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Tooth discoloration- Extrinsic and intrinsic factors
... The causes for tooth discoloration can be classified according to the location of the stains, either as extrinsic or (2,3,4) intrinsic . Extrinsic discoloration lies on the tooth surface or in the acquired pellicle. ...
... Occupation and environmental factors: Industrial exposure to iron, manganese, and silver may stain the teeth black. Mercury and lead dust can cause a blue-green stain; copper and nickel, green-to-blue-green stain and chromic acid (4) fumes may cause deep orange stain . There is a positive correlation between dental extrinsic stains and the concentration of trace elements, especially iron in the (27) water sources (Figure 3). ...
Discoloration of the tooth can erode the sparkle from a smile. In the management of patients with discolored tooth, knowledge of the mechanisms behind tooth discoloration is of relevance as it can influence the treatment plan. In certain instances it may even have an effect on the outcome of the treatment. A grasp of the pathological process involved in tooth staining will also allow the dental practitioner to explain to the patient the exact nature of the condition. An overview of the etiology and the clinical appearance of tooth discoloration are discussed in this review.
... Diğer bazı metaller, örneğin permanganat; ağız gargaralarında kullanıldığında menekşe ve siyah renklenme oluşturabilirler. Diş hekimliğinde kullanılan gümüş nitrat tuzu dişlerde gri renklenmeye, (Dayan D, Heifferman A, Gorski M, & Begleiter A. ,1983) stanöz florür ise sarımsı kahverengi renklenmeye neden olur [60]. Demir ve potasyum permanganat ilaçlarının bırakılması halinde renklenme ortadan kalkar. ...
... Fizyolojik atrizyonla görünümün düzelebileceği belirtilmiştir. Hafif fluorozisli ve minor lezyonları bulunan dişlerde mikroabrazyon ve eksternal beyazlatma uygulamalarından sonra CPP-ACP uygulamasının, minede remineralizasyonu sağlayarak hassasiyeti giderebileceği ve estetik görünümü destekleyebileceği belirtilmiştir (Dayan D, Heifferman A, Gorski M, & Begleiter A., 1983), (Waerhag M, Gjermo P, Rolla G, & Johansen J R.,1984). Orta derece fluorozisli dişlerde mikroabrazyon tekniği ve kompozit restorasyonların uygulanabileceği belirtilmiştir. ...
Günümüzde görsel ve estetik önemin artması, ayrıca sosyal medya etkisinin ortaya çıkması ile birlikte diş beyazlatma işlemleri hastaların en çok ilgi duydukları dental estetik tedavilerden biri haline gelmiş ve son on yılda hastaların diş beyazlatma tedavisine olan talepleri ciddi bir artış göstermiştir. Bunun yanı sıra dişlerdeki renklenmeler estetik kaygıyla birlikte psikolojik ve sosyal problemlere de neden olabilmektedir. Daha beyaz dişlere sahip olmanın hastalar için öneminin artması, yıllar içinde beyazlatma ajanları ve prosedürlerinin sayısında inanılmaz bir artışa neden olmuştur. Bu ajanlar, diş macunları, gargaralar, jeller, bantlar, beyazlatıcı ajan içeren fırçalar ve cigletler gibi diş hekimi danışmanlığı olmaksızın kullanılan ev tipi ürünler olabildiği gibi profesyonel olarak diş hekimi tarafından klinikte uygulanan yüksek konsantrasyonlu ofis tipi beyazlatma ajanlarıdır. Beyazlatma tedavisinin seçimi, diş renklenmesinin tipine, lokasyonuna ve yoğunluğuna göre değişiklik göstermektedir. Diş hekimleri, beyazlatma tedavisi arayışında olan hastaları, günümüzde popülaritesi oldukça artış gösteren bu ürünler hakkında doğru bir şekilde bilgilendirmeli, oral ve sistemik sağlık sınırları içinde en yüksek beyazlatmayı sağlayabilmelidirler. Diş renklenmeleri genel olarak iç kaynaklı ve dış kaynaklı renklenmeler olarak sınıflara ayrılabilir. Renklenmenin nedenini bilmek diş hekiminin beyazlatma tekniğini planlamasına ve tedavinin sonuçlarını tahmin etmesine yardımcı olur. Böylece bu derlemenin amacı, diş renklenmelerinin nedenlerini değerlendirerek, güncel tedavi seçenekleri için uygulanan materyal ve yöntemlerin kısa bir tasvirini sağlamaktır.
... It has been observed that the absorption of cations from precipitated anionic dietary chromogens is the likely cause of tooth staining. In a study conducted by Dayan et al., it was observed that industrial exposure to certain trace elements such as iron, manganese, silver can result in black coloured tooth, with mercury and lead resulting in blue-green tooth discoloration [10] . Genetic factors have also been observed to be causative factor in tooth discoloration, such genetic conditions include Vitamin D dependent rickets, Epidermolysis bullosa etc [10] . ...
... In a study conducted by Dayan et al., it was observed that industrial exposure to certain trace elements such as iron, manganese, silver can result in black coloured tooth, with mercury and lead resulting in blue-green tooth discoloration [10] . Genetic factors have also been observed to be causative factor in tooth discoloration, such genetic conditions include Vitamin D dependent rickets, Epidermolysis bullosa etc [10] . Despite the alarming level of etiological factors certain management techniques haven been developed which are dependent on the causative factor of tooth discoloration. ...
Objective: The study aim was to evaluate the distribution of discoloured central incisors among students of Delta State University, Abraka. Materials and Methods: This study employed a cross-sectional study design and multistage sampling was used to sample 384 students (138 males and 146 females). Prior to the collection of data, ethical approval was obtained from Delta State University, Research and Ethics Committee of Human Anatomy Department. Data were obtained via self-administered questionnaires. Chi-square test of association was used to assess categorical variable and probability was ascribed at value < 0.05. Results: Findings observed from the study was that 56 (14.6%) of the entire sample had discolouration of the central incisors tooth. Results showed females (61.0%) having a higher distribution of discoloured central incisors compared with male (39.0%) but no significant (p>0.05) gender association was observed. Findings showed that frequency of brushing has a significant association (p<0.05) with discoloration of central incisors. The findings also revealed no significant association (p>0.05) between certain variables (occurrences of plagues, dental caries, root canal therapy, scaling and polishing, bad breath, taking of tea, coffee and iron containing solutions) and discoloration of central incisors. Conclusion: Distribution of discoloured central incisors among the studied sample was 14.6% and there was no considerable gender association as regards discolouration of central incisors. Regularity of tooth brushing has a significant association with the occurrences of discoloured central incisors.
... In fact, the positive psychologic effects of improving a patient's smile often contribute to an improved self-image, enhanced self-esteem and available. The treatment includes removal of surface stains, bleaching, microabrasion or macroabrasion, veneering and placement of porcelain or porcelain fused [9][10][11] to metal crowns. ...
... An attractive smile plays a major role in the overall 2 perception of physical attractiveness. The discoloration originating from within the pulp chamber itself, can be either due to necrotic pulp tissues, hemorrhagic products or the endodontic materials placed in the chamber as a 10,12 part of the dental treatment. ...
