Top

Published in:

01-05-2019 | Original Article

Influence of different thickeners in at-home tooth bleaching: a randomized clinical trial study

Authors: Juliana do Carmo Públio, Marília Zeczkowski, Jonny Burga-Sánchez, Gláucia Maria Bovi Ambrosano, Franscico Carlos Groppo, Flávio Henrique Baggio Aguiar, Débora Alves Nunes Leite Lima

Published in: Clinical Oral Investigations | Issue 5/2019

Abstract

Objectives

To evaluate the effects of 10% carbamide peroxide (CP) with two different thickeners, carbopol (CPc) and natrosol (CPn), on color variation (CV), tooth sensitivity (TS), and cytotoxicity (CC).

Methods

Seventy subjects were distributed into the CPc or CPn groups (n = 35), in a parallel group, randomized, controlled, single-blind clinical trial. Bleaching gels were used by volunteers for 4 h daily for 2 weeks. Color evaluation was performed using a reflectance spectrophotometer, before bleaching treatment (BT), immediately after the first and second weeks of BT, and 1 week and 1 month after BT ended. TS was evaluated using two pain scales, before, during, and after BT. CC was evaluated using MTT after exposure of MDPC-23 cells to the bleaching gels for 4 h. Epoxy replicas of the subjects teeth were made before and after BT and analyzed using a scanning electronic microscope. The data was analyzed using statistical methods.

Results

CV and TS showed similar variation between both bleaching gels (p ≤ 0.05). None of the protocols affected cellular metabolism or the surface morphology of enamel.

Conclusions

Bleaching gels with carbopol and natrosol as thickening agents produced similarly effective tooth bleaching and TS, but did not cause cytotoxicity.

Clinical relevance

Natrosol could be an alternative as a thickener used in bleaching gels due to its similar bleaching effect and TS when compared with Carbopol.

Meireles SS, Goettems ML, Dantas RV, Bona ÁD, Santos IS, Demarco FF (2014) Changes in oral health related quality of life after dental bleaching in a double-blind randomized clinical trial. J Dent 42(2):114–121. https://doi.org/10.1016/j.jdent.2013.11.022 CrossRefPubMed

Serraglio CR, Zanella L, Dalla-Vecchia KB, Rodrigues-Junior SA (2016) Efficacy and safety of over-the-counter whitening strips as compared to home-whitening with 10% carbamide peroxide gel-systematic review of RCTs and metanalysis. Clin Oral Investig 20(1):1–14. https://doi.org/10.1007/s00784-015-1547-8 CrossRefPubMed

Almeida AF, Torre Edo N, Selayaran Mdos S, Leite FR, Demarco FF, Loguercio AD et al (2015) Genotoxic potential of 10% and 16% carbamide peroxide in dental bleaching. Braz Oral Res 29(21):1–7. https://doi.org/10.1590/1807-3107BOR-2015.vol29.0021 CrossRef

Wang Y, Gao J, Jiang T, Liang S, Zhou Y, Matis BA (2015) Evaluation of the efficacy of potassium nitrate and sodium fluoride as desensitizing agents during tooth bleaching treatment-a systematic review and meta-analysis. J Dent 43(8):913–923. https://doi.org/10.1016/j.jdent.2015.03.015 CrossRefPubMed

ADA (2012) Home-use tooth stain removal products. http://www.ada.org/sections/ scienceAndResearch/pdfs/guide_home_stain.pdf. Accessed 28 August 2013

Pintado-Palomino K, Peitl Filho O, Zanotto ED, Tirapelli C (2015) A clinical, randomized, controlled study on the use of desensitizing agents during tooth bleaching. J Dent 43(9):1099–1105. https://doi.org/10.1016/j.jdent.2015.07.002 CrossRefPubMed

Kose C, Calixto AL, Bauer JR, Reis A, Loguercio AD (2016) Comparison of the effects of in-office bleaching times on whitening and tooth sensitivity: a single blind, randomized clinical trial. Oper Dent 41(2):138–145. https://doi.org/10.2341/15-085-C CrossRefPubMed

Costa CA, Riehl H, Kina JF, Sacono NT, Hebling J (2010) Human pulp responses to in-office tooth bleaching. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109(4):59–64. https://doi.org/10.1016/j.tripleo.2009.12.002 CrossRef

Lima AF, Ribeiro AP, Soares DG, Sacono NT, Hebling J, de Souza Costa CA (2013) Toxic effects of daily applications of 10% carbamide peroxide on odontoblast-like MDPC-23 cells. Acta Odontol Scand 71(5):1319–1325. https://doi.org/10.3109/00016357.2012.762992 CrossRefPubMed

10.

