Search Results (36)

This study aimed to evaluate the effect of experimental bleaching gels containing chitosan and theobromine and compare their performance in terms of tooth surface roughness, microhardness, and colour change with the bleaching gels BioWhiten ProHome and FGM Whiteness Perfect. One hundred and forty-four upper central incisors were used for microhardness, surface roughness, and colour change analyses (n = 12). Prior to bleaching, surface roughness was measured using a profilometer, microhardness was analysed using a Vickers hardness test, and colour was measured using a spectrophotometer. For Group 1, the treatment consisted of an experimental gel containing chitosan–theobromine (16% CP); for Group 2, it was an experimental gel containing chitosan–theobromine (6% HP); for Group 3, it consisted of BioWhiten ProHome (6% HP); and for Group 4, it consisted of FGM Whiteness Perfect (16% CP). Microhardness and surface roughness tests were performed under the same conditions before bleaching, after bleaching, and 14 days after the initial treatment. Colour analysis was performed before the bleaching, during the application, 24 h after bleaching, and at 7 and 14 days after treatment. p < 0.05 was considered significant. No statistically significant increase in microhardness values after bleaching was detected in any group (p > 0.05), effective bleaching was detected in all groups, and the highest efficacy was observed in Group 4 (p < 0.05). The experimental gels containing theobromine and chitosan resulted in effective bleaching and did not exert any negative effects regarding surface roughness or microhardness. Full article

This study aimed to compare tooth mineralization and color changes achieved with two experimental bleaching gels containing chitosan and theobromine (16% CP or 6% HP, Group 1, 2) with the FGM Whiteness Perfect (16% CP) (Group 3) and BioWhitenProHome (6% HP) (Group 4). Ninety-six maxillary central teeth were divided into two groups for color and mineral evaluations. These groups were then further divided into four subgroups according to the bleaching agent (n = 12). Mineral analysis was performed with SEM-EDX before the bleaching, at the end of the treatment, and two weeks after treatment ended to assess changes. Color measurement was performed with a spectrophotometer before bleaching, on the 7th day of treatment, 24 h after final treatment, and two weeks after treatment ended. No significant difference among the groups was found in color change (p > 0.05), while mineralization differed significantly (p < 0.05). The ΔE₀₀₃ values of Group 4 and Group 2 were found to be close to each other. The highest calcium loss was detected in Group 3, whereas the most pronounced decrease in phosphorus values was observed in Group 4. Using theobromine and chitosan can provide clinicians with positive results for bleaching treatments, such as using lower HP concentrations and avoiding side effects. Full article

Background and Objectives: The rapid increase of whitening products use raises questions about enamel safety. We compared three high-concentration protocols—Opalescence Quick (45% carbamide peroxide ≈ 15% H₂O₂), Opalescence Boost (40% H₂O₂), and BlancOne Ultra (35% H₂O₂ + LED)—under controlled conditions to balance color change (ΔE) with enamel integrity (microhardness, FTIR). We also constructed a qualitative cytotoxicity risk profile from published data; no biological assays were performed in this study. Methods: Seventy-two matched half-crowns were randomized to Control or one of the three protocols. Outcomes were a change in Vickers microhardness, spectrophotometric color difference, and FTIR carbonate-to-phosphate ratio after 24 h in artificial saliva. We also compiled a qualitative cytotoxicity risk profile from published evidence; no biological assays were performed. One-way ANOVA with Tukey HSD on Δ-scores, Shapiro–Wilk and Levene’s tests for assumptions, Welch’s t-tests for tooth-class comparisons, and Pearson correlation between ΔE and ΔMH. Results: All active protocols produced clearly visible whitening (mean ΔE 5.7–6.3). Hydrogen-peroxide gels showed greater hardness loss and carbonate depletion than the carbamide-peroxide gel under similar contact time. The association between greater shade change and hardness loss was moderate and not predictive for individuals. Conclusions: Under harmonized conditions, all systems whitened effectively. Pursuing changes beyond ~6 units offered little extra benefit while increasing enamel impact. Carbamide-based Opalescence Quick achieved comparable aesthetics with lower acute enamel effects. Clinicians should individualize exposure time and pair in-office whitening with short-term remineralising care. Cytotoxicity comments are qualitative and literature-based only. Full article