... Copper causes a green stain in mouthrinses containing copper salts 49 and in workers in contact with the metal in industrial circumstances. 50 A number of other metals have associated colours such as potassium permangenate producing a violet to black colour 1 when used in mouthrinses; silver nitrate salt used in dentistry causes a grey colour, 50 and stannous fluoride causes a golden brown discolouration. 51 It was previously thought that the mechanism of stain production was related to the production of the sulphide salt of the particular metal involved. ...
... Copper causes a green stain in mouthrinses containing copper salts 49 and in workers in contact with the metal in industrial circumstances. 50 A number of other metals have associated colours such as potassium permangenate producing a violet to black colour 1 when used in mouthrinses; silver nitrate salt used in dentistry causes a grey colour, 50 and stannous fluoride causes a golden brown discolouration. 51 It was previously thought that the mechanism of stain production was related to the production of the sulphide salt of the particular metal involved. ...
To carry out an extensive review of the literature on tooth staining with particular regard to some of the more recent literature on the mechanisms of tooth staining involving mouthrinses.
Comprehensive review of the literature over four decades.
A knowledge of the aetiology of tooth staining is of importance to dental surgeons in order to enable a correct diagnosis to be made when examining a discoloured dentition and allows the dental practitioner to explain to the patient the exact nature of the condition. In some instances, the mechanism of staining may have an effect on the outcome of treatment and influence the treatment options the dentist will be able to offer to patients.
... 1 Many researchers classify discolorations as either extrinsic or intrinsic. [2][3][4] Extrinsic staining has been defined as being removable with a casual prophylactic cleaning procedure. 2 In contrast, intrinsic staining has been regarded as incorporated into the tooth matrix and can only be removed with bleaching. ...
... [2][3][4] Extrinsic staining has been defined as being removable with a casual prophylactic cleaning procedure. 2 In contrast, intrinsic staining has been regarded as incorporated into the tooth matrix and can only be removed with bleaching. Some discolorations are a combination of both types of stain. ...
The purpose of this clinical trial was to evaluate the efficacy of 2 over-the-counter whitening systems: a liquid whitening gel (5.9% hydrogen peroxide, twice a day for 15 minutes), and a sodium chlorite-based whitening gel applied in a tray system (10 minutes twice a day).
Sixty volunteers (minimum shade A3 on 1 maxillary tooth) were selected to participate in this single-blind (examiner-blinded), single-center, 2-group trial. The subjects were randomly divided into 2 groups (n = 30 each) and instructed to bleach their teeth for 2 weeks. Efficacy was measured using the Vita Classical shade guide and a spectrophotometer at baseline, as well as after 2 weeks and 6 months.
For the subjectively measured tooth shades, improvement for maxillary canines was 2.03 +/- 3.67 tooth shades in group 1 and 1.08 +/- 2.19 tooth shades in group 2 after 2 weeks; the maxillary incisors revealed a tooth shade improvement of 0.83 +/- 1.71 tabs in group 1 and 0.73 +/- 2.22 tabs in group 2 (P < .05, except maxillary incisors in group 2; t test). Objectively measured tooth shade scores revealed a change of 0 +/- 0.25 tooth shade tabs (P > .05).
The bleaching gel containing hydrogen peroxide achieved a slight improvement, and the sodium chlorite-based bleaching gel achieved only a small tooth color improvement. Moreover, subjectively and objectively measured tooth shades revealed considerably different results in the clinical situation.
... Màu sắc của một răng tự nhiên được xác định trước tiên bởi ngà răng và bị thay đổi bởi các yếu tố độ dày, độ trong mờ và màu sắc của men bao phủ xung quanh thân răng [1]. Màu sắc răng có thể bị thay đổi do sự hấp phụ các chất màu lên bề mặt men răng từ các loại thực phẩm hằng ngày, hiện tượng này gọi là nhiễm màu ngoại sinh [2]. ...
Background: Tooth bleaching is an effective method to remove both endogenous and exogenous stains. This study aims to evaluate and compare the bleaching efficacy of tea, coffee and cola stains on teeth. Materials and Methods: 30 bovine tooth samples were divided into three groups: tea, coffee and cola (n = 10/group). Staining was obtained by soaking the tooth samples for 3 weeks in each drinks. Before bleaching, tooth samples were polished with fine pumice powder and slow-speed handpiece for 10 seconds, speed of 2500 rpm. The bleaching process was performed with 10% carbamide peroxide for 14 days, 8 hours/day. The effectiveness of the bleaching process is evaluated through the change in the brightness (L*), saturation (a*, b*) values and the total color change (DE*) of the CIELAB system with Crystaleye spectrocolorimeter. Results: After bleaching process, all three stained groups showed the color changes in the following direction: increase L*, decrease a*, decrease b*. The polishing phase could remove part of the staining and the whitening phase achieved the fastest bleaching effect after 1 week. The tea group achieved a greater color change than the cola group during all phases and greater than the coffee group at the polishing phase (p<0.05). Conclusions: The polishing phase is effective in removing the exogenous stains on teeth due to beverage consumption. The bleaching efficacy between the teeth stained with tea, coffee and cola is different, in which the teeth stained with tea have a higher whitening effect. Key words: tea, coffee, cola, extrinsic stain, bleaching
... Eriksen and Norbodo also confirmed that black staining was found in patients with good oral hygiene and can be retentive particularly around cervical margins of the teeth [18]. Dayan et al., also reported that presence of black stains were associated with lower plaque scores and poor oral hygiene may result in green, brown-black and orange staining [19]. ...
Background: Occurance of black discolouration of teeth is very common and a clinical challenge in the present day dentistry. Stains associated with chromogenic bacteria have a high rate of recurrence even after thorough scaling and polishing procedures. The mechanism of stain formation is still not understood clearly though its chemical composition is mainly iron suiphide and bacteria like actinomyces have been identified in plaque samples of these patients which have the ability to form iron sulphides. The iron content of saliva is known to increase in iron deficiency anemia and iron overload. Iron deficiency anemia is also associated with low hemglobin levels. Aim: To determine the hemoglobins levels in patients with and without black chromogenic stains. Methodology: A total of 40 patients of age group 15-40 years were selected and divided in to two groups. Group ‘A’ (Test group) consisted of 20 patients with black stains on atleast 8 tooth. Group “B” (Control group) consisted of 20 patients without any stains on the tooth surfaces. The individuals were screened for Lobenes stain index, Oral hygiene index and haemoglobin levels. The scores were analysed using chi –square tests. Results: It was observed that there was no significant difference between the haemoglobin levels of patients with and without stains. The oral hygiene scores were found to be significantly higher in subjects with stains compared to controls. Conclusion: The study suggests that the presence of stains were not associated with the reduced haemoglobin levels. The chromogenic black stains were more prevalent among subjects with good oral hygiene.