Públio JC, D'Arce MB, Brunharo NM, Ambrosano GM, Aguiar FH, Lovadino JR, Lima DA (2013) Influence of surface treatments on enamel susceptibility to staining by cigarette smoke. J Clin Exp Dent 5(4):163–168. https://doi.org/10.4317/jced.51097 CrossRef

11.

Zeczkowski M, Tenuta LM, Ambrosano GM, Aguiar FH, Lima DA (2015) Effect of different storage conditions on the physical properties of bleached enamel: an in vitro vs. in situ study. J Dent 43(9):1154–1161. https://doi.org/10.1016/j.jdent.2015.06.004 CrossRefPubMed

12.

Leonard RH Jr, Eagle JC, Garland GE, Matthews KP, Rudd AL, Phillips C (2001) Nightguard vital bleaching and its effect on enamel surface morphology. J Esthet Restor Dent 13(2):132–139. https://doi.org/10.1111/j.1708-8240.2001.tb00435.x CrossRefPubMed

13.

Navarra CO, Reda B, Diolosà M, Casula I, Di Lenarda R, Breschi L et al (2014) The effects of two 10% carbamide peroxide nightguard bleaching agents, with and without desensitizer, on enamel and sensitivity: an in vivo study. Int J Dent Hyg 12(2):115–120. https://doi.org/10.1111/idh.12054 CrossRefPubMed

14.

Oliveira GPF, Toyoshim AER, Soldani P, Bueno ALN, Cassoni A, Amaral C, Rodrigues JA (2007) Effect of the thickener agent carbopol on dental enamel surface in the at-home dental bleaching. Rev Odontol UNESP 36:113–119. https://doi.org/10.1590/S1806-83242007000200013 CrossRef

15.

Gouveia TH, Públio J do C, Ambrosano GM, Paulillo LA, Aguiar FH, Lima DA (2016) Effect of at-home bleaching with different thickeners and aging on physical properties of a nanocomposite. Eur J Dent 10(1):82–91. https://doi.org/10.4103/1305-7456.175683 CrossRefPubMedPubMedCentral

16.

Morgan S, Jum’ah AA, Brunton P (2015) Assessment of efficacy and post-bleaching sensitivity of home bleaching using 10% carbamide peroxide in extended and non-extended bleaching trays. Brit Dent J 218(10):579–582. https://doi.org/10.1038/sj.bdj.2015.391 CrossRefPubMed

17.

Joiner A (2006) The bleaching of teeth: a review of the literature. J Dent 34(7):412–419. https://doi.org/10.1016/j.jdent.2006.02.002 CrossRefPubMed

18.

Jensen MP, Karoly P, Braver S (1986) The measurement of clinical pain intensity: a comparison of six methods. Pain 27(1):117–126. https://doi.org/10.1016/0304-3959(86)90228-9 CrossRefPubMed

19.

Caraceni A, Cherny N, Fainsinger R, Kaasa S, Poulain P, Radbruch L, de Conno F (2002) Pain measurement tools and methods in clinical research in palliative care: recommendations of an expert working group of the European association of palliative care. J Pain and Symptom Manag 23(3):239–255. https://doi.org/10.1016/S0885-3924(01)00409-2 CrossRef

20.

Price DD, McGrath PA, Rafii A, Buckingham B (1983) The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 17(1):45–56. https://doi.org/10.1016/0304-3959(83)90126-4 CrossRefPubMed

21.

Hanks CT, Fang DN, Sun Z, Edwards CA, Butler WT (1998) Dentin-specific proteins in MDPC-23 cell line. Eur J Oral Sci 106(1):260–266. https://doi.org/10.1111/j.1600-0722.1998.tb02185.x CrossRefPubMed

22.

