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Barbosa LMM, Amâncio Filha MBG, Leite JVC, Santos JVDN, De Medeiros JM, De Oliveira ILM, Pecho OE, Meireles SS, Lima RBW. Over-the-counter products in tooth bleaching: A scoping review. J Dent 2024; 145:104989. [PMID: 38582435 DOI: 10.1016/j.jdent.2024.104989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/08/2024] Open
Abstract
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.
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Affiliation(s)
| | | | - Juan Vitor Costa Leite
- Dental Materials Division, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas (FOP/UNICAMP), Piracicaba, São Paulo, Brazil
| | | | | | | | - Oscar E Pecho
- ATITUS Educação, Meridional Faculty, Passo Fundo, Rio Grande do Sul, Brazil
| | - Sônia Saeger Meireles
- Department of Restorative Dentistry, Federal University of Paraíba (UFPB), João Pessoa, Paraíba, Brazil
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de Mendonça LC, Rodrigues M, Bicalho AA, da Silva GR, Quagliatto PS, Santos DQ, Soares CJ. Analysis of Calcium and Phosphate Ion Extraction From Dental Enamel by Bleaching Gels Using Ion Chromatography, Micro-CT, and SEM. Oper Dent 2024; 49:157-165. [PMID: 38349817 DOI: 10.2341/23-026-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 02/15/2024]
Abstract
OBJECTIVES To evaluate the volume and depth of enamel loss promoted by 37.5% and 7.5% hydrogen peroxide (HP) gels, and quantify the loss of calcium (Ca) and phosphate (P) ions by using ion chromatography (IC) analysis after bleaching. METHODS Sixty bovine enamel specimens were randomly divided into three groups: Control - no bleaching gel; HP37.5%, application of HP 37.5% for 45 minutes for 14 days; and HP7.5%, application of HP 7.5% for 3 applications of 8 minutes. The surface analysis (n=5) was performed using a scanning electron microscope (SEM) and dispersive energy system (EDS) to calcium and phosphorus dosage. The micro-CT was used for the enamel loss analysis (n=5). IC was used to analyze extracted Ca and P (n=10). Data were analyzed by one-way ANOVA and two-way repeated measures ANOVA, followed by Tukey and Dunnett's tests (α=0.05). RESULTS Significantly higher volume and depth of enamel loss were found for bleached groups compared with the control group. HP7.5% had significantly higher enamel change than HP37.5%. SEM showed higher enamel porosity for HP37.5% and HP7.5% compared to control. The IC demonstrated a significant increase of Ca incorporated into the gel, however, only HP7.5% had a higher P presence than the control group. The HP7.5% showed higher Ca and P ion exchange than HP37.5% (p<0.001). CONCLUSION HP37.5% and HP7.5%, caused enamel mineral changes compared with the control group. The IC method was demonstrated to be an effective methodology for detecting enamel mineral loss by the bleaching gel.
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Affiliation(s)
- L C de Mendonça
- Ludmila Cavalcanti de Mendonça, DDS, MS, PhD student, Biomechanics Group, Department of Operative Dentistry and Dental Materials; professor, Technical School of Health, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - MdeLA Rodrigues
- Maria de Lara Araújo Rodrigues, DDS student, Biomechanics Group, Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - A A Bicalho
- Aline Arêdes Bicalho, DDS, MS, PhD, Biomechanics Group, Department of Operative Dentistry and Dental Materials; professor, Technical School of Health, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - G R da Silva
- Gisele Rodrigues da Silva, DDS, MS, PhD, professor, Biomechanics Research Group, Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - P S Quagliatto
- Paulo Sérgio Quagliatto, DDS, MS, PhD, professor and chairman, Biomechanics Research Group, Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - D Q Santos
- Douglas Queiros Santos, DDS, MS, PhD, professor, Technical School of Health, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - C J Soares
- *Carlos José Soares, DDS, MS, PhD, professor and chairman, Biomechanics Research Group, Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
