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This laboratory investigation was designed to test the influence of a novel bleaching formulation based on phthalimidoperoxycaproic acid (PAP) with additives on the surface and mechanical properties of nano- and micro-hybrid restorative composites. Twenty-four bar-shaped and twelve disk-shaped samples from each restorative composite were prepared. The samples from each restorative composite were randomly divided into two groups according to the treatment, i.e., experimental and control. The treated groups went through the bleaching process: by Opalescence Regular or novel PAP+-containing gel (HiSmile™). The treated group underwent a bleaching process for seven consecutive days (a 10-min session of bleaching application every day) before the properties were tested. A paired sample t-test was performed to compare the results between the experimental and the control groups. The level of significance was set at 0.05. The surface roughness of the nanohybrid composite using Opalescence Regular (p < 0.05) was significant. Additionally, a significant difference in nanohardness and elastic modulus between the experimental and the control groups of the microhybrid composite using Opalescence Regular was observed: p = 0.041 and p = 0.023, respectively. While a marked difference in flexural strength was observed in the experimental and control groups using Opalescence Regular, Hismile™ bleaching gel caused a diminutive and insignificant reduction in tested properties (p > 0.05). It was found that Opalescence Regular bleaching gel affects the surface and bulk properties of restorative composite materials, whereas the novel PAP+ formulation has no deleterious effect on either nano- or micro-hybrid restorative composites. Full article

(1) This study investigated the whitening effect, cytotoxicity and enamel surface alterations induced by different over-the-counter (OTC) bleaching agents in comparison to hydrogen peroxide. (2) Human teeth (n = 60) were randomly assigned into 6 groups (n = 10), stained with coffee solution for 7 d, followed by a whitening period of 7 d with either placebo, bromelain, sodium bicarbonate, sodium chlorite, PAP or hydrogen peroxide. Color measurements were performed with a spectrophotometer. Scanning electron micrographs (SEM) were taken to assess the enamel structure. Cytotoxicity of the tested substances was assessed based on the cell viability of primary human fibroblasts. (3) The application of all whitening gels resulted in a greater color difference of the enamel (ΔE) in comparison to the negative control. Hydrogen peroxide caused the greatest color difference. Bromelain and PAP treatment showed no enamel surface changes, in contrast to hydrogen peroxide treatment, which showed very mild interprismatic dissolution. Bromelain was the only non-cytotoxic agent. (4) The maximum effect achieved by all OTC bleaching agents was the removal of stains, whereas hydrogen peroxide was capable of further whitening the teeth. Bromelain treatment was neither cytotoxic, nor resulted in enamel surface alterations, and its whitening effect was less, yet still effective, compared to hydrogen peroxide. Full article

Background: Traditional bleaching agents based on hydrogen peroxide (HP) or carbamide peroxide (CP) have adverse soft and hard tissue effects. Objectives: This study tested a novel formulation of phthalimidoperoxycaproic acid (PAP) with additives to optimise its safety and effectiveness. Methods: A novel gel (PAP+) was formulated. Laboratory studies assessed effects of six 10-minute exposures to PAP+ vs. commercial CP and HP gels, using surface profilometry and microhardness. The effectiveness of PAP+ in vitro against complex polyphenol stains on enamel was compared to 6% HP. Results: Unlike HP gels, PAP+ gel did not erode enamel. Unlike both CP and HP gels, PAP+ gel did not reduce the surface microhardness of enamel. PAP+ gel on used on polyphenol stains was superior to 6% HP. In this model, six repeated 10-minute treatments with PAP+ gel could improve the shade by approximately eight VITA^® Bleachedguide shades. Conclusions: These laboratory results support the safety and effectiveness of this new PAP formula and its use as an alternative to CP and HP with superior safety and effectiveness. Full article