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PubMed2003

Evaluation of a whitening gel designed to accelerate whitening.

A clinical trial was conducted with 25 subjects to evaluate the effects and safety of Zoom! Take-Home whitening gel, a 6% hydrogen peroxide gel for vital tooth bleaching. Tooth bleaching was accomplished using a tray system overnight for 6 nights. Over the 6 nights, a significant change (from darker to lighter) was seen in tooth shades as demonstrated by 3 assessment methods: VITA Shade Value Oriented Guide, Trubyte Bioform Color Ordered Shade Guide scoring system, and the Chroma Meter CR-321 assessments. VITA Shade scores showed a mean change of -6.49 shades (P = .0001) from baseline to day 4 and a -7.72 shades (P = .0001) from baseline to day 7. The Trubyte scores showed a mean change of -9.31 shades (P = .0001) from baseline to day 4 and a -10.77 shades (P = .0001) from baseline to day 7. The Chroma Meter was used to measure tooth color. Analysis of Chroma Meter data showed a significant change in color (delta E), 13.82 mean score change (P = .0001) from baseline to day 4 and a 7.25 mean score change (P = .0001) from baseline to day 7. At day 4 minor tooth sensitivity was reported, and all tooth sensitivity resolved within a few days after treatment.

Adult↗
PubMed2002

Effect of peroxide concentration and brushing on whitening clinical response.

This clinical trial compared the effects of hydrogen peroxide concentration and toothbrushing on clinical response to vital bleaching. Tooth bleaching was accomplished with a flexible, polyethylene strip coated with a hydrogen peroxide bleaching gel worn for 30 minutes twice daily over a 14-day period. A total of 36 subjects were randomized to 1 of 3 treatment groups: 5.3% hydrogen peroxide strip plus prebrushing, 6.5% hydrogen peroxide strip plus prebrushing, or 6.5% hydrogen peroxide strip without prebrushing. Two groups brushed with regular anticavity toothpaste immediately before bleaching, while the other group performed ad libitum brushing only. Tooth color was measured over a 14-day period using digital images of the anterior dentition. Over the 14-day treatment period, all 3 strip groups experienced highly significant (P < 0.001) whitening as evidenced by decreased yellowness (delta b*) and increased brightness (delta L*), as well as composite color change (delta E*) relative to baseline. Keeping brushing constant, the 6.5% hydrogen peroxide strip plus prebrushing group experienced a 31% to 60% improvement in whitening relative to the 5.3% hydrogen peroxide standard. Keeping concentration constant at 6.5% hydrogen peroxide, the prebrushing group experienced a directional 5% to 33% improvement in whitening relative to no prebrushing. All treatments were generally well tolerated. This study demonstrates that for strip-based delivery, increasing hydrogen peroxide concentration to 6.5% results in a significant improvement in efficacy with few tolerability trade-offs.

Adult↗
PubMed1991

Duration of tooth color change after bleaching.

Tooth color change was monitored after a single, in-office bleaching technique using a colorimeter. Twenty young adults participated in the double-blind study at The Ohio State University College of Dentistry. Half of the participants had their maxillary anterior teeth bleached and half were controls. By one month, the large initial color change was considerably reversed and only noticed by one subject. After six months, the effect of bleaching was small, but still measurable.

Adult↗
PubMed2006

Hydrogen peroxide tooth-whitening (bleaching) products: review of adverse effects and safety issues.

Hydrogen peroxide in the form of carbamide peroxide is widely used for tooth whitening (bleaching), both in professionally- and in self-administered products. Adverse effects have become evident. Cervical root resorption is a possible consequence of internal bleaching and is more frequently observed in teeth treated with the thermo-catalytic procedure. Tooth sensitivity is experienced in 15-78% of patients undergoing external tooth bleaching. However, clinical studies addressing other adverse effects are lacking. Direct contact with hydrogen peroxide induces genotoxic effects in bacteria and cultured epithelial cells, but the effect is reduced or totally abolished in the presence of metabolising enzymes. Several carcinogenesis studies, including the hamster cheek pouch model, indicate that hydrogen peroxide (H(2)O(2)) might possibly act as a promoter. Until further clinical research is concluded to address the question of possible carcinogenicity, it is recommended that: tooth-bleaching products using concentrated H(2)O(2) should not be used without gingival protection; that H(2)O(2) containing products should be avoided in patients with damaged or diseased soft tissues. For nightguard vital bleaching, minimal amounts of low dose H(2)O(2) (including in the form of carbamide peroxide) are preferred, thereby avoiding prolonged and concentrated exposures.

Animals↗
PubMed1998

Rotary reduction, enamel microabrasion, and dental bleaching for tooth color improvement.

