Effects of charcoal-based whitening toothpastes on human enamel in terms of color, surface roughness, and microhardness: an in vitro study

Assessing the Effect of Toothpastes on Enamel Surface Roughness Using a Custom-Designed and Fabricated Toothbrush Simulator Device for Evaluation

The primary objective of this study is to emphasize the importance of maintaining optimal oral health through regular toothbrushing practices. To achieve this objective, a custom-designed electromechanical toothbrush simulator device was developed. This innovative tool enables researchers to investigate the impact of abrasive-based whitening toothpastes on enamel surface roughness compared to brushing without toothpaste. The device design is composed of multiple systems, including mechanical, motorization, and toothpaste irrigation components. The device incorporates various components, including mechanical, motorization, and toothpaste irrigation systems. Specifically, the mechanical aspect comprises fabricated metal parts, 3D printed elements, and a load cell for measuring brushing force. The motorization section integrates a microcontroller and a stepper motor, allowing for the adjustment of brushing cycles and speed. Furthermore, the toothpaste irrigation system employs a pump with adjustable speed, along with a toothpaste canister and a waste receptacle. By providing a controlled environment for evaluating the effects of different toothpaste formulations on enamel integrity, this simulator device contributes significantly to advancements in oral care research and product development.

Which Whitening Mouthwash With Different Ingredients Is More Effective on Color and Bond Strength of Enamel?

OBJECTIVE

To examine the effects of six whitening mouthwashes on tooth color and immediate bond strength to the enamel.

MATERIALS AND METHODS

Human incisors were divided into seven groups (n = 10) according to mouthwashes (R.O.C.S Black Edition White, Splat White Plus, Colgate Plax White Charcoal, Signal White Now, Listerine Advanced White, Colgate Optic White, and distilled water). After the initial color measurements, the teeth were exposed to mouthwash for 4 weeks. Then, the color measurements were repeated. Then, cylindrical composite resin blocks were immediately applied to the enamel surfaces and subjected to shear bond strength tests. Data were analyzed using Kruskal-Wallis and Bonferroni tests (α = 0.05).

RESULTS

Δ𝑏, Δ𝐿, and ΔE00 values did not present significant differences among the groups. Significant differences among the groups were determined for Δ𝑎 and ΔWID values (p < 0.05). R.O.C.S Black Edition White and Splat White Plus produced clinically acceptable color changes. Signal White Now, Splat White Plus, and Listerine Advanced White created acceptable whiteness changes. The mouthwashes did not statistically affect the bond strength compared to the distilled water (p > 0.05).

CONCLUSIONS

Whitening mouthwash containing blue covarine revealed more acceptable color and whitening changes. Mouthwash containing charcoal led to the lowest enamel bond strength values.

CLINICAL SIGNIFICANCE

The content of whitening mouthwashes affected the degree of tooth whitening and shear bond strength to enamel.

Abrasive challenge effects on enamel and dentin from irradiated human teeth: an in vitro study

This study aimed to evaluate the effects of radiotherapy (RT) and chemoradiotherapy (CRT) on the wear and surface roughness of in vitro irradiated human enamel and dentin subjected to abrasive challenge. Enamel and dentin specimens (n = 42) were prepared from teeth donated by healthy patients and those with head and neck cancer who had received radiotherapy (RT) or chemoradiotherapy (CRT). The specimens were categorized into three groups: control, RT, and CRT (n = 14 per group for both enamel and dentin). These samples were subjected to an in vitro abrasive experiment using a brushing machine, followed by wear and surface roughness assessments with a confocal laser scanning microscope conducted before and after the abrasive challenge, considering both exposed and non-exposed areas. Statistical analysis used Shapiro-Wilk tests for normality, Wilcoxon tests for comparing two means, and Kruskal-Wallis tests. A significance level of 5% was adopted. In enamel specimens, wear profile values ​​of CRT and RT groups were not different from the control (p > 0.05). The RT group presents lower step values than the CRT and control groups (p < 0.001). No significant difference in final surface roughness was observed in all groups (p > 0.05). In dentin specimens, no significant difference in wear profile and step was observed in all groups (p > 0.05). However, CRT and RT groups present higher values in final surface roughness (p < 0.001). The exposure to ionizing radiation (associated or not to chemotherapy) influenced the surface roughness of dentin and the wear (step) of enamel after the in vitro abrasive challenge.Trial registration: Ethical procedures were approved by the FORP/USP Research Ethics Committee (CAAE: 61308416.4.0000.5419), and Hospital do Câncer de Barretos/Fundação Pio XII (CAAE: 61308416.4.3001.5437).

Effect of hydrogen peroxide versus charcoal-based whitening mouthwashes on color, surface roughness, and color stability of enamel

BACKGROUND

Patients tend to favor the whitening mouthwashes as they are easily applied and affordable. This study aimed to evaluate the effect of hydrogen peroxide versus charcoal-based whitening mouthwashes on color, surface roughness, and color stability of enamel. In the current study, the whitening mouthwashes used have the ability to stop future stains due to their white seal technology.

METHODS

A total of 21 permanent central incisor teeth extracted for periodontal reasons were used in the present study. Teeth roots were sectioned and crowns were mounted in self-cured acrylic resin blocks. The specimens were randomly divided into three groups (n = 7) according to the tested whitening mouthwash: Control group ‟ DW" (Distilled water), ‟OW" group: Peroxide-based mouthwash (Colgate Optic White) and ‟CP" group: Charcoal-based mouthwash (Colgate® Plax Charcoal). Regarding ‟OW" and ‟CP" groups, the specimens were immersed in 20 ml of the tested mouthwash in each corresponding group for 1 min twice daily (morning and evening) for a total of 12 uninterrupted weeks. Color change was assessed using VITA Easyshade spectrophotometer and surface roughness (Ra) was measured using a white light interferometer. The specimens were stained using black tea solution and color was measured after 24 h of immersion for assessment of color stability.

RESULTS

Color change results revealed that both whitening mouthwashes were able to restore color comparable to the control group with no significant difference between them. Regarding surface roughness, the control group showed the highest mean Ra value, followed by ‟OW" group while ‟CP" group showed the lowest mean Ra value. While color stability after staining, the control group showed a significantly higher value than the ‟CP" and ‟OW" groups.

CONCLUSION

Hydrogen peroxide and charcoal-based whitening mouthwashes improve the color of enamel with no adverse effect on the surface roughness. Both whitening mouthwashes were beneficial to maintain the color after staining and prevent future enamel stains.

Over-the-counter products in tooth bleaching: A scoping review

OBJECTIVE

To map and summarize the current scientific evidence concerning the active ingredients, effectiveness, and adverse effects of over-the-counter (OTC) bleaching products.

DATA AND SOURCE

This study was conducted according to the PRISMA-ScR guidelines for scoping reviews and registered on the Open Science Framework platform.

STUDY SELECTION

Database searches were conducted in PubMed/MEDLINE, Embase, and Scopus up to January 2024. All in vitro, in situ, and clinical studies evaluating the effectiveness and adverse effects of OTC bleaching products were included. A descriptive analysis of the included studies was performed.

RESULTS

A total of 88 studies were included. Most of them were in vitro studies (n = 49), followed by randomized clinical trials (n = 28). The main OTC bleaching products identified were whitening or stain-removing toothpastes (n = 42), followed by whitening strips (n = 39). Most clinical studies indicate that whitening strips are effective in improving tooth color and providing whitening benefits. In contrast, the bleaching effectiveness of toothpastes, mouth rinses and whitening trays was mainly supported by in vitro studies. The main adverse effects associated with OTC bleaching agents were tooth sensitivity and gingival irritation.

