The use of 3D intraoral scanners (IOS) and software that can support automated detection and objective monitoring of oral diseases such as caries, tooth wear or periodontal diseases, is increasingly receiving attention from researchers and industry. This study clinically validates an automated caries scoring system for occlusal caries detection and classification, previously defined for an IOS system featuring fluorescence (TRIOS 4, 3Shape TRIOS A/S, Denmark). Four algorithms (ALG1, ALG2, ALG3, ALG4) are assessed for the IOS; the first three are based only on fluorescence information, while ALG4 also takes into account the tooth color information. The diagnostic performance of these automated algorithms is compared with the diagnostic performance of the clinical visual examination, while histological assessment is used as reference. Additionally, possible differences between in vitro and in vivo diagnostic performance of the IOS system are investigated. The algorithms show comparable in vivo diagnostic performance to the visual examination with no significant difference in the area under the ROC curves ($$p>0.05$$ p > 0.05 ). Only minor differences between their in vitro and in vivo diagnostic performance are noted but no significant differences in the area under the ROC curves, ($$p>0.05$$ p > 0.05 ). This novel IOS system exhibits encouraging performance for clinical application on occlusal caries detection and classification. Different approaches can be investigated for possible optimization of the system.

Objective To identify the hue angles that provide the optimal perception of tooth whitening. Methods Thirty-three male/female adult observers with normal color vision were recruited to assess teeth images on a color calibrated display. Images of teeth were generated which simulated color changes in each of eight hue directions in the CIE a*b* plane, each equi-distant from a baseline tooth color. Using a paired comparison study design, observers were asked to indicate which of two images had whiter teeth. The data were converted into an interval scale using Thurstone's Law of Comparative Judgment. The relationship between the hue angles and the scores was modeled by curve fitting. Results The optimal hues were found in a region between green and blue in the CIE a*b chart. When the tooth color travels in an optimal hue direction, the same amount of color change will result in a greater change in whiteness perception than when traveling in other hue directions. Conclusions The optimal hues for tooth whitening were identified from the visual perception study. The most effective tooth whitening direction is to change tooth color towards the greenish-blue hue direction. Clinical significance This study gives clinicians and researchers a better understanding of tooth color hue effects in tooth whiteness perception.

Objectives We aimed to confirm whether autofluorescence emitted from teeth can predict tooth bleaching efficacy and establish a novel model combining natural color parameters and tooth autofluorescence data to improve the predictability of tooth bleaching. Methods A total of 61 tooth specimens were prepared from extracted human molars/premolars and immersed in 35% hydrogen peroxide for 1 h for tooth bleaching. The changes in laser-induced fluorescence (∆LIF) were assessed using Raman spectrometry. Tooth color and autofluorescence data were obtained using quantitative light-induced fluorescence (QLF) technology. Pearson correlation analyses were used to confirm the relationship between ∆LIF and autofluorescence. Intraclass correlation coefficients (ICC) were calculated to compare the conventional and new prediction models. Decision tree analysis was performed to evaluate clinical applicability. Results The yellowness-to-blueness value from fluorescence imaging showed a moderate correlation with ∆LIF (r= –0.409, p = 0.001). The degree of agreement between the actual efficacy and that predicted by our novel model was high (ICC=0.933, p = 0.002). Decision tree analysis suggested that tooth autofluorescence could be a key factor in prediction of tooth bleaching outcomes. Conclusions Our findings showed that autofluorescence detected from QLF images may be used to predict tooth bleaching efficacy. Our proposed model appeared to improve the predictability of tooth bleaching.

Objectives: The purpose of this study was to evaluate shade matching ability of dental professionals and students using the VITA 3D-Master shade guide. Materials and methods: A hundred and twenty participants have been assigned to one of four groups as follows: specialists in prosthodontics (SPs), residents in prosthodontics (RPs), dental technicians (DTs) and dental students (DSs). The Toothguide Training Box (TTB) was used to test the participants’ shade-matching ability based on using 3 exercises and a final test. The mistakes were recorded during the exercises and mistake ratios (MR) were calculated. Time, scores, and color difference values (ΔE) were recorded and calculated. The one-way ANOVA was used to analyze the differences, and multiple regression analyses were used to evaluate the relationship in mean MRs, time, score and ΔE values between the groups. Results: Male participants needed significantly greater amount of time than females to complete the final test (P

Objectives: The aim of the study was to compare three color parameters assessed on the maxillary right central incisors using a spectrophotometer as the gold standard, along with RAW mobile calibrated and non-calibrated photos in different light conditions. Materials and methods: A total of 30 dental students participated in the study. CIE L*a*b* values were measured in the middle third of each maxillary right central incisor spectrophotometrically and digitally on RAW mobile dental photos using different light conditions (F-frontal light; L-lateral light; D-lateral light with diffusers; P- polarizing filter on frontal light; H-hybrid filter as combination of frontal light with polarizing filter and lateral lights with diffusers) with LEDs (light emitting diode) in full power, and with gray card calibration. The obtained results were compared. Results: Mean a* and b* values on calibrated, as well as mean L* values on non-calibrated RAW mobile photos did not significantly differ in different light conditions (P>0.05). CIE L*a*b* values on non-calibrated polarizing RAW mobile photos completely matched the same values obtained using a spectrophotometer on the subject’s maxillary right central incisor (P>0.05). Conclusions: Different light conditions and measuring procedures affected CIE L*a*b* values on RAW mobile photos in this study. Within the limitations, non-calibrated RAW mobile photos using a lightening device with polarizing filters on frontal LED light in standardized conditions can be a useful tool for digital dental shade determination.

