Indiana University-Purdue University Indianapolis (IUPUI) / In this thesis, we proposed and investigated the efficacy and safety of dental bleaching as
a non-invasive aesthetic treatment option for stained arrested caries lesions (s-ACLs).
Chapter 1 reports the suitability of this approach in extracted human teeth, as well as in a
selected clinical case. Visual improvement in the color lighteness of the s-ACLs was
observed and reported in photographs. In order to systematically study the impact of
dental bleaching on the s-ACLs, we developed in vitro models simulating the
development of metallic and non-metallic s-ACLs (Chapter 2). Human dental specimens
were submitted to incipient caries-like lesion formation, followed by a 5-day cycling
protocol based on remineralization and staining episodes. The created lesions were then
bleached (simulating in-office/40% hydrogen peroxide). Color change was measured
spectrophotometrically at baseline, after lesion creation, staining/remineralization cycling
and bleaching; while mineral loss and lesion depth were quantified by transversal
microradiography after staining/remineralization cycling. Metallic s-ACLs were darker,
more remineralized and more difficult to bleach, compared to the non-metallic ones
(p<0.05). In Chapter 3, we tested the efficacy and safety of different dental bleaching
systems (simulating at-home/15% carbamide peroxide and in-office/40% hydrogen
peroxide) using the in vitro models previously developed. Similar methods and outcomes
were used, with the addition of demineralization after bleaching to simulate and test
changes in caries susceptibility. At-home bleaching showed greater efficacy in color improvement compared to in-office (p<0.05), but also increased susceptibility to further
demineralization (p<0.05), regardless of the type of stain. Overall, bleached non-metallic
s-ACLs were more susceptible to demineralization compared to metallic ones (p<0.05).
Within the limited laboratory testing conditions, we concluded that dental bleaching can
improve the aesthetics of s-ACLs, with efficacy being dependent on the nature of the
stain. At-home bleaching presented greater efficacy, but also raised some potential safety
concerns, which should be further investigated in clinical conditions. In-office bleaching
protocol showed to be an effective and safe procedure for the aesthetic treatment of
stained arrested caries lesions.
| Identifer | oai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/12508 |
| Date | January 2017 |
| Creators | Alangari, Sarah Sultan A. |
| Contributors | Hara, Anderson T., Lippert, Frank, Platt, Jeffrey A., González-Cabezas, Carlos, Li, Yiming |
| Source Sets | Indiana University-Purdue University Indianapolis |
| Language | en_US |
| Detected Language | English |
| Type | Dissertation |
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