scholarly journals Tooth Bleaching—a Critical Review of the Biological Aspects

2003 ◽  
Vol 14 (4) ◽  
pp. 292-304 ◽  
Author(s):  
J.E. Dahl ◽  
U. Pallesen
Keyword(s):  
Hydrogen Peroxide ◽  
Root Resorption ◽  
Cultured Cells ◽  
Active Agent ◽  
Tooth Bleaching ◽  
Cheek Pouch ◽  
Common Side Effect ◽  
Professional Judgment ◽  
Sodium Perborate ◽  
Carbamide Peroxide

Present tooth-bleaching techniques are based upon hydrogen peroxide as the active agent. It is applied directly, or produced in a chemical reaction from sodium perborate or carbamide peroxide. More than 90% immediate success has been reported for intracoronal bleaching of non-vital teeth, and in the period of 1–8 years’ observation time, from 10 to 40% of the initially successfully treated teeth needed re-treatment. Cervical root resorption is a possible consequence of internal bleaching and is more frequently observed in teeth treated with the thermo-catalytic procedure. When the external tooth-bleaching technique is used, the first subjective change in tooth color may be observed after 2–4 nights of tooth bleaching, and more than 90% satisfactory results have been reported. Tooth sensitivity is a common side-effect of external tooth bleaching observed in 15%-78% of the patients, but clinical studies addressing the risk of other adverse effects are lacking. Direct contact with hydrogen peroxide induced genotoxic effects in bacteria and cultured cells, whereas the effect was reduced or abolished in the presence of metabolizing enzymes. Several tumor-promoting studies, including the hamster cheek pouch model, indicated that hydrogen peroxide might act as a promoter. Multiple exposures of hydrogen peroxide have resulted in localized effects on the gastric mucosa, decreased food consumption, reduced weight gain, and blood chemistry changes in mice and rats. Our risk assessment revealed that a sufficient safety level was not reached in certain clinical situations of external tooth bleaching, such as bleaching one tooth arch with 35% carbamide peroxide, using several applications per day of 22% carbamide peroxide, and bleaching both arches simultaneously with 22% carbamide peroxide. The recommendation is to avoid using concentrations higher than 10% carbamide peroxide when one performs external bleaching. We advocate a selective use of external tooth bleaching based on high ethical standards and professional judgment.

scholarly journals Evaluation of morphological and chemical alterations in enamel, dentin and cementum after internal bleaching technique using different bleaching agents

2016 ◽  
Vol 19 (4) ◽  
pp. 56
Author(s):  
Nadia De Souza Ferreira ◽  
Paula Elaine Cardoso ◽  
Natalia Passos Ferreira ◽  
Amanda Costa Corocher ◽  
Isabela Ferreira Paulino ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Hydrogen Peroxide ◽  
Scanning Electron Microscopy ◽  
Tooth Bleaching ◽  
Sodium Perborate ◽  
Carbamide Peroxide ◽  
Organic Part ◽  
Calcium Phosphorus ◽  
And Control ◽  
Scanning Electron

<p><strong>Objective</strong>: The aim of this study was to evaluate the morphological and chemical alterations in enamel, dentin and cementum after internal bleaching using scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS). <strong>Material and Methods:</strong> Seventy-two bovine incisor teeth were prepared, cut and bleached for 7 days as follows: HP: 35% hydrogen peroxide gel; HP+SP: 35% hydrogen peroxide gel + sodium perborate; CP: 37% carbamide peroxide gel; CP+SP: 37% carbamide peroxide gel + sodium perborate; SP: sodium perborate + water; and control: deionized water. The specimens were sectioned and prepared for morphological analysis under SEM and analysis of calcium, phosphorus, oxygen and carbon levels using EDS. <strong>Results</strong>: A significant reduction was found in the calcium levels in enamel after treatment with CP + SP and CP (p &lt; 0.05). Carbon (organic part) was hardly altered in enamel. A significant reduction in the calcium levels was found in dentin in Groups HP+SP, CP and CP+SP. Phosphorus levels increased after SP+H20 (p &lt; 0.05) and CP (p &lt; 0.05). Carbon levels showed little variation and the largest amount was found in Groups CP and CP+SP (p &lt; 0.05); in the other groups there was no alteration. A significant reduction in the calcium levels was found in the cementum in Group CP+SP (p &lt; 0.05). <strong>Conclusion</strong>: Alterations in the enamel, dentin and cementum compositions occurred after bleaching and these alterations showed to be less significant with sodium perborate and water.</p><p><strong>Keywords</strong>: Carbamide peroxide; Hydrogen peroxide; Scanning electron microscopy; Sodium perborate; Tooth bleaching.</p>

scholarly journals Combination of at-home and in-office bleaching techniques: case series

