Microhardness change of enamel due to bleaching with in-office bleaching gels of different acidity

Objective. The aim of this study was to assess the enamel microhardness treated with three in-office bleaching agents, containing 35% hydrogen peroxide with different acidity. Materials and methods. Bovine incisors were divided into three groups that received the following bleaching agents: Whiteness HP, Total Bleach and Opalescence Xtra. Three gel applications/10-min each, totaling 30-min of bleaching treatment, were made on the teeth and activated with a blue LED (1000 mW/470 nm) combined to a LASER (120 mW/795 nm) device (Easy Bleach-Clean Line). Vickers hardness (VH) was evaluated at baseline and after the bleaching procedure. The values of Hardness loss [HNL] (% reduction) were calculated. The two-sample t-test was used for comparison of the HNL of the three bleaching products (5% level of significance). Results. The Opalescence Xtra, which had the lowest pH value (pH = 4.30), showed a significant increase of HNL when compared with Total Bleach bleaching agent, which had the highest pH value (pH = 6.62). Conclusions. The 35% hydrogen peroxide bleaching agents resulted in a reduction in surface enamel microhardness and bleaching with the most acid agent resulted in a significant enamel hardness loss compared to the less acid agent (4.30 vs 6.62). Strategies proposed to reduce the enamel loss after bleaching treatment may include the use of daily fluoride therapy, mouth rinsing (fluoride, milk and sodium bicarbonate solution), fluoride/bicarbonate dentifrices without abrasives, do not toothbrush immediately after bleaching, fluorides and calcium add to bleaching agents.

Effects of 10% carbamide peroxide bleaching materials on enamel microhardness

Purpose: To evaluate the microhardness of enamel treated with two different 10% carbamide peroxide bleaching materials at different time intervals. Materials and Methods: Two bleaching agents were analyzed: Opalescence (OPA) and Rembrandt (REM). The control group (CON) consisted of dental fragments maintained in artificial saliva. Bleaching was accomplished for 8 hrs per day and stored during the remaining time in an individual recipient with artificial saliva. Enamel microhardness testing was performed before the initial exposure to the treatments and after 1, 7, 14, 21, 28, 35 and 42 days. Results: the ANOVA, followed by the Bartlet and Tukey tests, showed significant differences for treatments (P < 0.00001) from day 7-day 42. From the 7th to the 14th day, OPA presented an increase of enamel microhardness over time while REM presented a decrease of microhardness. Statistical differences were not found between REM and the control group (OPA > CON = REM). From the 21st-35th day, enamel fragments bleached with OPA and REM presented a decrease of microhardness. Statistical differences of microhardness were verified among all the treatments (OPA > CON > REM). on the day 42, statistical differences were not found between OPA and the control group, but they were found between REM and the control group (OPA = CON > REM). The polynomial regression showed an increase of microhardness for OPA until the 21st day, followed by a decrease of microhardness up to the 42nd day. A decrease of microhardness for REM was verified. There were alterations in enamel microhardness as a function of bleaching time when using the two different 10% carbamide peroxide whiteners. Over a 42-day treatment time, bleaching with REM agent caused a decrease in enamel microhardness. The OPA agent initially increased the microhardness, then returned to the control level. Different bleaching materials with the same concentration of carbamide peroxide have different effects on the enamel.

Sealing evaluation of the cervical base in intracoronal bleaching

Discoloration of non-vital teeth is an esthetic deficiency frequently requiring bleaching treatment. The purpose of this study was to evaluate in vitro the cervical base efficacy in order to prevent or to minimize the leakage along the root canal filling and into the dentinal tubules. Thirty-eight extracted single-root human teeth were used, which were biomechanically prepared, filled, and divided into three experimental groups: G1, a cervical base was applied (3 mm of thickness) below the cemento-enamel junction, with resin-modified glass-ionomer cement (Vitremer); G2, the base was done with glass-ionomer cement (Vidrion R); and G3 (Control), did not receive any material as base. A mixture of sodium perborate and hydrogen peroxide 30% was placed inside the pulp chamber for 3 days, and the access opening was sealed with Cimpat. This procedure was repeated thrice. Soon after this, a paste of calcium hydroxide was inserted into the pulp chamber for 14 days. All teeth were covered with two layers of sticky wax, except the access opening, and immersed in blue India Ink for 5 days. The results did not show statistically significant differences between the three groups concerning the leakage inside the dentinal tubules. Regarding the apical direction, a statistical difference (ANOVA P < 0.05) was observed among the experimental group G1 and control group G3. No statistically significant difference was observed between G2 and G3 groups. Therefore, the placement of a cervical base before internal bleaching procedures is still recommended.