Bleaching Gel Research Articles

Effect of accelerated stability on the physical, chemical, and mechanical properties of experimental bleaching gels containing different bioadhesive polymers.

To evaluate the physical-chemical (weight, pH, quantification of hydrogen peroxide) and mechanical (texture profile and rheology tests) properties of the experimental bleaching gel based on the bioadhesive polymer Aristoflex® AVC, after accelerated stability testing. A total of 300 syringes of bleaching gels were divided into 5 groups (n = 60): Whiteness Perfect® 10%-FGM (WP); carbamide peroxide 10% with aristoflex (CPa); carbamide peroxide 10% with Carbopol (CPc); aristoflex thickener (A); and Carbopol thickener (C). According to the following requirements and time, the accelerated stability test was performed: in an incubator at 40°C and 75% humidity per 1, 3, and 6months, and baseline (refrigerator at 5°C and 25% humidity). The variables were analyzed following the statistical tests: Two-way ANOVA and Tukey's test were applied to pH; weight data were analyzed using a mixed model for repeated measurements over time and the Tukey-Kramer test; one-way ANOVA and Tukey's test analyzed the rheology test; generalized linear models were used to quantify the peroxide amount and texture profile data. A significance level of 5% was considered. The experimental bleaches CPa and CPc had the highest pH values when compared to the others in 6months. Thickeners A and C did not change the pH, weight, and active content over the accelerated stability times (p > 0.05). Furthermore, there was weight loss after 3months of storage for CPa and CPc (p < 0.05). In the quantification of hydrogen peroxide, the WP group showed the highest values over time (p < 0.0001), only showing a significant loss after the 3rd month. Meanwhile, CPa and CPc showed a reduction in quantification from the 1st month. Temperature and humidity directly influenced the active content and properties of bleaching gels. In addition, the presence of components regardless of thickeners, such as stabilizers, in the commercial gel allowed for greater stability over time. The development of experimental bleaching gels for clinical use requires careful testing. Therefore, accelerated stability testing represents a valuable tool in the development and evaluation of cosmetic formulations.

Effect of bleaching gels with different thickeners under normal and hyposalivation conditions: in situ study

Bleaching gel thickeners induce important changes in tooth enamel and these changes are reversed by saliva. This in situ study aimed to evaluate the effect of bleaching gels with different thickeners on tooth enamel under normal and hyposalivation conditions. Of 28 participants, 14 had normal salivary flow and 14 had low salivary flow. For each salivary flow, four types of treatment were performed with different thickeners: no bleaching (negative control), bleaching with a commercial 10% carbamide peroxide (CP) gel with carbopol (positive control) and bleaching with experimental 10% CP gels with natrosol and aristoflex. Participants used a palatal appliance containing bovine enamel/dentin specimens for 15 days. From day 2 to day 15, specimens were bleached extraorally. The bleaching gel was applied according to the groups for four hours. When the bleaching gel was removed, the palatal appliance was inserted again in the participants' mouth until the next day for another bleaching application. This procedure was repeated for 14 days and on day 15, surface microhardness (SMH), color (ΔE*ab and ΔE00), surface roughness (Ra), scanning electron microscopy (SEM), and energy-dispersive X-ray spectrometry (EDS) analyses were performed and data were subjected to statistical analysis. Neither salivary flow nor thickeners influenced ΔE*ab and ΔE00 results. Carbopol had the lowest SMH, the highest Ra, and the lowest Ca% among all groups. For normal flow, natrosol and aristoflex had higher SMH. For low flow, aristoflex had higher SMH and natrosol and aristoflex had lower Ra. Aristoflex had higher Ca% and Ca/P and differed from carbopol for normal flow. For normal flow, 10% CP gels with natrosol and aristoflex caused fewer surface changes, and for low flow, only the 10% CP gel with aristoflex.

The effect of bleaching gel application on the physical properties of different CAD/CAM restorative materials

Objective: To evaluate the surface roughness and microhardness of CAD/CAM lithium disilicate, feldspathic ceramic, polymer infiltrated ceramic and nanohybrid composite before and after the application of bleaching gel. Material and methods: Disc shaped specimens were polished and divided into quadrants for roughness (Ra) and microhardness (Vickers, 19.61 N, 20 s) measurements. The 35% hydrogen peroxide was applied simulating three in-office bleaching sessions. Results: Paired t-test (α=0.05) showed that bleaching gel application did not affect the surface roughness of the tested material. The microhardness of polymeric materials (polymer infiltrated ceramic and nanohybrid composite) presented statistical significant increase (2 % increase, which may be clinically insignificant). Conclusion: Microhardness of polymeric CAD/CAM materials may be affected by bleaching gel application.

