The aim of this study is to evaluate the effectiveness of in-office bleaching in esthetic dentistry on the roughness and color stability of the enamel surface, using different concentrations of hydrogen peroxide (HP). Fifty human incisors were randomly divided into 5 groups (n = 10). No bleaching was performed in the control group. For these groups, concentrations of 40% HP with fluoride (F), 35% HP with calcium (Ca), 25% HP with nano-hydroxyapatite (nHA) and 18% HP with nHA were used for bleaching in the test groups. Surface roughness was assessed at baseline after bleaching occurred. Color measurements were first obtained at baseline, then after the first and second sessions of bleaching, and, finally, after the staining protocol. Scanning electron microscopy and atomic force microscopy were performed. Statistical analysis was conducted with a one-way ANOVA, followed by a post hoc Tukey’s test and a paired-samples t-test (p < 0.05). All the bleaching gels used exhibited a similar color change (p > 0.05). Bleaching gels containing 18% HP with nHA and that containing 35% HP with Ca caused less surface roughness of the enamel. Of these concentrations, 25% HP with nHA caused the most surface roughness and no significant difference was observed, compared with 40% HP with F. The highest coloration after bleaching was observed in 40% HP with F and 25% HP with nHA. The lowest coloration was obtained in 35% HP with Ca and 18% HP with nHA but no significant difference was observed between them and the control group. A concentration above 18% HP does not increase the bleaching effectiveness. The results show that 18% HP with nHA and 35% HP with Ca resulted in the least increase in enamel surface roughness when compared to high-concentrate HP; however, it also prevented recoloration after bleaching.

The aim of this study was to evaluate variations in the surface roughness and gloss of different single-shade resin composites after polishing with a range of systems. In total, 120 specimens were prepared from three different types of single-shade resin composites (supra-nanospherical—Omnichroma, nanohybrid—Charisma Diamond One, and microhybrid— Essentia Universal). The specimens were placed in distilled water and stored at 37 °C for 24 h. Each resin composite (n = 40) was divided into four groups (n = 10) according to the finishing/polishing (F/P) system: Mylar strip (control), Sof-Lex (multi-step), Twist Dia (two-step), and OneGloss (one-step). Surface roughness and gloss were measured. Surface characteristics were evaluated by atomic force microscopy (AFM) and a scanning electron microscope (SEM). A two-way analysis of variance (ANOVA) and Tukey’s honestly significant difference test were used for statistical analysis (p < 0.05). Among all the composites, both the highest surface roughness and lowest gloss values were obtained in the groups treated with the OneGloss polishing system (p < 0.05). Compared with all the composites, Omnichroma had the lowest surface roughness and highest gloss values (except Twist Dia) both unpolished and after polishing with all the F/P systems (p < 0.05). All composites treated with the Twist Dia F/P system had similar gloss values. The results of the AFM and SEM analyses were consistent with the surface roughness measurements. The gloss values of both the microhybrid and nanohybrid composites after F/P using the two-step system was superior to that of the traditional multistep system. The surface of the supra-nanofilled resin-based composite was smoother than that of both the microhybrid and nanohybrid composites.

Objective: This study aimed to evaluate the fracture strength of teeth restored using fiber-reinforced direct restorative materials after endodontic treatment with a conservative mesio-occlusal access cavity design. Materials and methods: A total of 100 extracted intact mandibular first molars were selected and distributed into a positive control group where teeth left intact and the following four test groups comprised of teeth with conservative mesio-occlusal access cavities that had undergone root canal treatment (n = 20/group): access cavity without restoration (negative control), bulk-fill resin composite with horizontal glass fiber post reinforcement, fiber-reinforced composite with bulk-fill resin and bulk-fill resin composite. Following thermocycling (10,000 cycles), fracture resistance was measured using a universal testing machine. Statistical analyses (one-way analysis of variance and the Tamhane test) were performed, and statistical significance was set at p < 0.05. Results: Groups with minimally invasive access cavities had lower fracture strength than intact teeth, regardless of the restoration material (p < 0.05). Fiber-reinforced composite groups demonstrated higher fracture strength than bulk-fill resin composite alone (p < 0.05). Fracture types varied among groups, with restorable fractures predominant in the fiber-reinforced composite groups. Conclusion: This study suggests that using fiber-reinforced composite materials, especially in combination with bulk-fill resin composites, can effectively enhance the fracture strength of endodontically treated teeth with conservative access cavities. However, using only bulk-fill resin composite is not recommended based on the fracture strength results. Clinical significance: When teeth that undergo endodontic treatment are restored using a conservative access cavity design and fiber-reinforced composite materials, especially in combination with bulk-fill resin composites, the fracture strength of the teeth can be effectively increased.

Objective: The study evaluated the longevity, efficacy, sensitivity, and impact on the oral health-related quality of life of in-office dental bleaching using low, medium, and high concentrate hydrogen peroxide. Material and Methods: Randomized, parallel, and double-blinded clinical trial was performed with 54 participants using18% hydrogen peroxide (HP), 25%HP, and 40%HP in-office bleaching agent. Tooth color was evaluated at baseline, after the 1st session bleaching, after the 2nd session bleaching and 6 months after finishing the bleaching using spectrophotometer. Tooth sensitivity (TS) was measured with the Visual Analog Scale at baseline, immediately after bleaching, after 1 day, and after 7 days. The impact on quality of life was evaluated using the 14-item Oral Health Impact Profile (OHIP-14) questionnaire at baseline, and 6 months after bleaching. The data were analyzed using the Kikare test, Kruskal Wallis test, one-way ANOVA, Wilcoxon, Friedman, Mann–Whitney (p < 0.05). Results: All groups achieved similar levels of bleaching during all evaluation times (p > 0.05), surpassing perceived value. There was no difference in TS levels among groups at all evaluation times (p > 0.05). TS significantly increased after bleaching (p < 0.05), decreased significantly after 24 h (p < 0.05), and there was no difference no difference between the initial sensitivity levels after 7 days (p > 0.05). All groups reported improved aesthetic self-perception following bleaching (p < 0.05) and there was no difference between the groups (p > 0.05). Conclusion: Low, medium, and high concentrations of HP did not affect both the final tooth color and the reported TS intensity, regardless of the evaluation time. In-office bleaching provides positive effects on aesthetic perception and different HP concentrations have not influenced this positive effect. Clinical significance: In this study, the efficacy, longevity, sensitivity, and impact on oral health-related quality of life of in-office bleaching using low, medium, and high concentration hydrogen peroxide agents from the same manufacturer were found to be similar. However, these results cannot be extrapolated to other in-office high-concentration hydrogen peroxide gels. Clinical trial registration number: NCT06700434.