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Limited studies have demonstrated that low intensity laser therapy (LILT) may have a therapeutic effect on the treatment of myofascial pain syndrome (MPS). Sixty (60) patients with MPS and having one active trigger point in the anterior masseter and anterior temporal muscles were selected and assigned randomly to six groups (n=10): Groups I to Ill were treated with GaAIAS (780 nm) laser, applied in continuous mode and in a meticulous way, twice a week, for four weeks. Energy was set to 25 J/cm2, 60 J/cm2 and 105 J/cm2, respectively. Groups IV to VI were treated with placebo applications, simulating the same parameters as the treated groups. Pain scores were assessed just before, then immediately after the fourth application, immediately after the eighth application, at 15 days and one month following treatment. A significant pain reduction was observed over time (p0.001). The analgesic effect of the LILT was similar to the placebo groups. Using the parameters described in this experiment, LILT was effective in reducing pain experienced by patients with myofascial pain syndrome. Thus, it was not possible to establish a treatment protocol. Analyzing the analgesic effect of LILT suggests it as a possible treatment of MPS and may help to establish a clinical protocol for this therapeutic modality.

The aim of this study was to evaluate in vitro the effect of different in-office bleaching systems on the surface morphology of bovine dentin. Thirty tooth fragments measuring 4 x 4mm, containing enamel and dentin, were obtained from the crowns of extracted bovine incisors. Samples were subjected to simulated intracoronal bleaching techniques using conventional (Opalescence Endo and Whiteness Super Endo) and light-activated systems (Opalescence Xtra) and Whiteness HP Maxx). Controls were treated with either sodium perborate mixed with 10% hydrogen peroxide or no bleaching agent. The samples were observed under SEM and the recorded images were evaluated for topographic alterations. The ultrastructural alterations of dentin observed in this study varied greatly between groups according to the products used. Higher pH products (Whiteness HP Maxx) and Opalescence Xtra) associated with in-office techniques yielded better maintenance of dentin ultrastructure. Apparently, both low pH and hydrogen peroxide oxidation play a role in altering the ultrastructure of dentin during internal dental bleaching. The use of alkaline products with reduced time of application (in-office techniques) may decrease such morphological alterations.

Este estudo teve como objetivos: 01.Avaliar ex vivo o efeito de diferentes sistemas clareadores na microdureza dentinária em dentes bovinos submetidos ao clareamento dental interno. 02.Avaliar ex vivo o efeito de diferentes sistemas clareadores na morfologia superficial da dentina bovina. Fragmentos de 4 x 4mm, contendo esmalte e dentina, foram obtidos de coroas de incisivos bovinos extraídos. Os espécimes foram submetidos ao clareamento dental interno com peróxido de hidrogênio a 35% e peróxido de carbamida a 37% utilizando sistemas convencionais (Opalescence Endo® and Whiteness Super Endo®) e fotoativados (Opalescence Xtra® and Whiteness HP Maxx®). Os controles foram tratados com perborato de sódio misturado com peróxido de hidrogênio a 10% ou nenhum tratamento foi realizado. A microdureza dentinária foi mensurada antes e após os tratamentos clareadores, e os valores de dureza Knoop (KHN) foram submetidos à análise estatística (two-way ANOVA, Tukey\'s port-test). Os espécimes foram observados e fotografados sob microscópio eletrônico de varredura e avaliados com relação às alterações morfológicas da superfície da dentina. Houve uma redução significante na microdureza dentinária para todos os grupos testados quando comparados aos grupos controles. Opalescence Xtra® (-11.36 ± 8.14 KHN), Opalescence Endo® (-13.71 ± 8.02 KHN), Whiteness HP Maxx® (-15.18 ± 9.58 KHN) e Whiteness Super Endo® (-16.97 ± 6.55 KHN) foram semelhantes estatisticamente. O grupo do perborato de sódio misturado com peróxido de hidrogênio 10% (2.10 ± 8.58 KHN) e o grupo sem tratamento clareador (-2.71 ± 2.40 KHN) também foram estatisticamente semelhantes entre si. Ocorreu uma grande variação no padrão de alterações da morfologia superficial da dentina com os sistemas clareadores utilizados. Todos os produtos testados apresentaram redução significativa da microdureza dentinária, exceto o grupo de perborato de sódio misturado com peróxido de hidrogênio a 10%. Ambos, pH e oxidação do peróxido de hidrogênio apresentam o papel de alterar a estrutura da dentina durante o clareamento interno. A utilização de produtos alcalinos com um tempo reduzido de aplicação (técnicas fotoativadas) pode diminuir as alterações morfológicas na dentina. The aim of this study was: 01. To evaluate in vitro the effect of different in-office bleaching systems on the surface morphology of bovine dentin. 02. To evaluate ex vivo the effect of different bleaching systems on the microhardness of bovine dentine. Tooth fragments measuring 4 x 4mm, containing enamel and dentin, were obtained from the crowns of extracted bovine incisors. Samples were submitted to simulated intracoronal bleaching techniques with 35% hydrogen peroxide and 37% carbamide peroxide using conventional (Opalescence Endo® and Whiteness Super Endo®) and light activated systems (Opalescence Xtra® and Whiteness HP Maxx®). Controls were treated either with sodium perborate mixed with 10% hydrogen peroxide or no bleaching agent. Dentine microhardness values were measured before and after bleaching procedures, recorded as KHN (Knoop Hardness Number), and the differences between them analyzed (two-way ANOVA, Tukey\'s port-test). The samples were observed under SEM and the recorded images were evaluated for topographic alterations. Significant reductions of dentine microhardness were observed for all treatments when compared to the control groups. Opalescence Xtra® (-11.36 ± 8.14 KHN), Opalescence Endo® (-13.71 ± 8.02 KHN), Whiteness HP Maxx® (-15.18 ± 9.58 KHN) and Whiteness Super Endo® (- 16.97 ± 6.55 KHN) presented similar differences. The walking bleach technique (2.10 ± 8.58 KHN) and the untreated groups (-2.71 ± 2.40 KHN) were statistically alike.The ultrastructural alterations of dentin observed in this study varied greatly between groups, according to the products used. Apparently, higher pH products associated to in-office techniques yielded to better maintenance of dentin ultrastructure. The in-office products tested in the present study caused a significant reduction in dentine microhardness. The walking bleach technique did not affect dentine microhardness. Both low pH and hydrogen peroxide oxidation play a role in altering the ultrastructure of dentin during internal dental bleaching. The use of alkaline products with reduced time of application (in-office techniques) may decrease such morphological alterations.

