This investigation aimed to assess the efficacy of reversal methods on bleached enamel via fluoride-activated Er:YAG, diode, femtosecond laser, focusing on Vickers hardness (VH), shear bond strength (SBS), calcium (Ca++)/phosphorus (P) ratio, and the interface between brackets and enamel.
Materials and Methods:
A total of 112 human maxillary premolars with intact enamel, which had been extracted, were included. About 96 specimens underwent bleaching using a 40% hydrogen peroxide (HP) Office bleaching agent. The remaining 16 samples were taken as control. The enamel samples were divided into six groups (2–7) based on the bleaching reversal technique (n = 16). Samples in Group 1 contained unbleached samples of sound enamel (n = 10). Group 1: Samples did not undergo bleaching; Group 2: bleached samples with no reversal; Group 3: bleached enamel reversal via fluoride activated by Er:YAG laser; Group 4: bleached enamel reversal via fluoride activated by diode laser; Group 5: bleached enamel reversal via fluoride activated by femtosecond laser; Group 6: bleached enamel reversal via Na-Ascorbate; and Group 7: bleached enamel reversal with fluoride. From controls and interventional groups, two pairs of samples were assessed for VH and one pair of samples for EDX to assess Ca/P. All samples were bonded with brackets for SBS assessment and bracket-enamel interface. Analysis of variance, followed by post hoc multiple comparison tests, was used to tabulate results for SBS, VH, and the Ca/P ratio.
Results:
Ca/P ratio, VH, and SBS in bleached enamel reversed via Er:YAG laser + fluoride and femtosecond laser + fluoride demonstrated the efficacy of reversal similar to bleached enamel reversed by a conventional method, Na-Ascorbate, and control.
Conclusions:
Fluoride-treated bleached enamel, activated via Er, YAG, or femtosecond lasers, was effective in reversing the undesirable effects of bleaching, improving SBS of orthodontic brackets, Ca/P ratio, and enamel hardness.
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References
1.
ÖrekiB, IrgnC, MalkoS, et al.Effects of staining solutions on the discoloration of orthodontic adhesives: An in-vitro study. Am J Orthod Dentofac Orthop, 2010; 138(6):741–746; doi: 10.1016/j.ajodo.2008.12.029
2.
SlackME, SwiftEJ, RossouwPE, et al.Tooth whitening in the orthodontic practice: A survey of orthodontists. Am J Orthod Dentofac Orthop, 2013; 143(4):S64–S71; doi: 10.1016/j.ajodo.2012.06.017
3.
NiñoMF, Hernández-VianaS, RestrepoFA, et al.The perception of tooth whitening practices during and after orthodontic treatment: A survey of orthodontists. J Clin Exp Dent, 2021; 13(6):536–541; doi: 10.4317/jced.57985
4.
Arboleda-LopezC, ManasseRJ, VianaG, et al.Tooth whitening during orthodontic treatment: A six-month in vitro assessment of effectiveness and stability. Int J Dent Oral Health, 2016; 1(4); doi: 10.1696/6/2378-7090.120
5.
AkinM, AksakalliS, BasciftciFA, et al.The effect of tooth bleaching on the shear bond strength of orthodontic brackets using self-etching primer systems. Eur J Dent, 2013; 7(1):55–60; doi: 10.1055/s-0039-1698996
6.
ImaniMM, AziziF, BahramiK, et al.In vitro bleaching effect of hydrogen peroxide with different time of exposition and concentration on shear bond strength of orthodontic brackets to human enamel: A meta-analysis of in vitro studies. Int Orthod, 2020; 18(1):22–31; doi: 10.1016/j.ortho.2019.09.001
7.
MoosaviH, HajizadehH, MamaghaniZSZ, et al.Comparison of various methods of restoring adhesion to recently bleached enamel. BMC Oral Health, 2024; 24(1):942; doi: 10.1186/s12903-024-04656-1
8.
Da Silva MachadoJ, CândidoMSM, SundfeldRH, et al.The influence of time interval between bleaching and enamel bonding. J Esthet Restor Dent, 2007; 19(2):111–118; discussion 119; doi: 10.1111/j.1708-8240.2007.00077.x
9.