Introduction. Tooth color can be represented in a three-dimensional color system by applying L* (lightness), a* (red-green color tone) and b* (yellow-blue color tone) coordinates. Clinically significant color difference, Delta-E, can be expressed in units that are correlated with visual perception using the International Commission on Illumination L*a*b* system. The aim of the study was spectrophotometric analysis of the natural maxillary central incisor color, and to establish any gender-related differences in lightness, red-green tone, and yellow-blue tone coordinates. Material and Methods. The study included 80 students (40 male and 40 female, with an average age of 22 years). The color of the maxillary right central incisor was determined using an intraoral spectrophotometer and VITAPAN Classical and VITA 3D-Master color shade guides. Lightness, red-green tone, and yellow-blue tone values were recorded for each result. The obtained data were processed by using χ2, Student’s t-test and Mann-Whitney test. Results. Results showed no statistically significant gender-related difference in color according to the VITApan Classical and VITA 3D-Master color key. No difference was found in the lightness of the central maxillary incisor between genders, or in terms of red-green tone (p = 0.860573). A statistically significant difference was found when observing the sex-related yellow-blue tone of the color of the central maxillary incisor. Conclusion. The analysis of colorimetric parameters of the International Commission on Illumination L*a*b* system provides useful information about the tooth color in the examined population, while potentially revealing differences in lightness, red-green tone and yellow-blue tone between genders.

SUMMARY Pronounced white color alterations due to structural anomalies of the enamel are often insufficiently masked by bleaching techniques or resin infiltration procedures alone. This frequently leads to the choice of more invasive prosthetic restorations in order to correct tooth color and form. This article describes a minimally invasive treatment option for esthetic and functional rehabilitation in the case of a 13-year-old female patient with suspected severe fluorosis and misalignment of the anterior teeth. The restorations were performed using underlying resin infiltration to homogenize the tooth shade. In a second step, direct composite veneers were applied on top to attain a natural tooth color and adjust tooth alignment and form. By joining the two minimally and noninvasive techniques, this treatment option combines the directive for preservation of hard tooth structure while treating adolescents with the benefits of easy adaptation and repair when the occlusion is still in adjustment.

Background: Resin infiltration and bleaching have been used as minimally invasive methods for the treatment of white spot lesions (WSLs) following orthodontic treatment.Objective: To compare the color uniformity of the tooth with WSL treated with either resin infiltration or bleaching.Material and Methods: WSLs were created in the right middle buccal half of the enamel surface of 40 sound extracted human premolars. The teeth were randomly assigned to 2 groups (n = 20) treated with: (I) resin infiltration, (II) chemically activated office-bleaching. Color parameter of the lesion and the adjacent enamel were measured by spectrophotometer at 3 time points: baseline (T0), after WSL formation (T1), after treatment (T2) and color difference ΔE* was calculated. Each tooth was visually scored for color homogeneity.Results: ΔE* was significantly smaller after treatment in group I compared to group II [mean difference = 5.03 ± 1.11, P

Nowadays 74% of people believe that an imperfect smile has a negative impact on their careers, and 92% believe that it is one that contributes to success in their personal lives. The desire of patients to have an aesthetically perfect smile has always aroused great interest from dentists and has led to the active development of such a trend in aesthetic dentistry, such as teeth whitening. The color of the crowns of teeth and the inherent color characteristics play an important role in the perception of the appearance of the person, the formation of his image and self-esteem. Therefore, they affect the quality of life of a person due to his dental health. There are 5 main treatments for altered teeth: microabrasion, teeth whitening, direct restoration of composites, veneering, restoration of ceramic and metal-ceramic crowns. In recent years, conservative treatments, which include different types of whitening, have been favored to achieve maximum aesthetic results in the correction of altered teeth. For whitening, a considerable number of different remedies are offered that allow the tooth color to change relatively quickly. Nowadays, the world of dental practice is increasingly paying attention to the development of more cost-effective methods that meet the aesthetic needs of patients. The most common procedure for improving the color of the crowns of teeth today is whitening, which does not affect the reduction of the volume of hard tissues of the tooth. Teeth whitening is a restoration of the natural color of the teeth with the application of a chemical agent that oxidizes the organic pigments of the hard tissues of the tooth. Bleaching process is possible due to the ability of the active chemical components ( carbamide peroxide, hydrogen peroxide) to penetrate into enamel and dentin to all parts of the tooth. These substances break down into oxygen radicals, which destroy the colored pigments, the formation of which leads to discoloration of the teeth. The structure of the tooth does not change. Nowadays, home, professional and combined teeth whitening are widely used. The effect of bleaching is analyzed using a scanning electron microscope. Most studies did not report significant changes in the surface morphology of enamel after bleaching with low concentrations of urea peroxide and hydrogen peroxide. Similarly, studies evaluating the effects of higher concentrations of hydrogen peroxide (35%) and carbamidee peroxide (35%) have also reported no significant changes in the morphology of the enamel surface. In general, it is obvious that tooth sensitivity is a common clinical side effect after a teeth whitening procedure. However, the sensitivity is transient and disappears shortly after the bleaching procedure has been stopped.

