Response of human pulps to different in-office bleaching techniques: preliminary findings.

Douglas Augusto Roderjan,Carlos Alberto De Souza Costa,Alessandra Reis,Alessandro D Loguercio,Rodrigo Stanislawczuk,Josimeri Hebling

doi:10.1590/0103-6440201302282

Douglas Augusto Roderjan, Carlos Alberto De Souza Costa + Show 4 more

Open Access

https://doi.org/10.1590/0103-6440201302282

Copy DOI

Abstract

This study evaluated a whitening effect and the likely side effect (tooth sensitivity and pulp response) of human teeth subjected to different in-office bleaching (IOB) techniques and materials, mainly the presence of calcium in the IOB materials. A calcium-free (CF) and a calcium-containing (CC) 35% hydrogen peroxide (HP) gels were evaluated. The CF was refreshed every 15 minutes, three times (CF 3-15) or in a single 45-min application (CF 1-45) at one bleaching appointment. The CC was used only in a single 45-min application (CC 1-45). Each technique was applied in 5 mandibular incisors scheduled for extraction for different patients. In control group, no tooth bleaching was performed. The tooth colour (TC) and tooth sensitivity (TS) were recorded at baseline and after IOB. The teeth were extracted 2 days after the application of IOB and subjected to histological analysis. The data was submitted to appropriate statistical analysis (α=0.05). The changes of TC were similar between groups and statistically different from the control (p<0.05). However, TS of groups bleached with CF was statistically higher than that recorded for CC and the control (p<0.05). In CF 3-15 and CF 1-45 groups, the coronal pulp tissue exhibited partial necrosis associated with tertiary dentin deposition. In CC 1-45 group smaller area of necrosis occurred only in three bleached teeth in which tertiary dentin deposition was observed. The calcium-containing 35%HP gel could be preferable for in-office bleaching because it caused less tooth sensibility and pulp damage.

Highlights

Clinical studies have shown that in-office bleaching can reach as satisfactory degree of whitening as the at-home bleaching as long as the materials are used for appropriate time [1] in-office tooth bleaching shows a high risk of tooth sensitivity (TS)
The age of the participants included in this study varied between 12 and 26 years old
The main goal of this study was to measure the human pulpal responses to different bleaching techniques, the bleaching efficacy and TS was assessed to verify if the bleaching agent was effective in producing a whitening effect and the likely side effect of the protocols evaluated

Summary

Introduction

Clinical studies have shown that in-office bleaching can reach as satisfactory degree of whitening as the at-home bleaching as long as the materials are used for appropriate time [1] in-office tooth bleaching shows a high risk of tooth sensitivity (TS). Within 5 to 15 min after application of bleaching gels, HP can be found in the pulp tissue, where it irritates nerves and produces a reversible pulpitis for at-home bleaching gels [7]. It seems that more severe effects occur, when a higher number of bleaching sessions were performed or when pulps of lower central incisors after application of a 38% HP in-office bleaching gel [8,9]. Several current in vitro studies have demonstrated the occurrence of transenamel and transdentinal damage to cultured pulp cells after in-office HP application on enamel [10,11,12,13]

Objectives

Methods

Results

Conclusion