UNASSIGNED: Previous in vitro studies determined the whitening effects of bleaching products on stained resin composite surfaces. This in vitro study aimed to verify the effectiveness of a whitening system on composite resin previously subjected to pigmentation, specifically examining the depth of whitening effectiveness within the material structure.
UNASSIGNED: A commercially available nano-filled composite resin was used. Specimens were stained using a coffee-based solution and a 10% carbamide peroxide-based gel was employed as the whitening agent. The pigment\'s penetration and the effect of the bleaching gel were evaluated by measuring color (CieLab values) from the outer edge to the inner part of the specimens. Color measurements were taken at 14 points, starting from 0.1 mm from the external perimeter up to 3.0 mm.
UNASSIGNED: Analysis of variance tests showed a statistically significant difference between the Control Group (CG), Pigmentation Group, and Whitening Group. The whitening agent was effective up to 1.5 mm in depth, with Whiteness index (W) values not statistically different from those of CG up to 0.5 mm in depth.
UNASSIGNED: Whitening agents on nano-filled resin composite previously pigmented appear effective in restoring the W to values similar to the original, particularly in the superficial layers of the sample.

This work proposes an evaluation of the Crystalline Index (CrI) in function of the bleaching process employed during cellulose extraction from corn husk, for further characterization using CP/MAS 13C NMR, XRD, and FT-IR. In that sense, CrI values were calculated by FT-IR and the bands associated with the crystalline and amorphous regions were observed at 1424 cm-1 and 896 cm-1, respectively. Similarly, the signals due to ordered (89.1 ppm) and disordered (84.2 ppm) cellulose chains were detected by solid-state 13C NMR, while the Segal equation was only used for comparison purposes. Additionally, PCA studies showed consistent results attributed to the crystalline region in cellulose domains analyzed by both, FT-IR and solid-state 13C NMR. The results revealed the coexistence of cellulose I/cellulose II and its effect on CrI, as well as the incomplete mercerization process, in some cases non-cellulosic residues can cause an overestimation of CrI. Additionally, the thermal stability and the glass transition temperature were determined by TGA/DTA and DSC analyses. Finally, a partially fibrillated-network morphology with a diameter of 20.47 ± 2.77 μm was observed in cellulose bleached with peracetic acid, whereas organosolv method provides flexible and clean microfibrils with diameter sizes between 10 and 9 μm.

OBJECTIVE: To compare the color change, the risk and intensity of tooth sensitivity (TS), and gingival irritation (GI) of at-home bleaching applied on the buccal surface only or the buccal and lingual surfaces.
METHODS: Sixty patients with canines A2 or darker were selected and their superior arches were randomized in two groups: at-home bleaching on the buccal-only or on the buccal and lingual surfaces, with 7.5% hydrogen peroxide, for 1 h daily/2 weeks. The color change was evaluated at baseline, 7, 14 days, and 1 month after bleaching using shade guides scales (ΔSGU) and a spectrophotometer (ΔEAB, ΔE00, and ΔWID). Risk and intensity of TS and GI were recorded daily using visual analogic scale (0-10). Patient satisfaction was evaluated with the orofacial esthetics. Paired t-test, McNemar\'s, and Wilcoxon signed-rank test were used for data analysis (α = 5%).
RESULTS: Neither the color change nor the risk/intensity of TS was statistically different between groups (p > 0.05). Patient satisfaction increased after bleaching for both groups (p < 0.05).
CONCLUSIONS: The addition of one contact surface does not result in an increased whitening degree compared to bleaching applied solely on the buccal surface.
CONCLUSIONS: Understanding the influence of surfaces interacting with the bleaching agent is crucial for comprehending the bleaching mechanism and avoiding unnecessary material expenses. Notably, employing the buccal-only technique is sufficient to achieve the desired efficacy.

