Restor Dent Endod.  2023 Nov;48(4):e33. 10.5395/rde.2023.48.e33.

Evaluation of at-home bleaching protocol with application on different surfaces: bleaching efficacy and hydrogen peroxide permeability

• Forville H
• Favoreto MW
• Wendlinger M
• Dias RM
• Borges CPF
• Reis A
• Loguercio AD

• KMID: 2548754
• DOI: http://doi.org/10.5395/rde.2023.48.e33

Abstract

Objectives
This study aimed to evaluate the bleaching efficacy and hydrogen peroxide permeability in the pulp chamber by the at-home bleaching gel in protocols applied on different dental surfaces.
Materials and Methods
Forty premolars were randomly into 4 groups: control group no bleaching, only application on the buccal surface (OB), only application on the lingual surface (OL) and application in buccal and lingual surfaces, simultaneously (BL). At-home bleaching gel (White Class 7.5%) was used for the procedure. The bleaching efficacy was evaluated with a digital spectrophotometer (color change in CIELAB [ΔE_ab ] and CIEDE 2000 [ΔE₀₀ ] systems and Whitening Index for Dentistry [ΔWI_D ]). The hydrogen peroxide permeability in the pulp chamber (µg/mL) was assessed using UV-Vis spectrophotometry and data were analyzed for a 1-way analysis of variance and Tukey’s test (α = 0.05).
Results
All groups submitted to bleaching procedure showed bleaching efficacy when measured with ΔE_ab and ΔE₀₀ (p > 0.05). Therefore, when analyzed by ΔWI_D , a higher bleaching efficacy were observed for the application on the groups OB and BL (p = 0.00003). Similar hydrogen peroxide permeability was found in the pulp chambers of the teeth undergoing different protocols (p > 0.05).
Conclusions
The application of bleaching gel exclusively on the OB is sufficient to achieve bleaching efficacy, when compared to BL. Although the OL protocol demonstrated lower bleaching efficacy based on the ΔWI_D values, it may still be of interest and relevant in certain clinical scenarios based on individual needs, requiring clinical trials to better understand its specificities.

Keyword

Color shade; Dental enamel permeability; Hydrogen peroxide; Tooth bleaching; Tooth whitening

Figure

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  Figure 1 (A) In the forty premolars used, the roots were removed with a cut 3 mm from the cementoenamel junction and the access to the pulp chamber was slightly enlarged. (B) Measurement of enamel and dentin thickness on the buccal and lingual surfaces of the teeth using digital radiography. (C) Silicone guides were created for each specimen, and initial color measurements (pre-operative value) were taken using a digital spectrophotometer. (D) Acetate buffer solution was inserted into the pulp chamber of each specimen. (E) Acetate trays were made for all teeth and bleaching gel was applied according to each group (CO [no bleaching], OB, OL, and BL). (F, G) Acetate buffer solution was removed to the pulp chamber of each specimen. This process was repeated. (H) Leucocrystal violet solution, horseradish peroxidase enzyme, and ultrapurified water were added. (I) The final solution was read using UV–Vis spectrophotometer. (J)The same silicone guides were used, and final color measurements were taken using a digital spectrophotometer.CO, control group with no bleaching; OB, bleaching applied on the buccal surface only; OL, bleaching applied on the lingual surface only; BL, bleaching simultaneous applied on both buccal and lingual surfaces.

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