Search Results (15)

Background/Objectives: Tooth bleaching is a widely requested aesthetic procedure in modern dentistry. However, the structural effects of high-concentration peroxide-based bleaching agents on enamel remain insufficiently understood. This study aims to evaluate and compare the effects of three in-office bleaching agents—Opalescence Boost (40% hydrogen peroxide [HP]), Opalescence Quick (45% carbamide peroxide [CP]), and BlancOne Ultra + (35% hydrogen peroxide [HP])—on enamel surface characteristics and color change using confocal laser scanning microscopy (CLSM) and spectrophotometric analysis. Methods: Forty-two extracted human teeth were sectioned and divided into experimental and control halves. Each experimental specimen underwent bleaching according to the manufacturer’s protocol. Color measurements were conducted at baseline, immediately post-treatment, at 3 days, 7 days, and 6 months following treatment using the Vita Easyshade^® spectrophotometer. Color differences were calculated using the CIEDE2000 (ΔE₀₀) formula. Enamel surface morphology was assessed by CLSM. Data were analyzed using Wilcoxon and Kruskal–Wallis tests (p < 0.05), performed with SPSS v23. Results: All bleaching agents produced clinically perceptible color changes (ΔE₀₀ > 3.3). Opalescence Boost achieved the highest and most consistent whitening effect (mean ΔE₀₀ > 11), while Opalescence Quick showed moderate efficacy (ΔE₀₀ ~6–8), and BlancOne Ultra+ induced milder changes (ΔE₀₀ ~4–5). CLSM imaging revealed surface alterations in all bleached samples, with more pronounced changes observed in specimens treated with higher peroxide concentrations. Conclusions: All three bleaching systems were effective in improving enamel color, with Opalescence Boost delivering the most substantial and durable effect. CLSM analysis confirmed morphological changes in enamel without evidence of severe damage. These results underscore the importance of selecting bleaching protocols that balance efficacy with enamel safety. Further in vivo studies are recommended to validate long-term structural effects and support clinical decision-making. Full article

Objective: Esthetic dentistry is an important factor in increasing patients’ quality of life. This study aimed to investigate the impact of laser use on bleaching procedures for natural teeth and dental restorative materials. Methods: In January 2024, an electronic search was conducted using PubMed, Web of Science (WoS), and Scopus databases with the keywords (tooth) AND (laser) AND (bleaching), following PRISMA guidelines and the PICO framework. The initial search yielded 852 articles, of which 441 were screened. After applying inclusion criteria, 376 articles were excluded as they did not focus on the use of lasers in bleaching natural teeth and restorative materials. Consequently, 40 articles were included in the final review. Results: Of the 40 qualified publications, 29 utilized a diode laser, of which 10 authors concluded that it increases the whitening effect comparing classical methods. Three of included publications investigated the whitening of dental materials, while another three focused on endodontically treated teeth. Whitening procedures on ceramics effectively removed discoloration, but the resulting color did not significantly differ from the initial shade. Conversely, composite materials not only failed to bleach but also exhibited altered physical properties, thereby increasing their susceptibility to further discoloration. The KTP laser demonstrated promising outcomes on specific stains. The Er,Cr:YSGG and Er:YAG lasers also showed beneficial effects, although there were variations in their efficacy and required activation times. Conclusions: The findings partially indicate that laser-assisted bleaching improves the whitening of natural teeth. Further research on the effect of laser bleaching on the physical parameters of restorative materials is necessary. Full article

