Effect Of Bleaching On Immediate Bonding Strength Of Human Enamel: A Systematic Review And Meta-analysis & Case Report

Part one.Effect of Bleaching on Immediate Bonding Strength of Human Enamel : A Systematic Review and Meta-analysis Purpose.This systematic review and meta-analysis aimed to evaluate the effect of enamel bleaching on the bonding strength of human enamel.Materials and methods.The literature search was conducted with PubMed,Web of Science,and Cochrane Library.The screening and quality assessment were performed by2 independent reviewers.The studies comparing the bond strength of human enamel bleached and unbleached were included in the meta-analysis.Meta-analyses were conducted with random-effects model,and used Review Manager Software(Cochrane Collaboration,Oxford,UK).Results.Of the 668 potentially relevant studies,123 articles were obtained by reading the abstract,66 articles were excluded by reading the full text.A total of 57 articles were included in the systematic review,and 53 were included in the qualitative analyses.The results showed significant difference between the experimental(bleached)group and the control group(unbleached).Conclusion.Most studies had showed that bleaching of human enamel leads to the decrease significantly of bonding strength.Most of the papers showed that the residual oxygen and hydrogen peroxide ions released by bleaching agents are considered to be the main reasons for the decrease of bond strength.Part two.Case ReportPurpose.To collect the cases of tooth discoloration and anterior tooth defect.Materials and methods.Five cases were collected from patients who visited the Department of Prosthodontics of Fujian Medical University Affiliated Stomatological Hospital from October 2019 to February 2021.Through the comparison of the operation process and the feedback of patients during and after treatment,refer to the relevant literature,and explore the relevant factors.Results.Communicated with patients before operation.Case 1,2,and 3 were used 10% carbamide peroxide at-home bleaching.Case 1 is a dental fluorosis,the treatment plan first step is microabrasion,the second step is at-home bleaching for 2 months,and the third step is resin infiltration.After 2 months of bleaching treatment,the teeth are significantly whitened.And wait a week for resin infiltration treatment after bleaching.Patient is satisfied with the final treatment effect.Case 2 is enamel hypoplasia.The treatment plan at-home bleaching for 2 months,after bleaching the teeth becomes whitened,and then it can improve the visual effect in this area of enamel hypocalcification.Due to the patient has tooth defect,wait a week after bleaching,and using resin composite to repair.Case 3 was teeth discoloration with age,the treatment plan is at-home bleaching for 1 month.The patient had no sensitive symptoms or other adverse reactions during the treatment,and the teeth color is increased by 3 color levels.Patient is satisfied with the final treatment effect.Case 4 was using digital smile design and instruct technicians to make Mock-up.The Final restorations were made of lithium disilicate glass-ceramic.Case 5 used lithium disilicate glass-ceramic to make the final restoration.One year later,the restoration remains intact,the marginal evaluation is intact,the occlusal test is normal,and no secondary caries were found.Conclusion.In recent years,with the improvement of health awareness and living standards,more and more patients prefer conservative treatment and minimally invasive treatment.The principle is retained tooth as much as possible,and the treatment of minimum abrasion and destruction of teeth is more favored by patients.In the past,veneer,inlay and crown were used to treat tooth discoloration and a small amount of tooth defect.In recent years,we have increased tooth bleaching,microabrasion and resin infiltration.According to my case report,using the combination of bleaching treatment,microabrasion and resin infiltration technology.It can improve the symptoms of dental fluorosis.According to my case report,after bleaching treatment,using composite resin can improve enamel hypocalcification,it can recover aesthetic performance.In these cases of anterior tooth defect,first through rigorous screening of indications,cooperate with digital smile design,standardized tooth preparation,precise moulding of silicone rubber,choose the right prosthesis material,choose the right bonding material,and then to ensure the aesthetic effect of the restoration.