CONCLUSION

A wide variety of OTC bleaching products is available for consumer self-administered use. Clinical studies have mainly confirmed the bleaching effectiveness of whitening strips, while the validation for toothpastes, mouth rinses and whitening trays has mainly relied on in vitro studies. Nevertheless, the use of OTC bleaching products may result in adverse effects, including tooth sensitivity, gingival irritation, and enamel surface changes.

CLINICAL SIGNIFICANCE

Some over-the-counter bleaching products may have whitening properties supported by clinical studies, particularly those containing hydrogen or carbamide peroxide. Nonetheless, clinicians must be aware of the potential risks associated with excessive self-administration of these products, which may result in adverse effects.

The Gloss Retention of Esthetic Restorations Following Simulated Brushing with Charcoal Oral Products: An In-Vitro Study

AIM

To assess the gloss and gloss retention of two esthetic restorative materials after brushing with a charcoal-infused toothbrush and activated charcoal toothpaste compared to their standard counterparts in all possible combinations.

MATERIALS AND METHODS

In this study,104 disc-shaped specimens were prepared, 52 from each of the two materials: Beautifil II LS composite resin (Giomer) and Fuji II LC resin-modified glass ionomer (RMGI). Specimens of each material were divided into 4 groups (n = 13) according to the tested brushing procedure: group A-standard toothbrush + standard non-whitening toothpaste (S-S), group B-standard toothbrush + activated charcoal toothpaste (S-CH), group C-charcoal-infused toothbrush + standard non-whitening toothpaste (CH-S), and group D-charcoal-infused toothbrush + activated-charcoal toothpaste (CH-CH). Gloss was recorded using a gloss meter initially and after each brushing protocol. The data were statistically analyzed with two-way analysis of variance (ANOVA) and Tukey HSD post hoc tests using SPSS® v.27 software at 5% significance level.

RESULTS

Beautifil II LS showed the highest gloss values after brushing in group D (44 ± 3.9), which was not significantly different from its initial value (46.1 ± 1.8), followed by groups A (32.2 ± 4), B (23.2 ± 3.6), and C (22.7 ± 3.9), while Fuji II LC showed its highest gloss values after brushing in groups D (16.6 ± 3.7) and a (15.4 ± 8.7), followed by groups C (10.9 ± 6) and B (4.4 ± 2.5), all were significantly lower than their respective initial gloss values.

CONCLUSION

The gloss of Giomer and RMGI reduced significantly following the brushing with the tested brushing procedures except for the Giomer group brushed with a combination of charcoal-infused toothbrush and activated-charcoal toothpaste.

CLINICAL SIGNIFICANCE

The brushing using a combination of charcoal-infused toothbrush and activated-charcoal toothpaste is recommended for the gloss retention of Beautifil II LS restorations. However, the gloss of the Fuji II LC cannot be retained after any of the brushing procedures. How to cite this article: Farghal NS, Awadalkreem F, Abouelhonoud NA, et al. The Gloss Retention of Esthetic Restorations Following Simulated Brushing with Charcoal Oral Products: An In-Vitro Study. J Contemp Dent Pract 2024;25(5):473-479.

Whitening efficacy of activated charcoal-based products: A single-blind randomized controlled clinical trial

OBJECTIVE

This randomized controlled clinical trial evaluated the whitening efficacy, tooth sensitivity (TS), and volunteers' satisfaction following the use of activated charcoal powder and toothpaste.

METHODS

Fifty-six volunteers were randomly allocated into 4 groups (n = 14) according to a 14-day toothbrushing or whitening treatment with activated charcoal powder (ACPW), activated charcoal toothpaste (ACT), regular fluoridated toothpaste (RT), and 10 % carbamide peroxide (CP). Objective (ΔE00) and subjective (ΔSGU) color and whiteness index (ΔWID) changes were calculated. Patients self-reported the risk and intensity of TS using a visual analogue scale and the volunteer's satisfaction was determined by a questionnaire. Color assessments were analyzed by Kruskal-Wallis followed by Dwas-Steel-Crithlow-Fligner, and absolute TS risk and volunteer's satisfaction by Fisher exact test (p < 0.05).

RESULTS

ACPW and ACT promoted similar effects in ΔE00, ΔSGU, and ΔWID to that observed for RT. No significant difference was found in terms of TS risk intensity. TS risk became high after 7 and 14 days, with higher TS prevalence in CP. Volunteers reported that ACPW exhibited the lowest ease-of-use, comfort, and whitening satisfaction among groups (p < 0.05).

CONCLUSION

Activated charcoal-based products presented a minor and unsatisfactory whitening effect while CP resulted in optimal tooth whitening and the highest level of satisfaction among volunteers. Risk was higher from 7 days onwards and was more pronounced in the CP.

CLINICAL RELEVANCE

Based on the whitening effect and patient satisfaction, this controlled-randomized clinical evidence supports that the use of activated charcoal-based products should be discouraged.

Color stability of bleached tooth enamel brushed with different stain-removing toothpastes

OBJECTIVE

The effects of four toothpastes on the color stability of in-office bleached tooth specimens were determined.

MATERIALS AND METHODS

We evaluated an experimental toothpaste (EXP) and three commercially available toothpastes: Colgate Optic White (OPW), Aquafresh White & Protect (AWP), and Crest 3D White (CDW). OPW, AWP, and CDW contained inorganic abrasives, whereas EXP and AWP contained sodium polyphosphate. Forty-eight randomly selected human-extracted maxillary central incisors were bleached and brushed twice daily over 30 days. We analyzed the final color difference (ΔE*ab, ΔE00 , ΔWID ), arithmetic average surface roughness (Ra) of the enamel measured on days 0 and 30, and scanning electron microscopy images of enamel surfaces and toothpastes. ΔE*ab, ΔE00 , ΔWID , and Ra were analyzed using one-way analysis of variance and Tukey's test (α = 0.05).

RESULTS

ΔE*ab and ΔE00 values were significantly lower after toothbrushing with EXP, OPW, and CDW than with AWP. OPW induced the greatest positive ΔWID . Ra was significantly increased by OPW and CDW, but slightly increased by AWP, with cube-like particles, and EXP, with no particle-like structures.

CONCLUSIONS

Only EXP stabilized the color of bleached teeth without increasing the enamel surface roughness. Sodium polyphosphate with approximately 10 phosphate groups was effective at removing stains.

CLINICAL SIGNIFICANCE

The effect of toothpaste on the color stability of bleached teeth depends on the constituting abrasives and chemical components. Polyphosphoric acid has different stain-removal effects depending on its degree of polymerization. Additionally, although certain types of abrasives may be effective for color stability, they also increase the surface roughness of the enamel.

The Effect of Charcoal-Based Dentifrice and Conventional Whitening Toothpaste on the Color Stability and Surface Roughness of Composite Resin: A Systematic Review of In Vitro Studies

The objective was to systematically review studies that evaluated the effect of charcoal-based dentifrices (CbDs) and conventional whitening toothpastes (CWTs) on the color stability (CS) and/or surface roughness (SR) of composite resin (CR). The question we focused on was "Do CbD and CWT affect the CS and/or SR of CR?" Indexed databases were searched without language and time restrictions up to and including May 2023 using different keywords. Original experimental studies were included. The risk of bias (RoB) was assessed using the Quality Assessment Tool for In Vitro Studies. Ten in vitro studies performed on CR were included. The number of CR samples assessed ranged between 18 and 200. In one study, CbDs altered the CS and SR of CR, whereas another study showed no difference in changes in the SR and CS of CR when CbDs were compared with CWTs. One study showed that compared with CWTs, CbDs caused changes in the CS of CR but changes in SR were similar between the two dentifrices. One study showed that CbDs and CWTs improved the overall color and enhanced the SR of CR. Three studies had a high RoB, five had a medium RoB, and two had a low RoB. Compared to CWTs, CbDs appeared to affect the CS of CR, but the SR of CR induced by both dentifrices remained consistent. Further well-designed and power-adjusted studies are needed.