Does the Bleaching Gel Application Site Interfere With the Whitening Result? A Randomized Clinical Trial.

This study aimed to evaluate the effect of the bleaching gel application site on chromatic changes and postoperative sensitivity in teeth. Thirty patients were selected and allocated to three groups (n=10 per group), according to the location of the gel: GI, cervical application; GII, incisal application; and GIII, total facial. The amount and time of application of the 35% hydrogen peroxide (H2O2) gel were standardized. Color changes were analyzed by ΔE and Wid (bleaching index), using the values obtained in the readings conducted on a digital spectrophotometer in the cervical (CRs) and incisal regions (IRs) of the teeth. Spontaneous sensitivity was assessed using the questionnaire, and the stimulated sensitivity caused by the thermosensory analysis (TSA). The analysis occurred in five stages: baseline, after the first, second, and third whitening sessions (S), and 14 days after the end of the whitening, using the linear regression statistical model with mixed effects and post-test by orthogonal contrasts (p<0.05). Although the IR was momentarily favored, at the end of the treatment, the restriction of the application site provided results similar to those obtained when the gel was applied over the entire facial surface. Regarding sensitivity, only the GI showed spontaneous sensitivity. In the TSA, GIII had less influence on the threshold of the thermal sensation. It was concluded that the chromatic alteration does not depend on the gel application site. Spontaneous sensitivity is greater when the gel is concentrated in the cervical region (CR), and the teeth remain sensitized by thermal stimuli even after 14 days.

In-office dental bleaching with violet light emitting diode: bleaching efficacy and pulpal temperature rise.

ObjectivesThis 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 MethodsBovine 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 , ΔE00 and ΔWID. 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%).ResultsVL exhibited lower color ( and ΔE00) and whiteness changes (ΔWID) than the other groups. HPVL presented higher color change values than HYB. HYB and HPVL showed not different ΔWID values; and HP showed the highest whiteness changes at all times. There were significant differences comparing ΔT with gel (8.9°C) and without gel application (7.2°C).ConclusionsHPLV 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.

Effect of Hydrogen Peroxide on the Color Stability and Roughness of Nano-Filled Composites: A Literature Review

This research seeks to ascertain the impact of hydrogen peroxide bleaching gel on the color stability and roughness of nano-filled composite restoration. The most important aesthetic elements of restoration are surface gloss, surface roughness, and color. It has been claimed that saliva, food ingredients, and beverages may compromise the integrity and aesthetics of dental composites, causing them to degrade in the mouth. For aesthetic restorations including anterior and posterior teeth, resin co

The effectiveness of in-office dental bleaching with and without sonic activation: A randomized, split-mouth, double-blind clinical trial.

This study was aimed at comparing the bleaching efficacy and bleaching sensitivity (BS) of two higher-concentration in-office bleaching gels (37% carbamide peroxide [CP] and 38% hydrogen peroxide [HP]) applied under two conditions: alone or in association with sonic activation. Fifty-six volunteers were randomly assigned in the split-mouth design into the following groups: CP, CP with sonic activation (CPS), HP, and HP with sonic activation (HPS). Two in-office bleaching sessions were performed. Color was evaluated using Vita Classical, Vita Bleachedguide, and digital spectrophotometer at baseline and at 30 days post-bleaching. Absolute risk and intensity of BS were recorded using two pain scales. All data were evaluated statistically (color changes [t test], BS [Chi-square and McNemar test], and BS intensity [VAS; t test; NRS; Wilcoxon; α=0.05]). Significant and higher whitening was observed for HP when compared with CP (p < 0.04). However, higher BS intensity was observed in the former (p < 0.001). No significant difference was observed in whitening effect or BS when the HP or CP bleaching gels were agitated (sonic application) compared with when they were not (p > 0.05). The 37% CP gel demonstrated lower bleaching efficacy and lower BS compared with the 38% HP bleaching gel. The whitening effect was not influenced by the use of sonic activation. The use of 37% CP gel did not achieve the same whitening effect when compared to 38% HP gel used for in-office bleaching. The use of sonic activation offers no benefit for in-office bleaching.