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Satti MK, Nayyer M, Alshamrani M, Kaleem M, Salawi A, Safhi AY, Alsalhi A, Sabei FY, Khan AS, Muhammad N. Synthesis, Characterization, and Investigation of Novel Ionic Liquid-Based Tooth Bleaching Gels: A Step towards Safer and Cost-Effective Cosmetic Dentistry. Molecules 2023; 28:molecules28073131. [PMID: 37049892 PMCID: PMC10096067 DOI: 10.3390/molecules28073131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/24/2023] [Accepted: 03/26/2023] [Indexed: 04/03/2023] Open
Abstract
The objective of this study was to synthesize a novel choline hydroxide ionic liquid-based tooth bleaching gel. Ionic liquid-based gels were synthesized and characterized using FTIR along with pH testing. Tooth sample preparation was carried out in line with ISO 28399:2020. The effects of synthesized gels on tooth samples were tested. Tooth samples were stained and grouped into three experimental groups: EAI (22% choline hydroxide gel), EAII (44% choline hydroxide gel), and EB (choline citrate gel) and two control groups: CA (commercial at-home 16% carbamide peroxide gel) and CB (deionized water). The tooth color analysis, which included shade matching with the Vitapan shade guide (n = 2), and digital colorimetric analysis (n = 2) were evaluated. The surface characteristics and hardness were analyzed with 3D optical profilometry, Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDX), and Microhardness testing (n = 3), respectively. The tooth color analysis (Vitapan shade guide) revealed that all the tooth samples treated with synthesized choline citrate gel (EB) showed an A1 shade as compared to the other four groups, giving a range of shades. An analysis of the ΔE values from digital colorimetry; EAI, EAII, CA, and CB showed ΔE values in a range that was clinically perceptible at a glance. However, EB showed the highest value of ΔE. The mean microhardness values for the five groups showed that the effects of three experimental gels i.e., 44% choline hydroxide, 22% choline hydroxide, and choline citrate, on the microhardness of the tooth samples were similar to that of the positive control, which comprised commercial at-home 16% carbamide peroxide gel. SEM with EDX of three tested subgroups was closely related in surface profile, elemental composition, and Ca/P ratio. The roughness average values from optical profilometry of four tested subgroups lie within approximately a similar range, showing a statistically insignificant difference (p > 0.05) between the tested subgroups. The synthesized novel experimental tooth bleaching gels displayed similar tooth bleaching actions without any deleterious effects on the surface characteristics and microhardness of the treated tooth samples when compared with the commercial at-home tooth bleaching gel.
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Effect of Over-The-Counter Tooth-Whitening Products on Enamel Surface Roughness and Microhardness. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12146930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: To evaluate the efficacy of new over-the-counter tooth-whitening products on enamel surface roughness and microhardness. Methods: A total of 120 enamel specimens were prepared and randomly allocated into six groups. Group A was treated with 10% carbamide peroxide; Group B was immersed in distilled water; Group C was treated with hydrated silica, sodium hexametaphosphate toothpaste; Group D was treated with sodium bicarbonate; Group E was treated with 0.25% citric acid; and Group F was treated with hydrated silica, charcoal powder. Results: A, B, and D demonstrated decreased Ra, whereas Groups C, E, and F showed an increased Ra after whitening. The changes in Ra from T0 to T1 in each group was statistically significant (p < 0.001) except for Group B (p = 0.85). The groups showed decreased KHN after whitening, except for specimens in Group B (distilled water). The KHN from T0 to T1 decreased significantly for groups A, C, E, and F (p = 0.001). Significant difference was observed at T1 (p < 0.0001). Conclusion: Within the limitations of this study, it could be demonstrated that surface roughness and enamel microhardness changes were influenced by the type, composition, and exposure time of the whitening product.