Is the whitening effect of charcoal-based dentifrices related to their abrasive potential or the ability of charcoal to adsorb dyes?

OBJECTIVES

To evaluate if tooth color alteration of activated charcoal-based dentifrices may be attributed to the dye adsorption potential of charcoal (chemical action - C - slurry only) or to the association of dye adsorption with abrasion (chemo-mechanical action - CM- slurry/toothbrushing). Potential adverse effects in surface roughness, gloss, and wear were also assessed.

METHODS

Bovine enamel/dentin specimens were randomly allocated into the groups according to treatments and test model (n = 15): deionized water (negative control- NC); Colgate Maximum Anticaries Protection (conventional toothpaste- positive control- PC); Colgate Luminous White Activated Charcoal (LW); Oral-B 3D White Therapy Charcoal (WT); Curaprox Black is White (BW); Dermavita Whitemax (Activated charcoal powder- WP). Specimens were exposed to the C or CM models, in 28-day staining-treatment cycling. Color change (ΔE00), whiteness index (ΔWID), percentage of alteration of surface roughness (%Raalt), and gloss (%GUalt) were calculated. Additional specimens (n = 9) were indented with a Knoop diamond and subjected to 100,000 abrasion cycles. Enamel wear was determined by calculating the decrease in indentations geometry. Data were analyzed by ANOVA/Tukey tests (α = 0.05).

RESULTS

The CM-model produced lower color change (staining) than C (p = 0.0001). PC, LW, WT, BW, and WP showed similar color results for both models, differing from NC (p < 0.05).%Ra and%GU did not differ among the C-model groups (p > 0.05) and WP exhibited the highest variation (%Ra and%GU) under CM-model. Enamel wear values were lowest in the NC and PC groups, intermediate for LW, WT, BW, and highest for the WP (p < 0.05).

CONCLUSION

Activated charcoal-based dentifrices have a similar ability to minimize tooth staining as the conventional toothpaste, with increased enamel wear potential in the long term (after 100,000 cycles). The activated charcoal powder damaged the enamel surface, showing a higher deleterious effect on enamel roughness, gloss, and wear.

CLINICAL SIGNIFICANCE

Dentifrices containing activated charcoal do not provide superior results to minimize tooth staining compared to conventional toothpaste. Charcoal powder should be used with caution because it promotes higher superficial alterations on the enamel surface.

Longevity of extrinsic stains on monolithic zirconia restorations: An in vitro study

STATEMENT OF PROBLEM

Three-mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) has been commonly used for fixed prosthodontic restorations. The opacity of 3Y-TZP may be masked with external staining, although the longevity of extrinsic stains applied to monolithic zirconia is unclear.

PURPOSE

The purpose of this in vitro study was to analyze the color and surface roughness of extrinsically stained zirconia specimens after thermocycling and toothbrushing.

MATERIAL AND METHODS

Monolithic Ø12.5×1.25-mm zirconia disks were milled from 3Y-TZP blocks, sintered according to manufacturer instructions, and then divided into 3 groups (C, J, and O; n=16) for application of stain and glaze. All specimens underwent 10 000 thermocycles in distilled water before being further divided into 2 dentifrice groups (n=8): normal grit, low relative dentin abrasivity (RDA) (Subgroup N) and abrasive grit, high RDA (Subgroup A). Specimens were brushed in a multistation brushing machine under 1.47 N of force using a 5:8 toothpaste and distilled water slurry for 10 000 cycles with a straight (American Dental Association Standard) toothbrush to simulate 1 year of toothbrushing. Color and surface roughness measurements were obtained at 3 time points: baseline, after thermocycling, and after brushing. A 2-way repeated measures ANOVA was used to independently assess changes in color and surface roughness with respect to thermocycling and brushing (α=.05).

RESULTS

Group J displayed no significant change in color for either dentifrice system (P>.05). However, a significant change in surface roughness was observed for both dentifrice subgroups (P<.001). Group C specimens displayed significant changes in color (P<.001) and surface roughness (P<.001) for both dentifrice systems. Group O specimens displayed significant changes in color (P<.025) for both dentifrice systems and significant changes in surface roughness (P<.004) for subgroup A, but no significant changes for subgroup N (P=.075).

CONCLUSIONS

Artificial aging of monolithic zirconia resulted in changes in color and surface roughness that did not surpass the thresholds for perceptibility and acceptability. This study failed to establish durability limits for extrinsic stains applied to 3Y-TZP.

Effect of whitening toothpastes on the surface roughness and microhardness of human teeth-an in vitro study

OBJECTIVE

To determine the effect of whitening toothpastes on the surface roughness and microhardness of human teeth.

METHODOLOGY

Surface roughness was estimated using the Talysurf instrument, and microhardness was estimated using the Vickers hardness tester before and after the application of whitening toothpastes on mounted extracted human teeth.

RESULTS

In the activated charcoal group, there was a reduction in the surface roughness from 1.21 at baseline to 1.09 at 1 month and a further reduction to 1.02 at 3 months, which was found to be statistically significant. However, no statistically significant difference in surface roughness was found in the other toothpaste groups. With respect to microhardness, all 4 whitening toothpastes showed a statistically significant reduction in microhardness after 3 months of brushing. However, the reduction was significantly higher in group 2 and in group 4 compared to the others.

CONCLUSION

This study showed that whitening toothpaste containing activated charcoal significantly reduced the surface roughness, whereas toothpastes with blue covarine and toothpastes containing activated charcoal significantly reduced the microhardness of the tooth.

CLINICAL RELEVANCE

This study emphasizes the need for healthcare professionals to be aware of the potential disadvantages of whitening toothpastes and make evidence-based decisions when recommending the product to patients.

"Afterglow" Photodynamic Therapy Based on Carbon Dots Embedded Silica Nanoparticles for Nondestructive Teeth Whitening

Teeth staining is a common dental health challenge in many parts of the world. Traditional teeth whitening techniques often lead to enamel damage and soft tissue toxicity due to the use of bioincompatible whitening reagents and continuous strong light irradiation. Herein, an "afterglow" photodynamic therapy (aPDT) for teeth whitening is proposed, which is realized by energy transition pathways of intersystem crossing. The covalent and hydrogen bonds formed by carbon dots embedded in silica nanoparticles (CDs@SiO2) facilitate the passage of energy through intersystem crossing (ISC), thereby extending the half-life of reactive oxygen species (ROS). The degradation efficiency of aPDT on dyes was higher than 95% in all cases. It can thoroughly whiten teeth by eliminating stains deep in the enamel without damaging the enamel structure and causing any tissue toxicity. This study illustrates the superiority of aPDT for dental whitening and the approach to exploring carbon-dots-based nanostructures in the treatment of oral diseases.

