Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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Effect of medium or high concentrations of in-office dental bleaching gel on the human pulp response in the mandibular incisors

  • Douglas Augusto Roderjan (Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa) ;
  • Rodrigo Stanislawczuk (Department of Restorative Dentistry, School of Dentistry, Campos Gerais Higher Education Center - CESCAGE) ;
  • Diana Gabriela Soares (Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo) ;
  • Carlos Alberto de Souza Costa (Department of Physiology and Pathology, Araraquara School of Dentistry, Sao Paulo State University) ;
  • Michael Willian Favoreto (Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa) ;
  • Alessandra Reis (Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa) ;
  • Alessandro D. Loguercio (Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa)
  • Received : 2022.07.19
  • Accepted : 2022.11.11
  • Published : 2023.05.31
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Abstract

Objectives: The present study evaluated the pulp response of human mandibular incisors subjected to in-office dental bleaching using gels with medium or high concentrations of hydrogen peroxide (HP). Materials and Methods: The following groups were compared: 35% HP (HP35; n = 5) or 20% HP (HP20; n = 4). In the control group (CONT; n = 2), no dental bleaching was performed. The color change (CC) was registered at baseline and after 2 days using the Vita Classical shade guide. Tooth sensitivity (TS) was also recorded for 2 days post-bleaching. The teeth were extracted 2 days after the clinical procedure and subjected to histological analysis. The CC and overall scores for histological evaluation were evaluated by the Kruskal-Wallis and Mann-Whitney tests. The percentage of patients with TS was evaluated by the Fisher exact test (α = 0.05). Results: The CC and TS of the HP35 group were significantly higher than those of the CONT group (p < 0.05) and the HP20 group showed an intermediate response, without significant differences from either the HP35 or CONT group (p > 0.05). In both experimental groups, the coronal pulp tissue exhibited partial necrosis associated with tertiary dentin deposition. Overall, the subjacent pulp tissue exhibited a mild inflammatory response. Conclusions: In-office bleaching therapies using bleaching gels with 20% or 35% HP caused similar pulp damage to the mandibular incisors, characterized by partial necrosis, tertiary dentin deposition, and mild inflammation.

Keywords

Acknowledgement

This study was partially supported by the National Council for Scientific and Technological Development (CNPq) under grants 304817/2021-0 and 308286/2019-7 and Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior-Brasil (CAPES)-Finance Code 001.

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