Spectrophotometric assessment of tooth bleaching under orthodontic braquets bonded with different materials

Abstract Introduction patients have been submitted to tooth bleaching during orthodontic treatment for aesthetic purposes or to anticipate the replacement of restorations after completion of the treatment. Objective to evaluate the effectiveness of tooth bleaching under orthodontic brackets bonded with different materials. Material and method a hundred bovine enamel blocks were divided into two groups, at-home and in-office tooth bleaching. In-office bleaching was subdivided into five groups (n = 10): HP (control - without brackets); SA(t) - brackets bonded with Transbond XT, without bleaching; SA(fm) - brackets bonded with Orthodontic Fill Magic, without bleaching; HP(t) - brackets bonded with Transbond XT subjected to bleaching; and HP(fm) - brackets bonded with Orthodontic Fill Magic subjected to bleaching. At-home bleaching followed the same treatments, only replacing the bleaching agent. Spectrophotometric assessment was used for tooth color determination at three moments: 1) before staining (baseline); 2) after staining; 3) after bonding the brackets and bleaching procedures. Data were submitted to ANOVA and analyzed by Tukey's test (p < 0.05). Result For both types of bleaching, the control group had an effective bleaching action. Groups using Transbond XT presented greater bleaching potential among the groups with orthodontic accessory, but the bleaching action differed from the positive control. Groups using Orthodontic Fill Magic presented no bleaching action, resembling the negative control groups (artificial saliva). Conclusion the orthodontic bracket impaired the effectiveness of the at-home and in-office bleaching treatment, regardless of the resin used for bonding.

摘要：部分患者为满足美学需求，或为提前规划正畸治疗完成后修复体的更换，在正畸治疗期间接受牙齿漂白治疗。研究目的：评估不同材料粘接的正畸托槽下牙齿漂白的效果。材料与方法：选取100块牛牙釉质块，分为家庭牙齿漂白组与诊室牙齿漂白组。其中诊室牙齿漂白组进一步分为5个亚组（n=10）：HP组（对照组，无托槽）；SA(t)组——使用Transbond XT粘接托槽且未行漂白治疗；SA(fm)组——使用Orthodontic Fill Magic粘接托槽且未行漂白治疗；HP(t)组——使用Transbond XT粘接托槽并行漂白治疗；HP(fm)组——使用Orthodontic Fill Magic粘接托槽并行漂白治疗。家庭牙齿漂白组采用相同分组方案，仅更换漂白剂。采用分光光度检测法在三个时间点测定牙齿颜色：1）染色前（基线）；2）染色后；3）粘接托槽并完成漂白治疗后。数据采用方差分析（ANOVA）处理，并通过Tukey检验进行多重比较（P<0.05）。结果：两种漂白方式下，对照组均表现出有效的漂白效果。在带有正畸托槽的各组中，使用Transbond XT的组别漂白效果更强，但其漂白效果与阳性对照组存在差异。使用Orthodontic Fill Magic的组别未表现出明显漂白效果，与阴性对照组（人工唾液组）结果相近。结论：无论使用何种树脂粘接正畸托槽，托槽均会削弱家庭牙齿漂白与诊室牙齿漂白的治疗效果。