In vitro evaluation of calcium and phosphorus concentrations in enamel submitted to an in-office bleaching gel treatment containing calcium

Self-Instruction Exercise No. 374
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Exercise No. 374
Subject Code: 781
Tooth Whitening/Bleaching

The 15 questions for this exercise are based on the article, In vitro evaluation of calcium and phosphorus concentrations in enamel submitted to an in-office bleaching gel treatment containing calcium, on pages 52-56. This exercise was developed by Kim Capehart, DDS, MBA, PhD(c), and Jean J. Carlson, DDS, FAGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing this exercise will enable you to:

  • understand the chemistry of hydrogen peroxide–based (HP) in-office bleaching systems with (WCa) and without (W) calcium gluconate;
  • identify the advantages and disadvantages of adding calcium and phosphorus to bleaching systems; and
  • recognize the effects of in-office bleaching systems on enamel.

Answers for this exercise must be received by August 31, 2016.
  1. Bleaching products with a low pH lead to mineral _______ or a(n) ________ in enamel microhardness over time.

    A. gain; increase
    B. gain; decrease
    C. loss; increase
    D. loss; decrease

  2. The bleaching agent W was applied to tooth surfaces 3 times per session for a total of ____ minutes per day.

    A. 45
    B. 40
    C. 35
    D. 30

  3. In-office bleaching products containing 35%-40% HP have been used for all of the following reasons except one. Which is the exception?

    A. faster initial results
    B. compliance of tray-intolerant patients
    C. total control of application by patients
    D. long-lasting results

  4. Borges et al observed that the addition of _____% calcium gluconate to HP gel reduced the susceptibility of enamel to erosion.

    A. 1
    B. 2
    C. 3
    D. 4

  5. This study evaluated calcium (Ca) and phosphorus (P) levels in enamel before, during, and after 35% HP in-office bleaching treatments. The hypothesis tested was that a 35% HP bleaching treatment containing Ca would increase Ca and P levels in enamel.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  6. The bleaching agent W was removed with gauze after _____ minutes.

    A. 5
    B. 10
    C. 15
    D. 20

  7. The enamel biopsy sample was collected by applying ________ for ______ seconds to the tooth surface.

    A. phosphoric acid; 35
    B. molybdic acid; 30
    C. citric acid; 25
    D. hydrochloric acid; 20

  8. What element was measured by the colorimetric reagent arsenazo end point analysis?

    A. phosphorus
    B. magnesium
    C. hydroxide
    D. calcium

  9. The data were analyzed with which statistical test?

    A. Dunnett test
    B. Newman-Keuls method
    C. Rodger method
    D. Tukey-Kramer test

  10. Adverse effects of in-office bleaching agents on enamel are attributed to all of the following except one. Which is the exception?

    A. contact time of gel with the tooth surface
    B. presence of calcium gluconate
    C. peroxide concentration
    D. pH of the bleaching gel

  11. Bleaching agents with low pH help keep HP stable. Bleaching agents with low pH help facilitate the bleaching process.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  12. The two agents showed no difference in Ca and P concentrations from the baseline values ______ days posttreatment.

    A. 10
    B. 12
    C. 14
    D. 16

  13. The P concentration level for WCa decreased after the _______ bleaching application.

    A. first
    B. second
    C. third
    D. fourth

  14. The bleaching agent WCa was allowed to remain on tooth surfaces for _____ minutes.

    A. 40
    B. 35
    C. 30
    D. 20

  15. The pH value of the bleaching agent WCa at 7 minutes was found to be _______.

    A. 7.8
    B. 7.9
    C. 8.0
    D. 8.1

Evaluation
Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent
Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
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Did this article present new information? Yes No
How much time did it take you to complete this exercise? mins

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