... Dişlerdeki renklenmelerin bazıları tek bir nedene bağlı olarak meydana gelmekle birlikte, bazen bir dişte farklı nedenlerle oluşmuş birden fazla renklenme de gözlemlenebilmektedir. 5 Eksternal renklenme, dış kromojenler diş yüzeyinde veya pelikıl tabakasında biriktiğinde ortaya çıkar. İnternal renklenme, kromojenler diş kütlesi içerisinde, genellikle dentin içinde ve sıklıkla sistemik veya pulpal kökenli olduğunda meydana gelir. ...
Dişlerdeki renk değişimleri, lokalizasyona (eksternal ve internal faktörler gibi) ve etiyololojiye dayanan çok faktörlü olgulardır. Hangi tip beyazlatma tedavisine ihtiyacımız olduğuna karar vermek en önemli durumdur. Kök kanal tedavisi uygulanmış dişlerdeki renk değişikliklerinin nedenleri arasında pulpa dokusu artıkları, kanal dolgu patları, irrigasyon ve pansuman materyalleri yer almaktadır. İntrakoronal beyazlatma tedavisi, devital dişlerin beyazlatılmasında etkili ve minimal invaziv bir yaklaşımdır.
Bu vaka raporunun amacı renklenmiş kök kanal tedavili sol maksiller santral kesici dişin beyazlatılması ve hastaya estetik restorasyonların sunulmasıdır.
... This is rather unsurprising, given that the extrinsic stain was the same color as the metal's sulphide. Those who proposed the concept, on the other hand, did not appear to grasp the complexities of the chemical process required to form a metal sulphide [2,[21][22][23][24][25][26]. ...
Tooth discoloration is a common dental occurrence that is linked to both clinical and aesthetic issues. The treatment of tooth discoloration has grown into highly complex, scientific, and therapeutic field by the twenty-first century. Dental surgeons must understand the etiology of tooth staining in order to provide an accurate diagnosis and thus management. Extrinsic causes produce tooth darkening, whereas intrinsic congenital or systemic influences cause tooth discoloration. Tooth bleaching is a safe and effective way to lighten the color of the teeth. Today, the physician has a number of options, including at-home tray-based bleaching treatments with low hydrogen peroxide or carbamide peroxide concentrations. Surgical options include dental restorations which is may be indicated for some cases. This review aims to summarize current evidence regarding causes, classification and management of tooth discoloration. Medline and PubMed public database searches were carried out for papers written all over the world on tooth discoloration. No predictive analytics technology was used.
... Black discoloration on teeth is one of the basic drawbacks regarding to consume these supplements in addition to its undesired metallic taste (Talebi et al. 2012;Young et al. 2018). Black discoloration could be due to an insoluble ferric compound generated by a mutual effect between iron ions or gingival fluid composition and hydrogen sulfide caused by bacteria (Dayan et al. 1983). Pani et al. (2015) investigated the staining effect of iron in the ferric form, ferrous form and combination of these syrups on primary teeth. ...
PurposeThe purpose of this study was to evaluate the impact of surface sealants on the stain resistance of restorative materials exposed to iron syrups.Methods
Sixty specimens were prepared from each of three restorative materials—compomer (Dyract XP), a microhybrid composite (Filtek Z250), and a nanohybrid composite (G-aenial Anterior). Specimens were divided into three solution groups (n = 20) and immersed in two iron syrups (Ferrum and Ferro Sanol B) and distilled water. Two subgroups, sealed (BisCover ( +)) and unsealed (BisCover (–)), were established for each group (n = 10). Color changes between baseline and measurements at 4, 8, 24, 48, and 72 h were calculated with CIEDE2000 (ΔE00) metrics. Data were analyzed with 4-factor mixed-design ANOVA.ResultsThe first null hypothesis of this study that the use of surface sealant would not mitigate the restorative materials’ susceptibility to staining was rejected: significant differences were found between BisCover ( +) and BisCover (−) groups in ΔE00 values for all restorative materials tested in Ferro Sanol B (p < 0.001) and Ferrum (p = 0.002) solutions. The ΔE00 values in the Ferro Sanol B/BisCover ( +) groups were significantly lower than in Ferrum/BisCover ( +) groups (p = 0.002), the second null hypothesis that different forms of iron syrups would not impact the staining resistance of restorative materials was rejected. ΔE00 values were different for each restorative materials tested, the third null hypothesis that the type of restorative material would not affect staining resistance was rejected.Conclusions
The application of surface sealant significantly improved the color stability of restorative materials. The content of iron syrups was also an important factor affecting color change. Nanohybrid composites seem to be more resistant to the staining effects of iron syrups.
... Its etiology is classified into extrinsic and intrinsic causative factors. The known extrinsic causes include chromogenic bacteria, systemic antibiotics (e.g., minocycline), copper salts contained in mouth rinse, and copper and nickel metal ions [3,4,14]. Intrinsic causes include hyperbilirubinemia, and drugs such as minocycline and ciprofloxacin [8,[15][16][17]. ...
... Discoloration of resin based composites may be caused by adsorption and absorption of colorants from oral environment. [3][4][5] Discoloration is a frequent reason for replacement of composite restorations, with 16.9% incidence -coming second after secondary caries. 6 So far, discoloration of resin composite has been analyzed for staining in red wine, 7-13 coffee, 7-14 tea, [7][8][9][10][11][12][13] Coca-Cola, 7-13 soy sauce, 9 orange juice, 13 Yerba mate, 7 grape juice, 7 Powerade, 15 Red Bull, 15 and Burn. ...
Objective
The aim of this study was to evaluate changes of color and fluorescence of resin based composite exposed to beer.
Materials and Methods
84 samples (13 mm in diameter and 1.5 mm thick) of microhybrid composite Gradia DirectTM extra bleach white were immersed in 5 different beers (dark and light) or distilled water. Color and fluorescence were measured prior and after 1-, 7-, and 14-day immersion by Spectrophotometer Thermo Evolution 600 and Fluorolog-3-221 spectrofluorometer.
Results
Resin based composites changed color after immersion in beers of different types. Beers with higher optical absorption induced greater color changes. The fluorescence intensity of composites was decreased after immersion in beer, but the shape of fluorescence spectra was not changed. 14-day immersion in Bernard dark beer caused the greatest changes in optical properties of composite: ΔE*=9.0 and 57.6% reduced fluorescence.
Conclusion
Dark and light beers changed optical properties of resin based composite. The color change come exclusively from the change of chroma.
Clinical Significance
To fully meet esthetic criteria when using dental materials in restoration it is crucial to match optical properties of teeth and dental restoration at the moment of placement, but also to keep the match over the time. Considering that staining in beer causes changes in color and fluorescence of composites and that discoloration is a frequent reason for replacement of composite restorations, the data and conclusions on discoloration of dental restorations caused by beer consumption should aid dental professionals when reaching for high esthetics of modern dentistry.
... Discoloration of resin based composites may be caused by adsorption and absorption of colorants from oral environment. [3][4][5] Discoloration is a frequent reason for replacement of composite restorations, with 16.9% incidence -coming second after secondary caries. 6 So far, discoloration of resin composite has been analyzed for staining in red wine, 7-13 coffee, 7-14 tea, [7][8][9][10][11][12][13] Coca-Cola, 7-13 soy sauce, 9 orange juice, 13 Yerba mate, 7 grape juice, 7 Powerade, 15 Red Bull, 15 and Burn. ...