Hanks CT, Sun ZL, Fang DN, Edwards CA, Wataha JC, Ritchie HH, Butler WT (1998) Cloned 3T6 cell line from CD-1 mouse fetal molar dental papillae. Connect Tissue Res 37(3–4):233–249. https://doi.org/10.3109/03008209809002442 CrossRefPubMed

23.

Mosmann T (1983) Rapid colorimetric assay for cellular growth and survival: application to proliferation and cytotoxicity assays. J Immunol Methods 65(1–2):55–63. https://doi.org/10.1016/0022-1759(83)90303-4 CrossRefPubMed

24.

Basting R, Amaral F, França F, Flório F (2012) Clinical comparative study of the effectiveness of and tooth sensitivity to 10% and 20% carbamide peroxide home-use and 35% and 38% hydrogen peroxide in-office bleaching materials containing desensitizing agents. Oper Dent 37(5):464–473. https://doi.org/10.2341/11-337-C CrossRefPubMed

25.

Bernardon JK, Sartori N, Ballarin A, Perdigão J, Lopes GC, Baratieri LN (2010) Clinical performance of vital bleaching techniques. Oper Dent 35(1):3–10. https://doi.org/10.2341/09-008CR CrossRefPubMed

26.

Carlos NR, Bridi EC, Amaral F, França F, Turssi CP, Basting RT (2017) Efficacy of home-use bleaching agents delivered in customized or prefilled disposable trays: a randomized clinical trial. Oper Dent 42(1):30–40. https://doi.org/10.2341/15-315-C CrossRefPubMed

27.

Rezende M, De Geus JL, Loguercio AD, Reis A, Kossatz D (2016) Clinical evaluation of genotoxicity of in-office bleaching. Oper Dent 41(6):578–586. https://doi.org/10.2341/15-207-C CrossRefPubMed

28.

Eimar H, Marelli B, Nazhat SN, Abi Nader S, Amin WM, Torres J, de Albuquerque RF Jr, Tamimi F (2011) The role of enamel crystallography on tooth shade. J Dent 39(3):3–10. https://doi.org/10.1016/j.jdent.2011.11.008 CrossRef

29.

Gerlach RW, Zhou X (2001) Vital bleaching with whitening strips: summary of clinical research on effectiveness and tolerability. J Contemp Dent Pract 15(3):1–16 PMID:12167923

30.

Wataha JC, Hanks CT, Strawn SE, Fat JC (1994) Cytotoxicity of components of resins and other dental restorative materials. J Oral Rehabil 21(4):453–462. https://doi.org/10.1111/j.1365-2842.1994.tb01159.x CrossRefPubMed

31.

Goldberg M, Smith AJ (2004) Cells and extracellular matrices of dentin and pulp: a biological basis for repair and tissue engineering. Crit Reviews in Oral Biol Med 15(1):13–27. https://doi.org/10.1177/154411130401500103 CrossRef

32.

Luque-Martinez I, Reis A, Schroeder M, Muñoz MA, Loguercio AD, Masterson D, Maia LC (2016) Comparison of efficacy of tray-delivered carbamide and hydrogen peroxide for at-home bleaching: a systematic review and meta-analysis. Clin Oral Investig 20(7):1419–1433. https://doi.org/10.1007/s00784-016-1863-7 CrossRefPubMed

33.

Boushell LW, Ritter AV, Garland GE, Tiwana KK, Smith LR, Broome A et al (2012) Nightguard vital bleaching: side effects and patient satisfaction 10 to 17 years posttreatment. J Esthet Rest Dent 24(3):211–219. https://doi.org/10.1111/j.1708-8240.2011.00479.x CrossRef

34.

de Lima AF, Lessa FC, Gasparoto Mancini MN, Hebling J, de Souza Costa CA, Marchi GM (2009) Cytotoxic effects of different concentrations of a carbamide peroxide bleaching gel on odontoblast-like cells MDPC-23. J Biomed Mater Res Part B, Appl Biomater 90((2):907–912. https://doi.org/10.1002/jbm.b.31362 CrossRef

35.

Berès F, Isaac J, Mouton L, Rouzière S, Berdal A, Simon S, Dessombz A (2016) Comparative physicochemical analysis of pulp stone and dentin. J Endod 42(3):432–438. https://doi.org/10.1016/j.joen.2015.11.007 CrossRefPubMed

36.