The aim of this in vitro study was to assess quantitatively dentin permeability of pulpless teeth after intracoronal bleaching therapy with three different agents. Twenty-four maxillary central incisors were randomly assigned to four groups according to the bleaching agent used: I--non-bleached control; II--37% carbamide peroxide; III--sodium perborate/20% hydrogen peroxide paste; IV--27% carbamide peroxide. After standard access and root-canal preparation the access opening, biomechanical preparation and root-canal filling, a cervical glass ionomer plug was prepared and intracoronal bleaching procedures were carried out in a standardized fashion. The access cavities were opened and the teeth were externally sealed and immersed in a 10% copper sulfate aqueous solution for 30 min, in vacuum for the first 5 min. Then, samples were removed, dried with absorbing paper and immersed in a 1% rubianic acid alcohol solution, for the same above-mentioned period in solution and in vacuum. Copper ion penetration was indicated by the rubianic acid staining. Mean values and SD for the experimental groups were: I--7.88% (+/-1.33), II--16.94% (+/-5.72); III--11.45% (+/-3.90) and IV--8.98% (+/-4.19). Data were submitted to one-way anova. The results showed that the 37% carbamide peroxide provided the highest increase in dentin permeability, followed by sodium perborate with 20% hydrogen peroxide. The 27% carbamide peroxide provided the lowest results and showed statistical similarity to the control group. On basis of these findings, it may be concluded that, among the tested intracoronal bleaching agents, 37% carbamide peroxide presented an optimized overall performance in increasing dentinal permeability.

OBJECTIVES: This study evaluated the effectiveness of different home bleaching agents on color alteration and their influence on surface and subsurface microhardness of discolored bovine enamel. MATERIAL AND METHODS: Forty-five fragments of bovine incisors were randomly allocated into 3 groups (n=15) according to the bleaching agent: 10% carbamide peroxide gel (CP10), 16% carbamide peroxide gel (CP16) and 6.5%-hydrogen-peroxide-based strip (HP6.5). Before bleaching treatment, initial values of Knoop surface microhardness and color (CIEL*a*b*) were obtained and the fragments were artificially stained in hemolyzed rat blood. Then, bleaching treatments were performed over a 21-day period. Color changes (ΔE) were assessed at 7, 14 and 21 days, and final surface microhardness reading was done after 21 days. Thereafter, the fragments were bisected to obtain subsurface microhardness. Data were subjected to ANOVA and Tukey's tests (α=5%). RESULTS: Color changes produced by CP16 were similar to those of CP10, and the color changes produced by these materials were significantly superior to those produced by HP6.5. Color changes at 21 days were superior to 7 days and similar to 14 days. The time did not influence color changes for CP16, which showed similarity between the 14- and 21-day results. No statistically significant differences were found among the home bleaching agents for surface and subsurface microhardness. CONCLUSIONS: Microhardness of bovine enamel was not affected by the bleaching agents. The 16% carbamide peroxide gel was the most effective for bleaching the stained substrate.