Objective:
The aim of this study was to evaluate changes of color and fluorescence of resin based composite exposed to beer.
Materials and methods:
84 samples (13 mm in diameter and 1.5 mm thick) of microhybrid composite Gradia Direct(TM) extra bleach white were immersed in 5 different beers (dark and light) or distilled water. Color and fluorescence were measured prior and after 1-, 7-, and 14-day immersion by Spectrophotometer Thermo Evolution 600 and Fluorolog-3-221 spectrofluorometer.
Results:
Resin based composites changed color after immersion in beers of different types. Beers with higher optical absorption induced greater color changes. The fluorescence intensity of composites was decreased after immersion in beer, but the shape of fluorescence spectra was not changed. 14-day immersion in Bernard dark beer caused the greatest changes in optical properties of composite: ΔE*=9.0 and 57.6% reduced fluorescence.
Conclusion:
Dark and light beers changed optical properties of resin based composite. The color change come exclusively from the change of chroma.
Clinical significance:
To fully meet esthetic criteria when using dental materials in restoration it is crucial to match optical properties of teeth and dental restoration at the moment of placement, but also to keep the match over the time. Considering that staining in beer causes changes in color and fluorescence of composites and that discoloration is a frequent reason for replacement of composite restorations, the data and conclusions on discoloration of dental restorations caused by beer consumption should aid dental professionals when reaching for high esthetics of modern dentistry.(J Esthet Restor Dent, 2016).
... The outward staining of teeth may be associated with occupational exposure to metallic salts and with a number of medicines containing metal salts. A number of heavy metal salts are associated discoloration of teeth; for example, stannous fluoride (SnF 2 ) causes a golden brown discoloration [55][56][57]. ...
Exposure of fluoride (F-) through drinking water and its adverse health effects have been reported in many parts of the world. Higher level of Fin groundwater has been reported from many parts of the developing countries and F-is endemic in at least 25 countries across the globe. In India, a large number of population are facing acute fluorosis problem due to intake of F-through drinking water. Presently, it has been estimated that fluorosis is prevalent in 56.2 millions of people in various parts of India. An estimated 62 million people from 19 out of the 32 states in India are affected with dental, skeletal and/or non-skeletal fluorosis. The extent of F-contamination of water varies from 1.0 to 48.0 mg L-1. The various geochemical factors that influence the leaching of F-from source to aquifer have been critically reviewed and presented in this paper. Moreover, the adverse health effects of F-on human and other living organisms have been critically emphasized with recent literature. The present review work will further help to design an appropriate F-removal technology in relation with environment friendly conditions.
... Out of 5 scrapings, 3 showed presence of ferrous ions of about 2.56%, calcium ions 17.15% and magnesium ions 0.72%, while the remaining 2 samples showed calcium 14.86%, magnesium ions 0.82% and no presence of ferrous ions (Tirth et al., 2009). Copper causes a green stain in mouthrinses containing copper salts ( Waerhag et al., 1984) and in workers in contact with the metal in industries (Dayan et al., 1983) (Table 1). ...
Tooth discoloration is a frequent dental finding associated with clinical and esthetic problems. It differs in
etiology, appearance, composition, location and severity. Knowledge of the etiology of tooth staining is of
importance to dental surgeons in order to enable a correct diagnosis. The practitioners should also have the
basic understanding of the mechanism of stain formation before carrying out any treatment procedures which will facilitate better treatment outcomes. Recently there have been advancements in the various treatment options in this field. This article is a comprehensive review on extrinsic stains and the treatment modalities.
... This type of discoloration is difficult to remove by bleaching, and tends to recur during the time [16,38]. Mercury, lead, and silver nitrate salts used in dentistry can cause a grey staining in teeth [16,39]. Dental discoloration can occur as a result of materials used for endodontic treatments. ...
Purpose: There has been a recent increasing interest in the management of dental staining as shown by the large number of tooth whitening materials appearing in the market. The aim of this review is to search the literature regarding tooth discoloration in order to introduce a new classification in terms of different clinical colors.
Methods: The PubMed database was searched for articles pertaining to the topic between the year 1932 and 2012. The search strategy for PubMed based on MeSH terms was: “tooth discoloration”, OR “tooth discolorations”, OR “tooth diseases”, OR “tooth bleaching”.
Results: Based on the relevant evidence, it was shown that tooth discoloration can be found in nine different color spectrums: black, brown, blue, green, grey, orange, pink, red, and yellow. Each color may represent various origins, which needs further investigations to be revealed.
Clinical significance: Our new classification based on clinical features of discolored teeth helps clinicians achieve timely diagnosis and avoid inappropriate therapeutic measures.
... In the current study, the application of AgNO 3 caused a visually noticeable discolouration to dentine, which was confirmed after examination with the Vita instrument. Tooth discolouration is known to be caused by AgNO 3 (Dayan et al. 1983;Kumar et al. 2012), but there has been no previous attempt to quantify the staining induced to dental tissues by Ag NPs. Measuring the colour difference between coated and uncoated dentine showed that AgNO 3 coating resulted in the strongest discolouration followed by the Ag NPs and chlorhexidine coatings (Table II). ...
Abstract The survival of pathogenic bacteria in the oral cavity depends on their successful adhesion to dental surfaces and their ability to develop into biofilms, known as dental plaque. Bacteria from the dental plaque are responsible for the development of dental caries, gingivitis, periodontitis, stomatitis and peri-implantitis. Certain metal nanoparticles have been suggested for infection control and the management of the oral biofilm. Here, we show that application of a silver nano-coating directly on dentine can successfully prevent the biofilm formation on dentine surfaces as well as inhibit bacterial growth in the surrounding media. This silver nano-coating was found to be stable (> 98.8%) and maintain its integrity in biological fluids. Its antibacterial activity was compared to silver nitrate and the widely used clinical antiseptic, chlorhexidine. The bacterial growth and cell viability were quantitatively assessed by measuring the turbidity, proportion of live and dead cells and lactate production. All three bio-assays showed that silver nanoparticles and silver nitrate dentine coatings were equally highly bactericidal (> 99.5%), while inhibiting bacterial adhesion. However, the latter caused significant dentine discolouration (ΔE* = 50.3). The chlorhexidine coating showed no antibacterial effect. Thus, silver nanoparticles may be a viable alternative to both chlorhexidine and silver nitrate, protecting from dental plaque and secondary caries when applied as a dentine coating, while they may provide the platform for creating anti-biofilm surfaces in medical devices and other biomedical applications.
... Staining is more obvious on hypomineralized and decalcified areas. Tooth staining due to iron supplement might be caused by an insoluble ferric compound such as ferric sulfide produced by interaction between Fe ions or gingival fluid composition and hydrogen sulfide produced by bacteria.[9] ...
Iron deficiency is estimated to be the most common nutritional deficiency in both developed and underdeveloped nations. Iron supplements at early age may prevent iron deficiency. The aim of this study was to assess the knowledge and management of parents about using iron supplements related to dental caries and staining among Iranian children (6 months to 2 year-old) and to identify some factors underlying these attitudes.