2021 ◽  
Vol 69 ◽  
Author(s):  
Marcela Alvarez FERRETTI ◽  
Matheus KURY ◽  
Beatriz Curvello de MENDONÇA ◽  
Marcelo GIANNINI ◽  
Vanessa CAVALLI ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Case Series ◽  
Tooth Bleaching ◽  
Central Incisor ◽  
Carbamide Peroxide ◽  
Tooth Sensitivity ◽  
Tooth Color ◽  
Shade Guide ◽  
At Home

ABSTRACT Tooth bleaching is one of the most conservative aesthetic techniques. At-home and in-office bleaching may be performed, as well as the combination of both techniques. As this combination may be done in different manners, distinct orders of combinations were proposed in this report. A 24 years-old man, whose upper central incisor and canine shades were A2 and A3 respectively, was initially treated by chair-side with 40-min application of 40% hydrogen peroxide (HP) for two sessions. Afterwards, an two-week overnight at-home bleaching was performed with 10% carbamide peroxide (CP). The shade of upper central incisors changed to 1M1 and canine was B1. Conversely, a 30 years-old woman was firstly conducted with at-home bleaching (overnight 4-weeks 10% CP) and, subsequently, with a single appointment of in-office bleaching for 45 minutes (35% HP). The shade of her upper central incisor changed from A1 to 0.5M1 and the upper canine from A3 to B1. The VITA classical (A1-D4) shade guide and VITA Bleached guide 3D-MASTER were used to determine the tooth color during the treatments. In both bleaching treatments, patients reported no significant tooth sensitivity and the final outcomes met their expectation.

An in-vitro Comparison of the Bleaching Efficacy of 35 Percent Carbamide Peroxide with Established Intracoronal Bleaching Agents

2020 ◽  
Author(s):  
Nandita Bansal
Keyword(s):  
Hydrogen Peroxide ◽  
Sodium Perborate ◽  
Distilled Water ◽  
Carbamide Peroxide ◽  
Human Teeth ◽  
Anterior Teeth ◽  
Group I ◽  
Group Ii ◽  
Control Evaluation

Introduction: Intracoronal bleaching is the simplest, least invasive, and least expensive means available to lighten non-vital discolored teeth. The objective of the study: To evaluate the intra coronal bleaching efficacy of 35% Carbamide peroxide relative to 35% Hydrogen peroxide and Sodium perborate using artificially stained extracted human teeth. Materials and Methods: Eighty extracted human permanent maxillary and mandibular anterior teeth and single-rooted premolars were artificially stained using whole human blood and root canal treatment was completed. They were bleached twice 7 days apart using: Group I (n=20) – 35% Carbamide peroxide gel, Group II (n=20) – 35% Hydrogen peroxide gel, Group III (n=20) – 2 gm Sodium perborate mixed with per ml of distilled water, Group IV (n=20)– Distilled water only (control). Evaluation of shade was performed on day 0,7,14. Results: On day 7, In Groups I and Group II, there was a reduction in the shade by 2 vita tab positions, whereas Group IIIlightened by 1-tab position only. On day 14, CP and HP lightened by overall 3-tab positions and SP by 2-tab positions. There were no statistical differences between the groups on day 7 and day 14. Conclusion: 35% Carbamide peroxide, 35% Hydrogen peroxide and Sodiumperborate were equally effective for Intra coronal bleaching.

scholarly journals Effects of Amorphous Calcium Phosphate Administration on Dental Sensitivity during In-Office and At-Home Interventions

2018 ◽  
Vol 6 (4) ◽  
pp. 52 ◽  
Author(s):  
Giacomo Oldoini ◽  
Antonino Bruno ◽  
Anna Genovesi ◽  
Luca Parisi
Keyword(s):  
Hydrogen Peroxide ◽  
Calcium Phosphate ◽  
Amorphous Calcium Phosphate ◽  
Potassium Fluoride ◽  
Tooth Bleaching ◽  
Carbamide Peroxide ◽  
Casein Phosphopeptides ◽  
Group 2 ◽  
Group 1 ◽  
At Home

