• Journal of dental hygiene science
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• v.20 no.4
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• pp.252-260
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• 2020

Background: In this study, the bleaching effect and surface damage of two types of over-the-counter home tooth bleaching agents were explored using an in vitro study of bleaching agents applied to bovine teeth specimens for 14 days. Methods: Domestic over-the-counter home tooth bleaching agents of gel and patch form that shared common active ingredients and manufacturers were selected and tested. The experiment specimens were made using composite resin with bovine tooth samples and then measured the initial microhardness. Specimens were then divided into a Gel group and a Patch group and underwent bleaching treatment once a day for two weeks for 30 to 60 minutes (recommended) or 7 hours. All specimens were coffee-stained prior to bleaching. The bleaching effect was measured using a spectrophotometer and surface damage was measured using a microhardness meter. Results: The difference in color following the bleaching procedure was positive in both the Gel and Patch group, although there were no statistically significant differences in bleaching effect between groups. There was no significant difference in bleaching effect based on duration. The microhardness test revealed that both the Gel group and the Patch group had surface damage after bleaching. The greatest surface damage was found in the Patch group that had undergone a 7-hour bleaching treatment, although the differences were not statistically significant. Conclusion: The bleaching effect of the home tooth bleaching agent was visible to the naked eye. However, longer applications than recommended did not result in greater bleaching, unlike consumers' expectations, and instead increased the chance of enamel damage. As such, there is a need for consumers to be alert and adhere to recommendations provided by each company.

• Journal of Technologic Dentistry
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• v.23 no.1
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• pp.85-93
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• 2001

The purpose of this study was to evaluate the effects of commercial home-tooth bleaching agents on the color of tooth. Twenty five sound extracted teeth were randomly divided into five groups. The color differences between before and after treatment with five types of tooth bleaching agents (7.5% hydrogen peroxide Nite White $Excel^{(R)}$, 10% carbamide peroxide Nite White $Excel^{(R)}$, 16% carbamide peroxide Nite White $Excel^{(R)}$, 10% carbamide peroxide Insta-BriteTM, 20% carbamide peroxide Insta-$Brite^{TM}$) were evaluated. The results were as follows: 1. By 2 week home tooth bleaching agent applications, the values ($L^*$) of bovine teeth increased as high as 4.38 $\sim$ 8.80 when comparing to those of the samples before treatment, and the color difference (${\Delta}E^*$) showed as high as 10.16 $\sim$ 15.04. 2. 16% carbamide peroxide Nite White Excel induced significantly greater ${\Delta}L^*$ than other test edgroups except for 7.5% hydrogen peroxide Day White Excel, and significantly greater ${\Delta}E^*$ than other tested groups by 2 week bleaching agent treatments (p<0.01). 3. 16% carbamide peroxide Nite White Excel(${\Delta}L^*$=8.80, ${\Delta}E^*$=15.04) induced significantly greater ${\Delta}L^*$ and ${\Delta}E^*$ than 10% carbamide peroxide Nite White Excel(${\Delta}L^*$=5.01, ${\Delta}E^*$=10.16)(p<0.01), but significant difference between 10% carbamide peroxide Insta-Brite(${\Delta}L^*$=4.38, ${\Delta}E^*$=10.51) and 20% carbamide peroxide Insta-Brite(${\Delta}L^*$=5.63, ${\Delta}E^*$=11.23) was not shown in ${\Delta}L^*$ and ${\Delta}E^*$(p>0.01). 4. 16% carbamide peroxide Nite White Excel(${\Delta}L^*$=8.80, ${\Delta}E^*$=15.04) which were applied in night time induced significantly greater ${\Delta}L^*$ and ${\Delta}E^*$ than 7.5% hydrogen peroxide Day White Excel(${\Delta}L^*$=8.47, ${\Delta}E^*$=12.75) which were applied in day time. Conclusions: These results demonstrate that all the commercial home-tooth bleaching agents have appreciable bleaching effect on teeth, and the effects of home-tooth bleaching agents which are used during night time are affected by content of carbamide peroxide. Especially the whitening effect of home tooth bleaching agents that are used through night time is greater than that of short time-applying tooth bleaching agent.