This randomized cross sectional study was carried out on the parents of 220 children (6 months to 2-year-old) evaluated in health services centers in Mashhad in 2008. Parents filled questionnaires assessing their opinions on the risk of using iron supplement on tooth staining and dental caries. The results were statistically analyzed by descriptive-analytical, Mann Whitney and Kruscal Wallis tests.
According to this study the relation between iron supplement application with tooth staining and its effect on dental caries, it must be noted that most parents (82.7%) had a moderate range of knowledge. Major of the parents (72.7%) had a moderate level of behavior. There was a significant difference between the knowledge level of fathers with their level of education (P = 0.01).
The finding of this study indicates that parental knowledge about consumption of iron supplements by their children (6 months to 2-year-old) has been moderate. But their behavior was poor and needs more attention.
... The color of tetracycline stained teeth become more intense on chronic exposure to artificial light and sunlight owing to the photo-oxidation of this complex 50 . The severity of stains depends on the time, duration, and amount of drug intake, and the type of tetracycline 51 Hematologic disorders cause a deposition of blood pigments in the dentin or enamel resulting in discoloration of the tooth structure. Erythroblastosis fetalis is characterized by destruction of red blood cells that may also induce severe jaundice in the newborn. ...
SUMMARY The purpose of this study was to compare two in-office bleaching methods with respect to tooth color change and level of hydrogen peroxide penetration into the pulp cavity and to evaluate relationships between penetration level and color change. Eighty extracted canines were exposed to two different bleaching regimens (conventional vs sealed bleaching technique). After exposure to 38% hydrogen peroxide gel for one hour, hydrogen peroxide amount was estimated spectrophotometrically. Color change was measured per Commission Internationale de l'Eclairage methodology. Linear regression was used to evaluate factors affecting color change, including bleaching technique. The conventional and sealed bleaching groups showed no difference for any color change parameters (ΔL, Δa, Δb, ΔE); however, there was significantly greater hydrogen peroxide penetration in the conventional bleaching group (p<0.05). Linear modeling of the change in lightness (ΔL) showed that the increase in lightness tended to be greater for teeth with lower initial L* values (r=-0.32, p<0.05). After adjustment for initial L*, there was no evidence that ΔL differed with hydrogen peroxide penetration levels (p>0.05) or bleaching technique (mean group difference in ΔL=0.36; p>0.05).
... It cannot therefore be dismissed as merely of cosmetic importance. 1 The aetiology of tooth discoloration is multifactorial, and tooth whitening will benefit patients with extrinsic and intrinsic discoloration. 2,3 However, the treatment of the discoloration shown in Figure 1 may prove to be a challenge! In a study of patient satisfaction with their tooth colour, up to 50% of patients reported indifference while 30% were dissatisfied and 10% highly dissatisfied with their tooth shade. ...
Unlabelled:
Current tooth lightening systems use hydrogen peroxide or carbamide peroxide which releases hydrogen peroxide as the bleaching agent. In vitro and in vivo studies, mostly comparing different bleaching systems, have demonstrated the efficacy of vital and non-vital tooth bleaching. Bleaching treatments are affected by a number of factors including the actual cause of tooth discoloration. All in-surgery bleaching agents are chemically activated and, whilst better results are possible with lights, these are not essential. Shade change can be evaluated subjectively and may be observed after only a few nights with Night Guard Vital Bleaching (NGVB). Objective methods of shade evaluation are used in most randomized controlled trials. There are a number of methods used to bleach teeth but NGVB using 10% carbamide peroxide in trays produces the optimal result with the least side-effects. The'inside/outside' bleaching technique using 10% carbamide peroxide is the most effective and safest method of bleaching non-vital teeth. Although more than 90% success has been reported, regression of the colour change is a common problem in vital and non-vital tooth bleaching and retreatment is necessary in many cases, usually after 1-3 years. The overwhelming evidence indicates that tooth bleaching is effective if supervised by a dentist.
Clinical relevance:
The clinician should be able to inform patients that both vital and non-vital tray bleaching using 10% carbamide peroxide can produce excellent results when supervised. However, shade regression is likely in 1-3 years.
Tooth discoloration is classified as extrinsic or intrinsic, with extrinsic stains arising from the accumulation of residue on the surface of the tooth and intrinsic discoloration from stains within the enamel or dentin. For both types of stains, tooth whitening with hydrogen peroxide is a common treatment. Hydrogen peroxide likely exerts its effects by interacting with chromophores within the tooth structure, acting via what is known as the “chromophore effect.” Despite having the desired cosmetic effect, however, hydrogen peroxide treatment likely also may affect sound tooth tissue; and the unknowns surrounding unwanted side effects remain a concern. Here, the etiology of extrinsic and intrinsic stains is summarized, as is our current understanding of hydrogen peroxide treatment and mechanisms of action. This information might guide further research and development efforts to create new technology for the treatment of tooth discoloration.
Recently, dental bleaching has been frequently sought by patients to improve the appearance and color of the teeth. Among various treatment options, in-office bleaching is commonly preferred by patients with severely discolored teeth due to its fast aesthetic results. In addition, other pretreatment methods, such as air-powder polishing, have been reported to increase the efficacy of bleaching treatment. Compared to other causes of tooth discoloration, occupational tooth discoloration caused by bronze alloy and further treatment have not been sufficiently documented in the literature. In the present case report, we explain a case of tooth discoloration following exposure to a bronze alloy and a conservative clinical approach used for the management of tooth discoloration. A 15-year-old male patient who worked in a foundry was presented with tooth discoloration. At the first session, a rubber-cap prophylaxis was performed. After one week, air-powder polishing was used to remove the remaining stains. Finally, at the third session, two cycles of bleaching were performed using hydrogen peroxide gel 35%, each for 20 minutes. Photographs were taken at the end of each session and used for visual evaluation. The final result was aesthetically satisfactory.
Tooth discoloration is a frequent dental finding associated with clinical and esthetic problems. It differs in etiology, appearance, composition, location and severity. Knowledge of the etiology of tooth staining is of importance to dental surgeons in order to enable a correct diagnosis. The practitioners should also have the basic understanding of the mechanism of stain formation before carrying out any treatment procedures which will facilitate better treatment outcomes. Recently there have been advancements in the various treatment options in this field. This article is a comprehensive review on extrinsic stains and the treatment modalities.
Objective
The purpose of this randomized clinical trial was to assess the efficacy of color change in combined in‐office/at‐home whitening.
Materials and Methods
Thirty participants were randomly divided into two groups: 15 received combined treatment in‐office whitening (6% hydrogen peroxide + 2 weeks at‐home whitening with 16% carbamide peroxide [CP]); 15 were assigned to control group. Instrumental color measurements were obtained before whitening (t0), immediately after in‐office whitening (tin‐office), after 1 week of active treatments (t1), and at the completion of the whitening treatment (t2). CIE L*a*b* values were recorded and CIE L*a*b* and CIEDE2000 color differences were calculated.