TopcuFT, ErdemirU, OzelE, et al.Influence of bleaching regimen and time elapsed on microtensile bond strength of resin composite to enamel. Contemp Clin Dent, 2017; 8(3):451–458; doi: 10.4103/ccd.ccd_234_17
10.
HardanL, BourgiR, Cuevas-SuárezCE, et al.Can sodium ascorbate increase the in vitro bond strength of the interface between a composite and bleached enamel? Coatings, 2023; 13(6):1064; doi: 10.3390/coatings13061064
11.
AnilM, PonnappaKC, NitinM, et al.Effect of 10% Sodium ascorbate on shear bond strength of bleached teeth - an in-vitro study. J Clin Diagn Res, 2015; 9(7):ZC31–ZC33; doi: 10.7860/JCDR/2015/12303.6194
12.
KimyaiS, ValizadehH. The effect of hydrogel and solution of sodium ascorbate on bond strength in bleached enamel. Oper Dent, 2006; 31(4):496–499; doi: 10.2341/05-85
13.
MirhashemiAH, SharifiN, EmadianE, et al.Effect of enamel surface pretreatment with different laser types and antioxidizing agents office-bleaching on the shear bond strength of orthodontic brackets. Laser Phys, 2020; 30(6):065603; doi: 10.1088/1555-6611/ab8a50
14.
OladzadM, ChiniforushN, BahramiR, et al.Evaluation of the effect of phosphoric acid or Er: YAG laser on the shear bond strength of orthodontic brackets to enamel surfaces followed by 980-Laser assisted bleaching: An in vitro study. J Lasers Med Sci, 2023; 14:e62; doi: 10.3417/2/JLMS.2023.62
15.
AzarbayjaniZ, Jafarzadeh KashiTSJ, ErfanY, et al.Efficacy of diode laser irradiation during dental bleaching in preventing enamel damage caused by bleaching. Dent Res J (Isfahan), 2018; 15(5):320–326; doi: 10.4103/1735-3327.240474
16.
AglarciC, DemirN, AksakalliS, et al.Bond strengths of brackets bonded to enamel surfaces conditioned with femtosecond and Er:YAG laser systems. Lasers Med Sci, 2016; 31(6):1177–1183; doi: 10.1007/s10103-016-1961-4
17.
KabasAS, ErsoyT, GülsoyM, et al.Femtosecond laser etching of dental enamel for bracket bonding. J Biomed Opt, 2013; 18(9):098003; doi: 10.1117/1.jbo.18.9.098003
18.
KlaricE, RakicM, SeverI, et al.Enamel and dentin microhardness and chemical composition after experimental light-activated bleaching. Oper Dent, 2015; 40(4):E132–E141; doi: 10.2341/14-148-L
19.
AlthubaitiA. Sample size determination: A practical guide for health researchers. J Gen Fam Med, 2023; 24(2):72–78; doi: 10.1002/jgf2.600
20.
AlnazehAA, KamranMA, AlmoammarS, et al.Visible light-activated curcumin-doped zinc oxide nanoparticles integrated into orthodontic adhesive on micro-tensile bond strength, degree of conversion, and antibacterial effectiveness against Staphylococcus Aureus. An investigation using scanning elect. J Photochem Photobiol B Biol, 2024; 253:112888; doi: 10.1016/j.jphotobiol.2024.112888
21.
AlahdalK, AlmoharebT, AldeebL, et al.Use of reparative agents topical fluoride activated by CO2 laser and CurodontTM repair and NR-5TM on vickers hardness and micro-shear bond strength of eroded enamel to composite restoration. Appl Sci, 2023; 13(23):12717; doi: 10.3390/app132312717
22.
HoteitM, NammourS, ZeinounT. Assessment of microcracks and shear bond strength after debonding orthodontic ceramic brackets on enamel priorly etched by different Er,Cr:YSGG and Er:YAG laser settings without acid application: An in vitro study. Int Orthod, 2019; 17(4):744–757; doi: 10.1016/j.ortho.2019.08.019
23.
ElkabbanySMH, MoslehAA, MetwallyNI. Remineralization effect of diode laser, Nanoseal®, and zamzam water on initial enamel carious lesions induced around orthodontic brackets. J Nat Sci Med, 2021; 4(1):50–57; doi: 10.4103/jnsm.jnsm_125_20
24.
