Effect of Calcium and Fluoride Addition to Hydrogen Peroxide Bleaching Gel On Tooth Diffusion, Color, and Microhardness

SUMMARY Objectives: The aim of this study was to evaluate the effect of calcium and fluoride addition to a 35% hydrogen peroxide (HP) bleaching gel with regard to its diffusion through the tooth structure, enamel microhardness, and bleaching efficacy. Methods and Materials: Eighty specimens (6 mm in diameter and 2 mm in height; 1 mm/enamel and 1 mm/dentin) were obtained from bovine incisors that were polished and divided into four groups (n=20) according to the remineralizing agent added to the gel: Ca = 0.5% calcium gluconate; F = 0.2% sodium fluoride; Ca+F = 0.5% calcium gluconate and 0.2% sodium fluoride; and control = no agent. Initial microhardness and color were assessed. The samples were positioned over simulated pulpal chambers filled with acetate buffer solution to capture the HP. Gels were applied over enamel for 30 minutes, and HP diffusion was assessed by spectrophotometry two hours after bleaching. Microhardness was measured immediately after bleaching and then the specimens were immersed into artificial saliva for seven days for final color assessment. Data were analyzed by one-way analysis of variance followed by Tukey test. Results: Bleaching reduced microhardness for all groups (p=0.0001), but the Ca+F and F groups showed lower reductions after bleaching. The addition of Ca, F, and Ca+F decreased the peroxide penetration through the tooth structure (p=0.0001), but there were no differences in color change for ΔL (p=0.357), Δa (p=0.061), Δb (p=0.823), and ΔE (p=0.581). Conclusion: The addition of calcium and fluoride in the gel did not affect bleaching efficacy, but it was able to reduce both the peroxide diffusion and the bleached enamel microhardness loss.

Enamel Remineralization Potential of Novel Dentifrice with Tetracalcium Phosphate/Monetite Powder Component

The aim was to investigate the enamel health benefits of a novel toothpaste with active tetracalcium phosphate/monetite mixtures under de/remineralization cycling. The enamel de/remineralization cycling protocol was consisted of demineralization in 1% aqueous solution of citric acid at pH 3.6 with following treatment with toothpastes and soaking in remineralization storage solution. Effectiveness of toothpastes to promote remineralization was evaluated by surface microhardness measurements, enamel erosion depth, analysis of surface roughness and fluorescent optical method. The novel tetracalcium phosphate/monetite toothpaste had the same remineralization potential as commercial calcium silicate/phosphate toothpaste and significantly higher than control storage solution group (p<0.05). Surface roughness was significantly lower after addition of fluorides to dentifrice (p<0.05). The enamel erosion depth was significantly reduced by applying toothpastes as compared to negative control (p<0.05) and did not differ from calcium silicate/phosphate toothpaste (p>0.66). The results showed that dentifrice formulations containing active tetracalcium phosphate/monetite mixture with or without fluoride addition had excellent enamel remineralization potential under de/remineralization cycling and successfully promote remineralization of enamel with daily using in the form of toothpaste.