Color change after tooth bleaching with ozone and 10% ozonized carbamide peroxide for in-office use

Abstract

There is a constant search for bleaching treatments that can offer greater safety with fewer adverse effects, especially in the techniques performed in the office, which usually employ hydrogen peroxide in high concentrations (35% to 40%) that are not recommended by some international control agencies. This in vitro study evaluated the color change after tooth bleaching with the use of ozone and a 10% ozonized carbamide peroxide bleaching treatment for in-office use. Thirty molars were allocated ( n = 10): three applications of ozone (1 hour every 3 days); three applications of 10% ozonized carbamide peroxide (1 hour every 3 days); 10% carbamide peroxide agent (8 hours a day for 7 days). The teeth were mounted on a plaster model to simulate the dental arch, and trays made of silicone were used for the application of the bleaching agents and to allow ozone to enter through. The ozone concentration used was 60 μg/mL, with an oxygen flow of 0.25 L/min. The values of color change showed no significant differences among treatments. The variations in the parameters over time, as well as the values of Δ E ab , Δ E 00 , and WI D , showed that there was no significant difference among the three treatments. The use of ozone and 10% ozonized carbamide peroxide for in-office use was effective for tooth bleaching with clinically perceptible and acceptable color alterations. The study was approved on September 10, 2019 by the São Leopoldo Mandic Ethics Research Committee (CAAE No. 17711719.4.0000.5374).

Ozone gas therapy for tooth bleaching preserves enamel microhardness, roughness and surface micromorphology

“…The bleaching protocols evaluated are shown in Table 1 . The ozone concentration in the ozone gas therapy followed protocols adapted from Tessier et al 25 , Santana et al 18 , and Ferreira et al 19 . The pH values for the 10% carbamide peroxide bleaching agent and the ozonized 10% carbamide peroxide were measured in triplicate, at different application times (baseline, 30, and 60 minutes), using a pH meter (MS Tecnopon Equipamentos Especiais, Piracicaba, SP, Brazil).…”

“…Although some studies have observed that the isolated use of ozone did not promote effective bleaching 16,20,24 , others have reported that ozone associated with a high concentration of hydrogen peroxide (37.5% 18 and 38% 13-15 ) during in-office bleaching techniques did so. Ozone applied together with carbamide peroxide in the office 19 or by patients on their own 18,19,25 has shown significant results in inducing clinically noticeable color change, in addition to reducing patient-reported sensitivity 14 . These differences in the whitening potential reported for ozone therapy in different studies stem from variations in ozone or peroxide dosages or low concentrations, low sample size, older ozone generation devices, and ozone circulation capacity in the application tray 15 , 19 .…”

“…Ozone applied together with carbamide peroxide in the office 19 or by patients on their own 18,19,25 has shown significant results in inducing clinically noticeable color change, in addition to reducing patient-reported sensitivity 14 . These differences in the whitening potential reported for ozone therapy in different studies stem from variations in ozone or peroxide dosages or low concentrations, low sample size, older ozone generation devices, and ozone circulation capacity in the application tray 15 , 19 . Among the protocols used, Ferreira et al 19 applied office treatments with ozone and carbamide peroxide associated to ozone therapy for 1 hour every 3 days (total 3 applications or 3 hours).…”

“…These differences in the whitening potential reported for ozone therapy in different studies stem from variations in ozone or peroxide dosages or low concentrations, low sample size, older ozone generation devices, and ozone circulation capacity in the application tray 15 , 19 . Among the protocols used, Ferreira et al 19 applied office treatments with ozone and carbamide peroxide associated to ozone therapy for 1 hour every 3 days (total 3 applications or 3 hours). These treatments promoted clinically noticeable, acceptable and comparable chromatic changes when 10% carbamide peroxide was applied in a tray for 8 hours daily for 7 days (totaling 56 hours of application).…”

“…Moreover, some bleaching agents with low pH can cause a change in mineral content 18 . Ferreira et al 19 showed that the pH remains neutral when a carbamide peroxide bleaching agent is associated with ozone for 60 minutes, but they also observed a slight decrease in microhardness values, possibly associated with the release of free radicals. This slight reduction could lead to changes not only in the mineral content of the enamel, but also in the roughness and micromorphology of the enamel, characterized by porosity and erosion.…”