Effects of microabrasion association to at-home bleaching on hydrogen peroxide penetration and color change.

This study aimed to quantify the penetration of hydrogen peroxide (HP) inside the pulp cavity and color change with two different concentrations of HP to at-home bleaching associated or not with enamel microabrasion (MA). Forty healthy premolars were randomly divided in four groups (n=10): only HP4%, MA + HP4%, only HP10%, MA + HP10%. The concentration (μg/ml) of HP was assessed using UV-Vis spectrophotometry. The color change (ΔEab , ΔE00 and WID ) was evaluated before and one-week after bleaching. Data were evaluated for a two-way ANOVA and the Tukey's test (α=0.05). The application of MA increased the amounts of HP inside the pulp chamber when compared to without MA, as well as PH10% when compared to PH4% (p < 0.0001). PH10% showed higher WID when compared to PH4%. No significant difference was observed when ΔEab , and ΔE00 were used. The enamel MA before at-home bleaching promotes greater penetration of HP, although this procedure did not significantly affect the color change. Since greater penetration of HP into the pulp chamber was detected when home bleaching was applied immediately after MA, the clinician should not apply home bleaching gels in the same session when MA was performed.

Effect of light and heat on bleaching action of hydrogen peroxide

This study aimed to verify the effect of light and heat on bleaching action of 40% hydrogen peroxide (Opalescence Boost PF – Ultradent, BR). Thirty-three bovine incisors were submitted to in-office dental bleaching and divided into three groups (n=11): CO group – control, no light or heat; CA group – heat with a hairdryer; LC group – light and heat with a photoactivation device. For this, a gingival barrier (OpalDam – Ultradent, SP, BR) isolated a circular area around the flatter region of the crown. Afterwards, the bleaching gel was applied for 15 minutes and repeated twice, totaling 45 minutes of application. For the CA and LC groups, the heat source was maintained during the application of the bleaching gel. Temperature was standardized in 5°C for both groups and monitored using a thermocouple inserted into the pulp chamber. The color measurement was performed before and after bleaching using a spectrophotometer. The inner margin of the isolated area of each dental crown was equivalent to the tip of the spectrophotometer (4 mm). Color change was verified by CIEDE2000 system (ΔE00). One way ANOVA and Tukey's test were used to analyze data (p-values set to 5%). The values of ΔE00 were equal for LC (2,66±0,29) and CA (2,44±0,88), and both were higher than CO (1,31±0,37). Therefore, light does not play a fundamental role for in-office dental bleaching. Same dental bleaching outcomes are obtained using different heat sources.

Effect of bleaching gel volume on color change and postoperative sensitivity: a randomized clinical study.

Although bleaching therapy is considered a dose-dependent treatment, the effect of the volume of product used is yet to be studied. This study thus aimed to evaluate the influence of bleaching gel volume on chromatic alteration and postoperative sensitivity. Thirty patients were selected and allocated into three groups; the lower canines were analyzed according to the volume of gel used: GI-0.025mL, GII-0.05mL, and GIII-0.10mL. Chromatic alteration analysis was performed using a portable digital spectrophotometer by calculating the ΔE, ΔE00, ΔL*, Δa*, and Δb* values and the whiteness index (WID). Spontaneous sensitivity was assessed using a questionnaire, and sensitivity was stimulated by thermo-sensory analysis. Analyses were conducted in five stages: baseline, after 1st, 2nd, and 3rd bleaching sessions, and 14days after the end. Data were analyzed using the two-way ANOVA test with repeated measures and Tukey's post hoc test (p < 0.05). It was observed that ΔE, ΔE00, and ΔL* were similar between groups at the end of the bleaching therapy; and the values of Δa*, Δb*, and WID were higher in the GIII group. For sensitivity, it was found that the GI was the one with the lowest values; o GII intermediate values; while the GIII group presents the highest values of spontaneous and stimulated sensitivity. Gel volume influenced the response to bleaching and significantly influenced the spontaneous sensitivity and cold stimulus. The amount of bleaching gel used during therapy is key to both the response to color change and postoperative sensitivity.

The influence of the renewal or the single application of the peroxide gel on the efficacy and tooth sensitivity outcomes of in-office bleaching-A systematic review and meta-analysis.