Effect of whitening toothpastes and activated charcoal powder on enamel wear and surface roughness

This study aimed to evaluate surface roughness (Sa), roughness profile (Rv), and enamel wear after brushing with different whitening toothpastes and charcoal powders. Sixty (n = 10) bovine enamel blocks (6 × 6 × 3 mm) were randomly distributed into six groups according to toothpaste type: regular toothpaste (CONT), toothpaste containing 2% hydrogen peroxide (HP), toothpaste containing titanium dioxide (TiO2), toothpaste containing charcoal (COAL), toothpaste containing charcoal and TiO2 (COAL+TiO2), and activated charcoal powder (COAL_PWD). Each block was subjected to 30,000 reciprocal cycles at a 1:3 proportion slurry. After brushing, the blocks were analyzed using an optical profilometer to determine Sa, Rv, and enamel wear. In addition, representative 3D images of each group and wear profiles were obtained. Sa was analyzed using generalized linear models followed by Bonferroni correction, whereas Rv was analyzed using one-way analysis of variance. After brushing, COAL and COAL+TiO2 showed higher Sa values than COAL_PWD. However, no significant difference was observed in Sa between whitening toothpaste and COAL_PWD, and CONT (p > 0.05). In addition, no differences were observed among the groups in Rv (p > 0.05). Conversely, enamel wear was higher for TiO2, COAL, COAL+TiO2, and COAL_PWD than for CONT. CONT showed the least enamel wear, whereas HP showed intermediate values. Representative 3D images and line profiles showed lower step-height and lower mean surface losses for the CONT and HP groups than for the other groups. Whitening toothpastes and COAL_PWD did not increase Sa or Rv compared with CONT, while CONT demonstrated lower enamel wear.

Remineralization, color stability and surface roughness of tooth enamel brushed with activated charcoal-based products

OBJECTIVE

To evaluate the effect of activated charcoal-based (AC) products on color alteration, remineralizing potential and surface roughness of dental enamel.

MATERIALS AND METHODS

Bovine incisors were cut into 6 × 6 × 2 mm fragments. Initial color (EasyShade, Vita) and surface roughness (Surfcorder SE1700, Kosakalab) readings were performed. Fragments were separated into five groups (n = 17) according to the treatment: Control: Fluoride toothpaste (Colgate Total 12, Colgate); Charcoal + NaF: AC toothpaste (ACT) with sodium fluoride (Colgate Natural Extracts, Colgate); Charcoal + MFP + n-HA: ACT with sodium monofluorophosphate and nanohydroxyapatite (Black is White, Curaprox); Charcoal: Fluoride-free ACT (ProActive, Hinode); and Charcoal powder: AC powder. Simulated toothbrushing was performed and final color and surface roughness readings were obtained. Fragments were then polished, and initial microhardness (HMV-2, Shimatzu) readings were done. Samples were artificially demineralized and brushed again. Final microhardness readings were taken. Data were statistically analyzed.

RESULTS

Fluoride-free charcoal presented the lowest surface roughness alteration (p < 0.05). Charcoal powder had the lowest color change (p < 0.05) and negative values for whiteness index for dentistry alteration. All the groups presented values below whiteness acceptability threshold and negative relative microhardness values. Control showed the highest remineralizing potential (p < 0.05).

CONCLUSIONS

ACPs did not produce color alteration different from the fluoride toothpaste, except for Charcoal powder that caused less color change. ACPs caused surface roughness alteration similar to the fluoride toothpaste. ACT with fluoride and AC powder did not have remineralizing potential.

CLINICAL SIGNIFICANCE

Activated charcoal-based products (ACP) promise effective tooth whitening and quick results, without teeth damage. In addition, some ACPs contain fluoride in toothpaste composition and promise rehardening potential. However, ACPs are not as effective as other whitening agents and can alter the surface roughness of the enamel. Even if the ACPs contain fluoride or other remineralizing agents, they might be ineffective.

Dynamicity, emerging patterns, and spatiotemporal trends of scientific production on the use of activated carbon in oral health: a scientometric study

BACKGROUND

The use of activated carbon (AC) in oral hygiene products has gained significant interest; however, its potential benefits for oral health remain uncertain. This study aimed to conduct a scientometric analysis to examine the dynamicity, emerging patterns, and trends over time in scientific production concerning the use of AC in oral health.

METHODS

The Web of Science database was searched for articles published between 2005 and 2022. Various bibliometric indicators, including the H-index, annual growth, Lotka's law, Bradford's law, and Sankey diagram, were used for data analysis. Overlay maps, timezone visualization, and three field plots were used to evaluate visualization patterns, time-temporal relationships, and trends. Information retrieval process was performed on March 11, 2023.

RESULTS

The analysis revealed that only six studies constituted the top references with the highest number of citations in recent years, with Brooks' 2017 study demonstrating the most significant increase in citation. The dual-map overlay demonstrated a close citation relationship between cluster 4 (Molecular Biology Immunology) and the areas of Environmental, Toxicology, and Nutrition. The visualization graph of publication patterns indicated the journals that accumulated the highest number of citations during the study period.

CONCLUSION

This scientometric study provides valuable insights into the use of AC in oral health and its impact on the field of dentistry. It determines the most productive journals, authors, and countries with the greatest influence. AC effectively removes pollutants and is gaining interest for use in dental effluent treatment. Thus, it may be a viable option for professionals.

In Vitro evaluation of the effects of whitening toothpastes on the color and surface roughness of different composite resin materials

BACKGROUND

The aim of this study was to evaluate the effects of traditional and whitening toothpastes on the color and surface roughness of different composite resin materials.

METHODS

Eighty disc-shaped samples were prepared for each of the following composite resins: nano-hybrid (Filtek Ultimate Universal; 3 M/ESPE, Saint Paul, USA), micro-hybrid (Charisma Smart; Kulzer, Hanau, Germany) and supra-nano-filled (Omnichroma; Tokuyama, Tokyo, Japan). Each composite-resin sample was randomly divided into the following four subgroups (n = 20 per group): Group 1, control; Group 2, traditional toothpaste (Colgate Total 12; Colgate Palmolive, New York, USA); Group 3, peroxide-based toothpaste (Colgate Optic White; Colgate-Palmolive, New York, USA); and Group 4, blue covarine-based toothpaste (Meridol Gentle White; CP-GABA, Hamburg, Germany). The samples for the toothpaste subgroups were immersed in a coffee solution for 10 min and washed twice a day before each brushing cycle. The specimens were brushed for 30 days. Color analyses were performed using a spectrophotometer (SpectroShade Micro, MHT, Italy). Surface roughness analyses were conducted using a profilometer (Surftest SJ-210 Mitutoyo, Tokyo, Japon). The color and surface roughness analyses were performed at baseline and 1, 7 and 30 days after each treatment. Furthermore, surface topography analysis was performed using Scanning Electron Microscopy (FEG 250-FeiQuanta, the Netherlands). The data were analysed with a three-way robust ANOVA and Bonferroni post-hoc correction (p < 0.05).

RESULTS

The smallest color change was observed for the micro-hybrid composite resin, and the greatest color change was observed for the nano-hybrid composite resin. Based on the tested composite resin samples, the greatest color change was obtained after using blue covarine-based toothpaste, while the smallest color change was observed after using peroxide-based toothpaste. Moreover, the supra-nano-filled composite resin samples exhibited the lowest roughness values (robust ANOVA test, p < 0.001). There was no statistically significant difference between the mean values of roughness for the composite, group and time interaction (p = 0.937).

CONCLUSION

Charisma Smart composite resin exhibited significantly lower staining than all the other composite resins tested after using all toothpastes included in the study. Further laboratory and clinical studies are needed to fully understand the long-term effectiveness of whitening toothpaste on composite resin materials.

Evaluation of the effects of whitening toothpaste containing nanohydroxyapatite on surface roughness and color change in restorative materials

Background

The effects of whitening toothpastes containing nanohydroxyapatite on the surfaces of restorative materials are not well known. This study evaluated the changes in surface roughness and color of coffee-stained restorative materials after brushing with nanohydroxyapatite and other whitening toothpastes.

Methods

Disc-shaped specimens were formed using microhybrid, nanohybrid, and supra-nano-filled composite (n = 30) and stained with a coffee solution. A brushing simulation was applied with toothpastes containing nanohydroxyapatite (Dentiste Plus White), perlite (Signal White System) and hydrogen peroxide (Colgate Optic White) for 7, 15, and 30 days. Color and surface roughness measurements were taken before and after brushing. Color change (∆E₀₀) was calculated using the CIEDE2000 system.

