[Bleaching vital teeth. "B.V. Bleaching Vital"].
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INTRODUCTION: The purpose of this in vitro study was to determine if enamel that had been bleached by carbamide (urea) peroxide gel (CPG) was at increased risk of either acid erosion or demineralisation (early caries) than un-bleached enamel. METHODS: Human incisors were employed. The samples were randomly assigned to one of 4 groups; a) 10% CPG, b) 16% CPG, c) 22% CPG and d) 10% CPG with xylitol, fluoride and potassium. Each specimen was moistened with saliva and the appropriate formulation placed for 2 hours for a total of 40 hours of exposure. In order to ensure that bleaching had taken place, tooth shades were monitored using the Shade-Eye device. Following the bleaching process, one half of the specimen was subjected to an erosive challenge, the other to a demineralisation system with one half of each sub-sample retained as a non-bleached control. Samples were assessed longitudinally with quantitative light-induced fluorescence (QLF) and at the conclusion of the study with transverse micro-radiography (TMR). RESULTS: Erosion was detected in all samples (DeltaQ 126+/-23.4), in both bleached and non-bleached areas. There was no statistical difference between the bleached and non-bleached areas either within the treatment groups or between them. Caries-like lesions were detected on all samples; TMR revealed sub-surface lesions on all teeth and QLF data supported this (DeltaQ 89+/-18.9). Following statistical analysis there were no differences detected between the bleached and non-bleached areas, nor between the different concentrations of the bleaching solution. CONCLUSION: These results suggest that tooth bleaching with carbamide (urea) peroxide (using commercially available concentrations) does not increase the susceptibility of enamel to acid erosion or caries.
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BACKGROUND: The effects of carbamide peroxide bleach on tooth structure are uncertain. PURPOSE: The purpose of this study was to investigate the effects of direct or indirect carbamide peroxide application on dentin flexural strength and modulus in vitro. MATERIALS AND METHODS: Dentin bars were machined from bovine incisors and treated with 10% carbamide peroxide for 6 h/d for 14 days. Four groups were created, with eight bars in each group: group 1-direct bleach application only; group 2-indirect bleach application only; group 3-direct bleach application followed by a 2-week storage in artificial saliva; group 4-direct bleach application followed by a 2-week storage in artificial saliva and daily topical fluoride treatments. The specimens' flexural strength and modulus were tested after 24 hours, and the results were compared with water controls using independent t-tests (p < .05). RESULTS: Flexural strength results (in megapascals) for bleached versus control dentin (1=205+/-26 vs 215+/-14, 2=257+/-25 vs 261+/-14, 3=180+/-22 vs 193+/-36, 4=157+/-18 vs 184+/-11) were significantly lower in group 4 (p=.005). Modulus results (in gigapascals) for bleached versus control dentin (1=10.7+/-1.4 vs 12.2+/-0.6, 2=14.2+/-1.7 vs 14.4+/-1.6, 3=10.0+/-2.0 vs 10.9+/-1.3, 4=9.0+/-1.2 vs 11.1+/-1.0) were significantly lower in groups 1 and 4 (p=.013 and p=.003, respectively). There were no significant differences in strength and modulus results between the bleached and control dentin in groups 2 and 3. A direct application of carbamide peroxide to bovine dentin significantly decreased some dentin mechanical properties in vitro. An indirect application of carbamide peroxide to dentin did not significantly decrease dentin strength and stiffness. CLINICAL SIGNIFICANCE: This in vitro study suggests that a bleaching treatment, when applied to the enamel of intact teeth, does not significantly affect the mechanical properties of the underlying dentin. However, when applied directly to dentin in clinical situations such as root exposure or occlusal attrition, the bleaching treatment may result in altered mechanical properties of dentin. The clinical consequences of this observation are, however, unknown.
This article describes how at-home bleaching procedures affect teeth and restorative materials. Specifically, it discusses the effects of tooth-whitening systems on enamel surfaces, enamel and dentin bond strengths, marginal integrity, color, and other properties of restorative materials.
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