Background. Tooth bleaching is the most frequently employed whitening procedure in clinics. The major side effect of tooth bleaching is dental sensitivity during and after the treatment. Here, we evaluated whether the administration of amorphous calcium phosphate (ACP), during in-office and at-home procedures may impact on dental sensitivity. Methods. Eighty patients, responding to the study requirements were enrolled according to the following criteria. Group 1 (n = 40), received in-office, 10% ACP prior to 30% professional hydrogen peroxide application. The whitening procedure continued at home using 10% carbamide peroxide with 15% ACP for 15 days. Group 2 (n = 40) received only 30% hydrogen peroxide application and continued the whitening procedures at home, using 10% carbamide hydroxide, without ACP- Casein phosphopeptides (CPP), for 15 days. Dental sensitivity was recorded with a visual analogue scale (VAS) at baseline, immediately after, and at 15 days after treatment in the two groups. Results. We observed that patients receiving ACP in the bleaching mixture experienced decreased dental sensitivity (* p ≤ 0.05), as detected by VAS scale analysis immediately following the procedures. Patients receiving ACP-CPP during at-home procedures showed a statistically significant (*** p ≤ 0.0001) reduction of dental sensitivity. Conclusions. We demonstrated that ACP-CPP administration, while exerting the same whitening effects as in control subjects receiving potassium fluoride (PF), had an impact on the reduction of dental sensitivity, improving patient compliance.

scholarly journals Comparação sobre a eficácia e sensibilidade dos diferentes tipos de clareamento dental: uma revisão de literatura

2021 ◽  
Vol 10 (7) ◽  
pp. e12810716516
Author(s):  
Maria Paula Novaes Camargo Manna ◽  
Rafaela Henriques Moreira ◽  
Yuri de Lima Medeiros ◽  
Isabella Silva Santos ◽  
Augusto de Sousa Lana ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Tooth Bleaching ◽  
Carbamide Peroxide ◽  
Dentin Sensitivity

Nos dias atuais, a estética do sorriso vem crescendo no mercado, visto que muitos consideram como parte do padrão de beleza desejável, o sorriso alinhado e os dentes brancos. Assim sendo, o clareamento dental constitui um dos procedimentos mais procurados e realizados pelos cirurgiões-dentistas, no quesito estética. Dessa forma, o cirurgião-dentista deve ter uma base sólida de conhecimento a respeito, para que faça uma avaliação clínica e o correto diagnóstico da estrutura dental, indicando a melhor técnica em cada caso. Para tanto, foi realizada uma revisão de literatura sobre os tipos de clareamento dental, comparando-os quanto à eficácia, em relação à alteração de cor, e quanto à sensibilidade, com buscas nas bases de dados, Pubmed, Scielo e Scopus, através dos descritores: Tooth bleaching; Carbamide peroxide; Hydrogen Peroxide; Dentin Sensitivity. Foram considerados elegíveis estudos em inglês, português ou espanhol, publicados entre 01/2006 a 05/2021. Assim, notou-se que as técnicas de clareamento são capazes de atingir os mesmos resultados quanto à mudança de cor, mas com variação no tempo e indicação. Quanto à sensibilidade, há uma tendência dessa ser maior, quando usado gel de maior concentração. Porém, já existem atualmente, géis clareadores contendo substâncias dessensibilizantes, e/ou protocolos que podem ser utilizados, para que se tenha uma redução da mesma. Além disso, quando realizada a técnica de clareamento caseiro, sugere-se dar preferência ao gel de Peróxido de Carbamida na menor concentração, uma vez que esse apresenta menor risco de desenvolvimento de sensibilidade dentária e é eficaz, se comparado às maiores concentrações.

Management of Discolored Tooth with separated Instrument

2017 ◽  
Vol 2 (1) ◽  
pp. 36-39
Author(s):  
Aadit Anilkumar ◽  
Faisal Nazar ◽  
Ratheesh Rajendran
Keyword(s):  
Hydrogen Peroxide ◽  
Hydrogen Sulfide ◽  
Root Canal ◽  
Iron Sulfide ◽  
Tooth Bleaching ◽  
Sodium Perborate ◽  
Root Canal Preparation ◽  
Tooth Structure ◽  
Tooth Discoloration ◽  
The Common

