Effect of Short- and Long-term Use of Home and In-Office Bleaching with Carbamide Peroxide and Hydrogen Peroxide on Enamel Microhardness
Bleaching is a well-known esthetic dental treatment performed to lighten the tooth shade. Among different cosmetic dental procedures, including direct and indirect tooth-colored restorations, bleaching is likely the most conservative approach. Bleaching has been accepted well by patients and proven as a safe and effective approach. Objective: Tooth bleaching can be conducted at home or in offices. This study was performed to compare the enamel microhardness before bleaching and one and eight weeks after the application of different bleaching agents. Methods: Forty human premolars were randomly divided into four groups, and their buccal surface underwent a Vickers microhardness test before and after bleaching. Bleaching was performed with 40% hydrogen peroxide (HP) in-office bleaching agent (n = 10), 15% HP at-home bleaching agent (n = 10), and 15% carbamide peroxide (CP) at-home bleaching agent (n = 10) for two weeks. Ten samples were stored in artificial saliva and set as the control group. The microhardness of the samples was measured again one and eight weeks after bleaching. Results: The microhardness significantly decreased in the four groups one week after bleaching. Conclusion: The enamel microhardness was temporarily decreased by in-office bleaching. However, the microhardness increased with time and returned to the baseline value. Although the enamel microhardness initially reduced, it increased eight weeks after 15% CP at-home bleaching agent was applied.
Meireles SS, Fontes ST, Coimbra LA, Della Bona A, Demarco FF. Effectiveness of different carbamide peroxide concentrations used for tooth bleaching: an in vitro study. J Appl Oral Sci: Revista FOB. 2012; 20(2):186–91.
Sun L, Liang S, Sa Y, Wang Z, Ma X, Jiang T, et al. Surface alteration of human tooth enamel subjected to acidic and neutral 30% hydrogen peroxide. J Dent. 2011; 39(10):686–92.
de Geus JL, Wambier LM, Kossatz S, Loguercio AD, Reis A. At-home vs in-office bleaching: a systematic review and meta-analysis. Oper Dent. 2016; 41:341–56.
Mushashe AM, Coelho BS, Garcia PP, Rechia BN, da Cunha LF, Correr GM, et al. Effect of different bleaching protocols on whitening efficiency and enamel superficial microhardness. J Clin Exp Dent 2018; 10(8):e772–5.
Ghanbarzadeh M, Ahrari F, Akbari M, Hamzei H. Microhardness of demineralized enamel following home bleaching and laser-assisted in office bleaching. J Clin Exp Dent. 2015; 7(3):e405–9.
Gallagher A, Maggio B, Bowman J, Borden L, Mason S, Felix H. Clinical study to compare two in-office (chairside) whitening systems. J Clin Dent. 2003; 13(6):219–24.
Giannini M, Silva AP, Cavalli V, Paes Leme AF. Effect of carbamide peroxide-based bleaching agents containing fluoride or calcium on tensile strength of human enamel. J Appl Oral Sci: Revista FOB. 2006; 14(2):82–7.
Faus-Matoses V, Palau-Martinez I, Amengual- Lorenzo J, Faus-Matoses I, Faus-Liacer VJ. Bleaching in vital teeth: combined treatment vs i n-office t reatment. J C lin E xp D ent. 2019; 11(8):e754–8
Carey CM. Tooth whitening: what we now know. J Evid Based Dent Pract. 2014:14 suppl 70-6.
Dantas AA, Bortolatto JF, Roncolato A, Merchan H, Floros MC, Kuga MC, et al. Can a bleaching toothpaste containing Blue Covarine demonstrate the same bleaching as conventional techniques? An in vitro, randomized and blinded study. J Appl Oral Sci: Revista FOB. 2015; 23(6):609–13.
Khamverdi Z, Kasraee S. Invitro comparison between the effects of two tooth bleaching agents on surface micro hardness of microhybrid composite. Eur J Dent. 2007; 31(1–2):37–46.
Yost F. On the definition of microhardness. Metall Mater Trans A. 1983; 14(4):947–52. 13. Lewinstein I, Rotstein I. Effect of trichloracetic acid on the microhardness and surface morphology of human dentin and enamel. Endod Dent Traumatol. 1992; 8(1):16–20.
Lewinstein I, Ofek L, Gedalia I. Enamel rehardening by soft cheeses. Am J Dent. 1993; 6(1):46–8.
