• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.33.1-33.12
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• 2023

Objectives: This study aimed to evaluate the bleaching efficacy and hydrogen peroxide permeability in the pulp chamber by the at-home bleaching gel in protocols applied on different dental surfaces. Materials and Methods: Forty premolars were randomly into 4 groups: control group no bleaching, only application on the buccal surface (OB), only application on the lingual surface (OL) and application in buccal and lingual surfaces, simultaneously (BL). At-home bleaching gel (White Class 7.5%) was used for the procedure. The bleaching efficacy was evaluated with a digital spectrophotometer (color change in CIELAB [ΔE_ab] and CIEDE 2000 [ΔE₀₀] systems and Whitening Index for Dentistry [ΔWI_D]). The hydrogen peroxide permeability in the pulp chamber (㎍/mL) was assessed using UV-Vis spectrophotometry and data were analyzed for a 1-way analysis of variance and Tukey's test (α = 0.05). Results: All groups submitted to bleaching procedure showed bleaching efficacy when measured with ΔE_ab and ΔE₀₀ (p > 0.05). Therefore, when analyzed by ΔWI_D, a higher bleaching efficacy were observed for the application on the groups OB and BL (p = 0.00003). Similar hydrogen peroxide permeability was found in the pulp chambers of the teeth undergoing different protocols (p > 0.05). Conclusions: The application of bleaching gel exclusively on the OB is sufficient to achieve bleaching efficacy, when compared to BL. Although the OL protocol demonstrated lower bleaching efficacy based on the ΔWI_D values, it may still be of interest and relevant in certain clinical scenarios based on individual needs, requiring clinical trials to better understand its specificities.

• Restorative Dentistry and Endodontics
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• v.45 no.1
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• pp.12.1-12.8
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• 2020

Objectives: The aim of this in vitro study was to evaluate the microhardness and surface roughness of composite resins before and after tooth bleaching procedures. Materials and Methods: Sixty specimens were prepared of each composite resin (Filtek Supreme XT and Opallis), and BisCover LV surface sealant was applied to half of the specimens. Thirty enamel samples were obtained from the buccal and lingual surfaces of human molars for use as the control group. The surface roughness and microhardness were measured before and after bleaching procedures with 35% hydrogen peroxide or 16% carbamide (n = 10). Data were analyzed using 1-way analysis of variance and the Fisher test (α = 0.05). Results: Neither hydrogen peroxide nor carbamide peroxide treatment significantly altered the hardness of the composite resins, regardless of surface sealant application; however, both treatments significantly decreased the hardness of the tooth samples (p < 0.05). The bleaching did not cause any change in surface roughness, with the exception of the unsealed Opallis composite resin and dental enamel, both of which displayed an increase in surface roughness after bleaching with carbamide peroxide (p < 0.05). Conclusions: The microhardness and surface roughness of enamel and Opallis composite resin were influenced by bleaching procedures.

• Restorative Dentistry and Endodontics
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• v.49 no.2
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• pp.14.1-14.13
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• 2024

This study aimed to answer the question through a systematic review: Can carbamide peroxide be as effective as hydrogen peroxide and cause less in-office bleaching sensitivity? A literature survey was performed in PubMed/MEDLINE, Embase, Scopus, ISI Web of Science, and gray literature. Primary clinical trials that compared the efficacy or the in-office bleaching sensitivity between carbamide and hydrogen peroxides were included. The risk of bias was evaluated using the RoB2. The certainty of the evidence was assessed using the GRADE approach. DPI training significantly improved the mean scores of the dental undergraduates from 7.53 in the pre-DPI-training test to 9.01 in the post-DPI-training test (p < 0.001). After 6 weeks, the mean scores decreased marginally to 8.87 in the retention test (p = 0.563). DPI training increased their confidence level from 5.68 pre-DPI training to 7.09 post-DPI training. The limited evidence suggests that the 37% carbamide peroxide may be similarly effective to the 35% hydrogen peroxide for bleaching teeth in-office and causes less bleaching sensitivity. However, more well-designed split-mouth clinical trials are necessary to strengthen the evidence.

• Restorative Dentistry and Endodontics
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• v.45 no.2
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• pp.20.1-20.14
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• 2020

Objectives: To minimize the tooth sensitivity caused by in-office bleaching, many dentists use non-steroidal anti-inflammatory drugs and topical desensitizing gels containing potassium nitrate and sodium fluoride. This study aimed to evaluate the influence of these substances on inflammation and the expression of substance P and calcitonin gene-related peptide in pulp nerve fibers. Materials and Methods: Seventy-two rats were divided into 6 groups as follows: GI, control; GII, only dental bleaching; GIII, only ibuprofen; GIV, ibuprofen administered 30 minutes before and after the bleaching treatment and every 12 hours until the analysis; GV, only topical application of a desensitizing agent; and GVI, topical application of a desensitizing agent before dental bleaching. Placebo gel was applied to the upper left jaw and the bleaching agent was applied to the upper right jaw in all groups. Subsequently, the groups were divided into 3 subgroups based on the time of analysis: 0, 24, and 48 hours after bleaching (n = 8). The rats were euthanized and the maxillae were processed and evaluated by histopathological and immunohistochemical analyses. The data were analyzed using the Kruskal-Wallis test, followed by the Dunn test (p < 0.05). Results: In the bleaching groups, the inflammatory process and expression of neuropeptides decreased over time. The animals in which a desensitizing agent was applied showed better results within 24 hours. Conclusions: The use of a desensitizing agent had positive effects on inflammation and pain-related neuropeptide expression, minimizing the painful effects of dental bleaching treatment.