A change in the color of a depulped tooth is a very common and multifactorial phenomenon according to etiology, which is a frequent reason for going to the dentist, especially if the darkened tooth is in the smile line. The color of teeth, in turn, along with their shape and optical properties, is the most important aesthetic criterion of modern man. The natural color, transparency and brilliance of the teeth in the smile area are important components of dental health, aesthetic and psychological balance and social comfort of a modern person. One way to correct the color of such teeth is intracrown whitening. But many dentists often refuse this method of treatment in favor of making a veneer or a metal-ceramic crown, as this method is often considered unpredictable and dangerous. Objective: to evaluate the effectiveness of intracrown whitening and restoration of the fluorescent properties of the devitalized teeth, depending on the type of sealer used for endodontic treatment and the cause of the depulpation. Materials and research methods. To study the effectiveness of intracoronary bleaching of re teeth, 194 teeth were whitened to 190 patients who applied to the VSMU Clinic and the Department of Therapeutic Dentistry «VSMU» in the period 2014–2018 with complaints of a change in the color of the teeth after endodontic treatment. The average age of patients was 34.6±8.2 years. To assess the causes of tooth discoloration and treatment results, a developed dental patient whitening card was used, according to which information about the cause and duration of tooth depulpation, the type of root sealer and mouth fill, the number of whitening procedures carried out and the result, as well as the original color of the devitalized tooth and final color after bleaching. Before whitening, the possibility of this procedure was evaluated, the absence of contraindications. An x-ray study of the depulped tooth was carried out, the quality of root canal obturation, the absence of periapical changes and signs of root and neck resorption were evaluated. Before the procedure of intracoronal bleaching of the pulpless teeth, mouth fillings were applied to isolate the bleaching agent from the root canal and periodontal tissues. Access to the root canal after our laboratory studies of the micropreadability of materials for the make of wellhead insulating gaskets was closed with self-adhesive self-etching composite cement. The results of the study. By whitening, the restoration of the fluorescent properties to the original characteristics of the vital tooth was achieved in 72 of 194 teeth (37.11%). In 122 teeth (62.89%), after bleaching, it was not possible to obtain a full recovery of the fluorescent light. In 122 teeth (62.89%), the necessary whitening and fluorescence recovery did not occur. Of these, 68 teeth were partially bleached (35.05%), 54 teeth were not bleached (27.84%). In teeth, root canals of which were occluded by materials based on eugenol, 50% of cases were restored to color and fluorescent parameters. During the obturation of the root canals of the pulsed teeth with a siller based on resorcinformalin, the restoration of color and fluorescence did not occur in any of the cases. No dependence was found on the effectiveness of bleaching of the pulpy teeth on the cause of the discolorite. However, the most common cause of a change in the color of a devitalized tooth was complicated caries. Perspectives of research. Further research on the effectiveness of intracoronary bleaching of depulped teeth, as well as the development of methods to improve the aesthetic restoration of tooth color after endodontic treatment, will help improve the quality of dental care in general, as well as in each specific clinical case.

Objective: This study aimed to assess possible differences in results provided by two shade guides and a spectrophotometer used to measure the color changes during tooth bleaching. Methods: Fifty-six patients underwent two sessions of in-office tooth bleaching with a 35% hydrogen peroxide with a week of an interval between them. The color evaluation was performed using shade match with two guide scales (Vita Classical, and Vita Bleach Guide) and a spectrophotometer providing CieLab data. The color was assessed at baseline and 7 days after each session, and 30 days after the last session. Data from scales were arranged in scores according to lightness (lowest to highest) and the color changes were calculated based on baseline data. For CieLab data, ΔL, Δa, Δb, and ΔE were calculated for each assessment time. Differences between the color changes observed in each session were assessed by Wilcoxon test (α = 0.05). Friedman`s test and One-way repeated measures ANOVA were used to analyze color changes among the assessment times. Spearman`s test was used to evaluate the correlation between the shade guide scores and data from Cielab. Results: All methods of color measurement demonstrated any additional effect of second bleaching session on color change, and stable color after 30 days (p < 0.001 for all methods). Both shade guide scales presented low correlation coefficients with ΔL, and moderate coefficients with Δb, Δa, and ΔE. Conclusion: Despite the weak/ moderate correlation among the methods used to measure tooth color, all methods showed similar results of tooth bleaching effectiveness.

