Enamel Surface Changes After Exposure to Bleaching Gels Containing Carbamide Peroxide or Hydrogen Peroxide

Cvikl, Barbara; Lussi, Adrian; Moritz, Andreas; Flury, Simon

doi:10.2341/15-010-l

Cited by 51 publications

(60 citation statements)

References 26 publications

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“…One possible factor that may have contributed to the reduction of enamel microhardness was the contact time of fluoride free bleaching gel with enamel surface which may have disrupted the balance between demineralization caused by the bleaching agent and the remineralization caused by artificial saliva. 27,33,34 These findings are in agreement with our SEM analyses, where was observed an irregular surface with depressions, porosity, and increased depth of enamel grooves. 13 Other studies also observed these alterations and the enamel microhardness decrease when low carbamide peroxide (10 or 15%) concentrations were used for long treatment times.…”

Section: Discussionsupporting

confidence: 90%

“…13,25,26 One reason for this may be the increasing of contact time of low concentrated bleaching gels with tooth surface, which promoted surface changes in concentration of ions calcium and phosphate, degradation of organic matrix, erosion, porosities, and depressions. 25,27 The gel used in this study was maintained in contact with enamel surface 4 hours/ day during two weeks. Additionally, the gel contains carbopol as thickening agent which has been suggested that can also adversely affect dental enamel.…”

Section: Discussionmentioning

confidence: 99%

“…13 Other studies also observed these alterations and the enamel microhardness decrease when low carbamide peroxide (10 or 15%) concentrations were used for long treatment times. 25,27,33,34 Additionally, the in situ effects of low concentrated bleaching agents on human enamel surface demonstrated no morphologic or chemical changes. This may be attributed to the protective effects of saliva, which provided dilution, buffering capacity, and supply Ca and P ions for tooth remineralization.…”

Section: Discussionmentioning

confidence: 99%

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Influence of three treatment protocols for dental fluorosis in the enamel surface: an in vitro study

Lins¹,

Andrade²,

Duarte³

et al. 2019

CRORJ

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Palavras-chave: Fluorose Dentária. Esmalte Dentário. Clareamento Dental. RESUMO Introdução:A fluorose dentária é uma alteração do esmalte caracterizada por manchas opacas causadas pela alta exposição aos íons fluoreto durante o desenvolvimento dentário. Objetivo: Este estudo in vitro objetivou avaliar mudanças na superfície do esmalte em dentes humanos hígidos após três protocolos de tratamento para a fluorose dentária: microabrasão com ácido fosfórico a 37% e pedra-pomes, clareamento caseiro com peróxido de carbamida a 10% e a associação destas técnicas. Métodos: Trinta e oito espécimes (5×5×2 mm) com superfície em esmalte foram obtidos a partir de 19 terceiros molares, sendo que dois não receberam tratamento e, trinta e seis foram randomizados em três grupos (n= 12): MAB-microabrasão do esmalte; CP10-clareamento caseiro; e MAB+CP10-associação destas técnicas. A rugosidade superficial e microdureza foram realizadas antes e após os protocolos de tratamento. Dois espécimes representativos de cada grupo foram avaliados por microscopia eletrônica de varredura (MEV). A análise de variância e teste de Tukey foram utilizados para análise dos resultados (p< 0,05). Resultados: Todos os protocolos de tratamento promoveram um aumento da rugosidade superficial do esmalte (p< 0,02). MAB e MAB+CP10 mostraram um aumento significativo da microdureza do esmalte (p< 0,04), enquanto que CP10 mostrou uma menor microdureza comparado ao MAB e ao MAB+CP10 (p< 0,05). As imagens de MEV demonstraram uma superfície mais lisa do MAB e MAB+CP10 e um padrão irregular do esmalte erodido para o CP10. Conclusão: Os protocolos testados para tratamento da fluorose dentária testados modificaram significativamente a rugosidade, microdureza e micromorfologia do esmalte. ABSTRACT Introduction:Dental fluorosis is an enamel alteration characterized with opaque stains caused by high exposures to fluoride during the dentition development. Aim: This in vitro study aimed to evaluate changes in the enamel surface of sound human teeth after three treatment protocols for dental fluorosis: microabrasion with 37% phosphoric acid and pumice, home bleaching with 10% carbamide peroxide, and a combination of these techniques. Methods: Thirty-eight specimens (5×5×2 mm) with enamel surface were obtained from 19 third molars. Thirty six specimens were randomized into three treatment groups (n= 12): MAB-enamel microabrasion; CP10-home bleaching; MAB+CP10-a combination of these techniques and two specimens not received treatment. Surface roughness and microhardness analyses were performed before and after treatment protocols. Two representative specimens from each group were evaluated by scanning electron microscopy (SEM). Analysis of variance and Tukey's tests were used for data analysis (p< 0.05). Results: All treatment protocols promoted an increased in enamel surface roughness (p< 0.02). MAB and MAB+CP10 showed a significant increase in the enamel microhardness (p< 0.04), while CP10 showed a microhardness lower than MAB and MAB+CP10 (p< 0.05). SEM images demonstrate...