LorenzoMC, PortilloM, MorenoP, et al.In vitro analysis of femtosecond laser as an alternative to acid etching for achieving suitable bond strength of brackets to human enamel. Lasers Med Sci, 2014; 29(3):897–905; doi: 10.1007/s10103-013-1278-5
25.
DuraisamyY, Elizabeth ChalyP, PriyadarshniVI, et al.Evaluation of remineralization potential of theobromine on human enamel surfaces—an in vitro study. Int J Sci Res, 2017; 6(11):435–438.
26.
CostenobleA, VennatE, AttalJP, et al.Bond strength and interfacial morphology of orthodontic brackets bonded to eroded enamel treated with calcium silicate-sodium phosphate salts or resin infiltration. Angle Orthod, 2016; 86(6):909–916; doi: 10.2319/111315-764.1
27.
RobaskiAW, PamatoS, Tomás-de OliveiraM, et al.Effect of saliva contamination on cementation of orthodontic brackets using different adhesive systems. J Clin Exp Dent, 2017; 9(7):e919–e924; doi: 10.4317/jced.53576
28.
AlShahraniI, KamranMA, AlmoammarS, et al.Photosensitization of Lithium Di-Silicate Ceramic by Er, Cr: YSGG and fractional carbon dioxide laser bonded to orthodontic bracket. Photodiagnosis Photodyn Ther, 2019; 28:273–276; doi: 10.1016/j.pdpdt.2019.08.017
29.
KuchibhotlaN, SathyamoorthyH, BalakrishnanS, et al.Effect of bonding agents on the shear bond strength of tooth-colored restorative materials to dentin: An in vitro study. J Contemp Dent Pract, 2024; 25(3):245–249; doi: 10.5005/jp-journals-10024-3662
30.
BuyukcavusE, UgurluM, BuyukcavusMH. Shear bond strength of orthodontic molar tubes to composite restoration bonded with particular adhesives after different surface pre-treatments. Orthod Craniofac Res, 2022; 25(4):541–548; doi: 10.1111/ocr.12567
31.
ScimecaM, BischettiS, LamsiraHK, et al.Energy Dispersive X-Ray (EDX) microanalysis: A powerful tool in biomedical research and diagnosis. Eur J Histochem, 2018; 62(1):2841–2899; doi: 10.4081/ejh.2018.2841
32.
ChengWS, ChenGY, ShihXY, et al.Vickers hardness value test via multi-task learning convolutional neural networks and image augmentation. Appl Sci, 2022; 12(21):10820; doi: 10.3390/app122110820
33.
HayannL, CiancagliniP, RamosAP, et al.Calcium and phosphate and their role in matrix vesicles: a biological view. In: Mineralizing Vesicles: From Biochemical and Biophysical Properties to Their Roles in Physiology and Disease. Elsevier BV; 2023; pp. 151–173; doi: 10.1016/B978-0-323-99158-2.00010-3
34.
SoesilawatiP, RezkikaYF, AyunnisaN, et al.Effectivity of calcium, phosphate and Vitamin D in dental caries prevention. DJKG, 2023; 17(2):67–74; doi: 10.3064/9/denta.v17i2.4
35.
MullinsJM, KaoEC, MartinCA, et al.Tooth whitening effects on bracket bond strength in vivo. Angle Orthod, 2009; 79(4):777–783; doi: 10.2319/042308-226.1
36.
BulutH, TurkunM, KayaAD. Effect of an antioxidizing agent on the shear bond strength of brackets bonded to bleached human enamel. Am J Orthod Dentofacial Orthop, 2006; 129(2):266–272; doi: 10.1016/j.ajodo.2004.03.043
37.
DahlJE, PallesenU. Tooth Bleaching - A critical review of the biological aspects. Crit Rev Oral Biol Med, 2003; 14(4):292–304; doi: 10.1177/154411130301400406
38.
TredwinCJ, NaikS, LewisNJ, et al.Hydrogen peroxide tooth-whitening (bleaching) products: Review of adverse effects and safety issues. Br Dent J, 2006; 200(7):371–376; doi: 10.1038/sj.bdj.4813423
39.
MirhashemiA, Emadian RazaviE S, BehboodiS, et al.Effect of laser-assisted bleaching with Nd:YAG and diode lasers on shear bond strength of orthodontic brackets. Lasers Med Sci, 2015; 30(9):2245–2249; doi: 10.1007/s10103-015-1800-z
40.
