PERIPHERAL CEMENTO-OSSIFYING FIBROMA – A CASE REPORT

Peripheral cemento-ossifying fibroma is a gingival overgrowth that occurs most commonly on the gingiva. It is a slow-growing reactive lesion. It is a benign tumor that grows to a considerable size and leads to pathologic migration of the teeth at later stages. It most commonly occurs following a gingival irritation or trauma. These lesions are said to arise from the PDL fibers excision of these lesions along with the periosteum is very important to avoid recurrence. The recurrence rate of peripheral cemento-ossifying fibroma has been reported to be 8–20%, so a close postoperative follow-up is required. Here, we are presenting two case of peripheral cemento-ossifying fibroma in the mandible.

Effects of domestic tooth whitening: literature review/ Efeitos do clareamento dental doméstico: revisão de literatura

Objectives: The scope is tooth whitening at home, the study focuses on the effectiveness of whitening and treatment effects.Material and Method: A search was carried out in the Medline, PubMed, Lilacs and Scielo databases, between the years 2000 to 2019. The keywords used in the databases were as follows: Tooth whitening, hydrogen peroxide, carbamide peroxide, whitening products , tooth, at home, whitening, effects, efficacy, whitening.Results: Of the 23 studies included in this review, 6 studies evaluated the effectiveness of tooth whitening, 4 studies evaluated the effect of whitening on tooth structure, 1 study evaluated the association of whitening treatment with dentifrice, 3 studies evaluated on cytotoxicity / toxicity, 3 studies evaluated the effect of whitening on dental materials, 2 studies assessed the social impact of tooth whitening, 3 studies assessed sensitivity during treatment and 1 study assessed the effect of bleaching gel storage.Conclusion: In order to try to minimize adverse effects that may arise such as sensitivity, cytotoxicity and gingival irritation, use with the minimum exposure time of the product is indicated; the home whitening technique shows less chance of recurrence after treatment.

Clinical evaluation of domestic dental whitening strategies

Tooth bleaching has become the first clinical option in reversing chromatic changes. This study evaluated the efficiency of four different approaches for home-based chemically induced tooth whitening. 32 patients were randomly distributed into four groups (n=8), according to the bleaching technique performed: G1: control group – at-home dental bleaching with 10% carbamide peroxide (Whiteness Perfect/FGM) delivered in a customized tray, G2: teeth whitening pen containing hydrogen peroxide (Walgreens), G3: night-time whitening gel (CVS) containing hydrogen peroxide and G4: whitening strips (3D White Oral B) containing 10% hydrogen peroxide. Chromatic changes (ΔE) were collected at baseline and at the middle and end of the treatment, using a digital spectrophotometer (EasyShade – Vita). Tooth sensitivity, gingival irritation, and degree of satisfaction were also recorded. The comparison between the average ΔE means, considering the final and initial values, revealed a statistically significant difference between the results obtained by G1 (ΔE2=11.65) and the other groups (ΔE2 of G2=4.38, G3=4.83 and G4 = 8.32). No significant difference was observed in the occurrence of tooth sensitivity and gingival irritation. The patients from G1 and G4 were more satisfied with the treatment outcome.

Clinical effect of 3.0% hydrogen peroxide containing bleaching patch with primer in a double-blind randomized controlled trial

Background: To clinically evaluate the efficacy and safety of a primer that contains taurine and self-bleaching patches containing 3.0% hydrogen peroxide.Methods: Overall, 55 participants were selected in this double-blinded randomized clinical trial between March and May 2019. Bleaching patches containing 3.0% hydrogen peroxide were attached using the primer on the labial surface of the upper six anterior teeth for 30 min once daily. △E* values of color changes were measured using Shade Eye NCC for determining the efficacy of bleaching on days 3, 5, 7, and 10 before and after attachment. The safety was assessed using gingival index and visual analog scale for tooth sensitivity and gingival irritation, respectively.Results: △E* values were visibly detected from day 7 after the attachment of patches, and the bleaching effect was identifiable. No statistically significant difference was observed in the gingival index (p = 0.069), tooth sensitivity (p = 0.983), and gingival irritation (p = 0.518).Conclusions: When the self-bleaching patches using 3.0% hydrogen peroxide with the primers were attached for 30 min once daily, visible bleaching effect was observed from day 7 of attachment, and it was verified to be safe for use without any significant adverse effect.Clinical Relevance: This study was conducted after securing safety for clinical trials.Trial registration: ISRCTN63650330

Moving Forward When CPAP Fails

This chapter discusses the role of oral appliance (OA) therapy for treating obstructive sleep apnea (OSA). Positive airway pressure (PAP) therapy is often the first-line treatment for OSA, but the average PAP adherence is approximately 50%. OA is a good alternative to PAP therapy that can be combined with other conservative options, such as weight loss and positional therapy. Many patients with OSA who cannot tolerate PAP therapy may be able to be managed by OA. Short-term side effects of OA device usage for OSA include tooth pain, gum soreness/gingival irritation, muscle soreness, myofascial pain, excessive salivation, dryness, and abnormal occlusion. OA adherence for OSA treatment is greater than that observed for PAP and shows comparable improvement in subjective sleepiness. PAP therapy continues to show greater improvement in the apnea/hypopnea and hypoxia index.