• The Journal of the Korea Contents Association
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• v.10 no.11
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• pp.235-242
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• 2010

The purpose of this study was to evaluate tooth whitening and microhardness after treatments with tooth bleaching agents containing dicalcium phosphate dihydrate (DCPD) and 35% hydrogen peroxide (HP) which were used in-office bleaching. Thirty enamel specimens were obtained from human premolars and randomly divided into 3 groups(n=10). Tooth bleaching agents were prepared with DCPD (0 g for controls, 0.1 g and 1 g for experimental groups) and HP solution (35% HP). All groups were applied to enamel surfaces for 60 min for 1 day. The pH of each tooth bleaching agent was measured. Tooth color, microhardness of enamel surfaces were also measured. The tooth bleaching agents containing DCPD showed a significant increase in pH compared to the ones without DCPD(p<0.05). Paired t-tests showed significant difference in color values of enamel before and after bleaching in all the groups(p<0.05). As a result, changes in color, containing DCPD group does not contain a statistically significant difference between groups was observed.(p>0.05). In all groups, tooth hardness after bleaching showed a significant decrease in microhardness (p<0.05). However, the DCPD concentration increased in the bleaching, microhardness values slightly decreased. Based on the above results, tooth bleaching agents containing DCPD and 35%HP were equally effective. Due to increases in pH and effective reduction of tooth surface decalcification, the surface characteristics are exposed to a reduced degree of negative effects, resulting in fewer constituent enamel alterations. Thus, commercial availability of the constituents of tooth whitening materials can be achieved.

• Restorative Dentistry and Endodontics
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• v.26 no.5
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• pp.399-408
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• 2001

Tooth bleaching has been prevailing recently for its ability to recover the color and shape of natural teeth without reduction of tooth material. However, it has been reported that bleaching procedure adversely affects the adhesive bond strength of composite resin to tooth. At the same time the bond strength was reported to be regained by application of some chemical agents. The purpose of this in vitro study was to investigate the effect of the removal of residual peroxide on the composite- enamel adhesion and also evaluated fracture mode between resin and enamel after bleaching. Sixty extracted human anterior and premolars teeth were divided into 5 groups and bleached by combined technique using of office bleaching with 35 % hydrogen peroxide and matrix bleaching with 10% carbamide peroxide for 4 weeks. After bleaching, the labial surfaces of each tooth were treated with catalase, 70% ethyl alcohol, distilled water and filled with composite resin. Shear bond strength was tested and the fractured surfaces were also examined with SEM. Analysis revealed significantly higher bond strength values. (p＜0.05) for catalase-treated specimens, but water-treated specimens showed reduction of bond strength, alcohol- treated specimens had medium value between the two groups(p＜0.05). The fracture mode was shown that the catalase group and the alcohol group had cohesive failure but the water sprayed group had adhesive failure. It was concluded that the peroxide residues in tooth after bleaching seems to be removed by gradual diffusion and the free radical oxygen from peroxide prevents polymerization by combining catalyst in the resin monomer. Therefore it may be possible to eliminate the adverse effect on the adhesion of composite resin to enamel after bleaching by using water displacement solution or dentin bonding agent including it for effective removal of residual peroxide.

• 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.

• Journal of Korean society of Dental Hygiene
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• v.12 no.3
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• pp.533-541
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• 2012

Objectives : The purpose of this study was to evaluate the effects of tooth bleaching agent contained 35% hydrogen peroxide on the color, microhardness and surface roughness of tooth-colored restorative materials. Methods : Four types of tooth-colored restorative materials, including a composite resin(Filtek Z350 ; Z350), a flowable composite resin(Filtek P60 : P60), a compomer(Dyract$^{(R)}$ AP ; DY), and a glass-ionomer cement(KetacTM Molar Easymix ; KM) were used in the study. The specimens($8mm{\times}5mm$) were made by using a customized acrylic mold. Each material was divided into two groups equally(n=40) : experimental group(35% HP) and control group(distilled water). 35% HP group was treated 30 mim/5 days for 15 days. Each 30 minute treatment session consisted of two 15 minute cycles of gel application with 20 second light exposure. The authors measured the color, microhardness, and roughness of the specimens before and after bleaching. The data were analyzed with ANOVA and T-test. Results : 35% HP group showed an apparent color change(${\Delta}E^*$) than control group. In particular, DY and KM showed a noticeable color change and statistically significant differences(p<0.05). 35% HP group showed a reduction in microhardness. Z350 and P60 does not have a statistically significant difference(p>0.05), DY and KM showed a statistically significant difference(p<0.05). Percentage microhardness loss(PML) of control group was 0.6 to 5.5% in the group, 35% HP group was 6.6 to 34.6%. Roughness was increased in 35% HP group after bleaching. Especially DY and KM were significantly increased(p<0.05). Conclusions : Bleaching agents may affect the surface of existing restorations; therefore, they should not be used indiscriminately when tooth-colored restorations are present.

