Tooth whitening with an experimental toothpaste containing hydroxyapatite nanoparticles

Nanotechnology in toothpaste: Fundamentals, trends, and safety

Several studies have revealed that healthcare nanomaterials are widely used in numerous areas of dentistry, including prevention, diagnosis, treatment, and repair. Nanomaterials in dental cosmetics are utilized to enhance the efficacy of toothpaste and other mouthwashes. Nanoparticles are added to toothpastes for a variety of reasons, including dental decay prevention, remineralization, hypersensitivity reduction, brightening, and antibacterial qualities. In this review, the benefits and uses of many common nanomaterials found in toothpaste are outlined. Additionally, the capacity and clinical applications of nanoparticles as anti-bacterial, whitening, hypersensitivity, and remineralizing agents in the treatment of dental problems and periodontitis are discussed.

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.

Tooth Whitening with Hydroxyapatite: A Systematic Review

A steadily increasing public demand for whiter teeth has resulted in the development of new oral care products for home use. Hydroxyapatite (HAP) is a new ingredient to whiten teeth. This systematic review focuses on the evidence of whether HAP can effectively whiten teeth. A systematic search using the PICO approach and PRISMA guidelines was conducted using PubMed, Scopus, Web of Science, SciFinder, and Google Scholar as databases. All study designs (in vitro, in vivo) and publications in foreign language studies were included. Of the 279 study titles that the searches produced, 17 studies met the inclusion criteria. A new "Quality Assessment Tool For In Vitro Studies" (the QUIN Tool) was used to determine the risk of bias of the 13 studies conducted in vitro. Moreover, 12 out of 13 studies had a low risk of bias. The in vivo studies were assigned Cochrane-based GRADE scores. The results in vitro and in vivo were consistent in the direction of showing a statistically significant whitening of enamel. The evidence from in vitro studies is rated overall as having a low risk of bias. The evidence from in vivo clinical trials is supported by modest clinical evidence based on six preliminary clinical trials. It can be concluded that the regular use of hydroxyapatite-containing oral care products effectively whitens teeth, but more clinical trials are required to support the preliminary in vivo evidence.

Remineralization of molar incisor hypomineralization (MIH) with a hydroxyapatite toothpaste: an in-situ study

AIM

This randomized, double-blind, crossover, in-situ study, compared the efficacy of toothpastes based on microcrystalline hydroxyapatite (HAP; fluoride-free) or fluoride, in remineralizing molar incisor hypomineralization (MIH).

METHODS

Two lesion-bearing enamel blocks were produced from each of thirty extracted permanent molars diagnosed with MIH. Sixty produced blocks were randomly assigned to two groups (30/group): 20% HAP or 1450 ppm fluoride toothpaste. Each group was subdivided into, etched (n = 20), with lesion surface treated with 32% phosphoric acid-etchant for 5 s, and unetched (n = 10). Blocks were cemented into intra-oral appliances (2 blocks/appliance) worn full-time by 15 subjects. Subjects used the toothpastes in a two-phase crossover manner, lasting 14 days per phase, after one-week washout period. Baseline and post-treatment mineral density (MD) was quantified using microcomputed tomography.

RESULTS

Overall, both groups showed statistically significant (paired t-test; p < 0.001) net-gain when MD was compared pre-treatment and post-treatment. HAP: pre-treatment (1.716 ± 0.315) and post-treatment (1.901 ± 0.354), Fluoride: pre-treatment (1.962 ± 0.363) and post-treatment (2.072 ± 0.353). Independent t-test demonstrated a practically significantly (≥10%) higher percentage remineralization with HAP toothpaste (26.02 ± 20.68) compared with fluoride toothpaste (14.64 ± 9.60). Higher percentage remineralization was observed in etched than unetched samples.

CONCLUSION

The tested toothpaste based on hydroxyapatite can remineralize MIH lesions. Pre-treating the tooth surface with acid-etchant enhanced remineralization.