To answer the question: "Does the peroxide gel application regimen (single application vs. renewal) influence the efficacy and the tooth sensitivity outcomes of in-office tooth bleaching?" The search was done in Pubmed, Cochrane, LILACS, Scopus, Web of Science, and EMBASE in February 2021 (updated in July 2021). Randomized clinical trials (RCT) comparing the single application vs. the renewal protocols of HP were included. The meta-analyses were performed for the objective (ΔEab ), subjective (ΔSGU) color changes, and absolute risk of tooth sensitivity (TS). Heterogeneity was evaluated using Q test (I2 ). Cochrane Collaboration tool assessed the risk of bias (RoB). The GRADE evaluated the certainty of evidence. Five RCT studies remained. Two studies showed high RoB, and three presented some concerns. No significant differences were observed between the protocols in terms of the ΔEab , ΔSGU, and TS. ΔEab exhibited substantial heterogeneity (I2 =87%), while ΔSGU (I2 =60%) and the TS (I2 =62%) presented a moderate one. The certainty of evidence was considered low or very low, depending on the variable response and the evaluation time. The application regimen (single vs. renewal of HP) did not impact color change or the absolute risk of TS. The renewal of bleaching gel during the in-office appointment may not be necessary. However, there is at least a low certainty of evidence. Because of this, further randomized clinical trials with appropriate methodology on this topic are encouraged.

A novel tooth bleaching gel based on peroxymonosulfate/polyphosphates advanced oxidation process: Effective whitening avoiding pulp damage and sensitivity

Pulp damage and bleaching sensitivity caused by existing hydrogen peroxide (HP) bleaching gel is a major challenge that needs to be solved urgently in the field of vital bleaching, mainly due to HP’s intrinsic high penetrability and strong oxidative property. The present study has successfully developed a novel non-hydrogen peroxide bleaching system based on peroxymonosulfate (PMS)/polyphosphates advanced oxidation process, with suitable penetration depth in dental structure. In addition to oxidizing active ingredients similar to HP gel, the new PMS gel also contains its characteristic free radical---•SO4−. Benefitting from excellent oxidative performance, novel bleaching gel exhibits a favorable tooth whitening effect. And tooth color stability after bleaching is better because it only induces a minor change on the enamel surface. Furthermore, cytological studies demonstrate that the new gel has less damage to human dental pulp fibroblasts (cell viability reaches 87.5% after 2 h’ exposure), which is mainly due to the relatively low content of oxidant (15.4%) and limited penetration depth (middle dentin). More excitingly, histological results show PMS gel applied on the molars of rats induce no inflammation of pulp tissues and no activation of pain-related receptors or peptides, consistent with the performance of blank control. These findings suggest that the new PMS/polyphosphates bleaching system has the advantages of good bleaching effectiveness, minor enamel alterations and non-damaged pulp tissue. It is expected to provide a new strategy for clinical vital bleaching treatment.

H2O2 gel bleaching induces cytotoxicity and pain conduction in dental pulp stem cells via intracellular reactive oxygen species on enamel/dentin disc.

Bleaching is widely accepted for improving the appearance of discolored teeth; however, patient compliance is affected by bleaching-related complications, especially bleaching sensitivity. This study aimed to investigate the role of reactive oxygen species (ROS) in cytotoxicity and pain conduction activated by experimental tooth bleaching. Dental pulp stem cells with or without N-acetyl-L-cysteine (NAC), an ROS scavenger, were cultured on the dentin side of the enamel/dentin disc. Subsequently, 15% (90 min) and 40% (30 min) bleaching gels were painted on the enamel surface. Cell viability, intracellular ROS, Ca2+, adenosine triphosphate (ATP), and extracellular ATP levels were evaluated using the Cell Counting Kit-8 assay, 2',7'-dichlorodihydrofluorescein diacetate, CellROX, fura-3AM fluorescence assay, and ATP measurement kit. The rat incisor model was used to evaluate in vivo effects after 0, 1, 3, 7, and 30 days of bleaching. Changes in gene and protein expression of interleukin 6 (IL-6), tumor necrosis factor-alpha (TNFα), transient receptor potential ankyrin 1 (TRPA1), and Pannexin1 (PANX1) in dental pulp stem cells and pulp tissue were detected through RT-PCR, western blotting, and immunofluorescence. The bleaching gel suppressed dental pulp stem cell viability and extracellular ATP levels and increased intracellular ROS, Ca2+, and intracellular ATP levels. The mRNA and protein expression of IL-6, TNFα, TRPA1, and PANX1 were up-regulated in vitro and in vivo. Furthermore, the 40% gel had a stronger effect than the 15% gel, and NAC ameliorated the gel effects. Our findings suggest that bleaching gels induce cytotoxicity and pain conduction in dental pulp stem cells via intracellular ROS, which may provide a potential therapeutic target for alleviating tooth bleaching nociception.

