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.

The Effect of Whitening Toothpastes on the Color Stability of a Smart Monochromatic Composite Resin

OBJECTIVE

The aim of this study was to evaluate the color stability of smart monochromatic composite resin after coloring with coffee solution, thermal aging and brushing with four different kinds of toothpaste.

MATERIALS AND METHODS

According to the manufacturer's instructions, 40 smart monochromatic composite resin (Omnichroma, Tokuyama Dental, Japan) specimens were prepared with a thickness of 2 mm and a diameter of 10 mm. The samples were divided into four groups. The first group (SFM) was brushed with Sensodyne Fresh Mint (Sensodyne GSK, UK), the second group (CW) with Colgate 2 in 1 Whitening (Colgate Palmolive, USA), the third group (OW) with Opalescence Whitening (Ultradent Products, Inc., USA), the fourth group (COW) with Colgate Optic White With Charcoal (Colgate Palmolive, USA). At time point t0, no brushing and thermal cycles were performed. For time point t1, simulations corresponding to 10 days of staining, thermal aging and brushing were performed. For time point t2, simulations corresponding to one year of staining, thermal aging and brushing were performed. The color of all specimens was measured at t0, t1 and t2 with a spectrophotometer. To examine the color change, ΔE00 values were calculated with the CIEDE 2000 color system. Shapiro Wilk, Kolmogorov Smirnov, Wilcoxon Signed Rank, Kruskal Wallis, and Mann-Whitney U tests were used to analyze the data.

RESULTS

According to the results of the intergroup comparison, there is no statistically significant difference between the groups in ΔE00(t0-t1) values in terms of t0-t1 time period measurement (p>0.05). There is a statistically significant difference between the groups in ΔE00(t1-t2)values in terms of t1-t2 time period measurement (p<0.05). The COW group had the lowest ΔE00(t1-t2) value and the OW group had the highest ΔE00(t1-t2) value. There is a statistically significant difference between the groups in ΔE00 (t0-t2) values in terms of t0-t2 time period measurement (p<0.05). The COW group had the lowest ΔE00(t0-t2) value and the OW group had the highest ΔE00(t0-t2) value.

CONCLUSION

The whitening efficacy of different kinds of toothpaste whitening mechanisms may differ from each other. Toothpastes also show whitening on composite resins. The lowest discoloration was observed in the group brushed with toothpaste containing activated charcoal and blue covarine. The efficacy of whitening toothpastes should be supported by in vivo studies.

Effects of different toothpastes on the color and whiteness of stained anterior composite resin

PURPOSE

To evaluate changes in the color of an anterior nanohybrid composite resin and differences in its whitening index after 30 days of brushing with six brands of whitening toothpaste in vitro to simulate the situation in individuals with high coffee consumption.

METHODS

Eighty-four disk-shaped resin specimens were prepared (shade A2). For initial staining, the samples were immersed in coffee solution for 14 days and then divided into eight groups for treatment with various toothpastes. Color was assessed at the baseline, after initial staining, and on days 7, 14, and 30 of the staining-and-brushing cycle. Color stability was evaluated based on the CIEDE2000 color difference (ΔE00), and differences in whiteness were determined using the whitening index for dentistry (WID).

RESULTS

The highest ΔE00 and ΔWID values were obtained with Colgate Herbal, followed by Opalescence Whitening and Crest Baking Soda and Peroxide, whereas the lowest values were obtained with distilled water, followed by Yotuel Pharma B5, on day 30 of the staining-and-brushing cycle.

CONCLUSION

In terms of improving the color and whiteness of coffee-stained anterior nanohybrid composite resin, Colgate Herbal, Opalescence Whitening, and Crest Baking Soda and Peroxide yielded promising results after 30 days of continuous use.

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.

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.

Effects of whitening toothpastes on the esthetic properties and surface roughness of a composite resin

PURPOSE

The aim of this study was to investigate and compare the effects of some whitening toothpastes on the surface roughness and coloration susceptibility of a composite resin, as well as their whitening effectiveness.