• Restorative Dentistry and Endodontics
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• v.29 no.3
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• pp.219-225
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• 2004

This study evaluated the microshear bond strength of composte resin to teeth bleached with commercial whitening strips and compared with those bleached with home bleaching gel. Twelve extracted human central incisors were cut into pieces and central four segments were chosen from each tooth and embedded in acrylic resin. Four blocks with 12 tooth segments embedded in acrylic resin were acquired and numbered from group one to group four. Group 1 was bleached with Crest Whitestrips, group 2 with Claren, group 3 with Opalescence tooth whitening gel (10％ carbamide peroxide). Group 4 was used as control. The bleaching procedure was conducted for 14 days according to the manufacturer's instructions ; the bleaching strips twice a day for 30 min and the bleaching gel once a day for 2hr. After bleaching, composite resin (Filtek Supreme) was bonded to the enamel surfaces with a self-etching adhesive (Adper Prompt L-Pop) using Tygon tube. Microshear bond strength was tested with a universal testing machine (EZ-test). The data were statistically analysed by one-way ANOVA. The study resulted in no statistical differences in microshear bond strength between the tooth segments bleached with 2 different whitening strips and bleaching gel. It can be concluded that the effect of bleaching with either commercial whitening strips or bleaching gel on enamel is minimal in bonding with self-etching adhesive to composite resin.

• 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.23 no.2
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• pp.656-669
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• 1998

Hydrogen peroxide at high concentration during walking bleaching may cause damage to the tooth structure and to the surrounding periodontal tissues and may develop external root resorption. Clinically, It is so important to find a method of prevention or minimization of these complications. The efficacy of various chamber-irrigating agents to eliminate residual hydrogen peroxide after walking bleaching was examined and compared with water rinse in this study. Extracted human 46 premolars without any cementoenamel junction defects were treated endodontically and based with IRM to 1 mm below CEJ and totally bleached 3 times for each tooth with 30% hydrogen peroxide and sodium perborate. Upon completion of the 3rd walking bleaching procedure, the cervical portion and pulp chamber of each group of teeth were irrigated with catalase, 70% ethylalcohol, acetone, and distilled water. And then, a radicular hydrogen peroxide penetration was measured with spectrophotometer immediately after each bleaching and following treatment with each chamber-irrigating agents, and the significance of their eliminating efficacy of residual hydrogen peroxide was analyzed by Kruskal-Wallis test. The results were obtained as follows. 1. Cervical root penetration of hydrogen peroxide was increased as the bleaching procedure was repeated(P<.01). 2. The most effective irrigant that removed residual hydrogen peroxide was the catalase, and the least effective one was water rinsing (P<.01).; there was no significant difference between the acetone and ethanol group. 3. The Irrigation with antioxidant enzyme or water-displacement solutions can eliminate residual oxygen radicals from the pulp chamber effectively after walking bleaching. So, these agents can reduce adverse effects such as cervical external resorption and periapical inflammation and prevent residual $O_2$ from impeding composite resin polymerization, thus increase the bonding strength of composite resin. This, in turn reduces microleakage and discoloration of the esthetic restoration, extending its service-life.

• Proceedings of the KACD Conference
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• 2003.11a
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• pp.573-573
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• 2003

I. Objective This study evaluated the microshear bond strength of teeth bleached with commercial whitening strips and compared with those bleached with home bleaching gel. II. Materials and Methods Twelve exrtacted central incisors were cut into pieces and central four segments were chosen from each tooth and embedded in acrylic resin. Four blocks with 12 tooth segments embedded in acrylic resin were acquired and numbered from one to four. Block 1 was bleached with Crest Whitestrips, block 2 with Claren, block 3 with Opalescence tooth whitening gel(10% carbamide peroxide).(omitted)