BACKGROUND: Intracoronal bleaching serves as a conservative option for nonvital teeth that exhibit discoloration. Hydrogen peroxide (H2O2) is frequently utilized in bleaching processes owing to its capability to produce free radicals. The main drawbacks of the currently available bleaching agents are the occurrence of cervical resorption and the multiple dental visits to achieve the desired result. Therefore, in our study, to address the limitations associated with cervical resorption and extended treatment duration for badly stained teeth, an attempt was made to incorporate a whitening agent (35% H2O2) with microbubbles.
OBJECTIVE:  This study aimed to compare and evaluate the effect of activated and nonactivated microbubbles on the efficacy of bleaching agents.
METHODS:  Forty-five human central incisors were collected and divided into three groups: Group I (HP), H2O2 plain (n = 15) (Control); Group II (HPM), H2O2-infused microbubbles without ultrasonic activation (n = 15) (experimental group); and Group III (HPMU), H2O2-infused microbubbles with ultrasonic activation (n = 15) (experimental group). The crowns were artificially stained. Microbubbles containing 35% H2O2 were generated using the probe sonication method. The bleaching agent H2O2 plain (0.04 mL) was syringed into the pulp chamber in group I, while H2O2-infused microbubbles (0.04 mL) were syringed into group II and group III. Group III was further activated ultrasonically. The evaluation of color shade differences was conducted using the Vita Lumin shade guide at three time points: baseline, day 7, and day 14.
RESULTS:  Data regarding color change using Vita shade were investigated for normality using the Kolmogorov Smirnov test and assessed a non-normal distribution. Intergroup comparisons at each particular time interval (baseline, day 7, and day 14) were analyzed using the Kruskal-Wallis H test followed by multiple pairwise comparisons using the Adjusted Bonferroni post hoc test. Intragroup comparisons between different time intervals were analyzed using related samples from Friedman\'s test followed by multiple pairwise comparisons using the post hoc Dunn test. The level of statistical significance was determined at P < 0.05. There was no statistical difference in the baseline values of all three groups. Group I (HP) exhibited an average increase of three Vita Lumin shade tabs on day 7 and day 14, respectively, whereas Group II (HPM) exhibited an average increase of six and four Vita Lumin shade tabs on day 7 and day 14, respectively, and Group III (HPMU) exhibited an average increase of 10 and 3 Vita Lumin shade tabs on day 7 and day 14, respectively.
CONCLUSIONS:  Microbubbles containing H2O2 were more efficient and faster than plain H2O2 for bleaching, and the efficacy of bleaching was enhanced when activated using ultrasonic technology.

UNASSIGNED: Nowadays it is estimated that worldwide more than 700 000 people die by suicide every year and a greater amount attempt this practice. Suicide is the fourth cause of death among 15-29 years old people. Sodium Hypochlorite (NaOCl) is used in household and com-mercial bleaches and due to its easy availability, accidental exposure to or intentional ingestion of NaOCl occurs frequently. In most cases health effects are only transient but if the subject ingests a large amount of this substance, this can generate severe consequences as oesophageal or stomach lesions and electrolytic imbalance. In the present study we analyse a rare case of suicide by fatal ingestion of bleach.
UNASSIGNED: Case of a caucasic 47 years old woman with a background of several suicide attempts by exogenous substance ingestion that was found death alone in her apartment. The purpose of our investigation was identifying the cause of death. A rigorous and multidisciplinary methodological approach was adopted, including an accurate judicial inspection of the environment, an anamnestic collection, an autoptic procedure completed by macro and microscopic examinations of internal organs and a toxicological examination of biological fluids. Furthermore, a literature overview of similar cases was carried out. The resulting evidence demonstrates that woman\'s death occurred after a massive bleach ingestion.
UNASSIGNED: This case report highlights the importance of forensic methodology in investigating the ingestion of exogenous substances. Crime scene investigation, a detailed post-mortem examination, toxicology and a complete histopathological study are mandatory to solve the enigma.

OBJECTIVE: This study aimed to evaluate the influence of different whitening toothpastes on color change and alteration in enamel surface roughness and microhardness compared to a conventional toothpaste.
METHODS: Fifty bovine incisors were selected, cleaned, and stored before being divided into five groups: a conventional toothpaste group (C) and three whitening toothpaste groups containing different abrasive agents: silica (S), hydrogen peroxide (PH), and activated charcoal (CA). Specimens underwent simulated brushing, staining with black tea solution, and subsequent analyses of color, surface roughness, and microhardness. Statistical analysis was performed using three-way ANOVA and Tukey post-hoc tests (P < .05).
RESULTS: The results showed that the color analysis revealed similar whitening potential among all toothpastes. Otherwise, showed significant differences in surface roughness (P < .001) and microhardness (P < .001) after simulated brushing. While all toothpastes caused a decrease in microhardness, the charcoal-based toothpaste showed a significant increase in surface roughness compared to the initial condition.
CONCLUSIONS: All toothpastes demonstrated whitening capability. Surface roughness changed after brushing with activated charcoal-based whitening toothpaste, but final roughness was similar across all groups. Whitening toothpastes led to a decrease in enamel microhardness, with similar final performance across all toothpastes analyzed.