METHODS

This study was carried out in two different stages. In experiment A, samples were divided into 7 subgroups to compare the surface roughness and coloration susceptibility of the composite resin: distilled water, conventional toothpaste, and 5 different whitening toothpastes. In experiment B, samples were divided into 8 subgroups to compare the whitening effectiveness of the whitening toothpastes: conventional toothpaste, 5 other whitening toothpastes, and two bleaching groups. After toothbrushing simulation, the color and surface roughness of the samples were measured. Data were subjected to one-way analysis of variance, paired t-test and Tukey post-hoc test (α = 0.05).

RESULTS

There were no statistically significant differences among the surface roughness values for the groups for any period before and after brushing (P > 0.05). In terms of the coloration susceptibility of the composite resin and the whitening effects of the toothpastes, no statistically significant differences were evident among the groups for any period before and after brushing (P > 0.05).

CONCLUSION

The results of this study indicate that effective toothbrushing is more important than the type of toothpaste employed.

Investigation of surface roughness values of various restorative materials after brushing with blue covarine containing whitening toothpaste by two different methods: AFM and profilometer

The aim of this study is to evaluate the effect of whitening toothpaste on the surface roughness of resin-based restorative materials by different measurement methods. Twenty four specimens from each of human enamel, a microhybrid composite and two nanohybrid composites discs (8.0 diameter × 4.0 mm thick) were divided into two groups (n = 12) according to toothbrushing solutıon and subjected to simulation toothbrushing (30,000 cycles) with both distilled water and whitening toothpaste containing blue covarine. Surface roughness was examined using atomic force microscopy (AFM), profilometer, and scanning electron microscopy (SEM), and the data obtained were subjected to analysis. Ra values of Tescera (TES) were significantly higher than Sonicfill 2 (SF2) when brushing both toothbrushing solutions for initial or 30,000 cycles. Roughness increased for SF2 and TES when brushed for 30,000 cycles and was higher than enamel and Herculite XRV Ultra (HXU). Human enamel was obtained lower surface roughness values brushed with toothpaste compared with distilled water. Evaluation of the surface roughness of control groups using the AFM revealed no statistically significant difference between the groups, but significant differences were found using a profilometer. The use of abrasive whitening toothpaste containing blue covarine and the number of brushing cycles affect the surface properties of human enamel and the restorative material, and also, the clinical success of the restoration. Toothbrushing for 30,000 cycles increased the surface roughness of all materials. The type of toothbrushing solution partially has affected surface roughness.

Abrasiveness and whitening effect of charcoal-containing whitening toothpastes in permanent teeth

BACKGROUND

Charcoal toothpastes can whiten teeth through abrasion. The purpose of this study was to determine the level of whitening and abrasiveness of charcoal toothpastes in permanent teeth.

MATERIALS AND METHODS

In this in vitro study, 30 premolars were polished, sectioned, mounted, and stored for 5 days in a coffee solution at 37°C. The color and surface profile of the teeth were measured by spectrophotometry and a profilometric device, respectively. The specimens were divided into 3 groups of 10 and were brushed 2000 times (equivalent to 3 times a day for 1.5 months) in a brushing machine using 20 g of each toothpaste (Bencer, Beverly, and Colgate) mixed with 40 ml of distilled water. The color and surface profile were remeasured. Bonferroni test and repeated measures analysis of variance (ANOVA) were used to examine the abrasion. One-way ANOVA was used to assess the whitening.

RESULTS

The three toothpastes caused changes in the surface profile (P = 0.0001). ΔE was equal to 3.3 (within the acceptable range) in all groups (95% confidence interval). There was no significant difference in abrasion (P > 0.05) and color change (P = 0.884) among toothpastes.

CONCLUSION

The results of this study showed that all the three used toothpastes have the abrasive and whitening effect on the samples significantly. The differences between the toothpastes were not significant.

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.

Effect of novel charcoal-containing whitening toothpaste and mouthwash on color change and surface morphology of enamel

Purpose:

The aim of this in vitro study was to investigate the effectiveness of a novel charcoal-containing whitening toothpaste and a mouthwash on tooth color change and the alterations of enamel that may be induced after toothbrushing, corresponding to a 90-day period.