ABSTRACT Tooth discoloration commonly occurs after trauma to tooth, which leads to pulpal injury. Trauma to the pulpal blood vessel leads to hemorrhage and releases iron from hemoglobin. The iron which is released from hemoglobin combines with hydrogen sulfide to form iron sulfide, which gives the tooth its characteristic dark appearance. Tooth discoloration can be treated by nonvital tooth bleaching, if the tooth structure is intact. A combination of hydrogen peroxide and sodium perborate reduces the discoloration of the tooth by a process of oxidation. During root canal preparation procedures, the common mishap that occurs is instrument separation inside the root canal. The fractured fragment in the root canal can hinder proper preparation of root canal space. Continuous pain or discomfort may result if it is not removed or bypassed. It is more conservative to bypass the fractured instrument, particularly in cases where access to the fragment is restricted (apical one-third of canal or beyond the canal curvature) and its removal may lead to excessive removal of dentin with associated sequelae. How to cite this article Rajendran R, Nair KR, Kuriakose MC, Anilkumar A, Nazar F. Management of Discolored Tooth with separated Instrument. Cons Dent Endod J 2017;2(1):36-39.

An in vitro Evaluation of Radicular Penetration of Hydrogen Peroxide from Bleaching Agents During Intra-Coronal Tooth Bleaching with an Insight of Biologic Response

2011 ◽  
Vol 35 (3) ◽  
pp. 289-294 ◽  
Author(s):  
Divya Sharma ◽  
Sanjay Sharma ◽  
SM Natu ◽  
Satish Chandra
Keyword(s):  
Root Resorption ◽  
Tooth Bleaching ◽  
Sodium Perborate ◽  
Human Teeth ◽  
External Root Resorption ◽  
Biologic Response ◽  
Group A ◽  
Group B ◽  
Almost All

Objectives: External root resorption is the complication of intra-coronal bleaching done with 30% H2O2alone or mixed with sodium perborate but not with sodium perborate mixed with water. The study was done to comparatively evaluate the H2O2 leakage from three H2O2 liberating bleaching agents. Study design:Fifty one single rooted human teeth were used. After root canal therapy gutta percha was removed below cemento-enamel junction. Three bleaching agents: sodium perborate mixed with water , sodium perborate mixed with 30% H2O2 and 30% H2O2 alone were used. Teeth without defect , with cervical root defect and with mid root defect constituted group A, group B and group C. According to various bleaching agents groups were subdivided into subgroup 1, 2 and 3. H2O2 leakage was measured with the help of spectrophotometer. Results: Almost all teeth showed H2O2 leakage. It was maximum in B1 followed by C1, B2,A1, A2, C2, B3, A3 and C3. Conclusion: Sodium perborate mixed with water was found to be the best bleaching agent.

scholarly journals Effect of Calcium Hydroxide on pH Changes of the External Medium after Intracoronal Bleaching

2011 ◽  
Vol 12 (3) ◽  
pp. 158-163 ◽  
Author(s):  
Carlos Rocha Gomes Torres ◽  
Patrícia Marra de Sá ◽  
Raffaela Di Iorio Jeronymo ◽  
Karen Cristina Kazue Yui ◽  
Eduardo Galera da Silva ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Calcium Hydroxide ◽  
Root Resorption ◽  
External Medium ◽  
Control Group ◽  
Sodium Perborate ◽  
Distilled Water ◽  
Water Control ◽  
Ph Changes ◽  
Periodontal Tissues

ABSTRACT Aim This in vitro study evaluated the effect of calcium hydroxide on pH changes of the external medium after intracoronal bleaching. Materials and methods A total of 50 extracted human premolars were prepared and filled with gutta-percha and endodontic sealer. The teeth were randomly divided into five groups according to the bleaching agents employed: (a) Sterile cotton pellet with distilled water (control group); (b) sodium perborate and distilled water; (c) sodium perborate and 10% carbamide peroxide; (d) sodium perborate and 35% hydrogen peroxide; (e) 35% hydrogen peroxide. The teeth were stored in vials containing distilled water and the pH values of the medium surrounding the teeth were analyzed. After 7-day storage, the bleaching agent was removed and replaced by calcium hydroxide, and the distilled water was changed, in which the teeth were kept stored for further 14 days. Measurement of pH of the external medium (distilled water) was performed 7 days after insertion of the bleaching agents, immediately, 7 and 14 days after insertion of the calcium hydroxide. Data were submitted to statistical analysis by the two-way ANOVA and Tukey, s test. Results There were pH changes of the external medium at 7- day period after bleaching procedures. These results confirmed the diffusion of bleaching agents to the external medium. Conclusion Calcium hydroxide increased the external medium pH and was effective for pH alkalinization after intracoronal bleaching. Clinical significance Intracoronal bleaching of endodontically treated teeth may cause cervical root resorption. A possible explanation for this process is the passage of bleaching agents to the periodontal tissues yielding an inflammatory process. In an attempt to keep the neutrality of the periodontal pH, the calcium hydroxide has been recommended. Results of this study showed that this material should be always used after intracoronal bleaching. How to cite this article de Sá PM, Jeronymo RDI, Yui KCK, de Silva EG, Huhtala MFRL, Torres CRG, Gomes APM. Effect of Calcium Hydroxide on pH Changes of the External Medium after Intracoronal Bleaching. J Contemp Dent Pract 2011;12(3): 158-163.