Tooth color and shade can have an important influence on a person's appearance. Brown and white enamel dysmineralization defects, white hypocalcification lesions, and natural variations in tooth shading can detract from an otherwise attractive smile. Bonded facial composite resins, porcelain veneers, or full-coverage restorations can be used for color correction. A more conservative and less expensive approach is to eliminate or reduce the discoloration. In select cases this can be done without removing significant tooth structure and without placing restorative material to mask the tooth. This article describes a combination of "microreduction," microabrasion, and dental bleaching for tooth color correction that has worked well for certain patients. The method is easily performed, conservative, inexpensive, and requires minimal subsequent maintenance.

Adolescent↗
PubMed1991

In vitro toothbrush abrasion and bond strength of bleached enamel.

Vital tooth bleaching is experiencing increased usage because of its convenient application and effectiveness for lightening teeth and stain removal. The purpose of this investigation was to evaluate the effect of bleaching agents on enamel toothbrush abrasion and bond strength.

Analysis of Variance↗
PubMed2003

[Inhibitive effects of chloroqquine on the decomposition of hydrogen peroxide].

OBJECTIVE: The purposes of this study were to investigate effects of chloroqquine (CQ) on inhibiting the decomposition of hydrogen peroxides (HP), and to optimize composition of the tooth-bleaching agent. METHODS: According to the principle of the color-changing reaction between horse radish peroxidase and substrate, the tooth-bleaching agent made of HP was divided into four groups with different amounts of CQ. The stability of HP was observed using ELISA for 3 months. RESULTS: With the prolongation of store time, the absorbance of HP solutions containing different concentrations of CQ declined at different degrees, which showed a dependent relation between absorbance values and concentrations of CQ. Within the range of experiment concentrations of CQ, the higher the concentration of CQ was, the stronger the stability of HP was. And the duration of tooth-bleaching effects in 150.0 mg/ml of CQ was prolonged 4 to 6 times compared to that without CQ. CONCLUSION: The data indicate that CQ can inhibit the decomposition of HP. The bleaching effect of the tooth-bleaching agent which is made of HP and proper amount of CQ is satisfactory.

Chloroquine↗
PubMed2003

Tray whitening: what the evidence shows.

In recent years, many dental professionals have changed their philosophy regarding the use of trays with at-home bleaching regimens. However, facts do not change--and successful vital tooth bleaching still occurs only when tooth surfaces are in direct contact with the appropriate concentration of active whitening agent for a specific amount of time. Because the science of tooth whitening is still in its infancy--this article reviews a series of remaining questions regarding vital tooth bleaching based on current scientific information and research findings on products using trays.

Carbamide Peroxide↗
PubMed2003

Digital photography and the assessment of therapeutic results after bleaching procedures.

UNLABELLED: The therapeutic outcome of tooth-bleaching procedures can be assessed by different methods, one of them being digital photography. However, none of the methods seems to be perfect. In this overview factors are discussed that have an influence on color rendition and image brightness in (digital) photography. A photographic procedure is proposed that results in comparable images. Beginning with a short description of some digital cameras currently used in dental photography, the article discusses the influence of light and camera technology on image brightness and color rendition in detail. Even if a highly standardized procedure is performed, there remain factors that affect color and brightness that cannot be excluded completely. Therefore, a photographic procedure is proposed that includes a piece of gray card in the picture as a neutral reference object. In this way, color casts can be eliminated and image brightness can be fine tuned using a standard image-editing program (Adobe Photoshop, Adobe Systems Incorporated, San Jose, CA, USA) before the relevant color values are metered by the same software. CLINICAL SIGNIFICANCE: A photographic procedure using digital cameras is proposed that is relatively simple and sufficiently precise to allow the assessment of the therapeutic outcome of tooth-bleaching procedures.

Color↗
PubMed2005

Effect of two different bleaching regimens on the gloss of tooth colored restorative materials.