Results

Supra-nano-filled composite-Dentiste Plus White, supra-nano-filled composite-Colgate Optic White, and nanohybrid composite-Signal White System were the groups with the greatest color change observed on the 7th, 15th, and 30th days, respectively. The smallest color change was seen in the microhybrid composite-Signal White System, microhybrid composite-Dentiste Plus White, and nanohybrid composite-Dentiste Plus White groups on the 7th, 15th, and 30th days, respectively. No significant surface roughness changes were observed in the nanohybrid composite-Dentiste Plus White, supra-nano-filled composite-Colgate Optic White, supra-nano-filled composite-Dentiste Plus White, or supra-nano-filled composite-Signal White System groups.

Conclusions

Whitening toothpaste containing nanohydroxyapatite provided a high degree of color change in the short term and did not create significant surface roughness in nanohybrid or supra-nano-filled composites.

Effect of Whitening Toothpastes with Different Active Agents on the Abrasive Wear of Dentin Following Tooth Brushing Simulation

The aim of this research was to evaluate the abrasive dentin wear that can be induced by three commercial whitening toothpastes following a tooth-brushing simulation (TBS) corresponding to a three-month period. Sixty human canines were selected, and the roots were separated from the crowns. Then the roots were randomly divided into six groups (n = 10) and were submitted to TBS using the following slurries: Group 1-deionized water (RDA = 5); Group 2-ISO dentifrice slurry (RDA = 100); Group 3-a regular toothpaste (RDA = 70); Group 4-a charcoal-containing whitening toothpaste; Group 5-a whitening toothpaste containing blue covasorb and hydrated silica; and Group 6-a whitening toothpaste containing microsilica. Following TBS, surface loss and surface roughness changes were evaluated using confocal microscopy. Additionally, surface morphology and mineral content changes were observed using scanning electron microscopy and energy-dispersive X-ray spectroscopy. The deionized water group presented the lowest surface loss (p < 0.05), while the charcoal-containing toothpaste presented the highest surface loss, followed by ISO dentifrice slurry (p < 0.001). Blue-covasorb-containing and regular toothpastes did not present statistically significant differences (p = 0.245), and neither didmicrosilica-containing toothpaste or ISO dentifrice slurry (p = 0.112). The surface height parameters and surface morphology changes of the experimental groups followed the surface loss patterns, while no differences were detected in mineral content after TBS.Although the charcoal-containing toothpaste exhibited the highest abrasive wear to dentin, according to ISO 11609, all the tested toothpastes exhibited appropriate abrasive behavior towards dentin.

Evaluation of the Efficacy of Low-Particle-Size Toothpastes against Extrinsic Pigmentations: A Randomized Controlled Clinical Trial

Stain-removing domiciliary protocols are focused on the elimination of dental extrinsic pigmentations by the application of abrasive toothpastes, extensively available in commerce. The goal of the present study is to evaluate the efficacy of two different stain removal molecule-formulated toothpastes by the reduction of clinical parameters: the micro-cleaning crystals and activated charcoal. A total of 40 participants with extrinsic dental pigmentations were enrolled and divided into two groups: a Control group, assigned to a toothpaste with micro-cleaning crystals (Colgate Sensation White); and a Trial group, with microparticle-activated charcoal toothpaste (Coswell Blanx Black). At T0 (baseline), T1 (10 days), T2 (1 month), and T3 (3 months), clinical parameters, including Lobene stain index calculated for intensity and extension, plaque control record, and bleeding on probing, were measured. Statistically significant differences were found in both groups (p < 0.05): a reduction of extrinsic pigmentation, both in intensity and extension, was obtained in the Control group, but their total elimination could be achieved only in the Trial group with the activated charcoal molecule, though without significant difference between the groups (p > 0.05). No intergroup differences were found for each timeframe for PCR, BoP, LSI-I, and LSI-E. Both tested toothpastes can be recommended for domiciliary oral hygiene of patients with extrinsic pigmentations.

In vitro assessment of activated charcoal-based dental products

OBJECTIVE

Assess the effects of activated charcoal-based products on whitening and changes on dental enamel surface.

MATERIAL AND METHODS

Fifty-two blocks of bovine dental enamel were randomly distributed in four groups (n = 13): brushing with activated charcoal-based powder (PW); brushing with activated charcoal-based dentifrice (AC); brushing with a conventional dentifrice containing 1450 ppm of fluoride (CD); and whitening with 10% carbamide peroxide (CP). Color, microhardness, and surface alteration were analyzed at baseline and after 14 days of treatment. Three samples per group were randomly selected and examined using scanning electron microscopy (SEM) to analyze the morphology.

RESULTS

PW exhibited greater color change for the ΔE₀₀ , ΔWID, Δb* and ΔL* parameters than other groups (p < 0.05). After treatment, microhardness decreased in AC and CP groups (p < 0.05). Also, PW and AC groups showed more surface alteration than CD and CP (p < 0.001). Changes in the morphology of dental enamel were observed by SEM in PW and AC groups.

CONCLUSION

Activated charcoal-based products showed a lower whitening effect than 10% carbamide peroxide. These products also influenced dental enamel microhardness, resulting in greater surface alteration.

CLINICAL SIGNIFICANCE

Activated charcoal-based products promoted minimum whitening effects with significant enamel surface alteration. The 10% carbamide peroxide was more effective for whitening and caused slight enamel surface alteration.

Effect of Activated Charcoal Toothpaste on Color Stability of Bleached Teeth Immersed in Different Drinks

OBJECTIVE

This study aimed to evaluate the effect of activated charcoal toothpaste on the color stability of teeth subjected to tooth bleaching and pigmenting agents.

METHODS

A total of 120 bovine crowns were randomly divided into 12 groups (n=10) according to two study factors: staining solutions (three levels): saliva (control), coffee, and red wine; and toothpaste (four levels): BPC, Bianco Pro Clinical (Bianco Oral Care) (Control); BIW, Black is White (Curaprox); BCA, Bianco Carbon (Bianco Oral Care); and NAT, Natural Suavetex (Suavetex). The samples were subjected to office bleaching with a 35% hydrogen peroxide-based gel (Whiteness HP Blue, FGM), followed by immersion in the solution for 45 minutes per day and daily toothbrushing for 7 days. The color (ΔE) and luminosity changes (ΔL*) were measured using reflectance spectroscopy (Vita EasyShade). The CIE values (L*, a*, b*) were measured at baseline after bleaching (T0) and immediately after immersion in solution each day (Ti1-Ti7) and after all toothbrushing cycles (Tb1-Tb7). ΔE and ΔL were analyzed using a two-way analysis of variance and Tukey's test (α=0.05). The clinically unacceptable level of ΔE > 3.3 was used to evaluate the color change.

RESULTS

The color change was significantly influenced by the staining solutions and toothpastes (p<0.001). The color change (ΔE) was significantly higher when immersed in wine than in coffee, and lower ΔE values were observed for artificial saliva (control), irrespective of the toothpaste used. In artificial saliva, BPC, BIW, and BCA resulted in significantly lower ΔE values than NAT, which presented a clinically unacceptable level of dental color change (ΔE>3.3). Coffee resulted in a lower (L*) reduction than wine, irrespective of the toothpaste used.

CONCLUSION

Charcoal toothpastes resulted in a color change on the surface of the tooth enamel (ΔE). The bleaching effect of the charcoal toothpastes and control evaluated in this study partially reduced the color changes on the surface of the tooth enamel caused by staining solutions but was unable to reestablish the measured values to the baseline. For teeth immersed in artificial saliva, the color change was not noticeable in BCA, BIW, and control-BPC (ΔE≥3.3), except for NAT, which showed a significant color change.

