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Clinical Oral Investigations
Published in: Clinical Oral Investigations 6/2015

01-07-2015 | Original Article

A new three-component formulation for the efficient whitening of teeth (Carbamide Plus)

Authors: Barry W. Hyland, Ailbhe McDonald, Nicholas Lewis, Christopher Tredwin, Aviva Petrie, Sean Hall, Chris Todd, Bridgeen McCaughan, John F. Callan

Published in: Clinical Oral Investigations | Issue 6/2015

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Abstract

Objectives

This study aimed to develop and characterise a new three-component dental whitening formulation which is as effective as the currently used carbamide peroxide but at significantly lower hydrogen peroxide concentrations.

Materials and methods

The new formulation (Carbamide Plus) was prepared containing hydrogen peroxide, urea, and sodium tripolyphosphate and compared directly with carbamide peroxide (containing just hydrogen peroxide and urea). To evaluate the clinical effectiveness of 5 % Carbamide Plus, a randomised double-blind placebo-controlled clinical trial was conducted comparing the tooth colour of 33 patients using L*a*b* scores at baseline and after a 2-week whitening treatment. The behaviour of the three components in solution was determined by 1H and 31P NMR spectroscopy and pH dilution experiments.

Results

This clinical trial revealed that 5 % whitening gels containing Carbamide Plus were as effective as those containing 10 % carbamide peroxide. 1H and 31P NMR spectroscopy revealed strong intermolecular interactions between hydrogen peroxide and both urea and sodium tripolyphosphate (STPP) with little apparent interaction between urea and STPP.

Conclusions

In this manuscript, we postulate that this increased whitening efficiency is due to a marked increase in local pH upon dilution which destabilises the hydrogen peroxide and expedites the whitening process. We postulate Carbamide Plus to be a three-component adduct with two molecules of carbamide peroxide binding to a central STPP unit with no direct interaction between STPP and urea. There were no statistically significant differences between Carbamide Plus and 10 % carbamide peroxide in tooth-whitening achieved at 2 weeks. These results were recorded following 2 weeks of 2-h daily wear of at-home trays.

Clinical relevance

Carbamide Plus offers the potential of using significantly lower levels of hydrogen peroxide concentration to achieve similar dental whitening effects.
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Metadata
Title
A new three-component formulation for the efficient whitening of teeth (Carbamide Plus)
Authors
Barry W. Hyland
Ailbhe McDonald
Nicholas Lewis
Christopher Tredwin
Aviva Petrie
Sean Hall
Chris Todd
Bridgeen McCaughan
John F. Callan
Publication date
01-07-2015
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 6/2015
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-014-1352-9

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