Polydorou O, Scheitza S, Spraul M, Vach K, Hellwig E. The effect of long-term use of tooth bleaching products on the human enamel surface. Odontology. 2018; 106(1):64–72.
Cakir FY, Korkmaz Y, Firat E, Oztas SS, Gurgan S. Chemical analysis of enamel and dentin following the application of three different at-home bleaching systems. Oper Dent. 2011; 36(5):529–36.
Toteda M, Philpotts CJ, Cox TF, Joiner A. Evaluation of a 6% hydrogen peroxide toothwhitening gel on enamel microhardness after extended use. Quintessence Int. (Berlin, Germany: 1985). 2008; 39(10):853–8.
Elfallah HM, Bertassoni LE, Charadram N, Rathsam C, Swain MV. Effect of tooth bleaching agents on protein content and mechanical properties of dental enamel. Acta Biomater. 2015; 20:120–8.
Vilhena KFB, Nogueira BCL, Fagundes NCF, Loretto SC, Angelica RS, Lima RR, et al. Dental enamel bleached for a prolonged and excessive time: Morphological changes. PLoS One. 2019; 14(4):e0214948.
Kutuk ZB, Ergin ECakir FY, Gurgan S. Effects of in-office bleaching agent combined with different desensitizing agents on enamel. J Appl Oral Sci. 2018; 27:e20180233.
Torres C, Zanatta RF, Silva TJ, Borges AB. Effect of calcium and fluoride addition to hydrogen peroxide bleaching gel on tooth diffusion, color, and microhardness. Oper Dent. 2019; 44(4):424– 32.
Chen X, Chen Z, Lin Y, Shao J, Yin L. Effects of tooth whitening agents and acidic drinks on the surface properties of dental enamel. Hua xi kouqiangyixue za zhi. 2013; 31(5):530–2.
Furlan IS, Bridi EC, Amaral F, Franca FMG, Turssi CP, Basting RT. Effect of high- or lowconcentration bleaching agents containing calcium and/or fluoride on enamel microhardness. Gen Dent. 2017; 65(3):66–70.
Attin T, Schmidlin PR, Wegehaupt F, Wiegand A. Influence of study design on the impact of bleaching agents on dental enamel microhardness: a review. Dent Mater. 2009; 25(2):143–57.
Imani MM, Azizi F, Bharami K, Golshah A, Safari-Faramani R. In vitro bleaching effect of hydrogen peroxide with different time of exposition and concentration on shear bond strength of orthodontic brackets to human enamel: a meta-analysis of in vitro studies. Int Orthod. 2020; 18:22–31.
Lilaj B, Dauti R, Agis H, Schmid-Schwap M, Franz A, Kanz F, et al. Comparison of bleaching products with up to 6% and with more than 6% hydrogen peroxide: whitening efficacy using BI and WID and side effects- An in vitro study. Front Physiol. 2019; 10:919.
Lewinstein I, Fuhrer N, Churaru N, Cardash H. Effect of different peroxide bleaching regimens and subsequent fluoridation on the hardness of human enamel and dentin. J Prosthet Dent. 2004; 92:337–42.
Al-Salehi SK, Wood DJ, Hatton PV. The effect of 24h non-stop hydrogen peroxide concentration on bovine enamel and dentine mineral content and microhardness. J Dent. 2007; 35:45–50.
Ulukapi H. Effect of different bleaching techniques on enamel surface microhardness. Quintessence Int 2007; 38:e201–5. 30. Joiner A, Thakker G, Cooper Y. Evaluation of a 6% hydrogen peroxide tooth whitening gel on enamel and dentine microhardness in vitro. J Dent 2004; 32:27–34.
Ameli, N., Kianvash Rad, N., Nikpour, F., Ghorbani, R., & Mohebi, S. Effect of Short- and Long-term Use of Home and In-Office Bleaching with Carbamide Peroxide and Hydrogen Peroxide on Enamel Microhardness. J Dent Indones. 2020;27(2): 50-55
Dental Hygiene Commons, Dental Materials Commons, Endodontics and Endodontology Commons, Health Economics Commons, Oral and Maxillofacial Surgery Commons, Oral Biology and Oral Pathology Commons, Orthodontics and Orthodontology Commons, Pediatric Dentistry and Pedodontics Commons, Periodontics and Periodontology Commons