SUMMARY Objective: To evaluate, in vitro, the effect of mouth rinse exposure on bleached enamel. Methods: Enamel/dentin bovine blocks (4×4×2 mm) were bleached with 35% hydrogen peroxide (HP) and were submitted to immersion twice daily for 14 days with different rinses (n=10), including those involving: distilled water (C [control]), 225-ppm NaF (FM, Colgate Plax Classic), essential oil (EM, Listerine Tartar Control), 1.5% hydrogen peroxide (HPM, Colgate Plax Whitening), and 2% hydrogen peroxide, pyrophosphates, and 225-ppm NaF (HPM+P, Colgate® Luminous White). The specimens were stored in a remineralizing solution during all experiments. Analyses of color (ΔE, L*, a*, b*) and roughness (Ra) were performed at the baseline, after HP, and after exposure to the rinse. The cross-sectional microhardness (CSMH) and images by scanning electron microscopy (SEM) were assessed at the end. The data were subjected to analysis of variance (ANOVA) (ΔE), repeated measures ANOVA (Ra), and split-plot ANOVA (CSMH), followed by the Tukey test. The L*, a*, and b* values were analyzed by generalized linear models (α=0.05). Results: Color changes were not statistically different in the groups. Ra increased in all groups after bleaching; however, it was reestablished in C, FM, and HPM+F and increased in EM after 14 days of the rinse. EM and HPM reduced the CSMH values differing from C and promoted alterations on the enamel surface visualized by SEM. Conclusion: The mouth rinses did not affect the whitening efficacy or promote benefits on bleached enamel properties. Moreover, the 1.5% hydrogen peroxide– or essential oil–based mouth rinses affected the bleached enamel properties, promoting an alteration in morphologic surface and mineral loss in depth.

Objective To estimate the time required for teeth to dehydrate and rehydrate and its relation to the accuracy of tooth shade selection. Materials and methods Thirty-two participants were recruited, and color measurements were conducted using a spectrophotometer placed with a custom jig. After isolation, baseline measurements were made at 1, 2, 3, 5, 7, 10, and 15 min intervals to determine dehydration time. After mouth rinsing, measurements were made to determine rehydration time. CIEDE2000 values were obtained for color change between the baseline recordings and all intervals and compared to the 50:50% perceptibility and acceptability thresholds. Analysis of variance (anova) and Tukey test was used for multiple comparisons. Result The tooth color changes were beyond the ΔE00 perceptibility threshold (0.8) within the first minute of dehydration (P > 0.0001). After the first minute, 87% of the teeth were beyond the ΔE00 perceptibility threshold (0.8), and 72% of the teeth were beyond the ΔE00 acceptability threshold (1.8). After 15 min of rehydration, 90% of the teeth were beyond the perceptibility threshold, and 65% were beyond the acceptability threshold. Conclusions Shade selection procedures should be carried out within the first minute and before teeth dehydrate by means of isolation. Teeth do not rehydrate within 15 min after rehydration. Clinical significance Teeth dehydration has a negative impact on shade selection, which can affect the final esthetic outcome. Shade selection should be performed at the beginning of any restorative procedure.

The field of dental materials has undergone more of a revolution than an evolution over the past 100 y. The development of new products, especially in the past half century, has occurred at a staggering pace, and their introduction to the market has been equally impressive. The movement has mostly come in the area of improved esthetics, marked by the gradual replacement of dental amalgam with dental composite and all-metal and porcelain-fused-to-metal indirect restorations with reinforced dental ceramics, all made possible by the rapid improvements in dental adhesive materials. This article covers the time course of dental materials development over the past century in which the Journal of Dental Research has been published. While there have been advances in nearly all materials used in the field, this article focuses on several areas, including dental amalgam, dental composites and light curing, dental adhesives and dental cements, ceramics, and new functional repair materials. A few short statements on future advances will be included at the end.

This systematic review assessed the effectiveness of ozone (O3) in the color change of in-office tooth bleaching in vital teeth (TB) and the sensitivity control. Only randomized controlled clinical trials were included. Seven databases were used as primary search sources, and three additional sources were searched to capture the "grey literature" partially. The JBI tool was used to assess the risk of bias. TB was assessed using the ΔELab color change metric comparing tooth color pre- and post-bleaching. We meta-analyzed the ΔELab estimates per method and calculated the absolute standardized mean difference using random-effect models. The GRADE approach assessed the certainty of the evidence. The ΔELab estimates ranged from 1.28 when the O3 was used alone to 6.93 when combined with hydrogen peroxide (HP). Two studies compared O3 and HP alone, but their TB was similar (SMD = − 0.02; 95%CI: − 0.54; 0.49). The bleaching effectiveness for the combination of O3 + HP compared to HP was similar (SMD = 0.38; 95%CI: − 0.04; 0.81). Thus, based on the available literature, our findings suggest that O3 is not superior to the conventional technique using HP on the change of tooth color. The O3 did not present sensitivity when used alone. When O3 was used in combination with HP, patients reported hypersensitivity only when O3 was applied before HP, i.e., no sensitivity was perceived when O3 was applied after HP.