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Karakaya İ, Cengiz-Yanardag E. Effects of Staining Beverages and Office Bleaching Agents on the Optical Characteristics and Surface Topography of Maxillary Incisor Teeth. CYPRUS JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4274/cjms.2020.2726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cua J, Crespo E, Phelps S, Ramirez R, Roque-Torres G, Oyoyo U, Kwon SR. Tooth Color Change and Erosion: Hydrogen Peroxide Versus Non-peroxide Whitening Strips. Oper Dent 2022; 47:301-308. [PMID: 35584321 DOI: 10.2341/20-302-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 11/23/2022]
Abstract
AIM The study evaluated the efficacy and potential erosion of non-peroxide strips compared to hydrogen peroxide (HP) whitening strips (WSs). METHODS Color evaluation samples (N=64) were distributed into four groups and treated according to manufacturer's directions. NC: Negative control treated with water; BT: Non-peroxide Brilliant Dissolving Strips; FM: Non-peroxide Fancymay Teeth WSs; WS: Crest 3D Brilliance HP White Strips. A contact-type spectrophotometer was used to measure color at baseline (T1), 1-day posttreatment (T2), and 1-week posttreatment (T3). Teeth were cut to a rectangular block for micro-CT erosion assessment. The samples (N=30) were divided into five groups. In addition to the four groups for color assessment, a positive control (PC) treated with 0.25% citric acid was added. The samples were scanned, reconstructed, and measured for erosion depth using a micro-CT analysis program software. Kruskal-Wallis test was used to determine differences in color change and erosion depth among the groups. Tests of hypotheses were two-sided with an alpha level of 0.05. RESULTS The mean ΔE*ab at 1-day/1-week posttreatment were 2.4/2.5, 2.8/2.9, 2.8/3.2, and 8.6/11.0 for NC, BT, FM, and WS, respectively. There was a statistically significant difference for ΔE*ab at 1-day and 1-week posttreatment (p<0.001). Group WS had the highest color change, while the other three groups did not differ from each other (p>0.05). Mean erosion depths in microns were 0.52, 0.58, 0.42, 0.49, and 29.55 for NC, BT, FM, WS, and PC, respectively. There was a statistically significant difference among the groups (p=0.004). Group PC had the greatest erosion, while the other groups had negligible erosion that did not differ from each other (p>0.05). CONCLUSION Peroxide WSs had superior whitening efficacy compared to non-peroxide strips. None of the tested products compromised tooth structure integrity through enamel erosion.
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Affiliation(s)
- J Cua
- John Cua, RDH, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - E Crespo
- Elisabeth Crespo, RDH, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - S Phelps
- Sarah Phelps, RDH, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - R Ramirez
- Rachel Ramirez, RDH, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - G Roque-Torres
- Gina Roque-Torres, DDS, MS, PhD, assistant professor, Center for Dental Research, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - U Oyoyo
- Udochukwu Oyoyo, MPH, assistant professor, Dental Education Services, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - S R Kwon
- *So Ran Kwon, DDS, MS, PhD, MS, professor & director of Student Research Program, Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA, USA
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Maciel CRDO, Amorim AA, Oliveira RFDL, Vivanco RG, Pires-de-Souza FDCP. Whitening efficacy of popular natural products on dental enamel. Braz Dent J 2022; 33:55-66. [PMID: 35766717 DOI: 10.1590/0103-6440202204863] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/05/2022] [Indexed: 11/21/2022] Open
Abstract
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.
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Affiliation(s)
- Carla Roberta de Oliveira Maciel
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Av do Cafe, s/nº, Ribeirão Preto, Sao Paulo, 14040-904, Brazil
| | - Ayodele Alves Amorim
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Av do Cafe, s/nº, Ribeirão Preto, Sao Paulo, 14040-904, Brazil
| | - Rebeca Franco de Lima Oliveira
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Av do Cafe, s/nº, Ribeirão Preto, Sao Paulo, 14040-904, Brazil
| | - Rocio Geng Vivanco
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Av do Cafe, s/nº, Ribeirão Preto, Sao Paulo, 14040-904, Brazil
| | - Fernanda de Carvalho Panzeri Pires-de-Souza
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Av do Cafe, s/nº, Ribeirão Preto, Sao Paulo, 14040-904, Brazil
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The power of weak ion-exchange resins assisted by amelogenin for natural remineralization of dental enamel: an in vitro study. Odontology 2022; 110:545-556. [PMID: 35147809 PMCID: PMC9170625 DOI: 10.1007/s10266-022-00688-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/20/2022] [Indexed: 10/28/2022]
Abstract
This study aims to develop an innovative dental product to remineralize dental enamel by a proper combination of ion-exchange resins as controlled release of mineral ions that form dental enamel, in the presence of amelogenin to guide the appropriate crystal growth. The novel product proposed consists of a combination of ion-exchange resins (weak acid and weak base) individually loaded with the remineralizing ions: Ca2+, PO43- and F-, also including Zn2+ in a minor amount as antibacterial, together with the protein amelogenin. Such cocktail provides onsite controlled release of the ions necessary for enamel remineralization due to the weak character of the resins and at the same time, a guiding tool for related crystal growth by the indicated protein. Amelogenin protein is involved in the structural development of natural enamel and takes a key role in controlling the crystal growth morphology and alignment at the enamel surface. Bovine teeth were treated by applying the resins and protein together with artificial saliva. Treated teeth were evaluated with nanoindentation, scanning electron microscopy and energy-dispersive X-ray spectroscopy. The innovative material induces the dental remineralization creating a fluorapatite layer with a hardness equivalent to sound enamel, with the appropriate alignment of corresponding nanocrystals, being the fluorapatite more acid resistant than the original mineral. Our results suggest that the new product shows potential for promoting long-term remineralization leading to the inhibition of caries and protection of dental structures.