Effects of tooth bleaching protocols assisted by Er,Cr:YSGG and diode (980 nm) lasers on color change of resin-based restoratives.

To evaluate color change of three resin-based restorative materials after two laser-assisted in-office tooth bleaching protocols using Er,Cr:YSGG and diode (980 nm) lasers. A nanohybrid composite resin (EP), a Bis-GMA free composite resin (EPBio) and a resin-matrix CAD-CAM ceramic (HC) were tested. Ninety specimens were prepared and stored in artificial saliva. Group 1 received an in-office bleaching treatment using 40% H2 O2. The same bleaching procedure was assisted by Er,Cr:YSGG laser in Group 2 and by a diode laser (980 nm) in Group 3. Color measurements were performed using a double-beam UV-Vis spectrophotometer at four time intervals (before, 24 h, 15 and 30 days), converted to L*, a*, and b* units of the CIELAB color space and assessed on the basis of 50:50% acceptability (ΔΕab *=2.7 and ΔΕ00 =1.77) and 50:50% perceptibility (ΔΕab *=1.2 and ΔΕ00 =0.81) thresholds. Three-way ANOVA with repeated measurements was used for statistical analysis of the data. Color and whiteness changes did not exceed the established 50:50% acceptability thresholds. EP presented the highest color change after the bleaching followed by EPBio and HC (p ≤ 0.05). Three-way ANOVA revealed that type of material and time interval significantly affected color change (p ≤ 0.001). The tested bleaching treatments assisted by Er,Cr:YSGG and diode (980 nm) lasers did not induce unacceptable color and whiteness changes in the resin-based restorative materials. The tested Er,Cr:YSGG and diode (980 nm) laser-assisted tooth bleaching protocols which may be recommended to accelerate the clinical procedures cannot affect the color of the existing resin-based restorations in case they are accidentally exposed on the bleaching gel and laser irradiation.

TRPA1 triggers hyperalgesia and inflammation after tooth bleaching

Hyperalgesia has become a major problem restricting the clinical application of tooth bleaching. We hypothesized that transient receptor potential ankyrin 1 (TRPA1), a pain conduction tunnel, plays a role in tooth hyperalgesia and inflammation after bleaching. Dental pulp stem cells were seeded on the dentin side of the disc, which was cut from the premolar buccal tissue, with 15% (90 min) or 40% (3 × 15 min) bleaching gel applied on the enamel side, and treated with or without a TRPA1 inhibitor. The bleaching gel stimulated intracellular reactive oxygen species, Ca2+, ATP, and extracellular ATP in a dose-dependent manner, and increased the mRNA and protein levels of hyperalgesia (TRPA1 and PANX1) and inflammation (TNFα and IL6) factors. This increment was adversely affected by TRPA1 inhibitor. In animal study, the protein levels of TRPA1 (P = 0.0006), PANX1 (P < 0.0001), and proliferation factors [PCNA (P < 0.0001) and Caspase 3 (P = 0.0066)] increased significantly after treated rat incisors with 15% and 40% bleaching gels as detected by immunohistochemistry. These results show that TRPA1 plays a critical role in sensitivity and inflammation after tooth bleaching, providing a solid foundation for further research on reducing the complications of tooth bleaching.