Evaluating the Effect of Active Charcoal-Containing Toothpaste on Color Change, Microhardness, and Surface Roughness of Tooth Enamel and Resin Composite Restorative Materials

Methods

Thirty-six bovine incisors and resin composite samples were prepared, stained with black tea, and then randomly divided into two groups. The samples were brushed with a charcoal-containing toothpaste (Colgate® MAX WHITE) and daily toothpaste (Colgate® Max Fresh) for 10,000 cycles. Before and after brushing cycles, color variables (ΔL, Δa, Δb), total color change (ΔE), plus Vickers microhardness were evaluated. Two samples of each group were prepared for surface roughness assessment via atomic force microscope. Data were analyzed by Shapiro-Wilk, Independent sample t-test and Mann-Whitney U tests.

Results

According to the obtained results, ΔE and ΔL were significantly higher whereas Δa and Δb were noticeably lower in charcoal-containing toothpaste group in comparison with daily toothpaste in both composite and enamel samples. The microhardness of samples brushed with Colgate® MAX WHITE was significantly higher than that of Colgate® Max Fresh in enamel (P = 0.04), whereas no significant difference was found in composite resin samples (P = 0.23). Colgate® MAX WHITE enhanced the roughness of both enamel and composite surfaces.

Conclusion

The charcoal-containing toothpaste could improve the color of both enamel and resin composite with no negative effect on microhardness. Nevertheless, its adverse roughening effect should be considered occasionally on composite restorations.

Effect of 16% Carbamide Peroxide and Activated-Charcoal-Based Whitening Toothpaste on Enamel Surface Roughness in Bovine Teeth: An In Vitro Study

Background: Activated charcoal is a nanocrystalline form of carbon with a large specific surface area and high porosity in the nanometer range, having consequently the capacity to absorb pigments, chromophores, and stains responsible for tooth color change, while carbamide peroxide is unstable and breaks down immediately upon contact with tissue and saliva, first dissociating into hydrogen peroxide and urea and subsequently into oxygen, water, and carbon dioxide. Therefore, the aim of the present study was to assess the effect of 16% carbamide peroxide and activated-charcoal-based whitening toothpaste on enamel surface roughness in bovine teeth. Materials and Methods: The present experimental in vitro, longitudinal, and prospective study consisted of 60 teeth randomly distributed in six groups: A: artificial saliva, B: conventional toothpaste (Colgate Maximum Protection), C: whitening toothpaste with activated charcoal (Oral-B 3D White Mineral Clear), D: 16% carbamide peroxide (Whiteness Perfect 16%), E: 16% carbamide peroxide plus conventional toothpaste (Whiteness Perfect 16% plus Colgate Maximum Protection), and F: 16% carbamide peroxide plus whitening toothpaste with activated charcoal (Whiteness Perfect 16% plus Oral-B 3D White Mineral Clear). Surface roughness was assessed with a digital roughness meter before and after each treatment. For the statistical analysis, Student’s t test for related samples was used, in addition to the ANOVA test for one intergroup factor, considering a significance level of p < 0.05. Results: The surface roughness variation of bovine tooth enamel, before and after application of bleaching agent, was higher in groups of whitening toothpaste with activated charcoal (0.200 µm, Confidence Interval (CI): 0.105; 0.296 µm) and 16% carbamide peroxide plus whitening toothpaste with activated charcoal (0.201 µm, (CI): 0.092; 0.309 µm). In addition, bovine teeth treated with conventional toothpaste (p = 0.041), whitening toothpaste with activated charcoal (p = 0.001), and 16% carbamide peroxide plus whitening toothpaste with activated charcoal (p = 0.002) significantly increased their surface roughness values. On the other hand, significant differences were observed when comparing the variation in surface roughness between the application of artificial saliva (control) and the whitening toothpaste with activated charcoal (p = 0.031), and the 16% carbamide peroxide plus whitening toothpaste with activated charcoal (p = 0.030). Conclusion: The use of whitening toothpaste with activated charcoal and in combination with 16% carbamide peroxide significantly increased enamel surface roughness in bovine teeth.

Comparing the Effect of Activated Charcoal Whitening Agents against Regular Whitening Toothpastes on the Enamel Surface of Premolar Teeth: In vitro Study

INTRODUCTION: There has been increase in demand to use natural whitening agents nowadays which include activated charcoal. Activated charcoal has gained popularity recently with various claims to its benefits that have not been proven. AIM: The aim of the study was to evaluate the effect of activated charcoal whitening agents and regular whitening tooth paste on enamel surface of first premolars and to compare between the effects of materials used. MATERIALS AND METHODS: Twenty-one mandibular first premolars were used and divided into control group: untreated teeth that were later incorporated into experimental group. Experimental group: Consisting of three subgroups: Subgroup I: treated with Carbon Coco. Subgroup II: treated with Venu activated charcoal. Subgroup III: treated with Crest 3D white. Brushing was done nine s for 30 days then teeth were preserved in artificial saliva. RESULTS: Scanning electron microscopic results showed areas with rodless enamel more observed in Subgroup III than Subgroups I and II. EREs were more numerous on Subgroups I and II than Subgroup III on enamel surface. Partially occluded EREs with precipitates were more observed on Subgroups I and II than Subgroup III. Energy dispersive X-ray analysis results for calcium showed significant increase between all groups with control. The highest value was recorded in Subgroup II followed by Subgroups I and III while control group was the lowest one. Phosphorous showed significant increase between all groups with control. The highest value was recorded in Subgroup I followed by Subgroups III and II while control group was the lowest one. Micro-hardness results of Subgroups I and II showed significant increase compared to control group and no significant difference between control and Subgroup III was detected. CONCLUSION: Powder form activated charcoal is more abrasive than whitening toothpastes. There is no visible difference between pure 100% activated charcoal powder and charcoal powder with additives to it.v

Thr in vitro Effect of Dentifrices With Activated Charcoal on Eroded Teeth

AIM

The objective of this research was to compare the abrasive potential of dentifrices containing activated charcoal with those of a conventional dentifrice on the development of erosive tooth wear (ETW) in vitro.

METHODS

Enamel and dentin samples were divided into toothpastes (n = 12): group (G)1-Colgate Triple Action (1450 ppm F) (positive control); G2-Colgate Natural Extracts (1450 ppm F); G3-Colgate Luminous White Activated Carbon (1450 ppm F); G4-Oral-B Whitening Therapy Charcoal (1100 ppm F); G5-Oral-B 3D White Mineral Clean (1100 ppm F); G6-Curaprox Black Is White (950 ppm F); and G7-erosion only (no abrasion, negative control). All samples were submitted to erosive pH cycles and G1 to G6 to abrasive challenges (15 seconds) using toothpastes' slurries plus 45 seconds of treatment for 7 days. The final profile was overlaid to the baseline one for the ETW calculation (µm). The data were subjected to analysis of variance/Tukey or Kruskal-Wallis/Dunn tests (P < .05).

RESULTS

Oral-B 3D White (13.0 ± 1.0, 9.37 [1.36] μm), Oral-B Whitening Therapy (15.1 ± 1.2, 8.58 [1.71] μm), and Colgate Luminous White (13.6 ± 1.0, 7.46 [0.94] μm) toothpastes promoted the greatest enamel and dentin wear. On the other hand, Colgate Triple Action (12.2 ± 1.2, 5.30 [1.26] μm), Colgate Natural Extracts (10.8 ± 1.1, 4.16 [1.11] μm), and Curaprox Black Is White (11.5 ± 1.5, 4.06 [0.92] μm) toothpastes promoted lower wear values, similar to erosion only (4.16 [0.94] μm) in the case of dentin but not enamel (7.1 ± 0.8 μm).

