ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Perform Bleaching Before Placing Composite Restorations
Clinical Question Is it better to place composite restorations before or after bleaching?
Clinical Bottom Line Bleaching has a negative effect on restorative materials such as composite restorations. Based on current literature, it is a better to perform bleaching before placement of composite restorations.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 15451241Attin/2004in vitro studySystemic Review
Key resultsBleaching can have negative impact on physical properties and marginal integrity of composite restoration materials, so it is beneficial to bleach before placing composite restorations.
Evidence Search National Library of Medicine (PubMed) was searched using following search terms: Dental bleaching, composite restoration.
Comments on
The Evidence
Information included in this review are from scientific papers and reviews which are listed in PubMed or ISI Web of science. The search terms that were used in this study are as followed: bleaching and (composite OR amalgam OR glass ionomer OR compomer OR resin OR alloy). The literature indicates that bleaching material has negative impact on enamel and dentin bond strength, physical property, marginal integrity and color of restorative material. These results come from in vitro studies. However there is no evidence indicating that the negative effect of bleaching on restorative material requires replacement of restorations.
Applicability Authors did not find any evidence that existing restorations are damaged to the point that they must be replaced.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords Composite restoration, dental bleaching
ID# 2072
Date of submission: 07/07/2011spacer
E-mail ghanizadeh@uthscsa.edu
Author Hoda Ghanizadeh
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author John Gildersleeve, DDS
Faculty mentor/Co-author e-mail GILDERSLEEV@UTHSCSA.EDU
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)
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by Qinlin Chen, Taylor Nguyen (San Antonio, TX) on 11/29/2017
A PubMed database search conducted in November 2017 yielded a random control trial (RCT) and an article which collectively support bleaching before composite as a sound clinical approach. Roubickova et al. 2013 (PMID 23570299) concluded that postoperative bleaching of etch-and-rinse adhesive and self-etch adhesives can lead to significant micro-leakage at resin margins. Türkmen et al. 2016 (PMID 26755225) conducted tests to measure shear bond strength before and after bleaching. It was concluded that there is no significance between self-etch and total-etch adhesives and no significance in shear bond strength in bleaching group. Clinicians are encouraged to consider all of this factors when creating treatment timelines and priority order
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