OBJECTIVES: Vital tooth bleaching with peroxide is one of the most common cosmetic procedures in dentistry and can be accomplished using a variety of methods or regimens. Recently, new generation of tooth color restorative materials were introduced to market. The purpose of this in vitro study was to determine the gloss changes of three different tooth color restorative materials: Flowable composite (Filtek Flow/3M), packable composite (Filtek P60/3M) and ormocer (Definite/DEGUSSA) after two different bleaching regimens (Vivastyle/VIVADENT) and (Crest Professional Whitestrips/PROCTER and GAMBLE). METHODS: 16 specimens 30 x 30 x 2 mm size were fabricated from each restorative material. After gloss values were measured with gloss meter, at two different angles of illumination (20 and 60 degrees ), 10% carbamide peroxide (Vivastyle) was applied for 2 h per day for fourteen days to the half of the specimens while 6.5% hydrogen peroxide strip bands (Crest Professional Whitestrips) were applied to the remaining eight of the specimens for 30 min twice daily for 14 days. During the test period the specimens were stored in 37 degrees C and 100% relative humidity. At the end of bleaching regimen the gloss measurements were repeated and the data were subjected to statistical analysis. RESULTS: The Wilcoxon Signed Rank Test analysis revealed that the gloss values were affected by both bleaching regimens (P=0.012). Whitestrips decreased the gloss values of Filtek P60 (at 20 and 60 degrees , P<0.001) and Filtek Flow (at 20 degrees , P=0.05 and at 60 degrees , P=0.05) significantly compared to Vivastyle, while the gloss values of Definite did not show any significant change between Vivastyle and Whitestrips application (at 20 degrees P=0.279; at 60 degrees , P=0.279, Mann-Whitney U Test). The gloss values of materials were significantly different before (at 20 degrees P<0.001; at 60 degrees , P=0.003) and after bleaching (at 20 degrees P<0.05; at 60 degrees , P<0.05) with the highest value of Filtek Flow followed Filtek P60 and then by Definite (Kruskal Wallis test). SIGNIFICANCE: As the gloss of tooth colored restorative materials could be affected by bleaching regimens, it is necessary to consider the type of the material before starting the treatment.

Carbamide Peroxide↗
PubMed2001

Clinical dentin hypersensitivity: understanding the causes and prescribing a treatment.

Dentin hypersensitivity is a common condition of transient tooth pain associated with a variety of exogenous stimuli. There is substantial variation in the response to such stimuli from one person to another. Except for sensitivity associated with tooth bleaching or other tooth pathology, the clinical cause of dentin hypersensitivity is exposed dentinal tubules as a result of gingival recession and subsequent loss of cementum on root surfaces. The most widely accepted theory of how the pain occurs is Brännström's hydrodynamic theory of dentin hypersensitivity. Dentinal hypersensitivity must be differentiated from other conditions that may cause sensitive teeth prior to treatment. Three principal treatment strategies are used. Dentinal tubules can be covered by gingival grafts or dental restorations. The tubules can be plugged using compounds that can precipitate together into a large enough mass to occlude the tubules. The third strategy is to desensitize the nerve tissue within the tubules using potassium nitrate. Several over-the-counter products are available to patients to treat this condition.

Dental Cementum↗
PubMed2006

Hydrogen peroxide tooth-whitening (bleaching): review of safety in relation to possible carcinogenesis.

Hydrogen peroxide in the form of carbamide peroxide is widely used in professionally and self-administered products for tooth whitening. Hydrogen peroxide is a highly reactive substance that can damage oral soft and hard tissues when present in high concentrations and with exposures of prolonged duration. This review examines the issue of oral mucosal damage and possible carcinogenicity relating to the use of hydrogen peroxide in the mouth for tooth whitening, with an emphasis on safety with prolonged exposure to low concentrations of peroxide products.

Animals↗
PubMed1992

Single-tooth home bleaching.

This article describes a simple but effective method of bleaching single vital discolored teeth. The patient applies a viscous 10% carbamide peroxide gel in a plastic mouth-guard designed to confine the gel only to the discolored tooth. This method has been effective for lightening vital teeth with calcified pulpal spaces.

Adult↗
PubMed1998

Dentist-prescribed home bleaching: current status.

White teeth have been an indicator of physical attractiveness throughout history. Only recently have we been able to whiten teeth with few side effects, making tooth bleaching a popular and effective dental treatment. The American Dental Association (ADA) has established guidelines on safety and effectiveness for tooth bleaching. External stains from aging or inherent dark color are more responsive to bleaching than internal stains. Dentist-prescribed home bleaching--including a careful dental exam, custom-fabricated trays, tacky high-viscosity gels, adequate instructions, and recall exams--has been shown to be an effective method for bleaching teeth. Trays can be worn overnight or during the day with similar effectiveness. The bleaching effect can last up to 3 years with more than 50% success.

American Dental Association↗
PubMed1992

Bleaching of vital and nonvital teeth.

Although tooth bleaching has been known to the dental profession for over 100 years, new knowledge is continually surfacing. This review discusses the 1990 to 1991 literature on two nonvital bleaching techniques (thermocatalytic and walking) and three classes of vital bleaching techniques (in-office; dentist-prescribed, home-applied; and over-the-counter kits). The choice for nonvital bleaching is the walking bleach technique, with the use of sodium perborate alone having less potential for cervical resorption. The choices for vital bleaching techniques are either the dentist-prescribed, home-applied technique, the in-office technique, or a combination of the two. Bonding should be delayed 2 weeks after bleaching. Microabrasion is a possible second choice for certain discolorations. These chosen bleaching techniques, when used in a professionally appropriate manner, seem as safe as other commonly used dental treatments.

Borates↗