Results
The color change at tin‐office was ΔEab = 4.7 and ΔE00 = 3.2 and overall color change of combined method at t2 was ΔEab = 8.2 and ΔE00 = 5.3 (P < 0.05). A statistically significant effect for the mean CIE L*a*b* and CIEDE2000 values was detected within time with the mean a*, b* and C′ values decreasing and mean h′ values increasing significantly (P < 0.05).
Conclusions
Combined in‐office/at‐home whitening was effective. Whitening efficacy increased upon application of 16% CP in combined in‐office/at‐home treatment (P < 0.05).
Clinical Significance
The statistically significant increase in color change recommends clinical application of combined in‐office/at‐home whitening treatment.
De nos jours, l'esthétique du sourire a pris une place prépondérante dans lespréoccupations de nos patients. Le cas de dyschromie unitaire d'une dent antérieure n'est pas exceptionnel, mais peut présenter un réel complexe psychologique pour certaines personnes.Ce travail s'intéresse plus particulièrement aux différentes techniques d'éclaircissement interne des dents dépulpées, en ambulatoire ou au fauteuil. Lorsque les indications sont maîtrisées, la thérapeutique ambulatoire s'avère être, dans la majorité des cas, une méthode simple, efficace, et à moindre coût pour le patient. En revanche, le risque de complication est majoré par les techniques au fauteuil, notamment de résorptions cervicales externes, mettant en jeu le pronostic de maintien de la dent sur l'arcade.
Currently there is a significant increase the in demand for procedures associated with dental esthetics. As a result, in recent years many systems have been developed for tooth bleaching through different forms of application. Despite its widespread use, it has been argued that this process can alter not only the structure of the enamel surface, but can interfere with bonding procedures required to carry out orthodontic treatment. Different studies have showed that in patients receiving dental treatment clearance, adhesion processes are not as efficient as those who did not. This article presents a literature review on the current state of tooth bleaching, and the relationship and / or effect on orthodontic treatment when it is done before, during or after bleaching.
Tooth discoloration is classified as extrinsic or intrinsic, with extrinsic stains arising from accumulation of residue on the surface of the tooth, and intrinsic discoloration from stains within the enamel or dentin. For both types of stains, tooth whitening with hydrogen peroxide is a common treatment. Hydrogen peroxide likely exerts its effects by interacting with chromophores within the tooth structure, acting via what is known as the “chromophore effect.” Despite having the desired cosmetic effect, however, hydrogen peroxide treatment also may likely affect sound tooth tissue; and the unknowns surrounding unwanted side effects remain a concern. Here, the etiology of extrinsic and intrinsic stains is summarized, as is our current understanding of hydrogen peroxide treatment and mechanisms of action. This information might guide further research and development efforts to create new technology for the treatment of tooth discoloration.
Background & Aims: Iron deficiency anemia is the most common kind of anemia in childhood. Iron supplements that are usually prescribed for the treatment stain teeth. The purpose of this study was an in vitro comparison of the adsorption rate of iron onto incisor primary teeth after exposure to three different Iron drops (Darupakhash, Fer-In- Sol, Shahredaru). Methods: This study was performed on sixty intact primary incisor teeth in two stages with one week interval. In each stage thirty teeth were examined. The teeth in each stage were divided into three groups and each group was exposed to one kind of Iron drop. The rate of Iron adsorption was measured by Atomic Absorption system. ANOVA (Kruskal - wallis) test was used for statistical analysis. Results: There was a significant difference among three types of Iron drops in adsorption of Iron (P<0.001). Fer-In-Sol had the least and darupakhash had the highest adsorption rate. Conclusion: Although all three Iron drops cause stain on primary incisor teeth, there is a significant difference among them.
This chapter begins with an introduction to the structure of the dentition and its environment followed by a review of the optical properties of teeth. Tooth colour will be reviewed with particular emphasis on colour distribution and variation. Important factors that influence tooth colour and its perception will be discussed. With the current interest in tooth whitening, this chapter will then describe approaches to quantifying tooth whiteness and the measurement of tooth colour, in particular, visual assessment approaches and instrumental techniques. In addition, methods to improve tooth colour will be reviewed including whitening toothpastes, tooth bleaching and microabrasion.
Objective
The aim of this study was to assess the prevalence of various types of mucosal lesions associated with different forms of arecanut/tobacco chewing habits.
Material and Method
The study was carried out by examining 640 patients with chewing habit history for one year, in the Department of Oral Medicine and Radiology and at various community oral health camps. A through habit history was taken and clinical examination were done for any oral lesions present.
Results
The most prevalent chewing habit was gutka followed by betel quid, tobacco and arecanut or combinations of habit. Oral lesions were present in 352 subjects. The prevalence of oral lesion in decreasing order were- oral submucous fibrosis, chewers mucosa, tobacco pouch keratosis, leukoplakia, lichenoid reaction, carcinoma and coated tongue or combination of lesions.
Conclusions
Our study revealed a high chewing habit related oral mucosal lesions. There is an urgent need for awareness programs for the prevention and early diagnosis of the lesions.
Objective: To investigate the antibacterial and anti-biofilm properties of a silver nanoparticles (Ag NPs) coating when applied directly to a dentine surface. Also, to examine the stability of the coating in biological fluids and determine whether it causes dentine discolouration.
Method: Dentine discs were coated applying a 10 g l-1 Ag NPs solution. The antibacterial efficacy of the coating was tested against S. mutans and was compared to AgNO3 and chlorhexidine. The tests were performed in 24-well plates. One dentine disc was placed at the bottom of each well, which was then inoculated with a bacterial suspension (OD595=0.1). Following a 24h exposure, the bacterial growth and cell viability in the media were quantitatively assessed by measuring the turbidity, proportion of live and dead cells (Backlight™, Invitrogen Ltd), and lactate production. These three bio-assays were also employed to investigate bacterial adhesion. The integrity of the antibacterial coatings was investigated using inductively coupled plasma optical emission spectrometry (ICP-OES). The optical properties of coated dentine were assessed with a VITA Easyshade®portable dental spectrophotometer.
Result: Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) confirmed that dentine specimens were successfully coated. Both silver coatings were found to be very stable (>97%). All three bio-assays showed that Ag NPs and AgNO3 dentine coatings were equally highly bactericidal (>99.5%), while inhibiting bacterial adhesion. The chlorhexidine coating showed no antibacterial effect. The Ag NPs coating did not affect the natural colour of dentine (ΔE* =4.3), while the AgNO3coating caused severe discolouration (ΔE* =50.3).
Conclusion: Ag NPs formed a stable dentine coating with remarkable bactericidal and anti-biofilm properties. Although equally effective to Ag NPs, AgNO3 coating was not aesthetically acceptable. Thus, it is suggested that Ag NPs coating may be a viable alternative to both chlorhexidine and AgNO3, inhibiting dental plaque formation and protecting from caries.