Tooth whitening is increasingly sought in both clinical and home settings, raising concerns about the efficacy and safety of various whitening agents and their delivery systems. This narrative review compares the whitening performance and biocompatibility of active ingredients, including hydrogen peroxide, carbamide peroxide, activated charcoal, sodium bicarbonate, fluoride compounds, and blue covarine, with particular emphasis on the role of polymer-based carriers in formulation strategies. Hydrogen peroxide and carbamide peroxide remain the most effective agents for intrinsic whitening, but are associated with risks of enamel surface alterations, microhardness reduction, and potential cytotoxicity, particularly at higher concentrations. Sodium bicarbonate provides moderate whitening effects through extrinsic stain removal, while fluoride compounds play a supportive role by reducing demineralization and tooth sensitivity, thereby preserving enamel integrity. These properties make them valuable adjuncts or alternatives for patients with high sensitivity risks. Blue covarine offers immediate optical effects without inducing intrinsic color changes, whereas activated charcoal poses risks of enamel abrasion and surface roughness with limited long-term efficacy. Polymer-based carriers such as Carbopol gels, polyvinylpyrrolidone, and hydroxypropyl methylcellulose are incorporated into whitening formulations to improve viscosity, adhesion, and modulate the release of active ingredients. These polymers might help minimize diffusion of bleaching agents into deeper dental tissues, potentially reducing cytotoxic effects, and may improve handling characteristics. However, dedicated studies evaluating the unique advantages of polymers in different whitening systems remain limited. A comprehensive understanding of both the active ingredients and delivery technologies is critical to balancing esthetic outcomes with long-term oral health. From a clinical perspective, polymer-based carriers might contribute to reducing whitening-related tooth sensitivity, improving patient comfort, and providing more predictable treatment outcomes. Continued research is needed to clarify optimal formulations and application protocols, ensuring safer and more effective tooth-whitening practices in both clinical and home-use scenarios. Full article

Background: The rising demand for aesthetic dental treatments has spurred interest in peroxide-free color correctors as alternatives to traditional hydrogen peroxide formulations, which are associated with tooth sensitivity and potential enamel demineralization. This systematic review evaluates the whitening efficacy and safety profile of hydrogen peroxide-free color corrector (HPFCC) products, focusing on color change metrics, enamel and dentin integrity, and adverse effects. Methods: Following PRISMA guidelines, we searched PubMed, Scopus, and Web of Science throughout January 2025 for randomized controlled trials, observational studies, and in vitro experiments comparing HPFCC to placebo or peroxide-based agents. The data extraction covered study design, sample characteristics, intervention details, shade improvement (ΔE00 or CIE Lab), enamel/dentin mechanical properties (microhardness, roughness, elastic modulus), and incidence of sensitivity or tissue irritation. Risk of bias was assessed using the Cochrane tool for clinical studies and the QUIN tool for in vitro research. Results: Six studies (n = 20–80 samples or subjects) met the inclusion criteria. In vitro, HPFCC achieved mean ΔE00 values of 3.5 (bovine incisors; n = 80) and 2.8 (human molars; n = 20), versus up to 8.9 for carbamide peroxide (p < 0.01). Across studies, HPFCC achieved a mean ΔE00 of 2.8–3.5 surpassing the perceptibility threshold of 2.7 and approaching the clinical acceptability benchmark of 3.3. Surface microhardness increased by 12.9 ± 11.7 VHN with HPFCC (p < 0.001), and ultramicrohardness rose by 110 VHN over 56 days in prolonged use studies. No significant enamel erosion or dentin roughness changes were observed, and the sensitivity incidence remained below 3%. Conclusions: These findings derive from one clinical trial (n = 60) and five in vitro studies (n = 20–80), encompassing violet-pigment serums and gels with differing concentrations. Due to heterogeneity in designs, formulations, and outcome measures, we conducted a narrative synthesis rather than a meta-analysis. Although HPFCC ΔE00 values were lower than those of carbamide peroxide, they consistently exceeded perceptibility thresholds while maintaining enamel integrity and causing sensitivity in fewer than 3% of subjects, supporting HPFCCs as moderate but safe alternatives for young patients. Full article

