New Trends on In-office Tooth Bleaching

Background: Vital tooth whitening has become an integral part of esthetic dentistry and remains one of the safest and most economic options today to improve dental esthetics without removing tooth structure. The tooth whitening materials have evolved into three categories: dentist-prescribed/dispensed (in office and patient home-use), and over-thecounter purchased and applied by patients. Objective: This review outlines the latest advances in dentist prescribed vital teeth whitening techniques, effects on tooth structure, soft tissues, and dental restoratives. Areas requiring additional research are also discussed. Methods: Electronic and manual literature search was conducted for key words such as tooth bleaching, and dental bleaching techniques using PubMed/MEDLINE, followed by manual selection of the studies that included whitening procedures in vital teeth. Results: The two main whitening agents are carbamide peroxide (CP) and hydrogen peroxide (HP or H2O2) whose concentration, duration of contact, and total treatment time can alter results. In addition, factors including the type of stain, and age of patient can affect results. Although whitening agents can affect tooth structure, restorative materials, and gingival tissues, the changes are temporary or can be treated using minimally invasive techniques. Conclusion: Areas requiring further research include the actual mechanism of whitening, its effect on tooth structure and restorative materials, and the development of an easy method to quantitate the degree of whitening in the dental office.

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The Whitening Effect and Histological Safety of Nonthermal Atmospheric Plasma Inducing Tooth Bleaching

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094714 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4714

Author(s):

Seoul-Hee Nam ◽

Byul Bo Ra Choi ◽

Gyoo-Cheon Kim

Keyword(s):

Alternative Energy ◽

Soft Tissues ◽

Inflammatory Responses ◽

Color Change ◽

Atmospheric Pressure Plasma ◽

Atmospheric Plasma ◽

Tooth Bleaching ◽

Histological Evaluation ◽

Light Sources ◽

Tooth Color

Various light sources have been applied to enhance the bleaching effect. This study was to identify the histological evaluation in oral soft tissues, as well as tooth color change after tooth bleaching by nonthermal atmospheric pressure plasma (NAPP). Nine New Zealand adult female rabbits were randomly divided into three groups (n = 3): group 1 received no treatment; group 2 was treated with NAPP and 15% carbamide peroxide (CP), which contains 5.4% H2O2, and group 3 was treated with 15% CP without NAPP. Color change (ΔE) was measured using the Shade Eye NCC colorimeter. Animals were euthanized one day later to analyze the histological responses occurring in oral soft tissues, including pulp, gingiva, tongue, buccal mucosa, and hard and soft palates. Changes in all samples were analyzed by hematoxylin and eosin staining and Masson’s trichrome. Teeth treated with plasma showed higher ΔE than that obtained with bleaching agents alone. Overall, the histological characteristics observed no appreciable changes. The combinational treatment of plasma had not indicated inflammatory responses as well as thermal damages. NAPP did not cause histological damage in oral soft tissues during tooth bleaching. We suggest that NAPP could be a novel alternative energy source to conventional light sources for tooth bleaching.

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Development of Controlled-Release Carbamide Peroxide Loaded Nanoemulgel for Tooth Bleaching: In Vitro and Ex Vivo Studies

Pharmaceuticals ◽

10.3390/ph14020132 ◽

2021 ◽

Vol 14 (2) ◽

pp. 132

Author(s):

Siriporn Okonogi ◽

Adchareeya Kaewpinta ◽

Sakornrat Khongkhunthian ◽

Pisaisit Chaijareenont

Keyword(s):

Drug Release ◽

Solid Dispersion ◽

Solid Dispersions ◽

Tooth Bleaching ◽

Polymer Mixture ◽

Release Mechanism ◽

Burst Release ◽

Order Kinetic ◽

Carbamide Peroxide ◽

Periodontal Tissues

Burst release of carbamide peroxide (CP) from traditional hydrogels causes severe inflammation to periodontal tissues. The present study explores the development of a novel CP nanoemulgel (CP-NG), an oil-in-water nanoemulsion-based gel in which CP was loaded with a view to controlling CP release. CP solid dispersions were prepared, using white soft paraffin or polyvinylpyrrolidone-white soft paraffin mixture as a carrier, prior to formulating nanoemulsions. It was found that carrier type and the ratio of CP to carrier affected drug crystallinity. Nanoemulsions formulated from the optimized CP solid dispersions were used to prepare CP-NG. It was found that the ratio of drug to carrier in CP solid dispersions affected the particle size and zeta potential of the nanoemulsions as well as drug release behavior and tooth bleaching efficacy of CP-NG. Drug release from CP-NG followed a first-order kinetic reaction and the release mechanism was an anomalous transport. Drug release rate decreased with an increase in solid dispersion carriers. CP-NG obtained from the solid dispersion with a 1:1 ratio of CP to the polymer mixture is suitable for sustaining drug release with high tooth bleaching efficacy and without reduction of enamel microhardness. The developed CP-NG is a promising potential tooth bleaching formulation.