Background Non-vital tooth discoloration is a common condition in dental practice. The aim of this in vitro study was to evaluate the efficacy of intracoronal bleaching treatments of non-vital teeth either activated or not by Er,Cr:YSGG laser (2780 nm) operating at 1.25 or 2.5 W. Methods Twenty four human canines were artificially stained after implementation of root canal treatment. Subsequently, the teeth were randomly divided into three groups (n = 8): Group 1 (control) received intracoronal bleaching treatment with a bleaching gel containing 35 % hydrogen peroxide for 40 min, Group 2 received the same treatment assisted with Er,Cr:YSGG laser (2780 nm) operating at 1.25 W average power for 30 s and Group 3 received the same treatment with Group 2, but the average power was adjusted to 2.5 W. The bleaching treatments repeated after one week. Spectrophotometric analysis of tooth color change (ΔE) was implemented 7 days after both bleaching sessions. Results The results of two-way ANOVA revealed that there was a tendency of no significant difference in color change between the three experimental groups (p = 0.063). However, the between-group comparisons showed that laser 2.5 W group had significantly higher ΔE than the control group after the first bleaching session. Moreover, a significant interaction between bleaching treatment and number of applications was detected (p = 0.026). Conclusions Er,Cr:YSGG laser irradiation significantly increased ΔE only after the first bleaching session when operating at 2.5 W. After the second bleaching session ΔE was not different compared to the control group, irrespectively of the laser power settings.

Tooth discoloration due to intra coronal bleeding after trauma can cause aesthetic disturbances andappearance. Internal bleaching is a non-invasive method to restore tooth color which is performed afterendodontic treatment by placing a strong oxidizing agent in the pulp chamber. Aim of this study was toreport the success of internal bleaching procedure to restore discolored teeth due to trauma. A 44-year-oldfemale came to Conservative Dentistry Universitas Airlangga with chief complaint of the upper right insisortooth looks darker than the adjacent teeth. The patient had fallen 10 years ago from her motorcycle and hertooth had been painful and then the pain disappeared. In intra oral clinical examination, it showed that tooth11 had discoloured, vitality test of tooth 11 showed no response to electric pulp test. Radiographic viewshowed that radiolucen in periapical area and no fracture was found. At the first visit, treatment of singlevisit root canal using rotary instrument and gave dressing calcium hydroxide. A week later on the secondvisit, internal bleaching with hydrogen peroxide 35% was done. After bleaching, calcium hydroxide wasapplied to neutralize the oxidizing agent and then re-evaluated for the color. At the third visit, it showed thatthe tooth colour was obtain as desire from C3 to A3 (Vitapan Classical). The internal bleaching procedureon the traumatized tooth was the best option to restore the function and aesthetics according to the originaltooth colour and also provided benefits in terms of saving time, lower price, and maximum results.

Objective. The aim of this clinical study was to evaluate the effectiveness of a whitening toothpaste containing 3% carbamide peroxide and lactoperoxidase. Materials and methods. Participants were instructed to brush their teeth using an enzymatic-activated dentifrice following a particular procedure for three weeks. Color was recorded before and after treatment using a VITA Easyshade spectrophotometer. Differences in L ∗ (tooth color lightness), a ∗ (displacement along the red-green axis), and b ∗ (displacement along the yellow-blue axis) were measured before and after treatment using the paired t and the Wilcoxon signed-rank tests. Color changes (ΔE) were calculated using the obtained measurements. Results. Thirty-four volunteers were included. ΔE was 4.03. For the set of 348 teeth, a greater tendency towards green (lower a ∗ ) and blue (lower b ∗ ) was observed ( p ∗ ) and blue (lower b ∗ ). Bleaching effectiveness was observed in both the upper and lower central incisors and in the lateral mandibular incisors. Conclusion. Based on these results, it may be concluded that brushing with an enzymatic-activated dentifrice is effective for whitening teeth.

Objective. Dental esthetic procedures are popular worldwide, and dentists are responsible for recommending several treatment options to their patients. To do this competently, dentists must have an educated opinion of their features. Therefore, we aimed to evaluate the self-perception of dental esthetics among male and female dental students and assess its effect on their desired treatment. Methodology. We conducted a questionnaire-based cross-sectional study involving 450 male and female dental students from five academic years with different grade point averages (GPAs) and monthly household incomes. The questionnaire comprised four sections. The subjects selected their teeth-color preferences using a commercial shade guide. The outcomes were presented using descriptive statistics and were compared with Pearson’s chi-square test. The level of statistical significance was set at a p -value of 0.05. Results. Female students (52%) showed a significantly higher preference for changing their tooth color (shade B1 was desired most often), whereas male students reported a higher need for orthodontic treatment and ceramic veneers ( p < 0.0001 and p = 0.002 ). Fifth-year students were more satisfied with their teeth color as compared with 1st-year students ( p = 0.047 ). High-GPA students showed significantly lower confidence regarding their smiles ( p = 0.030 ). A high percentage of students (39.1%) with household incomes of less than 10,000 SR preferred tooth-colored restorations. Conclusion. We concluded that the majority of dental students were confident about their smiles. Senior students were more satisfied with their teeth color, while younger students desired whiter teeth. Bleaching and orthodontics were the most desired treatment options.