Objective: To evaluate the color stability and microhardness of resin-based bioactive composites after brushing with over-the-counter whitening toothpastes. Methods: A conventional resin (Luna 2) and two bioactive resins (Stela Mix and Activa Presto) were tested. Four toothpastes were used: Colgate Fresh Gel (control), Colgate Max White, Yotuel, and Crest 3D White. Forty disks of each material were prepared and divided into four subgroups. The disks were brushed to simulate three months of daily brushing. Microhardness and color changes were measured before and after brushing. Color variation was calculated using the ΔE_ab, ΔE₀₀, and ΔWI_D indexes. Wilcoxon and two-way ANOVA tests were performed (p < 0.05). Results: In the Luna 2 and Stela groups, the b* parameter decreased significantly with all toothpastes (p < 0.05), while lightness and a* remained stable with no significant differences (p > 0.05). Stela Mix and Activa Presto exhibited color changes within the “moderately unacceptable” range according to ΔE₀₀ (>1.8 and ≤3.6). Based on the ΔWI_D index, Luna 2 showed the highest variation when treated with Colgate Max (2.14 ± 1.33) and the lowest in the control group (1.08 ± 0.56A), remaining within acceptable margins with all treatments. The microhardness values before/after treatment remained for Luna 2 between 77.44 and 76.97; for Stela Mix between 76.24 and 74.13; and for Activa presto between 74.5 and 71.33. Differences were not significant for any of the pastes within each composite (p > 0.05). Conclusions: The evaluated bioactive resins exhibited color changes within the moderately unacceptable range. Colgate Max White induced the most significant color changes. Microhardness was not affected by treatment with whitening toothpastes. Full article

This in vitro study evaluated the effects of incorporating quercetin (QC) at varying concentrations (0.25%, 0.5%, and 1%) into a 35% hydrogen peroxide (H₂O₂) bleaching gel on esthetic outcomes, enamel hardness and roughness, and H₂O₂ transamelodentinal diffusion. Bovine enamel/dentin discs (n = 180; 12/per group for each analysis) were allocated into five groups: (1) negative control (NC), (2) 35% H₂O₂ (HP), (3) HP + 0.25% QC, (4) HP + 0.5% QC, and (5) HP + 1% QC. Treatments were applied for 40 min per session across three sessions with 7-day intervals. Color changes were evaluated using the CIELab* color system (ΔE_ab), with further analysis performed using the CIEDE2000 formula (ΔE₀₀) and the whitening index (ΔWI_D). Enamel surface hardness, roughness, cross-sectional hardness, and H₂O₂ diffusion were also evaluated. Data were analyzed using ANOVA, followed by the Student–Newman–Keuls test, with statistical significance set at p < 0.05. All experimental gels resulted in significant color changes (p < 0.001), with similar ΔE_ab, ΔE₀₀, and ΔWI_D across QC groups. The HP group showed greater reductions in hardness and increased roughness compared to others (p < 0.0001), while the HP/1%QC group resulted in no statistically significant alterations under the tested conditions. H₂O₂ diffusion was significantly greater in the HP group, while it was notably lower in the HP/1%QC group (p < 0.05). The incorporation of 1% quercetin into a 35% H₂O₂ gel maintains its bleaching efficacy while protecting enamel properties and reducing hydrogen peroxide diffusion. Quercetin-enriched H₂O₂ gels may enhance bleaching safety by protecting dental tissues while maintaining esthetic benefits. Full article

Background/Objectives: The objective of this review is to establish a solid base of information regarding the use of proteolytic enzymes to replace hydrogen peroxide/carbamide in teeth whitening products. The use of proteolytic enzymes, such as bromelain and papain, can provide surprising results for solving two important aspects related to dental aesthetics: tooth whitening and the chemo-mechanical removal of damaged dental tissue. Due to their ability to degrade salivary proteins, these enzymes can be used successfully as active agents in tooth whitening and in the atraumatic treatment of caries without being accompanied by other side effects on dental components. Methods: Random-effects meta-analyses were performed with enzymes (bromelain, papain) used in dentistry. A keyword search of scientific publications was conducted using the Google Academic, Web of Science and PubMed search engines. Results: The results were systematized in the present work in two parts: bromelain and papain effects in tooth whitening and chemo-mechanical/atraumatic removal of damaged dental tissues. Conclusions: The findings from different studies and clinical reports indicate that bromelain and papain could be considered efficient and safe therapeutic agents not only in various medical conditions but also in dental problems. Full article