• Korean Journal of Dental Materials
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• v.46 no.1
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• pp.1-10
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• 2019

There are several causes of tooth discoloration following root canal treatment. In this study, we evaluated the effects of sealers on tooth discoloration and internal bleaching. Twenty-four teeth were divided into 4 groups: control group, AH plus, Endosequece BC, and MTA fillapex group. Root canal filling was performed using each sealer conventionally and non-vital bleaching was performed with sodium perborate. The L, a, and b values were measured using Vita easyshade. Tooth discoloration after root canal treatment occurs irrespective of the type of sealers and may cause discoloration with only gutta-percha cone. The effect of non-vital bleaching following the use of calcium silicate-based sealers such as Endosequece BC and MTA fillapex was higher than that of AH plus. Therefore, it needs careful use of sealers in endodontics and calcium silicate-based sealers have advantages of bleaching in case of discolored tooth.

• Journal of dental hygiene science
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• v.9 no.5
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• pp.525-530
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• 2009

The purpose of this study was to evaluate color change and enamel surface changes using the plasma arc light source during tooth bleaching treatments. Twenty-four extracted bovine incisors were selected and embedded in the resin blocks. All the specimens were highly polished and discolored with commercial $COCK^{(R)}$. High concentration carbamide peroxide with and without plasma arc were used for bleaching. Specimens were bleached for 1 hour per week during 3 weeks. Color and enamel surface changes were determined with colorimeter (TC-8600A), microhardness tester(MXT-a7), scanning electron microscope(S-4200). All the collected data analyzed with paired t-test, t-test and one-way ANOVA. After the bleaching, both groups showed the color changes(${\Delta}E^*$). Microhardness of two group decreased after tooth bleaching. The SEM evaluation of enamel surface of both group showed a similar morphology of decalcification after tooth bleaching. Office bleaching using the plasma arc application with 35% carbamide peroxide can increase the color change. Office bleaching using the high concentration of carbamide peroxide and plasma arc also detract the outer surface of enamel. It is recommended that careful procedures are needed during office bleaching with high concentration of carbamide peroxide and light source.

• Restorative Dentistry and Endodontics
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• v.47 no.1
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• pp.7.1-7.14
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• 2022

Objectives: This study evaluated the bleaching efficacy of different in-office protocols associated with violet light emitting diode (V-LED), and measured the pulpal temperature rise caused by V-LED with or without gel application. Materials and Methods: Bovine incisors were distributed in 4 groups (n = 10): VL - V-LED; HP - 35% hydrogen peroxide (control); HYB - hybrid protocol, V-LED applied without gel for 10 irradiation cycles followed by V-LED applied with gel for another 10 irradiation cycles; and HPVL - gel and V-LED applied for 20 irradiation cycles. Three bleaching sessions were performed with 7-day intervals. Bleaching efficacy was evaluated with ΔE_ab^*, ΔE₀₀ and ΔWI_D. Data were recorded at baseline, 7, 14, 21 and 70 days. For pulpal temperature rise, thermocouples were placed inside the pulp chamber of human incisors. To determine intrapulpal temperature, the teeth were irradiated with V-LED with or without application of bleaching gel. Color difference data were analyzed by 2-way repeated measures ANOVA and Tukey's test. Pulpal temperature was analyzed by t-test (α = 5%). Results: VL exhibited lower color (ΔE_ab^* and ΔE₀₀) and whiteness changes (ΔWI_D) than the other groups. HPVL presented higher color change values than HYB. HYB and HPVL showed not different ΔWI_D values; and HP showed the highest whiteness changes at all times. There were significant differences comparing ΔT with gel (8.9℃) and without gel application (7.2℃). Conclusions: HPLV was more efficient than HYB. The 2 protocols with VL showed similar results to control. Gel application combined with VL promoted higher pulpal temperature than to the no gel group.