Background: The discoloration of endodontically treated anterior teeth poses a significant aesthetic concern for many individuals, impacting their confidence and self-image. Porcelain veneers have emerged as a popular solution for the aesthetic restoration of such teeth. This paper explores the role of porcelain veneers in addressing tooth discoloration, examining their efficacy, durability, and aesthetic outcomes via a clinical case. Case description: In this clinical case, an aesthetic restoration of a discolored central incisor was performed using a ceramic veneer. Due to the high degree of discoloration, an internal bleaching of the tooth was carried out prior to the final restoration. Various factors influencing the selection of porcelain veneers as a treatment modality, including shade matching, preparation techniques, and adhesive bonding, are discussed. Conclusions: The advancements in materials and techniques have enhanced the versatility and aesthetic appeal of porcelain veneers, making them a valuable option for achieving natural-looking and durable aesthetic restorations in individuals with discolored endodontically treated anterior teeth. Full article

Worldwide, synthetic compounds are used for both in-office and at-home dental care. They are a valuable resource for both prophylactic and curative treatments for various dental problems, such as tooth decay, periodontal diseases, and many more. They are typically preferred due to their broad range of actions and ability to produce targeted, rapid, and long-lasting effects. Using a 0.12% chlorhexidine mouthwash is capable of reducing the plaque index from 47.69% to 2.37% and the bleeding index from 32.93% to 6.28% after just 2 weeks. Mouthwash with 0.1% OCT is also highly effective, as it significantly lowered the median plaque index and salivary bacterial counts in 152 patients in 5 days compared to a control group (p < 0.0001), while also reducing the gingival index (p < 0.001). When povidone-iodine was used as an irrigant during the surgical removal of mandibular third molars in 105 patients, it resulted in notably lower pain scores after 2 days compared to a control group (4.57 ± 0.60 vs. 5.71 ± 0.45). Sodium hypochlorite is excellent for root canal disinfection, as irrigating with 1% NaOCl completely eliminated the bacteria from canals in 65% patients. A 0.05% CPC mouthwash proved effective for perioperative patient care, significantly decreasing gingival bleeding (p < 0.001) and suppressing Streptococcus levels even one week post-surgery. Lastly, a 6% H2O2 paint-on varnish and 6% H2O2 tray formulations successfully bleached the teeth of 40 patients, maintaining a noticeably whiter appearance up to the 6-month follow-up, with significant color differences from the baseline (p < 0.005). Synthetic compounds have a large research base, which also provides a greater awareness of their mechanism of action and potential adverse effects. For a better understanding of how they work, several methods and assays are performed. These are protocolary techniques through which a compound’s efficacy and toxicity are established. Full article

Background: Tooth whitening with peroxide is linked to a number of negative consequences. This study aimed to evaluate the effect of tooth bleaching and color safety using no-ozone cold atmospheric-pressure plasma (NCP) with distilled water (DW) and to assess the microhardness and mineral composition of the treated teeth. Methods: The enamel of 90 extracted human teeth were randomly assigned to three groups (n = 30): Group 1 (no treatment), Group 2 (NCP + DW), and Group 3 (only DW). The overall color change (ΔE) was observed at 10 min, 20 min, 30 min, 1 day, 7 days, 1 month, 3 months, and 6 months after treatment and quantified. Six cadavers treated with NCP and DW for 30 min were evaluated for color change using ShadeEye NCC and the VITA Easyshade. Furthermore, the microhardness and mineral composition of the teeth were evaluated using a Vickers hardness tester and an electro micro analyzer, respectively. All statistical data were analyzed at a significance level of 5%. Results: Group 1 showed no color change. The ΔE values of Group 2 were 17.67 and 5.62 times higher than those of Group 3 after 30 min and 6 months, respectively. Methylene blue solution revealed that the concentration of hydroxyl radicals was higher in Group 2. The average ΔE value using ShadeEye NCC for cadaveric teeth was 4.0. Evaluation via VITA Easyshade showed that the brightness was increased by 5 levels. No significant differences were observed among the groups in terms of the microhardness of the enamel and dentin or the Ca, P, Na, Cl, Zn, and Mg values in the enamel and dentin. Conclusions: Tooth bleaching using NCP with DW exhibited high efficacy without inducing damage or demineralization in the dental hard tissue. Full article