This study aimed to evaluate the micro-nanostructure and color changes of dental enamel after treatment with new gel formulations containing papain or bromelain. Eighty caries-free, extracted human teeth were randomly divided into two groups (n = 40) and stained by immersion in either coffee or Tedi juice for 4 h daily over five consecutive days. After staining, the samples were washed and stored in artificial saliva at 37 °C. The stained samples were then treated with four different whitening gels (GC, G1, G2, and Opalescence 15%) for 4 h daily. Following each treatment, the samples were rinsed and stored in artificial saliva. Color changes were measured using a digital spectrophotometer to assess CIEL*a*b* ΔE* and the Whiteness index (WI). The enamel micro-nanostructure was analyzed using SEM and AFM. Data were statistically analyzed using one-way ANOVA followed by Tukey’s HSD test. The results showed that gels containing papain and bromelain were more effective than the commercial gel in removing stains. SEM and AFM analysis indicated that papain was particularly effective for removing coffee stains, while bromelain was better for stains from natural juices. Healthy enamel has a Ra value of approximately 10 nm, which increases to about 40 nm after staining. Papain restored enamel roughness to approximately 8 nm for coffee stains and bromelain restored it to 11 nm for juice stains, delivering optimal results, while commercial gel ensures a roughness of about 15 nm after stain removal. CIELAB reveals notable changes in ΔE and WI after bleaching, revealing that papain gel is optimal for coffee stain removal and bromelain gel is optimal for natural juice stains. In conclusion, dental stains should be assessed by a dentist to determine the most suitable gel for achieving optimal results. Full article

Objectives: Potential adverse effects and pH-related effectiveness of bleaching agents have raised some concerns. The aim of this study was to compare three bleaching agents containing hydrogen peroxide (HP) and carbamide peroxide (CP) in terms of whitening effectiveness, pH variation, and changes in enamel surface roughness. Methods: After controlled staining with a black tea solution, 42 human enamel specimens underwent bleaching treatment using the following agents: HP 40%; HP 35%; CP 16%. Color changes were evaluated according to the CIEDE2000 system. Gel pH was measured before and after each application. Surface roughness (Sa) was assessed through optical 3D profilometry before and after bleaching treatment. Results: The whitening effectiveness was similar for HP 40% and HP 35% while CP 16% had significantly lower results. HP 40% showed a remarkable pH acidification (−0.41), while HP 35% and CP 16% showed a mild increase in pH values (+0.26 and +0.03, respectively), and the differences between HP 40% and HP 35% and between HP 35% and CP 16% were statistically significant. Sa slightly decreased in all groups after bleaching, with no significant differences among them and a significant difference in HP 40% before and after treatment. Conclusions: Similar bleaching results were achieved regardless of pH and HP concentration for HP-based agents, while a lower bleaching effect was observed for the less concentrated CP-based agent, as anticipated. Higher HP and greater tendency to pH instability induced more pronounced modifications of surface roughness. This in vitro study suggests that bleaching gels with neutral and stable pH ensure good bleaching effectiveness and are less likely to cause enamel surface changes. Full article

Background/Objectives: Tooth whitening is a cosmetic dental treatment that improves the color of natural teeth, making them whiter and brighter; this review aimed to evaluate the greater effectiveness of in-office, at-home, and combined bleaching with hydrogen or carbamide peroxide, also in relation to possible relapses and side effects (tooth sensitivity). Methods: A literature search has been carried out through electronic databases, PubMed/MEDLINE, and Cochrane Library, focused on the use of the effectiveness of in-office, at-home, and combined dental bleaching. This review has been registered on PROSPERO (ID613248). Results: 30 articles have been included. Most of the studies did not find any more effective treatment than the proposed treatments; all types of bleaching have been shown to be effective in changing color; in the studies that have compared in-office and at-home bleaching, there was a lower recurrence of treatment with the use of the at-home trays with carbamide peroxide gel. There were no clear positions regarding tooth sensitivity, which would appear to be higher in professional in-office and combined dental bleaching. Conclusions: Bleaching is an effective treatment for the change of color of the tooth regardless of the type used (concentrations, type of gel, and duration of sessions), although, at home, it would seem to be more effective over time. It is, however, a clinical feature that may give a risk of tooth sensitivity after treatment. Full article