Objective To carry out an extensive review of the literature on tooth staining with particular regard to some of the more recent literature on the mechanisms of tooth staining involving mouthrinses.Design Comprehensive review of the literature over four decades.Conclusions A knowledge of the aetiology of tooth staining is of importance to dental surgeons in order to enable a correct diagnosis to be made when examining a discoloured dentition and allows the dental practitioner to explain to the patient the exact nature of the condition. In some instances, the mechanism of staining may have an effect on the outcome of treatment and influence the treatment options the dentist will be able to offer to patients.
This randomized clinical study assessed efficacy in terms of color change and production of sensitivity after home whitening alone and home whitening supplemented with in-office bleaching. Thirty-six subjects (aged 19 to 58 years) were randomly assigned to one of three different treatment groups: (A) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays; (B) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays supplemented with in-office bleaching with 9% hydrogen peroxide (in the same trays); or (C) home whitening for two weeks, with 16% carbamide peroxide in custom-made trays supplemented with in-office bleaching with 27% hydrogen peroxide (in the same trays). The efficacy of tooth whitening was assessed by determining the color change associated with the six upper anterior teeth using a value-ordered shade guide. Sensitivity was self-assessed with the use of a visual analog scale (VAS). Tooth shade and sensitivity were assessed at the following points: pretreatment; immediately after the home whitening phase; immediately after the in-office phase (groups B and C); and one week post active treatment. At the one week follow-up visit, subjects in group A had a mean (SD) color change of 5.9 (1.83) (teeth were lighter) immediately after cessation of treatment (p<0.01). Subjects in groups B and C experienced a greater change in mean (SD) shade immediately following their respective in-office treatments of 5.1 (1.53) and 5.4 (1.55). However, within one week, the shade of these teeth regressed to a similar degree to that achieved by subjects treated in group A. Overall, no significant difference in shade change or sensitivity was produced between the three groups. Investigators concluded that the in-office element of combined whitening produced no significant difference in tooth color or sensitivity when compared with home whitening alone.
Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, 2007. O objetivo da presente pesquisa foi avaliar o índice de dependência de nicotina, utilizando o índice de dependência de Fagerström, examinar as condições da mucosa oral e correlacionar os índices obtidos entre os índios Guarani Kaiowá/Nandeva, moradores da aldeia Bororó, localizada muito próxima à cidade de Dourados (MS). A amostra constou de 312 indígenas, todos maiores de 20 anos, que procuraram o atendimento odontológico no posto de saúde, de modo que, a cada dois pacientes atendidos, um foi convidado a participar da pesquisa. A aplicação do questionário e o exame clínico da mucosa foram realizados após assinatura do termo de consentimento livre e esclarecido, de acordo com a legislação brasileira. Os pacientes, baseados em auto-declarações, foram distribuídos em quatro grupos: fumantes, exfumantes, não fumantes e fumantes passivos. Além disso, foram selecionados por faixa etária. Dos 312 índios entrevistados, 80 pertencem ao sexo masculino e 232 ao sexo feminino. O estudo demonstrou que 24,68% (77) dos entrevistados são fumantes, o que corresponde a 41,25% (33) dos homens e 18,97% (44) das mulheres. A aplicação do teste de Fagerström mostrou que 36,36% (28) possuem um elevado grau de dependência de nicotina. O estudo encontrou 406 alterações patológicas, mas somente 55 casos (14,4%) foram considerados como lesões propriamente ditas. As lesões mais prevalentes foram: estomatite nicotínica, 24 casos (6,32%); fibroma, 5 casos (1,32%); doença de Heck, 5 casos (1,32%); leucoplasia, 9 casos (2,37%) e ulceração, 12 casos (3,16%). Do mesmo modo, foram encontradas 187 variações da normalidade. As variações da normalidade mais prevalentes foram: pigmentação melânica, 53 casos; grânulos de Fordyce, 48 casos (25.87%), e língua fissurada, 41casos (21,93%). Utilizando-se um intervalo de confiança de 0,005 e aplicando o teste exato de Fischer, estatisticamente significante foram os casos de leucoplasia, estomatite nicotínica e grânulos de Fordyce. O mesmo teste não demonstrou diferença estatística para o índice de dependência de nicotina e a prevalência das lesões Os resultados encontrados apontam para a necessidade de mudanças na abordagem da saúde oral indígena que hoje é voltada exclusivamente para o tratamento reabilitador. Como apontam os números deste trabalho, é fundamental que o cirurgião-dentista realize um exame clínico detalhado que possibilite estabelecer o diagnóstico e tratamento de lesões orais nas várias categorias: inflamatórias, reacionais, infecciosas, pré-malignas e malignas; participe do planejamento dos serviços odontológicos de forma a respeitar e incorporar a cultura local, e assuma a prevenção e tratamento ao tabagismo. ___________________________________________________________________________________________ ABSTRACT The present research evaluated the index of nicotine dependence, using the rate of dependence of Fagerström, to examine the conditions of the oral mucosa and to correlate the indices between Guarani Kaiowá/Nandeva aboriginals that live at Bororó village, located very next to the Dourados city (MS). In the studied sample, composed by 312 patients, all older than 20 years old, and those that looked for the odontological service in the health station, to each two taken patients, one was invited to participate of the research. The application of the questionnaire and the clinical examination of the mucosa were after the signature of the term of free and clarified assent, in accordance with the Brazilian legislation. The patients, based on auto-declaration, had been distributed in four groups: smokers, former-smokers, not smoking and smoking liabilities. They had been also selected by an age band. Of 312 interviewed aboriginals 80 belong of the masculine sort and 232 to the feminine sort. The study demonstrated that 24.68% (77) of the interviewed are smoking, what it corresponds 41.25% (33) of men and 18.97% (44) of the women. The application of the test of Fagerström showed 36.36% (28) have been classified as having a high degree of nicotine dependence. The study found 406 pathological alterations, but 55 cases (14,4%) had been only considered as injuries properly said. The most prevalent injuries were: nicotínica estomatite, 24 cases (6,32%); fibroma 5 cases (1,32%); illness of Heck, 5 cases (1,32%); leucoplasia 9 cases (2,37%) and ulceration, 12 cases (3,16%). In a similar way, 187 variations of normality had been found. The variations of normality most prevalent were: melânica pigmentation (53 cases), granules of Fordyce 48 cases (25.87%) and fissurated language 41cases (21,93%). Using a reliable interval of 0,005 and applying the accurate test of Fischer, significant statistically were the cases of leucoplasia, nicotínica estomatite and granules of Fordyce. The same test did not demonstrate statistically differences between the rate of nicotine dependence and the prevalence of the injuries. The results point out to the necessity of changes in the boarding of the aboriginal oral health; which today is exclusively toward the rehabilitation treatment. As the numbers shows in this work is necessary that the surgeon-dentist carries through a detailed clinical examination that makes possible to establish the diagnosis and treatment of oral injuries in some categories: inflammatory, reacionais, infectious, daily paymalignant and malignant. It is also necessary that the surgeon-dentist participate of the planning of the odontológical services to respect and to incorporate the local culture and assumes the prevention and treatment of the abuse of smoking.