Aim To evaluate ex vivo the efficacy of 35% hydrogen peroxide for intracoronal bleaching when activated by LEDs, halogen lamp or by the walking bleach technique. Methodology Forty extracted human maxillary central incisors had their crowns resected 1 mm below the amelo-cemental junction and were submitted to artificial staining in centrifuged rat haemolysed blood. A 2-mm thick glass ionomer cervical plug was placed inside the canal, at the level of the amelo-cemental junction. Samples were divided randomly into five groups: group I received 35% hydrogen peroxide gel activated by LEDs. Group II received 35% hydrogen peroxide gel activated by a halogen lamp-based light curing unit. Group III received 35% hydrogen peroxide gel followed by the walking bleach technique. Group IV was neither artificially stained nor bleached (positive control) and group V was stained, but not bleached (negative control). The shade of the teeth was assessed visually by three independent and calibrated evaluators, before and after bleaching. The results were analysed using Kruskal–Wallis one-way analysis of variance and Dunn's post-test. Results No statistical differences regarding sample shades were found amongst groups for the tested internal bleaching techniques (P > 0.05). Conclusions Hydrogen peroxide for intracoronal bleaching when activated either by LEDs, halogen lamp or by the walking bleach technique presented similar efficacy.

The aim of this in vitro study was to assess quantitatively the dentin permeability of human teeth after intracoronal bleaching therapy with 35% hydrogen peroxide activated by LEDs, halogen lamp or using the walking bleach technique. Forty human maxillary central incisors had standard access cavities performed and the cervical thirds of the canals were prepared with Gates-Glidden drills up to a size 130. Roots were resected between the coronal and middle thirds and the apical portions were discarded. A glass ionomer, 2 mm thick cervical plug was placed inside the canal, at the cement-enamel junction level. Group I received 35% hydrogen peroxide gel activated by LEDs. Group II was submitted to 35% hydrogen peroxide gel activated by halogen lamp. Group III received 35% hydrogen peroxide gel and the walking bleach technique was followed. Group IV (control) received a dry cotton pellet inside the pulp chamber with temporary restoration. Dentinal permeability was quantified by copper ion penetration. Linear measurements were obtained by analysis of digital images under x 5 magnification. Mean values and SD for the experimental groups were: I, 7.1% (+/-3.2%); II, 8.4% (+/-3.0%); III, 9.1% (+/-3.0%); IV, 1.3% (+/-2.8%). One-way ANOVA was used to analyze the results. Results showed an increase of permeability values for groups I, II and III when compared to group IV (control); however, no statistical differences were found between the three tested bleaching techniques. It can be concluded that 35% hydrogen peroxide activated by LED, halogen lamp or used following the walking bleach technique produced similar increase in dentinal permeability.

OBJECTIVES: to compare the apical sealing ability of four root canal sealers. MATERIAL AND METHODS: forty extracted human maxillary canines were instrumented 1 mm short of the anatomical apex and randomly assigned to four groups (n=10), according to the root canal sealer used for obturation: Endofill, AH Plus, EndoREZ and Epiphany. Root canals were obturated with gutta-percha points, except for the Epiphany group, in which resin points (Resilon) were used. The teeth were immersed in India ink for seven days and clarified using methyl salicylate. The extent of apical dye penetration was measured with a measuroscope in all aspects of the canal. RESULTS: AH Plus (0.02 mm ± 0.07), Epiphany (0.00 mm ± 0.00) and EndoREZ (0.32 mm ± 0.62) did not differ statistically to each other (p>0.01). EndoFill presented the highest dye penetration mean (0.83 mm ± 0.73) and was statistically different from the other sealers (p0,01). EndoFill apresentou a maior média de penetração do corante (0,83 mm ± 0,73) e diferiu estatisticamente dos demais (p