• Journal of Korean society of Dental Hygiene
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• v.10 no.3
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• pp.473-481
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• 2010

Objectives : To evaluate the effect of fluoride application on the color and microhardness of bleached enamel and compare it to that of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application. Methods : Twenty freshly extracted human adult molar were each sectioned into halves, the specimens divided and treated according to five experimental groups: Group 1, treatment with 10% carbamide peroxide (CP) bleaching agent; Group 2, treatment with 10% CP followed by a 1.23% fluoride gel application; Group 3, treatment with 10% CP followed by a 2.23% sodium fluoride varnish application; Group 4, treatment with 10% CP followed by a 0.11% sodium fluoride gel application; Group 5, treatment with 10% CP followed by a CPP-ACP gel application. All groups were treated 6 h per day for 14 days then immersed in distilled water for 2 weeks. Changes in enamel color were evaluated on Baseline and Day 14. Microhardness were evaluated on Baseline, Days 7 and 14. Statistical analysis was performed using one-way ANOVA and post-hoc Tukey tests. Results : All the bleached enamel specimens revealed increased whiteness and overall color value. Group 1 showed the lowest microhardness values than that of Groups 2, 3, 4 and 5. In all groups, the hardness of tooth after bleaching showed a significant decrease in the microhardness as compared with the one prior to tooth bleaching. The specimens treated with remineralizing agents showed relatively less reduction in enamel microhardness than control group. Conclusions : The addition of fluoride and CPP-ACP did not impede the whitening effect. The use of remineralizing agents during bleaching treatment can significantly enhance the microhardness of bleached enamel.

• Restorative Dentistry and Endodontics
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• v.14 no.1
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• pp.173-177
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• 1989

As widely known major cause of tooth discoloration is red blood cell in dentinal tubules after tooth trauma and extirpation. Hemoglobin in the red cells easily conbine with hydrogen sulfide and change natural tooth color into dark brown. To confirm and compare the effect of bleaching agents test material was made as fellows: No. 40 paper points were soaked in blood and put into the oven for 24 hours to dry. Dried paper points were again soaked in diluted yolk by distilled water for a minute and kept the points for a week to get fully sulfide. Hydrogen peroxide (25%), Sodium hypochlorite (2%), Sodium hyposulfate (2%), Sodium perborate and mixture of Hydrogen peroxide (25%) and Sodium perborate were employed as bleaching agents. About 0.2ml of each medicaments were put into the small test tubes and blood soaked paper points were gently placed vertically with the apex downward and kept 24 hours in the oven ($37^{\circ}C$). Every 24 hours the medicaments were renewed at 24 and 48 hours. Following are the results of the study: 1. Significant bleaching effect was found on the case of hydrogen peroxide (25%) after 24 hours. The area above 2mm from apex also fully bleached after 48 hours. 2. A mixture of hydrogen peroxide and sodium perborate treated case showed moderate effect at 24 hours and significant effect at 48 hours. High portion of the point (above 2mm) was bleached satisfactory at 72 hours. 3. The effect of sodium perborate at 48 hours showed moderate and significant at 72 hours. 4. Sodium hypochlorite and sodium hyposulfate were weak agent in bleaching. At 72 hours case revealed moderate effect and influenced on high portion of the point very weak effect.

• Restorative Dentistry and Endodontics
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• v.24 no.2
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• pp.392-398
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• 1999

The purpose of this study was to assess the effect of catalase used following bleaching for the elimination of hydrogen peroxide residues from human teeth on the microleakage at the tooth-resin composite interface. In this study, class V cavities were prepared on the buccal or lingual surfaces of seventy extracted human molar teeth, and crown of sixty teeth were immersed in 30% hydrogen peroxide at $37^{\circ}C$ for 5 days except for negative control group. Then the teeth were rinsed with water and distributed randomly into seven groups of 10 each and were conditioned as following Negative control group: No bleaching Positive control group : bleaching and no application of catalase (C-40) Experimental group 1 : one cycle of catalase application for 3 min. and water rinse for 2 min. after bleaching Experimental group 2 : two cycles of catalase application for 3 min. and water rinse for 2 min. after bleaching Experimental group 3 : three cycles of catalase application for 3 min. and water rinse for 2 min. after bleaching Experimental group 4 : four cycles of catalase application for 3 min. and water rinse for 2 min. after bleaching Experimental group 5 : five cycles of catalase application for 3 min. and water rinse for 2 min. after bleaching The cavities of each groups were restored with composite resin. The teeth were thermocycled, stained with 2% methylene blue, and sectioned buccolingually. Degree of dye penetration at tooth-restoration interfaces were examined by stereomicroscope(${\times}30$) at occlusal and gingival margin The results were as follows : 1. On the occlusal margin, there was no significant difference in the microleakage between the negative coltrol group and experimental groups (p>0.05). But on the gingival margin, experimental groups showed higher microleakage than the negative coltrol group (p<0.05). 2. On the occlusal margin, positive coltrol group showed higher microleakage than experimental groups (p<0.05) and among the experimental groups, group 1 showed higher microleakage than group 3, 4, 5 (p<0.05). 3. On the gingival margin, there was no significant difference between the positive coltrol group and experimental groups, and between experimental groups (p>0.05). The result indicated that catalase used in bleached cavity for the elimination of hydrogen peroxide residues from human teeth maybe reduced microleakage at the tooth-resin composite interface.