{"id":{"repo_id":"buffalo","oai_identifier":"oai:ubir.buffalo.edu:10477/86742"},"canonical_url":"https://search.dev.ndltd.org/etd/buffalo/oai:ubir.buffalo.edu:10477/86742","repository":{"repo_id":"buffalo","name":"Buffalo","base_url":"https://ubir.buffalo.edu/oai/request"},"display":{"title":"Comparison of Bleaching Agent Applied to White Spot Lesions Before or After Resin Infiltration: An In Vitro Study","abstract":"M.S.","abstract_html":"M.S.","abstract_has_math":false,"creators":["Youssef, Al-Shaheen; 0000-0001-5225-5070"],"institution":"State University of New York at Buffalo","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Covell, David","Orthodontics"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025-02-21T21:44:38Z","date_published":"2025-02-21T21:44:38Z","updated_at":"2026-07-27T19:05:34Z","subjects":["dentistry"],"languages":["eng"],"rights":["Users of works found in University at Buffalo Institutional Repository (UBIR) are responsible for identifying and contacting the copyright owner for permission to reuse. University at Buffalo Libraries do not manage rights for copyright-protected works and cannot assist with permissions.","Copyright retained by author."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/10477/86742","outbound_label":"Handle","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Covell, David","Orthodontics"]},{"key":"dc:creator","label":"Author","values":["Youssef, Al-Shaheen; 0000-0001-5225-5070"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2025-02-21T21:44:38Z","2020"]},{"key":"dc:publisher","label":"Institution","values":["State University of New York at Buffalo"]},{"key":"dc:type","label":"Dc Type","values":["Text","Thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["dentistry"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["eng"]},{"key":"dc:rights","label":"Dc Rights","values":["Users of works found in University at Buffalo Institutional Repository (UBIR) are responsible for identifying and contacting the copyright owner for permission to reuse. University at Buffalo Libraries do not manage rights for copyright-protected works and cannot assist with permissions.","Copyright retained by author."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["http://hdl.handle.net/10477/86742"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["M.S.","Objectives: To compare the color alteration achieved from bleaching white spot lesions (WSLs) before resin infiltration (RI) relative to bleaching WSLs after RI, and to evaluate how these color alterations compare to adjacent areas of bleached sound enamel. Materials & Methods: Artificial WSLs were created on the right side of the facial surfaces of 90 extracted bovine maxillary incisors. A split-tooth design was performed with the left sides remaining as sound enamel. The specimens were randomly assigned into two groups (n = 45 per group), whereby WSLs were bleached then treated with resin infiltration (B-RI), or WSLs were treated with resin infiltration and then bleached (RI-B). Bleaching agent was applied over the entire tooth surface to incorporate both the left and right sides. For the left sides, color measurements (CIE L*, a*, b* values) were obtained at baseline and after bleaching procedures. For the right sides, color measurements were obtained at baseline, after WSL formation, and then after bleaching and RI procedures. Color measurements following bleaching and RI procedures were obtained after the specimens were subjected to a simulated 14-day thermocycling procedure. Inter- and intra-group color alterations (ΔE) were calculated at selected timepoints. The surfaces of representative specimens from each group were evaluated by scanning electron microscopy (SEM). Statistical analyses were performed using Mann-Whitney U and Wilcoxon signed-rank tests (P ≤0.05).Results: There were no statistically significant differences in color alteration (ΔE) when comparing WSLs that were bleached before or after RI. When determining the difference in color alterations (ΔE) between WSLs that were bleached then resin infiltrated, to the adjacent bleached sound enamel, there was no statistically significant difference. When determining the difference in color alterations (ΔE) between WSLs that were resin infiltrated and then bleached, to the adjacent bleached sound enamel, there was a statistically significant difference; however, the difference was deemed not to be of clinical significance. SEM analysis revealed that applying bleaching agent after RI mildly altered the surface texture of the resin material. Conclusions & Clinical Implications: The primary outcomes of this study indicate that color alterations are comparable whether bleach is applied to WSLs before or after RI. Therefore, if a patient bleaches after RI was previously completed, they can expect that their teeth will bleach homogeneously, despite RI restorations placed in areas of WSLs. The clinical implication of this study's findings is that it is best to abide by the common recommendation to bleach prior to RI therapy, in that although color alterations remain clinically comparable, SEM analysis revealed that applying bleaching agent after RI roughened the surface texture of the resin material.","**To request an accessible version of the file(s) associated with this item, contact library@buffalo.edu. Please include the item's persistent URL [http://hdl.handle.net/. . .] in your request.