Introduction Obtaining the result expected during tooth bleaching requires a correct diagnosis of the type of staining presented. The causes of tooth staining differ depending on the etiological factor. Objective To assess the color change caused by the immersion of bovine teeth in coffee solution during at-home tooth bleaching using a 16% carbamide peroxide gel. Material and method Thirty-three sound bovine teeth were assigned to three groups of eleven teeth each: 1 – Teeth bleached (TB) four hours per day for 21 days; 2 – TB four hours per day for 21 days and immersed in coffee solution immediately after tooth bleaching; 3 – TB four hours per day for 21 days and immersed in coffee solution four hours after the end of tooth bleaching. Immersed in coffee was performed for 15 minutes and tooth color was assessed before the start of the bleaching procedure and after 21 days with an intraoral spectrophotometer. Test Shapiro-Wilk was used to assess homoscedasticity and data were submitted to one-factor Analysis of Variance (ANOVA) and Tukey’s test (p

OBJECTIVE: To evaluate whether a blue covarine containing silica-based toothpaste promotes a whitening effect immediately after tooth brushing.METHODS: A triple-blind, parallel group, randomized design was used to compare the tooth color before and after brushing. Two silica-based toothpastes were chosen, one of them containing blue covarine (BCT) and the other one without pigment to serve as control (CT). Tooth color was measured using a spectrophotometer and expressed as CIEDE 2000 ΔE, CIELAB values, WIO index, WID index and VITA scale tooth shade. In addition, the participants' satisfaction with and perception of their own tooth color were registered using an aesthetic numeric analogue scale.RESULTS: No significant changes in color components or dimensions measured using CIEDE 2000 ΔE (CT: mean = 1.3, 95% CI 0.8, 1.7; BCT: mean = 1.6, 95% CI 1.2, 2.1), WIO, WID, VITA scale or CIELAB values were detected for the CT and BCT groups, comparing the results before and after brushing. Likewise, the participants' satisfaction with the treatment results (P = 0.31) and the participants' evaluation of tooth color (P = 0.71) did not differ significantly between groups.CONCLUSION: After a single application, no significant improvement in tooth whiteness by the presence of blue covarine in a silica-based toothpaste was detected in color dimensions or by assessing the participants' satisfaction and perception.CLINICAL SIGNIFICANCE: The present study does not show a clinically relevant increase in tooth whiteness after a single brushing with a blue covarine containing toothpaste, nor could the study participants observe a difference between treatment with blue covarine containing toothpaste and control treatment.

Background The aim of the study was to compare a 2D and 3D color system concerning a variety of statistical and graphical methods to assess validity and reliability of color measurements, and to give some guidance when to use which system and how to interpret color distance measures, including ΔE and d(0M1).Methods The tooth color of teeth 14 to 24 of 35 patients with a regular bleaching treatment (BT) was visually assessed and electronically measured with the spectrophotometer Shade Inspector™. Tooth color was recorded before BT (T1/T2- Baseline), 14d (T3/T4) and 6 months (T5/T6) after BT. VITAPAN® Classical (VC) and VITA-3D-Master® (3D) served as reference systems.Results Intra-rater variability. The 2D system is better than the 3D system both visually and electronically in terms of ΔE and d(0M1) for statistics of agreement and reliability. All four methods show strong patterns of disagreement between repeated measurements in Bland-Altman plots. The 3D system lacks reliability of hue compared with that of lightness and chroma, which is more pronounced visually than electronically. The smallest detectable color difference (SDCD) differs by the four methods used and is most favorable in the electronical 2D system. Inter-rater variability. The agreement between the 2D and 3D system in terms of ΔE is not good according to Byrt’s classification. It is lower within the electronical method than within the visual method. Comparability of the 2D and 3D system is uncertain because confidence intervals of ICCs accounting for systematic error are wide. The systematic error between the 2D and 3D system cannot be neglected. The reliability of the visual and electronical method is substantially the same within the 2D and 3D system; this comparability is fair to good.Clinical Relevance: According to the results of this study, the 3D system may confuse human raters and even electronical devices. The 2D system is the natural and best choice.

Objective To evaluate effects of dehydration on tooth color determine whether color returns to baseline after 30 min or 24 h. Materials and methods Thirty participants with intact maxillary central and lateral incisors were recruited for the study. Color measurements were performed with a spectrophotometer (SpectroShade Micro) at baseline and at 10, 20, and 30 min of dehydration, as well as 30 min and 24 h of rehydration. CIEDE2000 color parameters were used to calculate color difference. The data were analyzed for color changes over time by repeated-measures analysis of variance (ANOVA), and the Bonferroni-Tukey test was used for post-ANOVA comparisons (P Results After 30 min of dehydration, all the tested teeth were above the perceptibility threshold (ΔE00 = 0.8), and 85% of the teeth were above the acceptability threshold (ΔE00 = 1.8). After 30 min of rehydration, 78.3% of the tested teeth were above the perceptibility threshold, and 31.6% of the teeth were above the acceptability threshold. After 24 h of rehydration, 99.2% of the teeth were below the acceptability threshold, and 90% of the values were below the perceptibility threshold. Conclusions Thirty-minute tooth dehydration can result in a clinically significant color change. After a 24-h rehydration period, reliable color assessment can be performed. Clinical significance Tooth dehydration causes significant color change, thus assessment of final color or clinical success should be considered after tooth rehydration for esthetic restorations and tooth bleaching.