Tooth Sensitivity After Dental Bleaching With a Desensitizer-containing and a Desensitizer-free Bleaching Gel: A Systematic Review and Meta-analysis

SUMMARY Objectives: A systematic review and meta-analysis were performed to evaluate the risk and intensity of tooth sensitivity (TS) after dental bleaching with a desensitizer-containing and a desensitizer-free bleaching gel in adult patients. Color change and risk of gingival sensitivity was also evaluated. Methods: A comprehensive search was performed MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), EMBASE and Cochrane Library, and System for Information on Grey Literature in Europe (SIGLE) without restrictions to identify randomized clinical trials. Abstracts from the annual conference of the International Association for Dental Research (1990–2016), unpublished and ongoing trials registries, dissertations, and theses were also searched. The quality of the evidence was rated using the Grading of Recommendations: Assessment, Development and Evaluation (GRADE) approach. Data: After duplicates were removed, 1352 articles were identified. After title and abstract screening, only 47 studies remained for qualitative evaluation. Most of the studies had unclear risk of bias. No difference between groups were observed for the risk ratio of TS (risk ratio = 0.99; 95% confidence interval [CI] = 0.74–1.33); intensity of TS (standardized difference in means [SMD] = 0.04; 95% CI = 0.79–0.70); color change in shade guide units (SMD – 0.04; 95% CI = 0.50–0.42); color change in ΔE* (SMD = 0.41 (95% CI = 0.07–0.89); and risk ratio of gingival irritation (SMD = 1.05; 95% CI = 0.81–1.36). Except for the risk of TS, graded as moderate quality of evidence, all other outcomes were rated as low and very low quality. Conclusions: Incorporating desensitizers in the bleaching gel did not reduce the risk of TS, and the quality of this evidence was considered moderate. On the other hand, the intensity of TS, color change, and risk of gingival irritation was similar between groups, but the quality of the evidence for these outcomes was graded as low or very low, thus reducing the level of confidence in these outcomes.

Clinical Evaluation of Different Delivery Methods of At-Home Bleaching Gels Composed of 10% Hydrogen Peroxide

SUMMARY Objectives: This study aimed to compare the tooth sensitivity, gingival irritation, and bleaching efficacy of at-home whitening performed with 10% hydrogen peroxide (HP) using a conventional tray-delivered system or two different bleaching systems (strips or prefilled disposable trays). Methods and Materials: Sixty patients, with maxillary incisors darker than A2 were selected for this single-blind, parallel randomized clinical trial. Teeth were bleached during 14 days with a 30-minute gel contact with teeth per day. The 10% HP was delivered in a bleaching tray (White Class, FGM) in strips (White Strips, Oral-B) or prefilled disposable trays (Opalescence Go, Ultradent). The color changes were evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easyshade Spectrophotometer) methods at baseline and 30 days after the second bleaching session. Tooth sensitivity was recorded during 14 days with a five-point numeric rating scale (NRS) and 0-10 visual analog scale (VAS). The risk of gingival irritation was also recorded during 14 days on a dichotomous scale. All data were submitted to appropriate statistical analysis (α=0.05). Results: No significant difference was observed in the risks of tooth sensitivity among groups (p>0.09). However, the conventional bleaching tray produced a higher intensity of tooth sensitivity when compared with the strips and prefilled disposable tray systems (p<0.04). Regarding gingival irritation, the prefilled disposable tray system showed a lower risk of gingival irritation when compared with the conventional bleaching tray (p=0.003). Significant whitening was observed in all groups after 30 days of clinical evaluation with no significant difference between them (p>0.06). Conclusions: All 10% HP bleaching systems showed similar whitening after a 14-day use. However, the strips and prefilled disposable trays produced lower intensity of tooth sensitivity than the conventional bleaching tray system. The prefilled disposable tray produced lower risk of gingival irritation when compared to the conventional bleaching tray.

Efek Penggunaan Produk Perawatan Gigi Dan Mulut Yang Dijual Bebas (Otc) Pada Mukosa Oral

Over-the-Counter (OTC) drug is a drug which is sold freely in the market and can be purchased without a prescription. Special markings on the packaging and etiquette of OTC drug is a green circle with a black edge. Over-TheCounter (OTC) Dental Care Products are dental care products sold directly to consumer without a prescription from the dentist. Nowadays, there has been a significant increase in the number of OTC products in the market for oral health such as mouth washes, breath fresheners, tooth whitening, tooth paste, denture cleaners etc. To find out the effect of inappropriate use of OTC dental care products on the oral mucosa. Many OTC dental products are freely sold, make easier for people to obtain the desired products without visiting the dentist. Besides those advantage, they may also cause undesirable effects due to the inappropriate use and indications which could actually risk the oral health of patients. Side effects that may occur in the oral cavity including altered taste, tooth staining, burning sensation, gingival irritation, desquamation, erosion, numbness and dryness of the oral mucosa. Discontinuing the use of these products usually will recover the oral mucosa conditions. The inappropriate use and indications of OTC dental care products could cause unwanted side effects.