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Objectives: The purpose of this study was to evaluate the influence of remineralizing agents, including artificial saliva, neutral fluoride, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), on the susceptibility
of bleached enamel to staining by cigarette smoke.
Study design: Fifty bovine enamel blocks were randomly divided into five groups (n = 10): G1- bleaching; G2-
bleaching and immersion in artificial saliva; G3- bleaching and application of CPP-ACP; G4- bleaching and application of neutral fluoride; and G5- untreated (Control). Teeth were bleached with 35% hydrogen peroxide and treated with the appropriate remineralizing agent. After treatment, all groups were exposed to cigarette smoke. Enamel color measurements were performed at three different times: before treatment (T1), after treatment (bleaching and remineralizing agent) (T2), and after staining (T3), by using the CIE Lab method with a spectrophotometer. The
data coordinate L* was evaluated by analysis of repeated-measures PROC MIXED and Tukey-Kramer's test, and
the ?E values were submitted to one-way ANOVA and Tukey¿s test (? = 0.05).
Results: The G1 group did not show any statistically significant difference for L* values between times T1 and
T2. The G4 and G5 groups showed lower L* values at T3 compared to T2. No significant differences between
the groups were observed for ?E (after treatment and staining). However, G4 showed a clinically apparent color
change.
Conclusions: Treatment of bleached enamel with neutral fluoride can contribute to the increased staining of enamel
due to cigarette smoke.
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