Influence of 35% hydrogen peroxide gel renewal on color change during in-office dental photobleaching with violet LED: A split-mouth randomized controlled clinical trial

BackgroundTo clinically evaluate the effect of 35% hydrogen peroxide gel renewal in association with violet LED (405-410nm) through a split-mouth randomized controlled clinical trial. MethodsThe treatment consisted in 3 bleaching sessions of 15 min each, with an interval of 7 days between them, using 35% hydrogen peroxide combined to violet LED irradiation. Selected patients had two experimental segments for the split-mouth design: No change of the bleaching gel during each session (NBGR) and 3 changes of the bleaching gel every 5 min for each session (BGR). During the 3 bleaching sessions, the selected quadrant received the same treatment. Patients had their upper canines and central incisors teeth color measured with a subjective (color scale - VITA Classical) and an objective (spectrophotometer - VITA Easyshade) method and their teeth sensitivity measured using a Visual Analog Scale (VAS) before, immediately after each bleaching session, and 14 days and 2 months (60 days) after the end of the treatment. ResultsThe protocol adopted in the present study reached satisfactory results regarding color change. No statistical difference between groups was observed immediately after the end of the treatment and in the follow-up analysis for both subjective and objective color evaluation. No difference in tooth sensitivity between segments was observed. ConclusionThere is no need for bleaching gel renewal when following the clinical protocol of 3 sessions of 15 min in a bleaching protocol of 35% hydrogen peroxide combined with violet LED.

Influence of Hydrogen Peroxide on Mineralization in Dental Pulp Cells: A Systematic Review

Background: Dental bleaching agents show the ability to permeate through dental hard tissues, which may lead to pulp tissue changes. This systematic review (PROSPERO register: CRD42020213767) is aimed at understanding the effects of bleaching agents on the process of mineralization of the pulp tissue.Methods: Only in vitro studies evaluating the influence of hydrogen peroxide (HP) on mineralization in dental pulp cells were included. Studies without a non-bleached control group or cells after co-treatment with a bleaching agent other than HP and/or carbamide peroxide were excluded. The primary outcomes evaluated were alkaline phosphatase (ALP) activity and mineralized nodule deposition. The mineralization markers analysis in dental pulp cells and the cell viability were considered secondary outcomes. Two independent authors conducted a systematic search (PubMed/MEDLINE, Scopus, Embase, Cochrane Library, and OpenGrey until January 2021) with no language restrictions and performed data extraction. The quality assessment was appraised according to a modified Joanna Briggs Institute critical appraisal checklist.Results: The search resulted in 473 studies, and 11 were considered eligible. Overall, a reduction in the process of mineralization was observed among pulp cells after bleaching. A reduction in the ALP activity was reported in the mostly bleached groups using different protocols and analysis periods of nine studies. Regarding mineralized nodule deposition, 6 studies reported a significant reduction from 7 to 21 days among bleached groups. Of those three studies that investigated other mineralization markers, two found a reduction in the expression of dentin matrix acidic phosphoprotein (DMP)-1, dentin sialophosphoprotein (DSPP), and matrix extracellular phosphoglycoprotein (MEPE) among some bleaching gel concentrations. In contrast, one study showed a greater expression of osteopontin (OPN) and osteocalcin (OCN) in 100 μmol/L HP after 5 or 10 min of exposure, and another study showed significant induction of DSPP in concentrations of up to 0.5 mmol/L HP.Conclusion: Especially, high concentrations of bleaching gel reduce the potential of mineralization in pulp cells in in vitro studies; however, different HP concentrations, bleaching protocols, and analysis periods can influence this outcome.

Photothermal-Enhanced Fenton-like Catalytic Activity of Oxygen-Deficient Nanotitania for Efficient and Safe Tooth Whitening.

The growing demand for charming smiles has led to the popularization of tooth bleaching procedures. Current tooth bleaching products with high-concentration hydrogen peroxide (HP, 30-40%) are effective but detrimental due to the increased risk of enamel destruction, tooth sensitivity, and gingival irritation. Herein, we reported a less-destructive and efficient tooth whitening strategy with a low-concentration HP, which was realized by the remarkably enhanced Fenton-like catalytic activity of oxygen-deficient TiO2 (TiO2-x). TiO2-x nanoparticles were synthesized with a modified solid-state chemical reduction approach with NaBH4. The Fenton-like activity of TiO2-x was optimized by manipulating oxygen vacancy (OV) concentration and further promoted by the near-infrared (NIR)-induced photothermal effect of TiO2-x. The TiO2-x sample named BT45 was chosen due to the highest methylene blue (MB) adsorption ability and Fenton-like activity among acquired samples. The photothermal property of BT45 under 808 nm NIR irradiation was verified and its enhancement on Fenton-like activity was also studied. The BT45/HP + NIR group performed significantly better in tooth whitening than the HP + NIR group on various discolored teeth (stained by Orange II, tea, or rhodamine B). Excitingly, the same tooth whitening performance as the Opalescence Boost, a tooth bleaching product containing 40% HP, was obtained by a self-produced bleaching gel based on this novel system containing 12% HP. Besides, negligible enamel destruction, safe temperature range, and good cytocompatibility of TiO2-x nanoparticles also demonstrated the safety of this tooth bleaching strategy. This work indicated that the photothermal-enhanced Fenton-like performance of the TiO2-x-based system is highly promising in tooth bleaching application and can also be extended to other biomedical applications.