SUMMARY Objective: The aim of this systematic review and meta-analysis was to evaluate a high concentration of hydrogen peroxide (35%) regarding tooth sensitivity and color change in tooth bleaching in comparison to low concentrations (6% to 20%). Methods and Materials: This review was conducted using the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and is registered on the Prospective Register of Systematic Reviews (CRD42017064493). The PICO question was “Does a concentration of hydrogen peroxide ≥35% using in-office bleaching procedure contribute to greater tooth sensitivity?” A search was made in PubMed/MEDLINE, Scopus, and the Cochrane Library. Results: Fourteen studies were selected for the qualitative analysis and seven for quantitative analysis. A total of 649 patients were evaluated (mean age: 36.32 years; range: 13.9 to 31 years), and the follow-up period ranged from one week to 12 months. The meta-analysis demonstrated that tooth sensitivity was higher in the patients submitted to treatment involving a high concentration of hydrogen peroxide (0.67; 95% confidence interval [CI]: 0.44 to 1.03; p=0.04; I2: 56%), and a significant difference was found regarding objective color ΔE (1.53; 95% CI: 2.99 to 0.08; p Conclusions: This study indicated that a lower concentration of hydrogen peroxide causes less tooth sensitivity and better effectiveness in objective color change (ΔE); however, there is no difference between them related to subjective color (ΔSGU).

The aim of this observational study was to analyze the effect of a toothpaste with biomimetic zinc hydroxyapatite (HAP) on subjective parameters after a four-week home use. Patients with subjective dentin hypersensitivity were recruited at three dental practices in Germany and received a questionnaire with visual analogue scales and Likert scales both at baseline and follow-up. The questionnaire was specifically developed for this study and focused on questions about subjective parameters like dentin hypersensitivity, tooth surface texture, tooth color, and freshness after toothbrushing. Patients answered the questionnaire both at baseline and after a four-week home use (follow-up) of the HAP toothpaste. Data of 46 patients were analyzed by paired t-test and non-parametric Wilcoxon signed-rank test, respectively. Subjective parameters on dentin hypersensitivity were reduced after the four-week use of the HAP toothpaste (p &lt, 0.001). Additionally, patients assessed their tooth surface as smoother (p &lt, 0.001), tooth color as whiter (p = 0.003), and reported a stronger feeling of freshness after toothbrushing (p = 0.014) after four-week use of the HAP toothpaste compared to the previously used toothpaste. In conclusion, the tested toothpaste with biomimetic HAP is well-suited for individuals suffering from dentin hypersensitivity, because subjective symptoms on dentin hypersensitivity were reduced. Additionally, patients reported smoother and whiter teeth after using the HAP toothpaste.

The assessment of tooth color is typically performed by subjective comparison with a visual shade guide or by using objective optical techniques such as quantitative light-induced fluorescence (QLF). QLF measurements rely on the precise wavelength calibration of fluorescence excitation and emission for enhancing the contrast between the white sound tooth and stained areas. These areas may change the fluorescence emission differently depending on the color that is most absorbed by the stain on the tooth surface. Although previous studies have monitored the staining contrast generated by the consumption of beverages on teeth, the information provided is based on total intensity. However, this intensity varies from each QLF device configuration and comparison across studies may not be possible. Few studies report the wavelength-dependent characterization of the staining process, which allow the comparison on the light attenuation on specific wavelengths and can be used to design fluorescence equipment with improved contrast for the tooth color assessment. In this study, we quantified the fluorescence spectral features (fluorescence intensity, wavelength shift of the maximum intensity, full width at half maximum, and wavelength-dependent intensity attenuation) of teeth in several degrees of coffee pigmentation by using 445 nm excitation. Most of the pigmentation effect was observed on the fluorescence intensity and a linear behavior was observed for the full width at half maximum (around 11.8% increase for each pigmentation level). We characterized the fluorescence properties of each degree of pigmentation level. Both spectral features and fluorescence properties can be used to design novel fluorescence equipment capable of increasing the contrast between white and stained teeth.

Objective In patients with color vision alterations (CVA), the correct determination of color is altered, but not the detection of changes in luminosity or value. There is no accepted training protocol for dental value selection in dental students with CVA. The objective of this pilot study was to determine the effectiveness of a dental color training protocol based on the dental value selection. Materials and methods An intervention study was carried out on dental students in a University setting, applying a specific dental color training protocol on two groups of students. Group 1:4 students with CVA, Group 2:4 healthy students. A third group of four students without intervention was used as a control group. An initial diagnostic test was applied, which was reapplied at the end of the training. Results The number of errors in the selection of the dental color decreased after training in all three groups, P > .05. For the value parameter, there was a statistically significant decrease in the number of errors after training (P = .014). Conclusions The applied training protocol could be of help in students with CVA, but multicenter studies are needed. Clinical significance Level 3 evidence level.