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A swift, easy and cheap protocol to evaluate the tooth bleaching in vitro

Journal of Clinical and Experimental Dentistry ◽

10.4317/jced.54828 ◽

2018 ◽

pp. 0-0

Author(s):

KVF Penha ◽

ACS Sousa ◽

CA Oliveira ◽

RSB de Andrade ◽

DFP Vasconcelos

Keyword(s):

Tooth Bleaching

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Tooth bleaching using a diode laser

BDJ ◽

10.1038/sj.bdj.4813647 ◽

2006 ◽

Vol 200 (11) ◽

pp. 619-619

Author(s):

C E Mercer

Keyword(s):

Diode Laser ◽

Tooth Bleaching

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Multidisciplinary Treatment after Orthodontics: Crown Lengthening and Dental Whitening in the Final Aesthetic Resolution of Smile

Ensaios e Ciência C Biológicas Agrárias e da Saúde ◽

10.17921/1415-6938.2020v24n4p402-409 ◽

2020 ◽

Vol 24 (4) ◽

pp. 402-409

Author(s):

Thais Akemi Sako ◽

Geórgia Rondó Peres ◽

Diego Oliveira Bavaresco ◽

Danielle Gregorio ◽

Larissa Sgarbosa de Araujo Matuda ◽

...

Keyword(s):

Orthodontic Treatment ◽

Correct Diagnosis ◽

Multidisciplinary Treatment ◽

Invasive Procedure ◽

Tooth Bleaching ◽

Tooth Whitening ◽

The Aesthetic ◽

Smile Aesthetics ◽

Dental Whitening ◽

The Relationship

Após a conclusão do tratamento ortodôntico, os pacientes começam a se preocupar com outros fatores estéticos para garantir um sorriso harmonioso, sendo mais exigentes com a aparência. Além de dentes alinhados e harmoniosos, os pacientes estão em busca de um sorriso mais branco, se tornando cada vez mais exigentes com a aparência, cabendo ao dentista atender a essas necessidades. Um outro fator que pode tornar o sorriso antiestético é a presença de dentes curtos, que resulta em exposição excessiva da gengiva e um sorriso com aspecto mais infantil, e que muitas vezes é percebido apenas a finalização do tratamento ortodôntico. O objetivo do presente estudo foi revisar o tratamento estético do sorriso após ortodontia, associando cirurgia periodontal para aumento de coroa clínica e clareamento dental. O sorriso gengival pode ser corrigido integrando várias especialidades odontológicas devido às suas inúmeras causas, podendo ser indicada a realização de procedimentos cirúrgicos, ortodônticos ou restauradores. Quanto ao amarelamento dos dentes, uma das técnicas utilizadas é o clareamento dental, que consiste num procedimento pouco invasivo, indicado na maioria dos casos de manchas extrínsecas. O clareamento pode ser caseiro ou de consultório, mas em ambos os casos, o cirurgião-dentista precisa dominar a técnica. Nesse contexto, cabe ao ortodontista identificar e diagnosticar essas necessidades do paciente e encaminhá-lo para outros especialistas. Em conclusão, para alcançar os resultados esperados pelo paciente são imprescindíveis uma boa anamnese, um correto diagnóstico e o planejamento multidisciplinar do caso. Portanto a inter-relação das especialidades é imprescindível a fim de obter resultados satisfatórios e agradáveis ao paciente. Palavras-chave: Periodontia. Gengivectomia. Estética Dentária. Sorriso. Clareamento Dental. Abstract After the end of orthodontic treatment, patients become more rigorous with their appearance and worry about other aesthetic factors to ensure a harmonious smile. In addition to aligned and harmonious teeth, patients are looking for a whiter smile, becoming more and more rigorous with their appearance, leaving the dentist to meet these needs. Another factor that can impair smile aesthetics is the presence of short teeth, which results in an overexposure of the gum and a smile with a more childlike aspect, and that it is often perceived only at the end of orthodontic treatment. The aim of the present study was to review the aesthetic treatment of the smile after orthodontics, associating periodontal surgery to increase the clinical crown and tooth whitening. Aesthetics is the relationship between several factors. The gummy smile can be corrected by integrating several dental specialties, due to its numerous causes, and surgical, orthodontic or restorative procedures may be indicated. For tooth whitening, one of the techniques most indicated is dental bleaching, which consists of a minimally invasive procedure, indicated in most cases of extrinsic stains. The whitening can be made at home or in office, but in both cases, the dentist needs to master the technique. In this context, it is up to the orthodontist to identify and diagnose these needs of the patient and refer him to other specialists. In conclusion, a good anamnesis, a correct diagnosis and multidisciplinary case planning are essential to achieve the results expected by the patient. Therefore, the interrelationship between specialties is important in order to obtain satisfactory and pleasant results for the patient. Keywords: Periodontics, Gingivectomy, Esthetics, Smiling. Tooth Bleaching.