Polymeric biomaterials maintained the esthetic efficacy and reduced the cytotoxicity of in‐office dental bleaching

Evaluate the kinetics of hydrogen peroxide (H2 O2 ) degradation, esthetic efficacy and cytotoxicity of a bleaching gel with 35%H2 O2 applied on enamel previously covered or not with polymeric nanofibrillar scaffold (SNan), polymeric primer catalyst (PPol), and both. Standardized enamel/dentin discs (n=128) obtained from bovine teeth were adapted to pulp chambers. After covering enamel with the polymeric products, the bleaching gel was applied for 45 min, establishing the following groups: G1: no treatment (negative control); G2: 35%H2 O2 (positive control); G3: SNan; G4: PPol; G5: SNan + PPol; G6: SNan + 35%H2 O2 ; G7: PPol + 35%H2 O2 ; G8: SNan + PPol + 35%H2 O2 . The kinetics of H2 O2 degradation (n=8), bleaching efficacy (ΔE/ΔWI; n=8), trans-amelodentinal cytotoxicity (n=8), and cell morphology (n=4) were assessed (ANOVA/Tukey test; p <0.05). Greater H2 O2 degradation occurred in G7 and G8. Bleaching efficacy (ΔE) was higher in G6, G7, and G8 in comparison with G2 (p <0.05). However, no difference was observed for ΔWI (p >0.05). G8 presented the lower level of trans-amelodentinal diffusion of H2 O2 , oxidative stress, and toxicity to the MDPC-23 cells (p <0.05). Polymeric biomaterials increased the kinetics of H2 O2 decomposition, as well as maintained the esthetic efficacy and minimized the cytotoxicity caused by a bleaching gel with 35%H2 O2 . CLINICAL SIGNIFICANCE: Application of a bleaching gel with 35%H2 O2 on enamel previously covered by polymeric biomaterials maintains the esthetic efficacy and reduces the cytotoxicity caused by a single session of in-office dental bleaching.

Influence of Bleaching Gel Peroxide Concentration on Color and Penetration through the Tooth Structure

The purpose of this study was to assess the effect of hydrogen peroxide concentration on the bleaching efficacy and penetration through the tooth structure. One hundred enamel/dentin specimens with cylindrical shape were obtained from bovine incisors. The surfaces were polished and the size standardized. They were divided into five groups (n = 20), following the concentration of hydrogen peroxide in the bleaching gels: 20, 25, 30, 35, and 40% (w/w). The specimens were placed over artificial pulpal chambers containing acetate buffer solution and bleached for 30 minutes (three applications of 10 minutes each). Aliquots of the acetate solution were collected, and the peroxide concentration was measured by an analytic spectrophotometer. The color of the samples was analyzed using a colorimetric spectrophotometer at the baseline and 7 days after the bleaching procedure. The color difference was calculated using the ∆Eab formula. The data were analyzed by one-way ANOVA and Tukey's test (p <0.05). The peroxide concentrations of 20-30% showed smaller bleaching effect than the higher concentrations (p = 0.001). The peroxide penetration was significantly higher (p = 0.001) for the more concentrated gels (35 and 40%). The higher peroxide concentrations enhance the bleaching efficacy, but also increased the peroxide penetration through the tooth structure. In-office bleaching gels with higher concentrations of hydrogen peroxide (35 and 40%) present superior whitening efficacy. Nevertheless, they might also intensify the negative biological effects on the pulpal tissue, since they exhibit increased penetration potential. How to cite this article: Torres CRG, Zanatta RF, Godoy MMM, et al. Influence of Bleaching Gel Peroxide Concentration on Color and Penetration through the Tooth Structure. J Contemp Dent Pract 2021;22(5):479-483.