CONCLUSIONS

Toothpastes containing charcoal combined with pyrophosphate may have a high abrasive effect on eroded tooth surfaces. Many patients influenced by digital marketing use toothpastes containing activated charcoal with the aim of bleaching their teeth. However, care should be taken when using these products, as they may have a high abrasive effect.

Effect of Whitening Toothpaste on Surface Roughness and Colour Alteration of Artificially Extrinsic Stained Human Enamel: In Vitro Study

Objective: The aim of this study was to compare five toothpastes in terms of alteration of surface roughness and colour of red-wine-stained human enamel over time after brushing simulation. Methods: Stained specimens were randomly divided into five groups (n = 8): Oral-B Gum and Enamel (C), ZACT Stain Fighter (ZW), Colgate Optic White Volcanic Mineral (CW), Oral-B 3D White Luxe Fresh Breath (3DW), and Thepthai (TW). The colour and surface roughness of the specimens were measured after brushing simulation for four durations; two weeks, one month, six months, and twelve months. Abrasive particles in toothpaste were inspected under a scanning electron microscope. Results: Surface roughness was increased in the specimens that underwent brushing simulation in all groups (p < 0.05). ZW (6.33 ± 0.98 μm) exerted the most changes in surface roughness for all durations. Other groups showed similar surface roughness at each time point. ΔE00 and ΔL were increased in all groups until twelve months; however, there were no significant differences between C (ΔE00 = 30.17 ± 4.16, ΔL = 38.19 ± 4.34), CW (ΔE00 = 24.25 ± 10.52, ΔL = 31.12 ± 11.00), and TW (ΔE00 = 29.00 ± 3.96, ΔL = 36.68 ± 4.53) at any time period. Moreover, ZW (ΔE00 = 45.6 ± 8.01, ΔL = 53.03 ± 6.71) and 3DW (ΔE00 = 43.6 ± 7.33, ΔL = 51.03 ± 6.47) exhibited a substantial change and were statistically differed from the other groups after four-weeks. Various characteristics of abrasive particles were inspected under SEM. Conclusion: All five toothpastes increased the surface roughness altered the colour of red wine-stained human enamel over time.

EFFECTIVENESS AND ABRASIVENESS OF ACTIVATED CHARCOAL AS A WHITENING AGENT: A SYSTEMATIC REVIEW OF IN VITRO STUDIES

INTRODUCTION

Tooth whitening is currently one of the most requested treatments to change the color of teeth. There are different types of whitening in the dental office and at home. There are also many whitening agents on the market. Nowadays, the public has shown great interest in a new natural compound: activated charcoal. It has an abrasive effect and it is included in toothpastes to whiten teeth quickly and easily.

OBJECTIVES

The main objective of the systematic review is to perform a qualitative synthesis of the available literature on the use of activated charcoal-based toothpaste for tooth whitening.

MATERIAL AND METHODS

An electronic search was carried out in PubMed, Web of Science, and Scopus databases. The search included the terms (charcoal-based OR activated charcoal OR charcoal OR soot) AND (toothpaste OR dentifrices OR bleaching OR oral hygiene OR enamel OR teeth). Inclusion criteria were articles that were published in English, that included activated charcoal toothpastes, that assessed the efficacy of activated charcoal bleaching and/or the safety of using activated charcoal toothpastes, that were conducted on humans or extracted teeth regardless of their origin and the year of publication.

RESULTS

Out of 208 articles, 11 met the inclusion criteria, the Risk of Bias of the selected studies was determined as medium-high. Regarding the whitening effect, there is a variety of results depending on the study: in some there are no significant differences between the proposed treatments and in others activated charcoal is not the most whitening agent. Regarding the abrasive effect, most studies agree that activated charcoal toothpaste has a higher abrasive potential.

CONCLUSION

Toothpastes based on activated charcoal possess a lower whitening effect than other alternatives and can be considered as less safe due to its high abrasive potential.

Whitening efficacy of popular natural products on dental enamel

The objective of this study was to evaluate the effect of natural bleaching products on the color, whiteness, and superficial properties of dental enamel. Seventy fragments of bovine teeth were obtained (6mm x 6mm x 2mm). Initial surface roughness (Surfcorder SE1700, Kosakalab), microhardness (HMV-2, Shimadzu), color (EasyShade, VITA), and surface gloss (Micro-Gloss 45º BYK, Gardner) readings were done. Samples were separated into five groups (n=14) according to the treatments used: CT-conventional toothpaste (negative control); CH-charcoal; TU-turmeric; BP-banana peel, and CP16%-16% carbamide peroxide gel (positive control, 4 h/day for 14 days), and then brushed for 560 cycles (T1) and 1200 cycles (T2), equivalent to 14 and 30 days of brushing. New measurements were performed after T1 and T2. The whiteness index for dentistry change (∆WID) and Weight loss (Wl) were calculated. CP16% demonstrated the highest (p<.05) color change (ΔE00) and ∆WID (2-way ANOVA, Bonferroni, p<.05). Surface gloss alterations were lower for TU, CP16%, and BP. CT and CH increased surface roughness (p<.05). CP16% decreased enamel microhardness. CH presented medium abrasiveness, and CT and TU, low abrasiveness. The popular bleaching products were not efficient for tooth whitening. Furthermore, brushing with charcoal increased the enamel surface roughness, and CP16% decreased enamel microhardness over time.

Abrasion Behavior of Different Charcoal Toothpastes on Human Dentin When Using Electric Toothbrushes

The aim of this study was to investigate abrasion on human dentin after brushing with activated charcoal toothpastes. A self-designed brushing machine was used to brush five groups (Group A: Water, Group B: Sensodyne Pro Schmelz, Group C: Splat Blackwood, Group D: Curaprox Black is White, and Group E: Prokudent Black Brilliant) with electrically powered toothbrushes for 4 h. The abrasive dentin wear was calculated using profilometry data. Furthermore, thermogravimetric analyses and scanning electron microscopy were used to analyze the composition of the toothpastes. Mean dentin loss by brushing were (71 ± 28) µm (Splat Blackwood), (44 ± 16) µm (Curaprox Black is White), (38 ± 13) µm (Prokudent Black Brilliant), (28 ± 14) µm (Sensodyne Pro Schmelz), and (28 ± 13) µm (Water). Groups A/B/D/E and group C each lie in one subset, which is statistically different from the other subset according to a post hoc Tukey test (p = 0.05). Within the limitations, it can be concluded that the content of activated charcoal in charcoal toothpastes had little influence on the observed abrasive behavior, although one of the charcoal toothpastes showed the highest abrasion on dentin.

Effect of whitening toothpaste on surface roughness and microhardness of human teeth: a systematic review and meta-analysis

Background: Whitening toothpastes exert a whitening effect on teeth through higher surface cleaning effectiveness resulting from the abrasive properties of the paste or specific chemical components. This systematic review and meta-analysis was conceptualized to examine the relationship between whitening toothpastes and surface roughness as well as microhardness of human teeth and to clarify the evidence base available around this relationship by conducting a systematic review and meta-analysis of studies in this topic area, looking at in vitro randomized control trials.

Methods: Criteria for including studies in the review were done based on population, intervention, comparison, outcomes and study and studies were identified from electronic databases. Covidence® was used for data screening and data extraction. The CONSORT tool was used for checking relevant content and methodology used in each of the papers reviewed. Systematic review was done followed by meta-analysis, using Review Manager.