Background: Dental aesthetic procedures aim to rectify flaws in dental elements’ shape, alignment, or overly dark color. One of the most common dental aesthetic procedures is tooth whitening. This study attempts to introduce key aspects of bleaching and describe the different techniques and the mechanism of action of bleaching agents, focusing on the clinical implications in orthodontic and on composite restorations. Methods: The research was performed on PubMed, Web of Science, and Science Direct databases for articles on our topic published between 2017 and 2023, and we found a total of 1512 studies. In total, 57 papers were considered for the qualitative analysis in the review. Results: This study found that both carbamide peroxide and hydrogen peroxide were clinically effective, although patients’ level of tooth sensitivity seemed to be lessened by the latter. However, the latter appears to be more effective at reducing patient-experienced tooth sensitivity. Conclusion: Carbamide and hydrogen peroxide based whitening techniques were shown to be equally successful at treating tooth discoloration after bracket composite removal, with no discernible differences between them. To increase the effectiveness of whitening on composites, more research is needed. To achieve the desired results and avoid the negative effects of whitening gels on teeth and soft tissue, a patient-specific approach is advised. Full article

We investigated the physical properties and tooth-whitening effect of polymeric tooth-whitening compositions based on orally acceptable polymers, polyvinyl acetate (PVAc), ethyl cellulose (EC), and polyvinyl pyrrolidone. The tooth-whitening composition was prepared with hydrogen peroxide (H₂O₂) as a tooth-bleaching agent and an orally acceptable polymer through simple mixing and stirring in ethyl alcohol. PVAc and EC polymers showed non-erosive features and sustainable polymeric matrices in a similar oral environment. In particular, non-erosive PVAc polymer exhibited excellent adhesive and flexible film matrix on bovine teeth. PVAc-H₂O₂ tooth-whitening composition presented a residual H₂O₂ and an overall color change value (ΔE*) of 26.5% and 16.54%, respectively. The non-erosive polymeric composition is expected to improve tooth-whitening efficacy in various oral products. Full article

The objective of this article was to systematically review the literature to determine how effective tooth whitening procedures are when carried out in tandem with orthodontic clear aligners. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Online searches of PubMed, Medline via Ovid, Science Direct, the Cochrane database of systematic reviews via Ovid, Scopus, and Google Scholar as well as manual searches of the references of the selected articles were conducted. Clinical studies which assessed the efficacy of dental bleaching using orthodontic clear aligners were included in the present study. Data from the included studies were extracted and assessed for risk of bias using the Cochrane risk of bias tool. Three studies met the inclusion and exclusion criteria and were included in this study. One study compared the efficiency of tooth bleaching between clear aligners and conventional bleaching trays. One study evaluated the effectiveness of dental bleaching using clear aligners by comparing the tooth shade of those patients to a control group of patients who did not receive dental bleaching during orthodontic clear aligner treatment. One study evaluated the effectiveness of different concentrations of different bleaching agents using clear aligners. All the included studies showed an improved tooth shade when using clear aligners as bleaching trays. Full article

Pre-eruptive enamel lesions occur during tooth formation and include fluorosis, traumatic hypomineralization, and molar incisor hypomineralization. Minimally invasive treatment approaches, such as microabrasion, should be considered for these cases. This article presents a case series of three patients with pre-eruptive enamel defects in esthetically compromised tooth regions which were treated with the microabrasion technique: two fluorosis cases, moderate and advanced, and one hypomineralization case of traumatic etiology. In Cases 1 and 3, there was a significant improvement in esthetics with a total resolution of the enamel defects. However, a slight yellowish coloration may be detected at close observation. In Case 2 (advanced fluorosis), although there was no full resolution of the white spots, there was a clear improvement in esthetics. Microabrasion is a safe and effective, minimally invasive treatment for pre-eruptive enamel lesions. It does not require local anesthesia, it is less destructive than restorative interventions, and allows good esthetic outcomes with no significant postoperative sensitivity. Its efficacy is directly related to the lesions’ severity and depth. Although there are some limitations, further improvement can be achieved with dental bleaching. More invasive treatments might be considered if results are still unsatisfactory. Full article

