Evaluation of the bleached human enamel by scanning electron microscopy

Since bleaching has become a popular procedure, the effect of peroxides on dental hard tissues is of great interest in research. Purpose: The aim of this in vitro study was to perform a qualitative analysis of the human enamel after the application of in-office bleaching agents, using Scanning Electron Microscopy (SEM). Materials and Methods: Twenty intact human third molars extracted for orthodontic reasons were randomly divided into four groups (n=5) treated as follows: G1- storage in artificial saliva (control group); G2- four 30-minute applications of 35% carbamide peroxide (total exposure: 2h); G3- four 2-hour exposures to 35% carbamide peroxide (total exposure: 8h); G4- two applications of 35% hydrogen peroxide, which was light-activated with halogen lamp at 700mW/cm2 during 7min and remained in contact with enamel for 20min (total exposure: 40min). All bleaching treatments adopted in this study followed the application protocols advised by manufacturers. Evaluation of groups submitted to 35% carbamide peroxide was carried out after two time intervals (30 minutes and 2 hours per session), following the extreme situations recommended by the manufacturer. Specimens were prepared for SEM analysis performing gold sputter coating under vacuum and were examined using 15kV at 500x and 2000x magnification. Results: Morphological alterations on the enamel surface were similarly detected after bleaching with either 35% carbamide peroxide or 35% hydrogen peroxide. Surface porosities were characteristic of an erosive process that took place on human enamel. Depression areas, including the formation of craters, and exposure of enamel rods could also be detected. Conclusion: Bleaching effects on enamel morphology were randomly distributed throughout enamel surface and various degrees of enamel damage could be noticed. Clinical significance: In-office bleaching materials may adversely affect enamel morphology and therefore should be used with caution.

Effects of dental bleaching on the color, translucency and fluorescence properties of enamel and dentin

The objective of this study was to evaluate the color, translucency and fluorescence of bovine enamel and dentin submitted to different bleaching modalities. Pairs of enamel and dentin discs (3 mm in diameter) were obtained from 150 bovine teeth. In 75 of the pairs, one specimen had the enamel removed (Dentin Group). The dentin was removed from one specimen of the remaining 75 pairs (Enamel Group) and the other specimen was left unaltered (Enamel + Dentin). The evaluation of color, translucency and fluorescence was performed with a spectrophotometer using the CIE L* a* b*. Each group was subdivided into three subgroups: Control, composed of specimens that were not bleached, and two experimental subgroups, bleached with either 10% carbamide peroxide (CP10%) or 35% hydrogen peroxide (HP35%). The CP10% bleaching gel was applied 2 h/day for 14 days. The HP35% bleaching agent was applied using two applications of 30 min each, with a one week interval between each application. When not being bleached, the specimens were immersed in artificial saliva. The color, translucency and fluorescence ratings were assessed using spectrophotometry 7 days after the treatment. Regarding color, significant differences were found between bleaching techniques in the groups Enamel and Enamel + Dentin, with a higher color difference for HP35%. Bleaching did not change the translucency of the dental tissues. There were significant differences for fluorescence for the HP35% subgroups of Dentin and Enamel + Dentin, and for the CP10% subgroup of Enamel. Dental bleaching changed the color and fluorescence of the dental tissues, however translucency was not affected.

Effect of incorporation of remineralizing agents into bleaching gels on the microhardness of bovine enamel in situ

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of simulated pulpal pressure on efficacy of bleaching gels

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Responses of human dental pulp cells after application of a low-concentration bleaching gel to enamel

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of home-bleaching gels modified by calcium and/or fluoride and the application of nano-hydroxyapatite paste on in vitro enamel erosion susceptibility

This in vitro study compared the effect of bleaching agents modified by the addition of calcium and/or fluoride and the application of a nano-hydroxyapatite paste after bleaching, on the susceptibility of enamel to erosion. Bovine enamel cylindrical samples (3 mm diameter) were assigned to six groups (n = 20 specimens/group) according to the bleaching agent: no bleaching (C-control), 7.5% hydrogen peroxide gel (HP), HP with 0.5% calcium gluconate (HP+Ca), HP with 0.2% sodium fluoride (HP+F), HP with calcium and fluoride (HP+Ca+F) and HP followed by the application of a nano-hydroxyapatite agent (HP+NanoP). The gels were applied on the enamel surface (1 h) followed by cyclic erosive challenges (Sprite Zero®-2 min), for 14 days. The paste was applied after bleaching for 5 min (HP+NanoP). The enamel surface alteration was measured by contact profilometry (µm) (after 7 and 14 days). C-control (mean ± SD: 2.29 ± 0.37 at 7 days/4.86 ± 0.72 at 14 days) showed significantly lower loss compared to the experimental groups. HP+Ca (3.34 ± 0.37/6.75 ± 1.09) and HP+F (4.49 ± 0.92/7.61 ± 0.90) presented significantly lower enamel loss than HP (4.18 ± 0.50/10.30 ± 1.58) only for 14 days and HP+Ca+F (4.92 ± 1.03/8.12 ± 1.52) showed values similar to the HP+F group. The HP+NanoP (5.51 ± 1.04/9.61 ± 1.21) resulted in enamel loss similar to the HP after 14 days. It was found that 7.5% hydrogen peroxide increased the susceptibility of enamel to erosion. The addition of calcium or fluoride to the bleaching gel reduced the erosion effect, while the nano-hydroxyapatite agent did not provide any protective effect.

Influence of whitening gel application protocol on dental color change

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The oxidation of p-phenylenediamine, an ingredient used for permanent hair dyeing purposes, leads to the formation of hydroxyl radicals: oxidative stress and DNA damage in human immortalized keratinocytes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)