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Manso AP, De Morais DC, Yamamoto K, Owen G, de Carvalho RM, Palma-Dibb RG. Effects of prolonged use of over-the-counter bleaching agents on enamel: An in vitro study. Microsc Res Tech 2021; 85:1016-1027. [PMID: 34693595 DOI: 10.1002/jemt.23970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/29/2021] [Accepted: 10/08/2021] [Indexed: 11/10/2022]
Abstract
This study evaluated the effects of four over-the-counter (OTC) bleaching products on the properties of enamel. Extracted human molars were randomly assigned into four groups (n = 5): PD: Poladay (SDI), WG: White Teeth Global (White Teeth Global), CW: Crest3DWhite (Procter & Gamble), and HS: HiSmile (HiSmile). The hydrogen peroxide (H2 O2 ) content in each product was analyzed via titration. Twenty teeth were sectioned into quarters, embedded in epoxy resin, and polished. Each quarter-tooth surface was treated with one of the four beaching times: T0: control/no-bleaching, T14: 14 days, T28: 28 days, and T56: 56 days. Materials were applied to enamel surfaces as recommended. Enamel surfaces were examined for ultramicrohardness (UMH), elastic modulus (EM), superficial roughness (Sa), and scanning electron microscopy (SEM). Ten additional teeth were used to evaluate color and degree of demineralization (DD) (n = 5). Data were statistically tested by two-way ANOVA and Tukey's tests (α = 5%). Enamel surfaces treated with PD and WG presented UMH values significantly lower than the controls (p < .05). Elastic modulus (E) was significantly reduced at T14 and T28 for PD, and at T14 for HS (p < .05). A significant increase in Sa was observed for CW at T14 (p < .05). Color changes were observed in the PD and WG groups. Additionally, DD analysis showed significant demineralization at T56 for CW. Overall, more evident morphological alterations were observed for bleaching products with higher concentrations of H2 O2 (p < .05), PD, and WG. Over-the-counter bleaching products containing H2 O2 can significantly alter enamel properties, especially when application time is extended.
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Affiliation(s)
- Adriana P Manso
- Division of Restorative Dentistry, Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Dayana C De Morais
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Kayoko Yamamoto
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Gethin Owen
- Centre for High-Throughput Phenogenomics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ricardo Marins de Carvalho
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Regina G Palma-Dibb
- Department of Restorative Dentistry, Faculty of Dentistry, The University of Sao Paulo at Ribeirao Preto, Ribeirao Preto, Brazil
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Kolsuz Ozcetin H, Surmelioglu D. Effects of bleaching gel containing TiO 2 and chitosan on tooth surface roughness, microhardness and colour. Aust Dent J 2020; 65:269-277. [PMID: 32585733 DOI: 10.1111/adj.12786] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study aimed to evaluate the effects of an experimental bleaching gel made with TiO2 and chitosan, along with the Opalescence Boost PF and Philips Zoom bleaching agents, on tooth surface roughness, microhardness and colour. MATERIALS AND METHODS The experimental gel, containing 6% hydrogen peroxide (HP), was evaluated against the two existing treatments, which incorporate 40% and 25% HP. For colour evaluation, 36 human premolar teeth were divided into three groups (n = 12). For surface roughness and microhardness evaluation, 72 bovine incisor samples were divided into six groups (n = 12). Data on colour alteration were analysed with the CIEDE2000 formula. Surface roughness was measured using a profilometer, and microhardness was measured with a Vickers hardness tester. ANOVA was used for statistical analysis. RESULTS There were no statistically significant differences among the groups for surface roughness, microhardness values or colour change after bleaching (P > 0.05). The lowest bleaching efficacy was observed for the 40% HP agent, and the highest efficacy was observed for the 25% HP agent (P < 0.05). CONCLUSIONS An experimental 6% HP gel containing TiO2 and chitosan provided effective bleaching without adverse effects on tooth surface roughness or microhardness. The use of TiO2 with chitosan can provide clinicians with positive results.