The available tooth whitening products in the market contain high concentrations of hydrogen peroxide (H₂O₂) as an active ingredient. Therefore, in order to curb the high H₂O₂ concentration and instability of liquid H₂O₂, this study evaluated the efficacy and cytotoxicity of the bleaching gel composed of 10% calcium peroxide (CaO₂) and visible-light-activating nitrogen-doped titanium dioxide (N-TiO₂) with methyl cellulose as a thickener. Extracted bovine teeth were discolored using coffee and black tea stain solution and were divided into two groups (n = 6). Bleaching was performed thrice on each tooth specimen in both the groups, with one minute of visible light irradiation during each bleaching time. The CIELAB L*a*b* values were measured pre- and post-bleaching. The N-TiO₂ calcinated at 350 °C demonstrated a shift towards the visible light region by narrowing the band gap energy from 3.23 eV to 2.85 eV. The brightness (ΔL) and color difference (ΔE) increased as bleaching progressed each time in both the groups. ANOVA results showed that the number of bleaching significantly affected ΔE (p < 0.05). The formulated bleaching gel exhibits good biocompatibility and non-toxicity upon exposure to 3T3 cells. Our findings showed that CaO₂-based bleaching gel at neutral pH could be a stable, safe, and effective substitute for tooth whitening products currently available in the market. Full article

Burst release of carbamide peroxide (CP) from traditional hydrogels causes severe inflammation to periodontal tissues. The present study explores the development of a novel CP nanoemulgel (CP-NG), an oil-in-water nanoemulsion-based gel in which CP was loaded with a view to controlling CP release. CP solid dispersions were prepared, using white soft paraffin or polyvinylpyrrolidone-white soft paraffin mixture as a carrier, prior to formulating nanoemulsions. It was found that carrier type and the ratio of CP to carrier affected drug crystallinity. Nanoemulsions formulated from the optimized CP solid dispersions were used to prepare CP-NG. It was found that the ratio of drug to carrier in CP solid dispersions affected the particle size and zeta potential of the nanoemulsions as well as drug release behavior and tooth bleaching efficacy of CP-NG. Drug release from CP-NG followed a first-order kinetic reaction and the release mechanism was an anomalous transport. Drug release rate decreased with an increase in solid dispersion carriers. CP-NG obtained from the solid dispersion with a 1:1 ratio of CP to the polymer mixture is suitable for sustaining drug release with high tooth bleaching efficacy and without reduction of enamel microhardness. The developed CP-NG is a promising potential tooth bleaching formulation. Full article

Background: Dental bleaching has become an everyday procedure for treating teeth presenting discoloration, as a therapy on its own or as a part of restorative dentistry. The most widely used bleaching products available for vital teeth are hydrogen peroxide and carbamide peroxide, marketed as a range of products adapted to different treatment modes. The purpose of the study was to evaluate the clinical whitening efficacy of four high-concentration bleaching products for vital teeth applied in single in-office sessions. Methods: This clinical trial included 40 patients divided into four groups according to the concentration of the hydrogen peroxide-based (HP) product used (Group 1: HP 35%; Group 2: HP 37.5%; Group 3: HP 38%; Group 4: HP 40%). Each patient received one in-office whitening treatment of maxillary and mandibular anterior teeth (incisors, canines, and premolars), making a total of 791 teeth. The color changes produced in central incisors and canines were measured. Results: All groups underwent significant color changes from initial to final evaluations for color parameters L*, a*, and b*. No significant differences between the four groups were found for either the L* or a* parameters. Analysis of the b* parameter found significant differences between the HP 38% group and the HP 35% group. No significant differences in ΔE were found between the four groups (ANOVA p = 0.174). HP 38% obtained the highest ΔE (4.63), while HP 40% obtained 4.01. Conclusions: A single in-office whitening session, regardless of the bleaching product used, modifies tooth color effectively. All four products achieved increases in the L* parameter and significant reductions in parameters a* and b*. The ΔE did not show significant differences between the four groups. In-office whitening with high concentration hydrogen-peroxide-based products was found to be an effective treatment for moderate and severe dental discoloration. Full article