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

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-863720200003620190149 ◽

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.

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3D Surface Profile and Color Stability of Tooth Colored Filling Materials after Bleaching

BioMed Research International ◽

10.1155/2015/327289 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Bryant Anthony Irawan ◽

Stacey Natalie Irawan ◽

Sam’an Malik Masudi ◽

Ninin Sukminingrum ◽

Mohammad Khursheed Alam

Keyword(s):

Surface Profile ◽

Color Stability ◽

Tooth Bleaching ◽

Force Microscopy ◽

Color Changes ◽

Filling Materials ◽

Atomic Force ◽

3D Surface ◽

Restorative Materials ◽

Dental Restorative

This study aims to evaluate the effects of vital tooth bleaching with carbamide peroxide home bleaching and in-office bleaching on the color stability and 3D surface profile of dental restorative filling materials. Thirty discs (n=30) measure 6 mm in diameter and 2 mm thick for each of three restorative materials. These are nanofilled composite Filtek Z350 XT, the submicron composite EsteliteΣQuick, and nanofilled glass ionomer Ketac N100 nanoionomer and were fabricated in shade A2. Each group was further divided into three subgroups (n=10): subgroup A (Opalescence PF), subgroup B (Opalescence Boost in-office bleaching), and subgroup C (distilled water) serving as control. Samples were bleached according to the manufacturer’s instructions for a period of two weeks. The Commission Internationale de L’Eclairage (CIEL*,a*,b*) system was chosen for image processing, while 3D surface profile was tested with atomic force microscopy (AFM). Statistical analyses were performed with the Mann-Whitney tests and Krusal-Wallis with aPvalue of ≤0.05. The three restorative materials showed significant color changes (ΔE);P≤0.05. In diminishing order, the mean color changes recorded were EsteliteΣ(3.82 ± 1.6) > Ketac Nano (2.97 ± 1.2) > Filtek Z350 XT (2.25 ± 1.0). However, none of the tested materials showed statistically significant changes in surface roughness;P>0.05.

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Hydrogen Peroxide Might Bleach Natural Dentin by Oxidizing Phosphoprotein

Journal of Dental Research ◽

10.1177/0022034518784260 ◽

2018 ◽

Vol 97 (12) ◽

pp. 1339-1345 ◽

Cited By ~ 5

Author(s):

T. Jiang ◽

Y.R. Guo ◽

X.W. Feng ◽

Y. Sa ◽

X. Yang ◽

...

Keyword(s):

Amino Acids ◽

Hydrogen Peroxide ◽

Acetic Acid ◽

Aromatic Amino Acids ◽

Disodium Salt ◽

Tooth Bleaching ◽

Distilled Water ◽

Fluorescent Properties ◽

Fluorescent Intensity ◽

Tooth Color

Recent studies suggested that bleaching agents may whiten teeth by oxidizing the fluorescent materials, which are the proteins located in the organic-inorganic interface. Therefore, we postulated that fluorescence of dentin came from dentin phosphoprotein (DPP) and that bleaching agents might bleach dentin by oxidizing DPP. Fifty-six specimens were randomly divided into 4 groups and exposed to distilled water, hydrogen peroxide (HP), ethylenediamine tetraacetic acid disodium salt (EDTA), and acetic acid for 24 h. After measuring the organic and inorganic components, fluorescence, and color characteristics of dentin before and after exposure, we found that when DPP was removed from dentin by EDTA, fluorescent intensity declined proportionally with the reduction in Raman relative intensity, and dentin was whitened considerably, with an Δ E value 6 times higher than that of the distilled water group. On the contrary, due to the incapability of acetic acid to dissolve DPP during decalcification, fluorescent intensity values and tooth color remained nearly unchanged after exposure to acetic acid. Dentin exposed to neutral HP showed no obvious morphologic and organic/inorganic component changes except for the destruction of DPP. Similarly, dramatically decreased fluorescent intensity and lightened color were found in the HP group. Moreover, DPP solution of the HP group exhibited decreased ultraviolet absorbance, especially between 250 and 300 nm, which arose from aromatic amino acids. The results indicated that DPP was responsible for the fluorescent properties of dentin and that HP might bleach dentin by the oxidization of aromatic amino acids in DPP. These findings are of great significance in promoting our further understanding of the mechanism of tooth bleaching and the fluorescent property of normal dentin.

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