The occurrence and health risks of fluorescent whitening agents (FWAs) in bottled water were reported for the first time. FWA184 and FWA393 were the most frequently detected FWAs, with mean concentrations of 3.99-17.00 ng L-1. Phthalates (PAEs) such as dibutyl phthalate (DBP), di-iso-butyl phthalate (DiBP), and diethylhexyl phthalate (DEHP) were prevalent in bottled water, with mean levels of 40.89-716.66 ng L-1, and their concentrations in bottled water were much higher than those of FWAs. FWAs and PAEs in bottles and caps were extracted using organic solvent, and the correlation analysis showed that FWA393 and DEHP most likely originated from bottles, while bottle caps were the main sources of DBP and DiBP. The calculated risk quotients (RQs) of target substances and all age groups were considerably lower than the threshold of 0.1, indicating that consuming bottled water containing these plastic additives was unlikely to pose health risks for people of all ages. However, RQ values for underage people were several times higher than those for adults and hence cannot be neglected; therefore, special attention should be paid to understand the potential risks posed by the exposure to these plastic additives during early life stages, especially the infant stage.

Fluorosis is a widespread condition that is endemic and found in approximately 25 nations worldwide. It manifests as dental fluorosis, an inherited enamel imperfection resulting from excessive fluoride exposure during tooth development. This condition can lead to varying degrees of tooth discoloration, often requiring aesthetic correction. Bleaching represents one of the treatment approaches for such instances, with in-office power bleaching being a technique that comprises the clinical implementation and triggering of bleaching agents using light to expedite the procedure. This case report outlines the successful aesthetic revision of moderate dental fluorosis through power bleaching, obviating the demand for intrusive procedures. It underscores the efficacy and conservative nature of in-office power bleaching to address tooth discoloration associated with extensive fluorosis.

This systematic review examines studies focusing on tooth bleaching and its effects on healthy enamel or incipient caries and bacterial adhesion. The aim is to explore the impact of different bleaching agents on incipient caries lesions and healthy enamel. Clinical studies, in vitro studies, and observational studies that compared at least two groups were included. A search strategy was used to select studies from the MEDLINE via Pubmed and Scopus databases. Two evaluators performed data extraction, screening, and quality assessment independently. Only studies written in English were included. From 968 initial records, 28 studies were selected for a full-text evaluation. Of these, 7 studies were classified as cluster 1 (bacterial adherence on teeth), 12 studies as cluster 2 (no bacteria involved), 4 studies as cluster 3 (no teeth deployment), and 5 clinical studies were cluster 4. Of the selected studies, 6 (21.4%) supported increased bacterial attachment capacity and cariogenic dynamics, 4 (14.3%) decreased adhesion and cariogenic activity, 7 (25%) showed no difference, and 11 (39.3%) followed a different methodological approach and could not be categorized. The risk of bias appeared to be high, mainly because of the different methodologies in the studies, so we cannot reach a confident conclusion. Nevertheless, as far as carbamide peroxide bleaching is concerned, there does not seem to be a clinically significant alteration, neither in microorganism counts nor in enamel microstructure.

Aim and objective The aim of the present in vitro study is to evaluate the morphological and elemental alterations in enamel following bleaching with hydrogen peroxide-based bleaching agents of different concentrations and pH values when exposed to different treatment times. Materials and method Twenty extracted maxillary central incisors were selected for the study. Tooth samples were prepared by sectioning the tooth cervico-incisally into two halves. The teeth were divided into different groups based on the bleaching protocol and bleaching agent applied: Group IA, Group IB, Group IIA, and Group IIB. Group IA received a 35% hydrogen peroxide-based bleaching agent of pH 6 for 10 minutes with light application. Group IB received a 35% hydrogen peroxide-based bleaching agent of pH 6 for 30 minutes with light activation. Group IIA received a 40% hydrogen peroxide-based bleaching agent of pH 8.5 for 10 minutes with chemical activation. Group IIB received a 40% hydrogen peroxide-based bleaching agent of pH 8.5 for 30 minutes with chemical activation. The morphology of the enamel before and after the application of the bleaching agent was evaluated using field emission scanning electron microscopy. The elemental analysis of enamel between the control and test samples was done with the help of energy dispersive spectroscopy. Results Paired t-test was used to analyze the data obtained from the study. The test samples showed erosive alterations in enamel surface morphology and also a decrease in the concentration of minerals when compared to the corresponding control groups. Conclusions The present study evidences the erosive potential of hydrogen peroxide-based bleaching agents. It can be concluded that bleaching agents containing high concentrations of hydrogen peroxide with acidic pH can cause mineral loss and surface erosion of enamel which is extremely detrimental to the tooth integrity.