**"]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Comparison of Bleaching Agent Applied to White Spot Lesions Before or After Resin Infiltration: An In Vitro Study"]}]}],"canonical_facts":{"dc:contributor":["Covell, David","Orthodontics"],"dc:creator":["Youssef, Al-Shaheen; 0000-0001-5225-5070"],"dc:date":["2025-02-21T21:44:38Z","2020"],"dc:description":["M.S.","Objectives: To compare the color alteration achieved from bleaching white spot lesions (WSLs) before resin infiltration (RI) relative to bleaching WSLs after RI, and to evaluate how these color alterations compare to adjacent areas of bleached sound enamel. Materials & Methods: Artificial WSLs were created on the right side of the facial surfaces of 90 extracted bovine maxillary incisors. A split-tooth design was performed with the left sides remaining as sound enamel. The specimens were randomly assigned into two groups (n = 45 per group), whereby WSLs were bleached then treated with resin infiltration (B-RI), or WSLs were treated with resin infiltration and then bleached (RI-B). Bleaching agent was applied over the entire tooth surface to incorporate both the left and right sides. For the left sides, color measurements (CIE L*, a*, b* values) were obtained at baseline and after bleaching procedures. For the right sides, color measurements were obtained at baseline, after WSL formation, and then after bleaching and RI procedures. Color measurements following bleaching and RI procedures were obtained after the specimens were subjected to a simulated 14-day thermocycling procedure. Inter- and intra-group color alterations (ΔE) were calculated at selected timepoints. The surfaces of representative specimens from each group were evaluated by scanning electron microscopy (SEM). Statistical analyses were performed using Mann-Whitney U and Wilcoxon signed-rank tests (P ≤0.05).Results: There were no statistically significant differences in color alteration (ΔE) when comparing WSLs that were bleached before or after RI. When determining the difference in color alterations (ΔE) between WSLs that were bleached then resin infiltrated, to the adjacent bleached sound enamel, there was no statistically significant difference. When determining the difference in color alterations (ΔE) between WSLs that were resin infiltrated and then bleached, to the adjacent bleached sound enamel, there was a statistically significant difference; however, the difference was deemed not to be of clinical significance. SEM analysis revealed that applying bleaching agent after RI mildly altered the surface texture of the resin material. Conclusions & Clinical Implications: The primary outcomes of this study indicate that color alterations are comparable whether bleach is applied to WSLs before or after RI. Therefore, if a patient bleaches after RI was previously completed, they can expect that their teeth will bleach homogeneously, despite RI restorations placed in areas of WSLs. The clinical implication of this study's findings is that it is best to abide by the common recommendation to bleach prior to RI therapy, in that although color alterations remain clinically comparable, SEM analysis revealed that applying bleaching agent after RI roughened the surface texture of the resin material.","**To request an accessible version of the file(s) associated with this item, contact library@buffalo.edu. Please include the item's persistent URL [http://hdl.handle.net/. . .] in your request.**"],"dc:format":["application/pdf"],"dc:identifier":["http://hdl.handle.net/10477/86742"],"dc:language":["eng"],"dc:publisher":["State University of New York at Buffalo"],"dc:rights":["Users of works found in University at Buffalo Institutional Repository (UBIR) are responsible for identifying and contacting the copyright owner for permission to reuse. University at Buffalo Libraries do not manage rights for copyright-protected works and cannot assist with permissions.","Copyright retained by author."],"dc:subject":["dentistry"],"dc:title":["Comparison of Bleaching Agent Applied to White Spot Lesions Before or After Resin Infiltration: An In Vitro Study"],"dc:type":["Text","Thesis"]},"updated_at":"2026-07-27T19:05:34Z"}