The chemical reactions that take place at the amalgam surface when exposed to bleaching agents are not well-understood. It is known, however, that mercury ions are released from dental amalgam when bleached. We hypothesized that increasing concentrations of hydrogen peroxide are more effective than water at increasing mercury ion release from dental amalgam. We prepared dental amalgam discs (n = 65) by packing amalgam into cylindrical plastic molds and divided them into 13 equal groups of 5 discs each. The discs in each group were individually immersed in either 0%, 3.6%, 6%, or 30% (w/v) hydrogen peroxide at exposure periods of 1, 8, 48, and 168 hrs. Samples were taken for mercury ion release determination by inductively coupled plasma mass spectrometry. There were significant increases in mercury release between control and all other hydrogen peroxide concentrations at all exposure times (p < 0.05).
This clinical report describes the situation of a patient who was concerned about the appearance of porcelain crowns that were placed on the maxillary incisors 4 years prior. The mechanicochemical gingival retraction technique combining the use of ferric sulfate and knitted retraction cord is described as a possible etiology of internalized discoloration of the dentin in this situation. The hypothesis is explained by the high acidity of gingival retraction fluids (GRFs) and the high affinity of iron for hard tooth tissues, resulting in an interaction with bacterial byproducts and precipitation of insoluble ferric sulfide in the porous demineralized dentin. A prospective clinical trial is warranted to track the effects of GRFs on tooth structure. This article describes the treatment of internalized discoloration of dentin under porcelain crowns.
To quantitatively test the hypothesis that a new paint-on bleaching gel has the potential to lighten tooth color in clinical situations and to evaluate the change of the tooth color six months after the bleaching procedure.
Ten adult subjects requesting tooth bleaching were selected to participate in this randomized clinical trial involving a new in-office bleaching technique using VivaStyle Paint On Plus (Ivoclar Vivadent), originally designed as an over-the-counter bleaching gel. Digital images and CIE Lab spectrophotometric measurements were taken at baseline (I), after the bleaching treatment (PB), and 6 months after bleaching (6M). Differences in Lab values were tested with a repeated measures analysis of variance (ANOVA). Differences in Delta E values were tested with a factorial ANOVA.
Significant (P < .05) differences were detected in L, as well as in a and b values, between initial (I) and post-bleaching (PB) and between initial (I) and 6 months post-op (6M). In contrast, there was no significant difference between post-bleaching (PB) and 6 months post-op (6M).
This new bleaching technique proved to be efficient over a period of 6 months. It could be a less aggressive and more convenient alternative to traditional bleaching techniques.
Tooth discoloration after endodontic treatment is frequently attributed to drugs and filling materials. In this in vitro study the staining potential of various dental materials was investigated by means of a visual method to determine tooth color. Extracted human premolars were prepared, and the following materials were introduced into the pulp cavities: Cavit, Durelon, Dycal, Fletcher's cement, IRM, AH26-silver free, gutta-percha, Duo Percha, Fuji ionomer, and zinc phosphate cement. Before the materials were applied, the original tooth color was assessed on the external buccal tooth surfaces. Further color determinations were undertaken at regular intervals for 6 months after the materials were introduced. Durelon, Fuji ionomer, Fletcher's cement, and zinc phosphate cement did not induce measurable tooth discoloration. Cavit, Dycal, gutta-percha, and IRM caused a mild stain. For the teeth filled with AH26-silver free and Duo Percha, a moderate discoloration was recorded.
As part of a large-scale fluoridation cessation study, standardized examiners assessed 8,281 school-aged children for dental fluorosis using the Thylstrup Fejerskov index, or TFI, in which scores range from 0 (no fluorosis) to 9 (severe loss of enamel with change of anatomical appearance).
Dentists, parents and children were asked to respond to a statement, "The color of these teeth (mine or my child's) is pleasing and looks nice." Agreement or disagreement with the statement was indicated on a five-level scale, with a rating of 1 representing total agreement with the reference statement. The authors used repeated-measures analysis of variance to ascertain differences in satisfaction with the esthetic appearance of the subject's tooth color across dentists', parents' and subjects' perceptions.
Girls were more critical of their tooth color than were boys; however, parents and dentists were more critical of boys' tooth color than of girls'. While younger subjects were more critical than older subjects, parents of younger subjects were less critical than those of older subjects. Dentists' ratings were not significantly associated with subjects' age group. Subjects with a TFI score of 1 or 2 were not significantly more critical than subjects with a TFI score of 0, while those with a TFI score of 3 of higher were. Similarly, only parents of subjects with a TFI score of 3 of higher had significantly different ratings.
The three stakeholders in the esthetic treatment of children-parents, dentists and patients-appear to see the potential outcome of such treatment differently.
Dentists should ensure that parents and children agree about the course of treatment, the rationale for undertaking it and the results that could reasonably be expected.
Tetracyclines (TCN) were introduced in 1948 as broad-spectrum antibiotics that may be used in the treatment of many common infections in children and adults. One of the side-effects of tetracyclines is incorporation into tissues that are calcifying at the time of their administration. They have the ability to chelate calcium ions and to be incorporated into teeth, cartilage and bone, resulting in discoloration of both the primary and permanent dentitions. This permanent discoloration varies from yellow or gray to brown depending on the dose or the type of the drug received in relation to body weight. Minocycline hydrochloride, a semisynthetic derivative of tetracycline often used for the treatment of acne, has been shown to cause pigmentation of a variety of tissues including skin, thyroid, nails, sclera, teeth, conjunctiva and bone. Adult-onset tooth discoloration following long-term ingestion of tetracycline and minocycline has also been reported. The remarkable side-effect of minocycline on the oral cavity is the singular occurrence of "black bones", "black or green roots" and blue-gray to gray hue darkening of the crowns of permanent teeth. The prevalence of tetracycline and minocycline staining is 3-6%. The mechanism of minocycline staining is still unknown. Most of the reviewed literature consisted of case reports; longitudinal clinical trials are necessary to provide more information on the prevalence, severity, etiology and clinical presentation of tetracycline and TCN-derivative staining in the adult population.
This study evaluated the clinical efficacy and duration of effectiveness of a new bleaching lacquer for self-application without the use of mouth guards. It compared two different application times.
Forty-six adult subjects who requested bleaching treatment were selected to participate in this randomized, single-blind (examiner-blinded), single center, two-group trial. The subjects were randomly divided into two groups (n=23 each), each being instructed to bleach (8% carbamide peroxide) their six maxillary anterior teeth for two weeks. Daily contact time in Group 1 was 20 minutes once a day and, in Group 2, the time was 20 minutes twice a day. Efficacy was measured subjectively using the Chromascop Complete shade scores obtained at baseline and after one, two and three weeks, as well as after one, three, six and nine months.
After two weeks of treatment, the teeth in the Group 1 subjects exhibited a 2.4 +/- 0.2 mean shade scores improvement compared to baseline (p < 0.001; t-test for paired samples), and the subjects' teeth in Group 2 exhibited a 3.5 +/- 0.1 mean shade scores improvement (p < 0.001). However, the difference between both groups was not statistically significant (p > 0.05). The observed effects were stable for six months.
It can be concluded that the new bleaching lacquer is efficacious; however, a double application does not seem to be obligatory.
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