Materials and Methods:

Forty human canines were used, stained with coffee, and divided into four groups (n = 10) as follows: Group 1 (control) submitted to toothbrushing with deionized water, Group 2 with a regular toothpaste, Group 3 with a whitening toothpaste (1% charcoal), and Group 4 with the same whitening toothpaste in combination with a mouthwash (1% charcoal and 0.5% H₂O₂). After the treatments, ΔΕ of the teeth was evaluated using an ultraviolet/Vis spectrophotometer, whereas the changes in surface morphology were observed by means of a confocal microscope.

Results:

The whitening toothpaste increased significantly ΔΕ (40.5%) compared to the control group (P < 0.001). In addition, the tested whitening toothpaste also increased ΔΕ (17.7%) compared to the regular toothpaste (P = 0.023). The whitening toothpaste presented smoother surfaces after toothbrushing, but more heterogeneous with numerous large craters, whereas the whitening mouthwash did not influence surface morphology changes.

Conclusions:

Charcoal-containing toothpastes may enhance the whitening of the teeth, but they should be used carefully due to changes that may induce on enamel. The patients should consult a dental professional for proper use. A charcoal-containing mouthwash in combination with whitening toothpastes probably cannot offer additional whitening effect.

Assessment of cytotoxic and genotoxic effects of conventional and whitening kinds of toothpaste on oral mucosa cells

OBJECTIVE

This study aimed to evaluate possible DNA damages to oral epithelial cells exposed to whitening kinds of toothpaste considering the effect of conventional non-whitening toothpaste.

MATERIALS AND METHODS

Sixty volunteers were assigned into three experimental groups, each of them using a different regular toothpaste for the initial 2 months, followed by the use of whitening kind of toothpaste of the same brand for next 2 months. The oral epithelial cells were sampled prior and 30, 60, 90 and 120 days after the beginning of the use of tested kinds of toothpaste. Chromosomal damages were analyzed by micronucleus assay.

RESULTS

For just one kind of tested whitening toothpaste was observed the significant increase in the number of micronucleated cells after 60 days of use compared values obtained 60 days of usage of conventional non-whitening toothpaste (6.35 ± 3.67 and 2.8 ± 1.91; p < .05). There was no statistically significant difference in other micronucleus assay endpoints between tested types of toothpaste at either of the sampling times during the period of toothpaste application.

CONCLUSIONS

Based on the results, it can be concluded that the use of certain whitening kinds of toothpaste may cause a limited biologically insignificant genotoxic effect on buccal epithelial cells.

Comparison of effectiveness of abrasive and enzymatic action of whitening toothpastes in removal of extrinsic stains - a clinical trial

OBJECTIVE

To compare the effectiveness of abrasive component (perlite/calcium carbonate) and enzymatic component (papain and bromelain) of whitening toothpaste in removal of extrinsic stains.

METHODS

This study is a randomized, triple blind and parallel group study in which 90 subjects aged 18-40 years were included. At baseline, stains scores were assessed by Macpherson's modification of Lobene Stain Index and subjects were randomly assigned to two groups with 45 subjects in each. Group 1 used whitening toothpaste with enzymatic action and group 2 with abrasive action. After 1 month, stain scores were assessed for the effectiveness of the two toothpastes and 2 months later to check the stain prevention efficacy. Wilcoxson's test was used to compare between baseline 1 and 2 months stain scores, and Mann-Witney U-test was applied for intragroup comparison.

RESULTS

The mean baseline total stain score for the subjects allocated to the enzymatic toothpaste was 37.24 ± 2.11 which reduced to 30.77 ± 2.48 in 1 month, and for the abrasive paste, total stain reduced from 35.08 ± 2.96 to 32.89 ± 1.95. The reductions in total stain scores with both the pastes were significant compared with baseline stain scores (at 1 month Group 1, P = 0.0233 and Group 2, P = 0.0324; at 2 months, Group 1 P = 0.0356). Both the toothpastes proved to be equally good in removal of extrinsic stains; however, the enzymatic paste showed better results as compared to abrasive toothpaste.

CONCLUSION

Whitening toothpaste with abrasive action and enzymatic action are equally effective in removal of extrinsic stains; however, whitening toothpaste with abrasive action needs to be used with caution.