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Affiliation(s)
- H Kolsuz Ozcetin
- Department of Restorative Dentistry, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey
| | - D Surmelioglu
- Department of Restorative Dentistry, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey
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Kury M, Wada EE, Silva DPD, Tabchoury CPM, Giannini M, Cavalli V. Effect of violet LED light on in-office bleaching protocols: a randomized controlled clinical trial. J Appl Oral Sci 2020; 28:e20190720. [PMID: 32428059 PMCID: PMC7213781 DOI: 10.1590/1678-7757-2019-0720] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/24/2020] [Indexed: 11/30/2022] Open
Abstract
Objective This study evaluated the clinical effect of violet LED light on in-office bleaching used alone or combined with 37% carbamide peroxide (CP) or 35% hydrogen peroxide (HP). Methodology A total of 100 patients were divided into five groups (n=20): LED, LED/CP, CP, LED/HP and HP. Colorimetric evaluation was performed using a spectrophotometer (ΔE, ΔL, Δa, Δb) and a visual shade guide (ΔSGU). Calcium (Ca)/phosphorous (P) ratio was quantified in the enamel microbiopsies. Measurements were performed at baseline (T 0 ), after bleaching (T B ) and in the 14-day follow-up (T 14 ). At each bleaching session, a visual scale determined the absolute risk (AR) and intensity of tooth sensitivity (TS). Data were evaluated by one-way (ΔE, Δa, ΔL, Δb), two-way repeated measures ANOVA (Ca/P ratio), and Tukey post-hoc tests. ΔSGU and TS were evaluated by Kruskal-Wallis and Mann-Whitney, and AR by Chi-Squared tests (a=5%). Results LED produced the lowest ΔE (p<0.05), but LED/HP promoted greater ΔE, ΔSGU and Δb (T 14 ) than HP (p<0.05). No differences were observed in ΔE and ΔSGU for LED/CP and HP groups (p>0.05). ΔL and Δa were not influenced by LED activation. After bleaching, LED/CP exhibited greater Δb than CP (p>0.05), but no differences were found between these groups at T 14 (p>0.05). LED treatment promoted the lowest risk of TS (16%), while HP promoted the highest (94.4%) (p<0.05). No statistical differences of risk of TS were found for CP (44%), LED/CP (61%) and LED/HP (88%) groups (p>0.05). No differences were found in enamel Ca/P ratio among treatments, regardless of evaluation times. Conclusions Violet LED alone produced the lowest bleaching effect, but enhanced HP bleaching results. Patients treated with LED/CP reached the same efficacy of HP, with reduced risk and intensity of tooth sensitivity and none of the bleaching protocols adversely affected enamel mineral content.