AlmoharebT, Al AhdalK, MaawadhAM, et al.Bleached enamel reversal using grape seed extract, green tea, curcumin-activated photodynamic therapy, and Er: YAG on microleakage and bond integrity of composite material bonded to the enamel surface. Photodiagnosis Photodyn Ther, 2024; 45:103943–103943; doi: 10.1016/j.pdpdt.2023.103943
41.
ErginE, Ruya YaziciA, KalenderB, et al.In vitro comparison of an Er:YAG Laser-Activated Bleaching System with different light-activated bleaching systems for color change, surface roughness, and enamel bond strength. Lasers Med Sci, 2018; 33(9):1913–1918; doi: 10.1007/s10103-018-2555-0
42.
LiuY, HsuCYS, TeoCMJ, et al.Potential mechanism for the laser-fluoride effect on enamel demineralization. J Dent Res, 2013; 92(1):71–75; doi: 10.1177/0022034512466412
43.
VorobyevAY, GuoC. Femtosecond laser surface structuring technique for making human enamel and dentin surfaces superwetting. Appl Phys B, 2013; 113(3):423–428; doi: 10.1007/S00340-013-5482-6
44.
HikovT, PechevaE, MontgomeryP, et al.Precise femtosecond laser ablation of dental hard tissue: Preliminary investigation on adequate laser parameters. J Phys: Conf Ser, 2017; 794:012036; doi: 10.1088/1742-6596/794/1/012036
45.
IssatayevaA, FornainiC, MasinoM, et al.Potential role of Er:YAG laser and fluoride in the dental enamel remineralization: A raman spectroscopy preliminary Ex Vivo study. Laser Ther, 2022; 29(2):87–93; doi: 10.4081/ltj.2022.294
46.
ShinYC, WuB, LeiS, et al.Overview of laser applications in manufacturing and materials processing in recent years. J Manuf Sci Eng Trans ASME, 2020; 142(11); doi: 10.1115/1.4048397
47.
LeiS, ZhaoX, YuX, et al.Ultrafast Laser Applications in Manufacturing Processes: A State of the Art Review. In: ASME 2019 14th International Manufacturing Science and Engineering Conference, MSEC 2019 American Society of Mechanical Engineers (ASME); 2019; doi: 10.1115/MSEC2019-2968
48.
Al-HassnawiAK, RadhiNJM. Impact of titanium tetra flouride material and 810nm diode laser on demineralized human enamel (In Vitro Study). Egypt J Hosp Med, 2023; 90(1):727–732; doi: 10.2160/8/ejhm.2023.279846
49.
ReynoldsIR, von FraunhoferJA. Direct bonding of orthodontic brackets–a comparative study of adhesives. Br J Orthod, 1976; 3(3):143–146; doi: 10.1179/bjo.3.3.143
50.
LewinsteinI, FuhrerN, ChuraruN, et al.Effect of different peroxide bleaching regimens and subsequent fluoridation on the hardness of human enamel and dentin. J Prosthet Dent, 2004; 92(4):337–342; doi: 10.1016/j.prosdent.2004.07.019
51.
ThakurR, ShigliAL, SharmaD, et al.Catalase and sodium fluoride mediated rehabilitation of enamel bleached with 37% Hydrogen Peroxide. J Indian Soc Pedod Prev Dent, 2015; 33(4):324–330; doi: 10.4103/0970-4388.165702
52.
RomanosGE, EstrinNE, LesniewskiA, et al.Penetration depth of initiated and non-initiated diode lasers in Bovine Gingiva. Appl Sci, 2022; 12(24):12771; doi: 10.3390/app122412771
53.
LishnaKT, ShaloobM, AntonyV, et al.Assessment of enamel surface using scanning electron microscope after debonding conventional and self-ligating metal and ceramic brackets: An in vitro study. J Int Oral Health, 2024; 16(3):214–222; doi: 10.4103/jioh.jioh_270_23
54.
BaherimoghadamT, AkbarianS, RasouliR, et al.Evaluation of enamel damages following orthodontic bracket debonding in fluorosed teeth bonded with adhesion promoter. Eur J Dent, 2016; 10(2):193–198; doi: 10.4103/1305-7456.178296