Amac: Bu in vitro calismanin amaci; farkli konsantras - yonlara sahip kitosan tasiyici icerikli beyazlatma ajanlarinin beyazlatma etkinliklerinin incelenmesidir. Gerec ve Yontem: Calismada kullanilan cekilmis 30 adet A3 ve daha yukari renge sahip anterior disi rastgele 3 gruba ayrildi. Grup 1; karbopol icerikli ticari bir urun Whiteness Super Endo, Grup 2; Kitosan tasi - yici icerikli %37 karbamid peroksit, Grup 3; Kitosan tasiyici icerikli %16 karbamid peroksit. Kok kanal per e pasyonlari yapildiktan sonra dolduruldu. Mine semet sinirdan 2 mm asagida olacak sekilde gutta perka kesildi. Yaklasik 2 mm kalinlikta cam iyonomer siman yerlestirildi. Beyazlatma ajani 3-4 gun arayla 3 kez tekrarlandi. Spektrofotometre cihazi ile beyazlatma etkinlikleri olculdu. Gruplarin karsilastirilmasinda tek yonlu varyans analizi ve Tukey HSD testleri, kullanildi ( α =0.05). Bulgular: Spektrofotometre analizi sonuclarina gore beyazlatma etkinlikleri acisindan butun gruplar arasin - da anlamli bir farklilik gozlenmedi. Farkli konsantras - yonu denenen Kitosan icerikli beyazlatma ajanlarinin beyazlatma etkinlikleri benzer bulundu. (p>0.05) Sonuc: Bu in vitro test kosullari altinda kitosan, beyazlatma ajanin icerisinde alternatif bir tasiyici olarak kullanilabilir. Anahtar Kelimeler: Dis beyazlatma, kitosan, karbamid peroksit EFFECT OF BLEACHING AGENT INCORPORATED CHITOSAN ON TOOTH COLOR CHANGE ABSTRACT Aim : The aim of this in vitro study was to compare the bleaching efficacy of different concentrations of bleaching agents containing chitosan delivery system. Materials and Methods : Thirty extracted maxillary incisors tooth which colour with A3 or over, randomly divided into 3 test groups; Group 1 was carpobol with Whiteness Super Endo (%37 carbamid perxoide) Group 2 was chitosan with %37 carbamid peroxide, Group 3 was chitosan with %16 carbamid peroxide. After finishing canal preparation and root canal filling, the root fillings were removed to a level 2 mm apical to the cementoenamel junction. Glass ionomer base was placed approximately 2-mm thick. Bleaching agents was placed into the rest of the cavity for 3-4 days at 3 times. Bleaching efficiency was measured a spectrophotometer. Groups were compared by using one way analysis of variance (ANOVA) and Tukey’s HSD post hoc tests ( a =0.05). Results : According to the spectrophotometer analysis, statistically no significant color changes were found in all groups. Bleachings agents containing chitosan were similar whitening effeciency.(p>0.05). Conclusion: According to the results of this in vitro study it can be concluded that chitosan, bleaching, can be used as an alternative carrier. Keywords: Teeth bleaching, chitosan, carbamid peroxide

Tooth color and the correlation of the compostion of dental enamel with color were investigated in samples of teeth from two medieval Serb cemeteries. Differences in the composition of apatite crystals in the dental enamel of the two samples were found. Color ranges of teeth from the two samples differ in hues and chromas. This result suggests that enamel composition may have an influence on the color of teeth. The prevalence of chlorapatite in enamel causes tooth color to be closer to red and of higher chroma than teeth whose enamel consists of hydroxylapatite. No evidenc indicated that soil ingredients were incorporated into the dental enamel of either sample.

Made available in DSpace on 2018-12-11T16:55:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01 Purpose: Intracoronary bleaching is a minimally invasive, alternative treatment that addresses aesthetic concerns related to non-vital teeth discoloration. However, to the best of our knowledge, no studies have assessed the psychosocial impacts of such procedures on patients’ aesthetic perceptions. The aim of this study was to evaluate aesthetic perceptions and the psychosocial impact of patients up to 3 months after their teeth had been bleached with hydrogen peroxide (35%) and carbamide peroxide (37%) using the walking bleach technique. Methods: The patients were randomly divided into two groups according to the bleaching agent used: G1 = hydrogen peroxide 35% (n = 25) and G2 = carbamide peroxide 37% (n = 25). Non-vital bleaching was performed in four sessions. Color was objectively (ΔE) and subjectively (ΔSGU) evaluated. Aesthetic perception and psychosocial factors were evaluated before, 1 week and 1 month after the bleaching using the Oral Health Impact Profile (OHIP) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) questionnaires. Results: The color change (ΔE) values at 1 month were G1 = 16.80 ± 6.07 and G2 = 14.09 ± 4.83. These values remained stable until the third month after treatment (p > 0.05). There was a decrease in the values of OHIP-aesthetics and PIDAQ after treatment versus baseline (p < 0.05). This status was maintained through the third month after treatment. Conclusions: Both agents were highly effective and had a positive impact on the aesthetic perception and psychosocial impact of patients, values that also remained stable over time. Non-vital bleaching yields positive and stable impacts on aesthetic perception and psychosocial factors. ClinicalTrials.gov identifier NCT02718183. Department of Restorative Dentistry Faculty of Dentistry University of Chile Department of Restorative Dentistry School of Dentistry University Estadual Paulista-UNESP Departament of Conservative Dentistry Faculty of Dentistry University of Chile BioMAT’X Centro de Investigación Biomédica Facultad de Medicina Universidad de los Andes, Av. Mons. Álvaro del Portillo Faculty of Dentistry Universidad Los Andes, Av. Mons. Álvaro del Portillo Instituto de Ciencias Biomédicas Universidad Autónoma de Chile, Av. Pedro de Valdivia 425 Department of Restorative Dentistry School of Dentistry University Estadual Paulista-UNESP