scholarly journals Effect of Short- and Long-term Use of Home and In-Office Bleaching with Carbamide Peroxide and Hydrogen Peroxide on Bleaching with Carbamide Peroxide and Hydrogen Peroxide on Enamel Microhardness Enamel Microhardness

2020 ◽  
Vol 27 (2) ◽  
Author(s):  
Nazila Ameli ◽  
◽  
Niloofar Kianvash Rad ◽  
Farzane Nikpour ◽  
Raheb Ghorbani ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Dental Treatment ◽  
Artificial Saliva ◽  
Tooth Bleaching ◽  
Control Group ◽  
Bleaching Agent ◽  
Carbamide Peroxide ◽  
Dental Procedures ◽  
Before And After ◽  
At Home

Bleaching is a well-known esthetic dental treatment performed to lighten the tooth shade. Among different cosmetic dental procedures, including direct and indirect tooth-colored restorations, bleaching is likely the most conservative approach. Bleaching has been accepted well by patients and proven as a safe and effective approach. Objective: Tooth bleaching can be conducted at home or in offices. This study was performed to compare the enamel microhardness before bleaching and one and eight weeks after the application of different bleaching agents. Methods: Forty human premolars were randomly divided into four groups, and their buccal surface underwent a Vickers microhardness test before and after bleaching. Bleaching was performed with 40% hydrogen peroxide (HP) in-office bleaching agent (n = 10), 15% HP at-home bleaching agent (n = 10), and 15% carbamide peroxide (CP) at-home bleaching agent (n = 10) for two weeks. Ten samples were stored in artificial saliva and set as the control group. The microhardness of the samples was measured again one and eight weeks after bleaching. Results: The microhardness significantly decreased in the four groups one week after bleaching. Conclusion: The enamel microhardness was temporarily decreased by in-office bleaching. However, the microhardness increased with time and returned to the baseline value. Although the enamel microhardness initially reduced, it increased eight weeks after 15% CP at-home bleaching agent was applied.

scholarly journals Evaluation of Extraradicular Diffusion of Hydrogen Peroxide during Intracoronal Bleaching Using Different Bleaching Agents

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Mohammad E. Rokaya ◽  
Khaled Beshr ◽  
Abeer Hashem Mahram ◽  
Samah Samir Pedir ◽  
Kusai Baroudi
Keyword(s):  
Hydrogen Peroxide ◽  
Sodium Perborate ◽  
Water Mixture ◽  
Carbamide Peroxide ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Materials Used ◽  
Diffusion Of Hydrogen ◽  
Group 1

Objectives. Extra radicular diffusion of hydrogen peroxide associated with intracoronal teeth bleaching was evaluated.Methods. 108 intact single rooted extracted mandibular first premolars teeth were selected. The teeth were instrumented with WaveOne system and obturated with gutta percha and divided into four groups (n=27) according to the bleaching materials used. Each main group was divided into three subgroups (n=9) according to the time of extra radicular hydrogen peroxide diffusion measurements at 1, 7, and 14 days: group 1 (35% hydrogen peroxide), group 2 (35% carbamide peroxide), group 3 (sodium perborate-30% hydrogen peroxide mixture), and group 4 (sodium perborate-water mixture). Four cemental dentinal defects were prepared just below the CEJ on each root surface. The amount of hydrogen peroxide that leached out was evaluated after 1, 7, and 14 days by spectrophotometer analysis. The results were analyzed using the ANOVA and Tukey’s test.Results. Group 1 showed highest extra radicular diffusion, followed by group 3 and group 2, while group 4 showed the lowest mean extra radicular diffusion.Conclusion. Carbamide peroxide and sodium perborate-water mixture are the most suitable bleaching materials used for internal bleaching due to their low extra radicular diffusion of hydrogen peroxide.

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