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Affiliation(s)
- Matheus Kury
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
| | - Erica Eiko Wada
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
| | - Daylana Pacheco da Silva
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
| | - Cínthia Pereira Machado Tabchoury
- Departamento de Ciências Fisiológicas, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
| | - Marcelo Giannini
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
| | - Vanessa Cavalli
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brasil
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Omar F, Ab-Ghani Z, Rahman NA, Halim MS. Nonprescription Bleaching versus Home Bleaching with Professional Prescriptions: Which One is Safer? A Comprehensive Review of Color Changes and Their Side Effects on Human Enamel. Eur J Dent 2019; 13:589-598. [PMID: 31891975 PMCID: PMC6938424 DOI: 10.1055/s-0039-1700659] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES This study evaluates the efficacy and safety of the professionally prescribed and nonprescription over-the-counter (OTC) bleaching agents. MATERIALS AND METHODS: Extracted human upper central incisors were prepared and stained with red wine for 14 days before being subjected to four different bleaching agents: professionally prescribed opalescence PF 15%, VOCO Perfect Bleach 10%, nonprescription OTC Crest 3D Whitestrips, and Whitelight Teeth Whitening System. Colorimetric measurement was performed with Vita Easyshade Handheld Spectrophotometer, enamel surface microhardness measured using Vickers Hardness machine, and surface roughness was evaluated with profilometer, before and after bleaching. Scanning electron microscope (SEM) evaluation and atomic force microscopy were conducted postbleaching. STATISTICAL ANALYSIS The data were analyzed with t-test, two-way ANOVA, one-way ANOVA, and Turkey's test at a significance level of 5%. RESULTS All bleaching products have the same efficacy to whiten stained enamel. Opalescence PF 15% showed significant increase in the microhardness (92.69 ± 68.316). All groups demonstrated significant increase in surface roughness (p < 0.05). SEM evaluation showed that Opalescence PF 15% resulted in same microscopic appearance as unbleached enamel, while VOCO Perfect Bleach 10%, Whitelight Teeth Whitening System and Crest 3D Whitestrips demonstrated mild to moderate irregularities and accentuated irregularities, respectively. CONCLUSION Professionally prescribed bleaching agent of Opalescence PF 15% is effective tin whitening the teeth, while the other bleaching products may be effective but also have deleterious effects on the enamel.
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Affiliation(s)
- Farhana Omar
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Zuryati Ab-Ghani
- Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Normastura Abd Rahman
- Dental Public Health Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohamad Syahrizal Halim
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Abstract
Objective: The purpose of this study was to evaluate the effect of low calorie soda beverages on the enamel of primary teeth. Study Design: Fifty enamel slabs were prepared from twenty primary extracted teeth and were equally divided into five groups: a) 0.9% NaCl (Control), b) Coca-Cola Classic (Sucrose), c) Diet Coke (Aspartame), d) Zevia Cola (Erythritol), e) Coca-Cola Life (Stevia). Each specimen was exposed to the beverage for a total of sixty minutes. Enamel surface roughness was measured before and after the exposures using a LEXT OLS4000 3D Laser Measuring Microscope. Results: All tested sodas resulted to a statistically significant change on the surface roughness of the enamel (p =.000). However, this effect did not differ significantly between the different treatment groups (p =.103). Conclusions: Both regular soda and low calorie soda containing different commercial sweeteners appear to have an effect on the surface morphology of primary tooth enamel. Thus, it is important to discourage the intake of any type of soda as part of the dietary advice provided in the dental office.
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Zanolla J, Marques ABC, da Costa DC, de Souza AS, Coutinho M. Influence of tooth bleaching on dental enamel microhardness: a systematic review and meta-analysis. Aust Dent J 2017; 62:276-282. [DOI: 10.1111/adj.12494] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2016] [Indexed: 11/29/2022]
Affiliation(s)
- J Zanolla
- Faculty of Dentistry; Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
| | - ABC Marques
- Faculty of Dentistry; Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
| | - DC da Costa
- Faculty of Dentistry; Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
| | - AS de Souza
- Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
| | - M Coutinho
- Faculty of Dentistry; Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
