Abstract
Background
The purpose of this study was to compare color alterations (?E) of white-spot lesions
(WSLs) bleached before versus after resin infiltration (RI).
Methods
Using the facial surfaces of bovine maxillary incisors, WSLs were created and the
teeth were allocated into 2 groups (n = 45/group): bleach then RI (B-RI group) and
RI then bleach (RI-B group). To determine ?E, Commission Internationale de l’Eclairage
L* a* b* (L* represents lightness, ranging from black to white [0-100]; a* represents green to red chromaticity [-150-+100]; and b* represents blue to yellow chromaticity [-100-+150]) measurements were obtained at
baseline, after WSL formation, and after RI and bleaching. Representative specimens
were evaluated by means of scanning electron microscopy. Statistical analyses included
the Mann-Whitney U and Wilcoxon signed rank tests (P <= .0016) and repeated measures analysis of variance (P <= .05).
Results
No differences in ?E were found comparing B-RI with RI-B groups or when the B-RI group
was compared with bleached enamel. A statistically significant difference was found
when the RI-B group was compared with bleached enamel (?E, 0.81; P < .001), but the difference was deemed not clinically significant. Scanning electron
microscopy revealed that bleaching after RI increased surface roughness of the resin.
Conclusions
There were no clinically significant differences in ?E of WSLs when bleach was applied
before or after RI; however, applying bleaching agent after RI roughened the surface
of the resin material.
Practical Implications
Results indicate that ?E were not clinically significantly different between WSLs
bleached before versus after RI, although it is best to sequence bleaching before
RI therapy, as bleaching after RI roughened the restoration’s surface.
Key Words
White-spot lesions
demineralization
resin infiltration
tooth bleaching
Abbreviation Key:
?E (Color alterations), B-RI (Bleach then resin infiltration), CIE (Commission Internationale de l’Eclairage), Con (Control), Exp (Experimental), NA (Not applicable), RI (Resin infiltration), RI-B (Resin infiltration then bleach), SEM (Scanning electron microscopy), Tx (Time point), WSL (White-spot lesion)
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Biography
Dr. Youssef was a postdoctoral student, Department of Orthodontics, School of Dental Medicine, State University of New York, University at Buffalo, Buffalo, NY, when the work described in this article was conducted. He now is an orthodontist in private practice, Buffalo, NY.
Biography
Dr. Covell is a professor and the L.B. Badgero Endowed Chair, Department of Orthodontics, School of Dental Medicine, State University of New York, University at Buffalo, 140 Squire Hall, Buffalo, NY 14214.
Biography
Mr. Makowka is a research specialist and the laboratory director, Dental Materials Research Laboratory, Department of Restorative Dentistry, School of Dental Medicine, State University of New York, University at Buffalo, Buffalo, NY.
Biography
Dr. Gailey is a general dentist in private practice, Hamburg, NY.
Biography
Mr. Dunford is a statistician, Department of Oral Biology, School of Dental Medicine, State University of New York, University at Buffalo, Buffalo, NY.
Biography
Dr. Al-Jewair is an associate professor and the graduate program director, Department of Orthodontics, School of Dental Medicine, State University of New York, University at Buffalo, Buffalo, NY.
Biography
Dr. Haraszthy is a professor and the chair, Department of Restorative Dentistry, School of Dental Medicine, State University of New York, University at Buffalo, Buffalo, NY.
Article Info
Publication History
Published online: November 08, 2021
Publication stage
In Press Corrected Proof
Footnotes
Disclosure. None of the authors reported any disclosures.
The authors wish to thank Mr. Peter Bush, and director, South Campus Instrument Center, State University of New York, University at Buffalo, for his assistance with the scanning electron microscopy, and Mr. Jason Chwirut, instructional media specialist, for his assistance with manuscript preparations.
Identification
DOI: https://doi.org/10.1016/j.adaj.2021.07.017
Copyright
(C) 2021 American Dental Association. All rights reserved.
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