Goldberg M, Septier D (2002) Phospholipids in amelogenesis and dentinogenesis. Crit Rev Oral Biol Med 13(3):276–290. https://doi.org/10.1177/154411130201300305 CrossRefPubMed

37.

Arana-Chavez VE, Massa LF (2004) Odontoblast: the cells forming and maintaining dentin. Int J Biochem Cell Biol 36(8):1367–1373. https://doi.org/10.1016/j.biocel.2004.01.006 CrossRefPubMed

38.

Lima AF, Lessa FC, Mancini MN, Hebling J, Costa CA, Marchi GM (2010) Transdentinal protective role of sodium ascorbate against the cytopathic effects of H₂O₂ released from bleaching agents. Oral Surg Oral Med Oral Pathol Oral Rad Endod 109(4):70–76. https://doi.org/10.1016/j.tripleo.2009.12.020 CrossRef

39.

Soares DG, Ribeiro AP, Sacono NT, Coldebella CR, Hebling J, Costa CA (2011) Transenamel and transdentinal cytotoxicity of carbamide peroxide bleaching gels on odontoblast-like MDPC-23 cells. Int Endod J 44(2):116–125. https://doi.org/10.1111/j.1365-2591.2010.01810.x CrossRefPubMed

40.

De Arruda AM, dos Santos PH, Sundfeld RH, Berger SB, Briso AL (2012) Effect of hydrogen peroxide at 35% on the morphology of enamel and interference in the deremineralization process: an in situ study. Oper Dent 37(5):518–525. https://doi.org/10.2341/11-112-L CrossRefPubMed

41.

Justino LM, Tames DR, Demarco FF (2004) In situ and in vitro effects of bleaching with carbamide peroxide on human enamel. Oper Dent 29(2):219–225. https://doi.org/10.1590/0103-6440201600385 CrossRefPubMed

42.

D'Amario M, D'Attilio M, Baldi M, De Angelis F, Marzo G, Vadini M et al (2012) Histomorphologic alterations of human enamel after repeated applications of a bleaching agent. Int J Immunopathol Pharmacol 25(4):1021–1027. https://doi.org/10.1177/039463201202500419 CrossRefPubMed

43.

Carpenter GH (2013) The secretion, components, and properties of saliva. Annual Review Food Science Technol 4:267–276. https://doi.org/10.1146/annurev-food-030212-182700 CrossRef

44.

Vukosavljevic D, Custodio W, Buzalaf MAR, Hara AT, Siqueira WL (2014) Review: acquired pellicle as a modulator for dental erosion. Arch of Oral Biol 59(6):631–638. https://doi.org/10.1016/j.archoralbio.2014.02.002 CrossRef

45.

Attin T, Schmidlin PR, Wegehaupt F, Wiegand A (2009) Influence of study design on the impact of bleaching agents on dental enamel microhardness: a review. Dent Mater 25(2):143–157. https://doi.org/10.1016/j.dental.2008.05.010 CrossRefPubMed

Title: Influence of different thickeners in at-home tooth bleaching: a randomized clinical trial study
Authors: Juliana do Carmo Públio
Marília Zeczkowski
Jonny Burga-Sánchez
Gláucia Maria Bovi Ambrosano
Franscico Carlos Groppo
Flávio Henrique Baggio Aguiar
Débora Alves Nunes Leite Lima
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 5/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2613-9

At a glance: The STEP trials

Springer Medicine

Influence of different thickeners in at-home tooth bleaching: a randomized clinical trial study

Abstract

Objectives

Methods

Results

Conclusions

Clinical relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 5/2019

Comparison of linear and volumetric measurements obtained from periodontal defects by using cone beam-CT and micro-CT: an in vitro study

Presentation of gaps around endodontic access cavity restoration by phase contrast-enhanced micro-CT

Distances of root apices to adjacent anatomical structures in the anterior maxilla: an analysis using cone beam computed tomography

Bone repair in craniofacial defects treated with different doses of alendronate: a histological, histomorphometric, and immunohistochemical study

Do dental bleaching agents induce genetic damage on oral mucosa cells?

Alveolar bone preservation by a hydroxyapatite/collagen composite material after tooth extraction