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Brambert P, Qian F, Kwon SR. Erosion Potential of Tooth Whitening Regimens as Evaluated with Polarized Light Microscopy. J Contemp Dent Pract 2015; 16:921-5. [PMID: 26718302 DOI: 10.5005/jp-journals-10024-1782] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Tooth whitening is a widely utilized esthetic treatment in dentistry. With increased access to over-the-counter (OTC) systems concerns have been raised as to potential adverse effects associated with overuse of whitening materials. Therefore, this study aimed to evaluate enamel erosion due to different whitening regimens when used in excess of recommended guidelines. MATERIALS AND METHODS Extracted human teeth (n = 66) were randomly divided into 11 groups (n = 6/group). Specimens were exposed to OTC products: Crest Whitestrips and 5-minute natural white and a do-it-yourself (DIY) strawberry whitening recipe. Within each regimen, groups were further divided per exposure time: specimens receiving the recommended product dosage; 5 times the recommended dosage; and 10 times the recommended dosage. Negative and positive controls were treated with grade 3 water and 1.0% citric acid, respectively. Specimens were nail-varnished to limit application to a 1 × 4 mm window. Following treatment, specimens were sectioned and erosion (drop in μm) measured using polarized light microscopy. Two-sample t-test was used to detect difference in amount of enamel erosion between negative and positive groups, while one-way analysis of variance (ANOVA), followed by post hoc Dunnett's test was used to detect difference between set of treatment groups and negative control groups or among all experimental groups. RESULTS There was significant difference in mean amount of enamel erosion (p < 0.0001). Mean enamel erosion for positive control group was significantly greater than that for negative control group (23.50 vs 2.65 μm). There was significant effect for type of treatments on enamel erosion [F(9,50) = 25.19; p < 0.0001]. There was no significant difference between the negative control and each of treatment groups (p > 0.05 for all instances), except for Natural White_10 times treatment group (p < 0.0001) that was significantly greater than the negative control group (14.82 vs 2.65 μm). CONCLUSION Caution is advised when using certain over-the-counter products beyond recommended guidelines as there is potential for enamel erosion. CLINICAL SIGNIFICANCE Enamel erosion due to the overuse of whitening products varies for different modalities and products. Therefore, caution is advised when using certain over-the-counter products beyond recommended guidelines, as there is potential for enamel erosion.
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Affiliation(s)
- Patrick Brambert
- Department of Dentistry, University of Iowa College of Dentistry Lowa City, United States
| | - Fang Qian
- Department of Preventive and Community Dentistry, Division of Biostatistics and Research Design, University of Iowa College of Dentistry, Lowa City, United States
| | - So Ran Kwon
- Associate Professor, Department of Center for Dental Research, Loma Linda University School of Dentistry, 11175 Campus, Street Suite A 1010, Loma Linda 92350, California United States, Phone: 909 558 8069, e-mail:
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Kwon SR, Dawson DV, Schenck DM, Fiegel J, Wertz PW. Spectrophotometric Evaluation of Potassium Nitrate Penetration Into the Pulp Cavity. Oper Dent 2015; 40:614-21. [PMID: 26151563 DOI: 10.2341/14-214-l] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the penetration level of potassium nitrate-containing desensitizers or whitening materials into the pulp cavity with regard to the concentration and viscosity of the formulation. METHODS AND MATERIALS Fifty extracted human molar teeth were prepared and randomized into five groups of 10 specimens each. The control received a 30-minute treatment without any treatment material; the other four groups corresponded to treatment with DayWhite, a 14% hydrogen peroxide whitening material containing potassium nitrate; PreviDent 5000 Sensitive, a desensitizing toothpaste; Relief ACP, a desensitizing gel; or UltraEZ, a desensitizing gel. Potassium nitrate penetration levels were measured spectrophotometrically based on the Griess assay method. Treatment materials were measured for viscosity as a function of shear rate through the use of a cone-and-plate rheometer. RESULTS Nitrate penetration levels were significantly different among the five groups (p<0.0001, Kruskal-Wallis test). After adjustment for multiple comparisons using an overall 0.05 level of type I error, the distribution of nitrate penetration values was found to differ significantly among all groups with the exception of DayWhite (median: 10.72 μM) and UltraEZ (median: 9.22 μM), which differed significantly from other groups but not from each other. The highest levels of nitrate penetration value were observed for PreviDent (median: 27.61 μM) followed by Relief ACP (median: 19.64 μM). The lowest penetration level was observed for the control group (median: 3.41 μM). Stable end-point viscosities of 11.43 ± 0.67 Pa/s, 1.33 ± 0.06 Pa/s, 0.85 ± 0.09 Pa/s, and 0.40 ± 0.01 Pa/s were observed for UltraEZ, ReliefACP, DayWhite, and PreviDent, respectively. CONCLUSION Potassium nitrate included in different formulations can penetrate the enamel and dentin within 30 minutes. The level of potassium nitrate penetration is influenced by concentration and may also be partly affected by the viscosity of the material as well as other constituents of proprietary preparations.
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