The effects of seven carbamide peroxide bleaching agents on enamel microhardness over time. 2003

Roberta Tarkany Basting, and Antonio Luiz Rodrigues, and Mônica Campos Serra
Dentistry Research Center São Leopoldo Mandic, Campinas, Brazil.

BACKGROUND Different concentrations of carbamide peroxide (10 to 22 percent) have been used successfully as bleaching agents, but the adverse effects on enamel microhardness at different times are unknown. METHODS The authors analyzed seven bleaching agents and a placebo. The agents were applied on the surface of human dental fragments for eight hours per day for 42 days and stored in vials containing artificial saliva. Microhardness measurements were performed at baseline, eight hours and seven, 14, 21, 28, 35 and 42 days, as well as at seven and 14 days after treatment had ended. RESULTS Enamel treated with different bleaching agents or a placebo experienced a similar decrease in microhardness values over time, with the exception of fragments exposed to Opalescence PF 20 percent (Ultradent Products, South Jordan, Utah), or OPA20. Until the 49th day, the enamel exposed to OPA20 exhibited the lowest differences from baseline values. After 14 posttreatment days, enamel treated with placebo, Nite White 10 percent Excel (Discus Dental, Los Angeles), Nite White 16 percent Excel and Opalescence 10 percent exhibited the greatest differences from baseline values. An increase in enamel microhardness occurred at the end of the posttreatment period, although baseline values were not reached. CONCLUSIONS Different concentrations of carbamide peroxide agents result in decreases in enamel microhardness. A post-bleaching period in artificial saliva resulted in recovery of baseline microhardness values (one agent) or an increase in values, although baseline values were not reached for these products. Clinical Implications. Higher concentrations of carbamide peroxide containing 0.11 percent ion fluoride can bleach teeth in a shorter period, with fewer hazardous effects on the enamel mineral content.

UI MeSH Term Description Entries
D010545 Peroxides A group of compounds that contain a bivalent O-O group, i.e., the oxygen atoms are univalent. They can either be inorganic or organic in nature. Such compounds release atomic (nascent) oxygen readily. Thus they are strong oxidizing agents and fire hazards when in contact with combustible materials, especially under high-temperature conditions. The chief industrial uses of peroxides are as oxidizing agents, bleaching agents, and initiators of polymerization. (From Hawley's Condensed Chemical Dictionary, 11th ed) Peroxide
D003743 Dental Enamel A hard thin translucent layer of calcified substance which envelops and protects the dentin of the crown of the tooth. It is the hardest substance in the body and is almost entirely composed of calcium salts. Under the microscope, it is composed of thin rods (enamel prisms) held together by cementing substance, and surrounded by an enamel sheath. (From Jablonski, Dictionary of Dentistry, 1992, p286) Enamel,Enamel Cuticle,Dental Enamels,Enamel, Dental,Enamels, Dental,Cuticle, Enamel,Cuticles, Enamel,Enamel Cuticles,Enamels
D004338 Drug Combinations Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. Drug Combination,Combination, Drug,Combinations, Drug
D006244 Hardness The mechanical property of material that determines its resistance to force. HARDNESS TESTS measure this property. Hardnesses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006863 Hydrogen-Ion Concentration The normality of a solution with respect to HYDROGEN ions; H+. It is related to acidity measurements in most cases by pH pH,Concentration, Hydrogen-Ion,Concentrations, Hydrogen-Ion,Hydrogen Ion Concentration,Hydrogen-Ion Concentrations
D000077463 Carbamide Peroxide A urea peroxide compound that is commonly used in tooth whitening agents; topical anti-infective agents, and earwax remover. Perhydrol Urea,Urea Hydrogen Peroxide,Urea Peroxide,Hydrogen Peroxide, Urea
D012464 Saliva, Artificial A solution used for irrigating the mouth in xerostomia and as a substitute for saliva. Artificial Saliva
D014073 Tooth Bleaching The use of a chemical oxidizing agent to whiten TEETH. In some procedures the oxidation process is activated by the use of heat or light. Teeth Bleaching,Teeth Whitening,Tooth Whitening,Bleaching, Teeth,Bleaching, Tooth,Whitening, Teeth,Whitening, Tooth
D014089 Tooth Remineralization Therapeutic technique for replacement of minerals in partially decalcified teeth. Remineralization, Tooth

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