Background: In cases of moderate to severe dental discoloration, vital tooth whitening usually requires a prolonged treatment time if it is to obtain satisfactory outcomes. Variations in the clinical efficacy of whitening products in terms of their concentration and application time mean that we need to be aware of the real bleaching capacity of each whitening method and each product. This randomized clinical trial aimed to analyze with a spectrophotometer the effect of the number of in-office vital tooth whitening sessions (one or two) on the number of weeks of ensuing home whitening until color stability was obtained. Methods: Twenty patients with moderate/severe discoloration were treated with combined vital tooth whitening. Ten patients were treated with a single in-office session consisting of two applications of a product containing 40% hydrogen peroxide, followed by home treatment with individualized splints and a 16% carbamide peroxide gel (Group 1S). The other ten patients (Group 2S) were treated in two in-office sessions with two applications of the same product as Group 1S, followed in the same way by home treatment. Results: Comparing the two groups (1S and 2S), no significant differences in Euclidean distance (ΔE) were found after in-office whitening, or when color stabilization was obtained and home whitening ceased. Significant differences in the number of weeks of home whitening until color stabilization reached the same outcomes were found between 1S and 2S; 1S required a mean of 11.6 weeks home whitening, while 2S required 8.2 weeks. Conclusions: Combined tooth whitening with two in-office sessions significantly reduces the number of weeks (by three to four weeks) of subsequent home tooth whitening needed to reach color stabilization. Full article

This systematic review aimed to describe and characterize internal tooth bleaching techniques, conventional (walking-bleach) and combined (inside–outside), referring to their efficacy. The research was conducted on the main databases: PubMed, Cochrane Library, EMBASE, and Web of Science. Only randomized controlled trials and cohort studies were considered, on humans of 18 years old or older. A Population, Intervention, Comparison, Outcome (PICO) question was designed to evaluate the scientific evidence. The quality of each randomized controlled trial and cohort study was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions and the Methodological Index for Non-Randomized Studies (ROBINS-I), respectively. The walking-bleach and the combined techniques were both effective at the end of the treatment, obtaining similar aesthetic results. Regardless of the technique used, internal tooth bleaching is an effective procedure, with good aesthetic results, in the treatment of non-vital teeth. The cervical barrier is a standard of care in internal bleaching techniques and should be used. Considering the similarity in the esthetic results obtained in both techniques, the concentrations used for both, and since the biocompatibility of the bleaching agent is more important than its efficiency or speed in obtaining results, the combined technique should be considered the method of choice rather than the walking-bleach technique. Full article

Besides prevention of caries and periodontitis, an increasing number of oral care products focus on teeth whitening. The aim of this review is to summarize and discuss frequently used whitening agents and their efficacy from a chemical viewpoint. Therefore, a comprehensive literature survey on teeth whitening agents and products was conducted. The current whitening methods are analyzed and discussed from a chemist’s viewpoint. Frequently used whitening agents are abrasives (mechanical removal of stains), antiredeposition agents (prevention of deposition of chromophores), colorants (intended to lead to a white color), proteases (degradation of proteins), peroxides (oxidation of organic chromophores), and surfactants (removal of hydrophobic compounds from tooth surface). In-office bleaching using peroxides is effective, but side effects like tooth sensitivity or a damage of the natural organic matrix of enamel and dentin may occur. The applicability of abrasives in teeth whitening is limited due to potential tooth wear, especially when toothpastes with high RDA values are used. The effect of other whitening agents in vivo is often unclear because of a shortage of placebo-controlled clinical trials. Full article