The aim of this study was to investigate, in vitro, the percentage of filling of simulated lateral canals in teeth obturated with TP medium and standardized gutta-percha points. Twenty human mandibular canines were prepared with LA Axxess (SybronEndo) and K3 Endo rotary system (SybronEndo) up to a #50 file, according to the Free Tip Preparation Technique. During instrumentation, the root canals were alternately irrigated with 1% sodium hypochlorite and 17% EDTA. Six artificial lateral canals were prepared at the apical third of each tooth. Then, the teeth were assigned to two groups (n=10): Group 1 - filled with TP medium master gutta-percha points (Dentsply, Mailleffer); Group 2 - filled with standardized master gutta-percha points (Dentsply, Mailleffer). Root canal filling was complemented with AH Plus sealer (Dentsply, Mailleffer) and accessory gutta-percha points (Dentsply, Mailleffer), according to the classic technique. The teeth were radiographed and the images obtained were digitized. Linear measurements of the percentage of filling of the artificial lateral canals in each group were accomplished on the Image Tool 2.02 software. Statistical analysis of the data using Mann-Whitney U non-parametric test evidenced significant difference (p

This in vitro study aimed to assess dentin permeability quantitatively after the use of different irrigants into the pulp chamber, with or without ultrasonic activation, before the application of an internal bleaching agent. Thirty maxillary anterior teeth, treated endodontically, were randomly assigned to six groups, according to the irrigant used: group I, distilled water; group II, 17% EDTA; group III, 1% sodium hypochlorite; for groups IV, V, and VI, respectively, the same solutions were used, but were ultrasonicated. In groups I, II, and III, the irrigant that filled the pulp chamber was left undisturbed for 15 s and was then aspirated; in groups IV, V, and IV, the irrigants were placed into the pulp chamber, ultrasonic-activated for 15 s, and were then aspirated. This sequence was repeated three times for all groups. Afterwards, for all groups, the pulp chamber was dried, filled with a bleaching agent, and sealed with glass ionomer cement. At each change of the whitening agent, these procedures were repeated. Then, the temporary restorations were removed, access cavities were cleaned, and teeth were immersed in a 10% copper sulfate aqueous solution, submitted to vacuum and immersed in a 1% rubianic acid alcohol solution. Copper ion penetration was revealed by the rubianic acid. After staining, roots were removed at the cemento-enamel junction (CEJ) and sectioned in a mesiodistal direction starting from the cervical plug level. The sections were thinned, observed under an optical microscope, the images were digitized, and copper ion penetration was measured in each section using a specific software. Means and SD were: group I, 2.41 (+/-1.45); group II, 5.22 (+/-1.79); group III, 8.32 (+/-2.55); group IV, 3.73 (+/-0.89); group V, 14.83 (+/-4.99); and group VI, 10.51 (+/-2.65). Statistical analysis using two-way anova and Tukey test showed that, regardless of the irrigant, ultrasonication increased dentinal permeability (P < 0.01). Comparing the overall effectiveness of the tested solutions, EDTA yielded the greatest increase in dentinal permeability (P < 0.01). Based on these results, it may be concluded that use of ultrasonic-activated irrigants in the pulp chamber, before the accomplishment of internal dental bleaching procedures, may result in a remarkable increase of dentin permeability, which may enhance the efficiency of the whitening agent.

The aim of this in vitro study was to assess quantitatively dentin permeability of pulpless teeth after intracoronal bleaching therapy with three different agents. Twenty-four maxillary central incisors were randomly assigned to four groups according to the bleaching agent used: I--non-bleached control; II--37% carbamide peroxide; III--sodium perborate/20% hydrogen peroxide paste; IV--27% carbamide peroxide. After standard access and root-canal preparation the access opening, biomechanical preparation and root-canal filling, a cervical glass ionomer plug was prepared and intracoronal bleaching procedures were carried out in a standardized fashion. The access cavities were opened and the teeth were externally sealed and immersed in a 10% copper sulfate aqueous solution for 30 min, in vacuum for the first 5 min. Then, samples were removed, dried with absorbing paper and immersed in a 1% rubianic acid alcohol solution, for the same above-mentioned period in solution and in vacuum. Copper ion penetration was indicated by the rubianic acid staining. Mean values and SD for the experimental groups were: I--7.88% (+/-1.33), II--16.94% (+/-5.72); III--11.45% (+/-3.90) and IV--8.98% (+/-4.19). Data were submitted to one-way anova. The results showed that the 37% carbamide peroxide provided the highest increase in dentin permeability, followed by sodium perborate with 20% hydrogen peroxide. The 27% carbamide peroxide provided the lowest results and showed statistical similarity to the control group. On basis of these findings, it may be concluded that, among the tested intracoronal bleaching agents, 37% carbamide peroxide presented an optimized overall performance in increasing dentinal permeability.