In vitro colorimetric evaluation of the efficacy of various bleaching methods and products

In Vitro Evaluation of Tooth-Whitening Potential of Peroxide-Free OTC Dental Bleaching Agents

Purpose: To evaluate and compare the tooth-whitening potential of five over-the-counter (OTC), peroxide-free dental bleaching methods as well as an experimental tooth-whitening solution containing 0.1% hydrogen peroxide complexed with doping agents with a gold standard (positive control) containing 16% carbamide peroxide. Material and Methods: Eighty permanent bovine incisor teeth were randomly allocated to eight different groups. Two teeth from each group were immerged into five staining solutions represented by coffee, tea, red wine, and curry mixed in warm oil or distilled water (control group) and stored at 37 °C for 28 days in an incubator. The teeth were then reallocated to the eight groups, resulting in ten samples per group, and each group was matched with a bleaching product. The bleaching procedures were executed following the manufacturer’s recommendations. The color of each sample was assessed over a white and black background using a quantitative numerical measurement approach with a calibrated spectrophotometer. Spectrophotometric measurements were performed after exposing the teeth to the bleaching agent for 60 min (T2), 100 min (T3), and 200 min (T4), and ΔE00 was calculated. Results: When analyzed over a white background, the mean ΔE00 values ranged from 2.14 (placebo) to 6.32 (Opalescence PF). When analyzed over a black background, the mean ΔE00 values ranged from 2.31 (placebo) to 5.78 (Opalescence PF). Statistically significant ΔE00 color changes over time for the eight groups and five staining solutions at T1 and T4 were assessed for both backgrounds using repeated ANOVA followed by Fisher’s LSD post hoc test (p-value < 0.01). Conclusions: All tested over-the-counter whitening kits except one exhibited positive color variation. However, the individual performance differed vastly from one brand to the other, and the overall performance was less effective compared to the conventional carbamide-peroxide-based positive control.

Hydrogen Peroxide Diffusion through Enamel and Dentin

The purpose of this study was to evaluate the in vitro diffusion of commercial bleaching products (hydrogen peroxide (HP) or carbamide peroxide (CP) based) with different application protocols. Human enamel-dentin discs were obtained and divided into 20 groups. Four commercial products based on HP (Pola Office+(PO), Perfect Bleach (PB), Norblanc Office-automix (NO), and Boost (BT)), and one based on CP (PolaDay CP (PD)), were evaluated with different application protocols (3 applications × 10 min or 1 application × 30 min, with or without light activation). Artificial pulp chambers with 100 µL of a buffer solution were prepared. After each application, the buffer was removed and diffused HP was quantified by fluorimetry. Data were analyzed with two-way analysis of variance (ANOVA) and Tukey’s test. In groups where 3 × 10 min applications were done, after the first 10 min, PB, NO, and PD showed similar diffusion (p < 0.05). After the second and third applications, diffusion proved similar for PO and PD, while PB exhibited the greatest diffusion. In the 30 min application groups, PO and BT showed no significant differences (p > 0.05), with similar results for NO and PD. Comparing products with or without light activation, PO, BT, and PB showed significantly greater diffusion with light activation (p < 0.05). Reapplication, and light activation, increased HP diffusion independently of the concentration of the product.

Effect of tooth discolouration severity on the efficacy and colour stability of two different trayless at-home bleaching systems

Background. The use of trayless at-home bleaching agents in darker teeth is raising some concerns due to their unknown efficacy. The purpose of this in vitro study was to evaluate the effect of tooth discolouration severity on the efficacy and colour stability of two different trayless at-home bleaching systems.

Methods. Ninety enamel-dentin samples were divided into two groups: lighter tand darker teeth. The teeth in each group were further divided into three groups (n=15): (1) tray-based system with 10% carbamide peroxide (Opalescence Oh) (control group); (2) a tray applied whitening membrane with 10% hydrogen peroxide (Treswhite Supreme); and (3) a whitening pen with 22% carbamide peroxide (Hollywood Smiles). After bleaching, the teeth were stained for 9 days using red wine. Colour readings before bleaching treatment were determined using a dental spectrophotometer and were repeated 24 h after bleaching treatment and 24 h after staining process. Analysis of variance, Bonferroni and Dunnett C tests were used at 5% significance level.

Results. No differences were observed between the bleaching efficacy of Treswhite Supreme and Opalescence Oh in the lighter teeth, while Opalescence Oh had the best bleaching efficacy in the darker teeth (p<0.05). Hollywood Smiles had the worst bleaching efficay but the best color stability in both lighter and darker teeth (p<0.05). No differences were observed between the color stability values of Treswhite Supreme and Opalescence Oh.

Conclusion. This study suggested that both the tooth discolouration severity and the type of trayless system used affected the bleaching efficacy, whereas only the type of trayless system affected the color stability.