(1) This study investigated the whitening effect, cytotoxicity and enamel surface alterations induced by different over-the-counter (OTC) bleaching agents in comparison to hydrogen peroxide. (2) Human teeth (n = 60) were randomly assigned into 6 groups (n = 10), stained with coffee solution for 7 d, followed by a whitening period of 7 d with either placebo, bromelain, sodium bicarbonate, sodium chlorite, PAP or hydrogen peroxide. Color measurements were performed with a spectrophotometer. Scanning electron micrographs (SEM) were taken to assess the enamel structure. Cytotoxicity of the tested substances was assessed based on the cell viability of primary human fibroblasts. (3) The application of all whitening gels resulted in a greater color difference of the enamel (ΔE) in comparison to the negative control. Hydrogen peroxide caused the greatest color difference. Bromelain and PAP treatment showed no enamel surface changes, in contrast to hydrogen peroxide treatment, which showed very mild interprismatic dissolution. Bromelain was the only non-cytotoxic agent. (4) The maximum effect achieved by all OTC bleaching agents was the removal of stains, whereas hydrogen peroxide was capable of further whitening the teeth. Bromelain treatment was neither cytotoxic, nor resulted in enamel surface alterations, and its whitening effect was less, yet still effective, compared to hydrogen peroxide.

Introduction: This study evaluated the reproducibility of electronic color determination system evaluations of the marginal gingiva, which could be important for adhesive cervical fillings or prosthetic restorations that imitate the gingiva. Material and methods: In 50 subjects, the L*, a*, and b* color coordinates were evaluated five times at a point in the marginal area of a central incisor using different electronic color determination systems: (SP) Shadepilot, (ES) Easyshade, (CE) Crystaleye, and (SV) X-Rite. The mean color difference (ΔE) and its standard deviation between the five measurements from each participant were calculated separately for each device. Further ICC for interdevice reliability was determined. Results: The L*, a*, and b* color coordinates and ΔE values differed significantly among the systems (p < 0.001). Within each patient and measurement system, ΔE ranged from 1.4 to 3.2 (SD 1.1–2.5), L* from 2.6 to 5.7 (SD 2.6–5.7), a* from 11.9 to 21.3 (SD 3.6–3.9), and b* from 15.1 to 28.9 (SD 1.7–4.3). Interdevice reliability ranged between 0.675 and 0.807. Conclusions: Color determination of the marginal gingiva using the electronic tooth color determination systems tested herein showed limited reproducibility. The results obtained with the different measurement systems differed enormously. Clinical relevance: These results show that the electronic color measurement devices tested allow no high reproducible determination of color coordinates of the marginal gingiva.

Stefan Wentaschek, DMD, MSc/Karl Martin Lehmann, DMD, PhD/Herbert Scheller, DMD, PhD/Gernot Weibrich, MD, DMD, PhD/Nikolaus Behneke, DMD, PhD: Purpose: The aim of this in vitro study was to assess the increase in the polygonal area of implant-retained prosthesis supports in edentulous maxillae with the use of tilted distal implants compared with the use of straight distal implants, using a variety of implant lengths. Materials and Methods: A total of 25 DICOM datasets of atrophic edentulous maxillae were provided. Bone augmentations in the molar region had to be avoided. Two straight reference implants were virtually inserted in the anterior region. Two additional implants were placed far distally on both sides (4 groups: [1] straight, 12-mm length; [2] straight, 10 mm; [3] straight, 8 mm; [4] tilted, 12?16 mm). The resulting implant-supported polygon was measured for each of the 4 groups using three-dimensional planning software. Results: The mean sagittal depth of the supported polygon in Group 1 was 9.9 mm (standard deviation [SD] 4.4) on the right and 10.2 mm (SD 4.4) on the left, and it was 33.7 mm (SD 5.8) in width. For Group 2, the mean sagittal depth was 11.5 mm (SD 5.0) on the right and 11.9 mm (SD 4.7) on the left, and the width was 35.2 mm (SD 5.6). The measurements for Group 3 were 13.8 mm (SD 4.9) deep on the right, 13.8 mm (SD 5.1) deep on the left, and 37.0 mm (SD 5.4) in width. For Group 4, the depth was 15.8 mm (SD 4.9) on the right and 16.4 mm (SD 5.8) on the left, and the width was 39.0 mm (SD 5.1). Conclusion: The area of implant-retained prosthesis support can be enlarged by the use of tilted implants (12 to 16 mm in length, 42 to 45 degrees) compared to the use of straight 8-mm implants (resulting increase: about 15%).

Background: CAD/CAM systems enable the production of fixed partial dentures with small and reproducible internal and marginal gaps. Purpose: The purpose of this study was to evaluate the reproducibility of the marginal and internal adaptations of four-unit fixed partial denture frameworks produced using four CAD/CAM systems. Materials and Methods: Prepared dies of a master model that simulated the loss of the first left molar were measured. Fifteen frameworks were manufactured using four CAD/CAM systems (A–D). The internal fit was determined by the replica technique, and the marginal gap was determined by microscopy. ANOVA was carried out to detect significant differences, and the Bonferroni adjustment was performed. The global level of significance was set at 5%. Results: The mean gap size ranged from 84 to 132 µm (SD 43–71 µm). The CAD/CAM systems showed significant variance (p < 0.001), and system A (VHF) showed the smallest gaps. The smallest gaps for each system were in the molar part and in the marginal region of the frameworks (p < 0.001). Conclusions: The CAD/CAM systems showed significantly different gap sizes, particularly between premolars and molars and among the marginal, axial and occlusal regions. All of the systems are suitable for clinical application.