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Influence of three treatment protocols for dental fluorosis in the enamel surface: an in vitro study

Lins¹,

Andrade²,

Duarte³

et al. 2019

CRORJ

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“…Since the introduction of the Nightguard Vital Bleaching technique using 10% carbamide peroxide [2], studies have been conducted to evaluate the possible effects produced on dental tissues during and after whitening procedures. Despite the favorable results achieved with bleaching treatment [3,4], there are many controversies as regards its adverse effects [5] such as dental sensitivity during treatment, a decrease in enamel surface hardness [4,6,7], volume and mineral loss [8] and morphologic alterations after exposure to bleaching agents [9][10][11]. The controversies presented in the literature are not only related to the results found by different research groups, but also to the significant variety of methods that have been used to investigate the possible effects of bleaching agents on the physical and chemical properties of enamel [12][13][14][15].…”

Section: O R I G I N a L A R T I C L Ementioning

confidence: 99%

Effects of different degrees of acidity and concentration of bleaching agents on human enamel mineral content and surface morphology over time

Andrade

Shimaoka

Cardoso

et al. 2018

BDS

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Objective: The aim of this study was to evaluate the effect of pH and concentration of bleaching agents on the mineral content and surface morphology of human dental enamel for 14 days. Material and Methods: Eighty human central incisors were randomly divided into 8 groups (n=10): G1-7.5% hydrogen peroxide/pH=9.0; G2–9.5% hydrogen peroxide/pH=9.0; G3-7.5% hydrogen peroxide/pH=7.0; G4-9.5% hydrogen peroxide/pH=7.0; G5-10% carbamide peroxide/pH=5.0; G6-16% carbamide peroxide/pH=5.0; G7-37% phosphoric acid 15s (positive control); G8-no treatment (negative control). The mineral analysis of the bleaching gel collected was assessed by ICP-AES and surface morphology was observed by SEM. Results: Friedman and Dunn’s statistical test demonstrated significant differences among the proposed treatments (p<0.01). No significant difference was found among groups treated with hydrogen peroxide (G1, G2, G3, and G4) or among groups G5, G6 and G7 (p>0.01). However, the latter groups showed significantly higher values as compared to groups G1, G2, G3 and G4 (p<0.01). Conclusion: Alteration in enamel mineral content may not be influenced by concentration when bleaching agents with the same pH are compared. The most apparent alterations in mineral content and surface morphology may be noted when more acidic products are used. The daily mineral content measurement may not be influenced by repeated applications of bleaching agents. KeywordsDental bleaching; Mineral content; Enamel; Peroxide; Demineralization; pH.

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“…Vital tooth bleaching is considered to be a conservative esthetic treatment modality to improve tooth color because no sound tooth structure is removed. Although adverse effects to enamel surface properties such as reduction in hardness [2], change in surface morphology [3] and increased susceptibility to abrasion/erosion [4] have been reported, the wide variety of different bleach concentrations and application methods, as well as different study designs, have contributed to equivocal conclusions. In general, the effects of tooth bleaching on the enamel surface have been considered to be minor or clinically insignificant [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Effect of tooth whitening strips on fatigue resistance and flexural strength of bovine dentin in vitro

Tam¹,

Kim²,

Souza³

2017

PLoS ONE

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ObjectiveTo determine the effects of whitening strips on bovine dentin fatigue resistance and flexural strength in vitro.Materials and methodsA total of eighty bovine dentin specimens (2x2x17mm) were treated with either: control glycerine gel on plastic film wrap or whitening strips containing 9.5% hydrogen peroxide. Treatment was applied for 30 minutes, twice a day, for 1- or 4-weeks. After the last treatment, ten specimens per group were randomly selected to undergo fatigue testing (106 cycles, 3Hz, 20N) while the other ten were subjected to flexural strength testing after ten days of storage in artificial saliva. Kaplan-Meier method with a log rank test, Wilcoxon test and Cox regression were used to assess fatigue test results (p<0.05). One-way ANOVA and Tukey’s tests were used to compare the flexural strength results (p<0.05).ResultsThere were significant differences in survival during the fatigue test among the groups (p<0.001). Treatment (control or bleach) was a significant factor for specimen survival (p<0.001, Exp(B) = 33.45). There were significant differences in mean flexural strength (p<0.001). No significant difference was found between “1-wk control” and “4-wk control”. The mean flexural strength and fatigue resistance of the “4-wk bleach” were significantly lower than all the other groups.ConclusionsThe use of whitening strips reduced the fatigue resistance and flexural strength of bovine dentin in vitro. Until the effect of whitening strips on mechanical properties of human dentin is fully elucidated, it remains prudent to advise patients to avoid excessive direct use of whitening strips on dentin.

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Enamel Surface Changes After Exposure to Bleaching Gels Containing Carbamide Peroxide or Hydrogen Peroxide

Abstract: All six bleaching gels effectively bleached the enamel specimens independent of their concentration of peroxide. Gels with low peroxide concentration and longer contact time negatively affected the enamel surface.

Cited by 51 publications

References 26 publications

Influence of three treatment protocols for dental fluorosis in the enamel surface: an in vitro study

Influence of three treatment protocols for dental fluorosis in the enamel surface: an in vitro study

Effects of different degrees of acidity and concentration of bleaching agents on human enamel mineral content and surface morphology over time

Effect of tooth whitening strips on fatigue resistance and flexural strength of bovine dentin in vitro

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