Results: A total of 125 articles were obtained on key word search. After duplicate removal and title screening, 17 articles were eligible for full text review. Finally, 7 studies were included for systematic review and meta-analysis was conducted on 4 studies. The forest plot for surface roughness showed that that the meta-analytic effect was statistically significant with surface roughness value being higher in the intervention group. The forest plot for microhardness showed that the meta-analytic effect was statistically significant with the microhardness value being lesser in the intervention group.

Conclusions: Although whitening toothpastes typically can lighten tooth color by about one or two shades, there is some evidence to show that these toothpastes also affect the mineral content of teeth by increasing surface roughness and reducing microhardness. More evidence and further research are needed to identify the type of whitening agent which will whiten the tooth effectively while maintaining the integrity of the tooth structure.

Impact of desensitizing/whitening toothpastes on tooth color change after abrasion and erosion-abrasion

OBJECTIVE

To evaluate the impact of desensitizing toothpastes (D), their whitening versions (DW) and whitening toothpastes (W) on tooth color change.

METHODS

Tooth specimens were allocated into 11 groups (n = 10): 1. Artificial saliva (control); 2. Sensodyne Repair & Protect (SRP-D); 3. Sensodyne Repair & Protect Whitening (SRP-DW); 4. Colgate Sensitive Pro-Relief (CSPR-D); 5. Colgate Sensitive Pro-Relief Real White (CSPR-DW); 6. Colgate Total 12 (CT12); 7. Colgate Total 12 Whitening (CT12-W); 8. Sensodyne True White (ST-W); 9. Curaprox Black Is White (CB-W); 10.Oral-B 3D White Perfection (OB3D-W) and 11. Erosion-only. They were submitted to two models: A. abrasion; B. erosion/abrasion. Color change (ΔE₀₀ ), ΔL, Δa, and Δb were determined with a spectrophotometer. Data were statistically evaluated (α = 0.05).

RESULTS

For both models, ∆E₀₀ of D did not differ significantly from DW. An overall decrease in luminosity (-∆L) and increase (+∆b) in yellowness of the tooth occurred. In abrasion, all groups reduced redness (-∆a) and only SRP-DW differed from control (p = 0.016), but for ∆E₀₀ , ∆L and ∆b, all toothpastes did not differ from the control. In erosion/abrasion, CB-W showed significantly lower ∆E₀₀ and ∆b than the control (∆E₀₀ : p = 0.026; ∆b: p = 0.005) and SRP-D (∆E₀₀ : p = 0.028; ∆b: p = 0.025). Only SRP-DW, CSPR-DW, ST-W, CB-W, and erosion-only had increased redness (+∆a), but none differed from control.

CONCLUSIONS

The toothpastes did neither promote whitening nor avoid the yellowish aspect of the tooth after abrasion and erosion-abrasion, regardless of their claim.

CLINICAL SIGNIFICANCE

Desensitizing and/or whitening toothpastes induced similar changes on tooth color, without promoting whitening effect or reduction in its yellowish aspect.

Effect of whitening toothpaste on surface roughness and microhardness of human teeth: a systematic review and meta-analysis

Background: Whitening toothpastes exert a whitening effect on teeth through higher surface cleaning effectiveness resulting from the abrasive properties of the paste or specific chemical components. This systematic review and meta-analysis was conceptualized to examine the relationship between whitening toothpastes and surface roughness as well as microhardness of human teeth and to clarify the evidence base available around this relationship by conducting a systematic review and meta-analysis of studies in this topic area, looking at in vitro randomized control trials. Methods: Criteria for including studies in the review were done based on population, intervention, comparison, outcomes and study and studies were identified from electronic databases. Covidence® was used for data screening and data extraction. The CONSORT tool was used for checking relevant content and methodology used in each of the papers reviewed. Systematic review was done followed by meta-analysis, using Review Manager. Results: A total of 125 articles were obtained on key word search. After duplicate removal and title screening, 17 articles were eligible for full text review. Finally, 7 studies were included for systematic review and meta-analysis was conducted on 4 studies. The forest plot for surface roughness showed that that the meta-analytic effect was statistically significant with surface roughness value being higher in the intervention group. The forest plot for microhardness showed that the meta-analytic effect was statistically significant with the microhardness value being lesser in the intervention group. Conclusions: Although whitening toothpastes typically can lighten tooth color by about one or two shades, there is some evidence to show that these toothpastes also affect the mineral content of teeth by increasing surface roughness and reducing microhardness. More evidence and further research are needed to identify the type of whitening agent which will whiten the tooth effectively while maintaining the integrity of the tooth structure.

Effectiveness and Adverse Effects of Over-the-Counter Whitening Products on Dental Tissues

The role of bleaching agents (e.g., hydrogen peroxide) in tooth bleaching is quite well-described in a few literature studies and considered as the option choice for those desiring brighter teeth, but alternative methods have emerged to fulfill the desire of patients in a faster, easier, and cheaper way. In this context, whitening over-the-counter (OTC) products are available in several vehicles, such as toothpaste, rinses, gums, paint-on varnishes, and strips, but their effectiveness in terms of bleaching is questioned. This review aimed to describe their mode of action, whitening effectiveness, and harmful effects associated with the indiscriminate use of these products. Dentifrices usually present a combination of abrasives that can induce damage to the tooth surface without evidence of promoting real bleaching. The same was found for rinses, which might present a low pH, with an erosive potential. Charcoal has been included in the composition of these products to improve their whitening effect but there is no evidence supporting it. Regarding strips, they present hydrogen peroxide in a variety of concentrations and are the only OTC products able to promote bleaching. Despite the vehicle, an indication for the use of these products should be made after a careful individual diagnosis of the etiology of the dental staining, considering that most of them seem to be effective only in removing extrinsic stains or preventing their formation over enamel. Also, their indiscriminate use might induce damage and deleterious effects over tooth tissues or gingival tissues. The dentist should be aware of the composition and mode of action of each individual product as they change according to the composition and the vehicle used to recommend the best mode of usage. Still, there is no sound evidence that any of the described OTC products promote a better bleaching effect than the products indicated for a professional.

Colour stability of stained composite resins after brushing with whitening toothpaste

OBJECTIVE

The aim of this study was to evaluate the effect of brushing with whitening toothpaste on the colour change of composite resins discoloured with coffee.

METHODS

Disc-shaped samples were prepared using one nano-hybrid (Clearfil Majesty Esthetic), one micro-hybrid (GC G-aenial Anterior) and one nano-ceramic composite (Zenit) (n = 6). After initial colour measurements, the samples were coloured in the coffee solution for 5 days. Colour measurements were made again after the colouring process, and brushing simulation was applied for 7, 15 and 30 days with two different whitening toothpastes containing calcium carbonate+perlite (Signal whitening system, SWN) and hydrated silica+hydrogen peroxide (Colgate optic White, COW) and a conventional non-whitening toothpaste containing hydrated silica (Sensodyne pronamel, SPN). Colour change (∆E₀₀ ) after brushing was calculated using the CIEDE2000 system. Repeated measures variance analysis was used for the analysis of data.

RESULTS

G-aenial anterior and Zenit showed significant coloration compared to Majesty esthetic after coloration with coffee (p < 0.05). The colour change in all composite resins was above the clinically acceptable limit (ΔE₀₀  > 1.8). Colour change over time after brushing with both whitening toothpastes differed significantly (p < 0.05). SWN and COW exhibited a significantly higher whitening effect than SPN (p < 0.05). While there was no significant difference in composite groups brushed with the SWS (p > 0.05), there was a significant difference between Majesty esthetic, G-aenial anterior and Zenit in groups brushed with COW (p < 0.05).

CONCLUSIONS

Colour change was high in micro-hybrid and nano-ceramic composites which were discoloured in coffee. The whitening toothpastes were effective in reducing the coloration caused by coffee.