Introduction: In recent years, tooth whitening has become one of the most popular ways of achieving the original tooth color. The effect of whitening gel can be improved through heat, light or laser. The bond strength between the enamel and the composite can be reduced through bleaching and laser radiation. The purpose of this study is to assess the shear bond strength of resin composite to enamel after a bleaching process using hydrogen peroxide, with and without a laser (970 nm and 445 nm lasers). Method: This study used 51 extracted anterior teeth without caries that were divided into three groups. A 40% hydrogen peroxide gel was used on the enamel of all teeth. The control group received bleaching without a laser. Both the second and third treatment groups received bleaching with a laser, one with 970 nm and the other with 445 nm. After the bleaching process, all groups had etching, bonding and curing of the composite performed. Lastly, the shear bond strength between the enamel and the composite was measured and the failure modes were recorded. The data were compared using a one-way ANOVA test. Results: The mean shear bond strength between the enamel and the composite in the 445 nm group three (445 nanometer) was significantly lower than the other groups (p < 0.05). There was no significant difference between the control and the 970 nm groups (p = 0.2). Conclusion: According to the laser wavelengths and parameters that were used in this study and the results of this study, office bleaching with a 445 nm laser weakened the shear bond strength between the enamel and the composite. Full article

The basis of modern tooth whitening systems is the use of a whitening gel, which usually contains hydrogen peroxide or carbamide peroxide. The study included 81 patients aged 22 to 35 years with a tooth color A2 and a darker color on the Vita Classic scale. The purpose of our research was to identify a new approach to whitening teeth to improve safety and gentleness. To perform this, we assessed the effect of the tooth whitening procedure on the mineral composition of the oral fluid. A new approach to the teeth whitening procedure was to use a mouth retractor and a tool for aspirating the whitening gel, which we developed. Before the procedure, a protective film-forming aerosol, which included sodium ascorbate, was applied. After the tooth whitening procedure, the enamel was remineralized with a sealing liquid for 14 days. The concentrations of calcium and phosphorus in the oral fluid were determined using a spectrophotometer with a set of reagents (Human). The results obtained indicate that the new approach to the teeth whitening procedure contributed to less pronounced changes in the concentrations of calcium (+29.07, p < 0.001) and phosphorus (−14%, p < 0.001) in the oral fluid immediately after the procedure and in combination with the standard procedure for teeth whitening; immediately after this procedure, the calcium concentration increased by 74.4% (p < 0.001), and the phosphorus concentration decreased by 23.07% (p < 0.001). The use of remineralizing agents led to a faster recovery of the initial levels of calcium and phosphorus in the oral fluid. Full article

Laser-activated tooth bleaching is discussed as a means to optimize results, while minimizing adverse side effects, but it lacks consensus in the scientific literature. Therefore, this systematic review aims to evaluate the protocols and outcomes of laser-activated vs. non-activated bleaching methods for safe and effective approaches. The PubMed, Cochrane, Scopus, ScienceDirect, and Google Scholar search engines, with the following MeSH terms and keywords: (bleaching OR whitening) AND laser AND (tooth OR dental OR enamel OR dentine), were used to identify human clinical trials and in vitro studies regarding laser-activated dental bleaching. After applying the keywords and additional filters, and inclusion and exclusion criteria, the final number of included articles was 19 clinical and 20 in vitro studies. Laser activation yielded no significant color improvement, but reduced gel contact time (10 min). Laser-activated bleaching required 24% less hydrogen peroxide (HP) concentration to achieve similar results. Additionally, there were no significant differences in terms of sensitivity and hard tissue alterations between the laser-activated and conventional groups. The benefits associated with laser-activated bleaching render it a compelling option. Nevertheless, a comprehensive evaluation of bleaching gels and activation protocols is imperative. Ultimately, this analysis provides clinical guidance pertaining to the facilitatory employment of laser irradiation. Full article

Hand hygiene is a crucial measure in the prevention and control of infections, and there is a growing awareness among individuals who are making a conscious effort to maintain hand cleanliness. With the advent of the SARS-CoV-2 outbreak, the demand for hand hygiene products has also gradually shifted towards those with antimicrobial properties. Among these products, hand sanitizer gels (HSGs) have gained considerable popularity as an efficient method of hand cleaning, due to their rapid drying and sustained antimicrobial efficacy. Concurrently, there has been a growing interest in novel HSGs that offer additional functions such as skin whitening, moisturizing, and anti-inflammatory effects. These novel HSGs effectively address concerns associated with the ingestion of antimicrobial ingredients and demonstrate reduced skin irritation, thereby alleviating hand dermatological issues. This review provides an extensive overview of the application scenarios, classification, and challenges associated with HSGs while emphasizing the emergence of novel components with biological functions, aiming to contribute to the advancement of hand hygiene practices and offer novel insights for the development of novel HSGs with outstanding antimicrobial properties with other multiple biological functions and desirable biosafety profiles. Full article