Clinical evaluation of the bleaching effect of chewing gum containing amorphous calcium phosphate, hydroxyapatite, and tricalcium pyrophosphate on human enamel

Eun-Kyong Kim; Ho-Young Yoon; Hae-Young Yang; Min-Jeong Cho; Youn-Hee Choi; Keun-Bae Song

doi:10.11149/jkaoh.2013.37.3.126

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Kim, Yoon, Yang, Cho, Choi, and Song: Clinical evaluation of the bleaching effect of chewing gum containing amorphous calcium phosphate, hydroxyapatite, and tricalcium pyrophosphate on human enamel

Original Article

J Korean Acad Oral Health 2013;37(3):126-131.

Published online: 12 September 2013

DOI: https://doi.org/10.11149/jkaoh.2013.37.3.126

Clinical evaluation of the bleaching effect of chewing gum containing amorphous calcium phosphate, hydroxyapatite, and tricalcium pyrophosphate on human enamel

Eun-Kyong Kim, Ho-Young Yoon, Hae-Young Yang, Min-Jeong Cho, Youn-Hee Choi, Keun-Bae Song

Department of Preventive Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea

Corresponding Author: Keun-Bae Song Department of Preventive Dentistry, Kyungpook National University School of Dentistry, 2177 Dalgubeol-daero, Jung-gu, Daegu 700-412, Korea Tel: +82-53-660-6875 Fax: +82-53-423-2947 E-mail: kbsong@knu.ac.kr

Received 11 September 2013 Revised 24 September 2013 Accepted 24 September 2013

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The purpose of this study was to evaluate the bleaching effect of chewing gum containing amorphous calcium phosphate (ACP), hydroxyapatite (HA), and tricalcium pyrophosphate (TSP) on human enamel.

Methods

Seventy-three subjects aged 20-30 years were recruited after obtaining their informed consent and approval of the Institutional Review Board. All subjects were randomly assigned to the following four groups: (I) negative control group; (II) 50% gum group; (III) 100% gum group; and (IV) positive control group (10% carbamide peroxide). They received gum containing ACP, HA, and TSP, three times a day, for 4 weeks. Group IV also received 10% CP application using individual trays, once a day, for 2 weeks. Color change was measured using the Shade Eye-NCC colorimeter at weekly intervals, during the 4-week period. Statistical analysis was performed using SPSS 18.0.

Results

Color changes (∆E*) were significantly different among the groups at 2 and 4 weeks after chewing the gum (P<0.05). Given that bleaching effect of Group IV was 100%, bleaching effects of Group III, Group II, and Group I were 54%, 46%, and 36%, respectively.

Conclusions

Chewing gum containing ACP, HA, and TSP was effective enough to bleach the human enamel. Further comprehensive studies and assessment will be required to ascertain the bleaching effects and mechanism of chewing gum containing various components such as ACP, HA, and TSP using various methods of experiment and analysis.

Keywords: Amorphous calcium phosphate, Bleaching, Hydroxyapatite, Tricalcium pyrophosphate

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Fig. 1.

Flow chart of clinical test.

Fig. 2.

Color changes (ΔE*) of tooth after 4 weeks.

Fig. 3.

Percentage of color changes compared with Group IV’s.

Table 1

Inclusion criteria	- Be in good general and oral health
	- Have all natural anterior teeth of which shade are between D3-A2 shade guide
	- Willing to return for postwhitening evaluation
	- Agree to sign a consent form
Exclusioncriteria	- Have anterior teeth with orthodontic braces or restoration
	- Have critical pathological lesion in oral tissue
	- Have gingival inflammation or multiple dental caries
	- Have more than two teeth need to be treated immediately
	- Have ever been involved in other study in 6 months
	- Have experience of high sensitivity during dental bleaching
	- Have ever used of whitening agent in 6 months

Table 2.

Color changes (ΔE*) of all teeth by bleaching times

Group	1 week	2 weeks*	3 weeks	4 weeks*
I^†	1.71±0.92	1.43±0.84^a	0.95±0.72	2.04±0.90^a
II^†	1.82±1.30	1.69±1.14^ab	2.33±1.16	2.59±1.74^ab
III^†	2.04±1.29	2.24±1.64^b	3.88±6.48	2.98±1.86^b
IV	-	5.52±2.04	-	-
P-value		<0.017		<0.032

Values are mean±S.D. *Significantly different among the group at each time by one-way ANOVA procedure.

^† Significantly different during among experimental time by repeated measures ANOVA procedure.

^a bSame letters indicate no significant different between groups by Tukey's multiple comparison at each bleaching time. GroupⅣ was measured at only after 2 week of treatment and excluded in statistically analysis.

Table 3.

Color changes of specimens with time according to the NBS system

	Group		Time
	Group	1 week	2 weeks	3 weeks	4 weeks
NBS system	Group I	1.57±0.82	1.31±0.63	1.80±0.72	1.88±0.85
		(Noticeable)	(Slight)	(Noticeable)	(Noticeable)
	Group II	1.67±0.79	1.55±0.59	2.15±1.01	2.38±1.23
		(Noticeable)	(Noticeable)	(Noticeable)	(Noticeable)
	Group III	1.88±1.29	2.06±1.63	3.57±1.39	2.74±1.88
		(Noticeable)	(Noticeable)	(Appreciable)	(Noticeable)
	Group IV		(Appreciable)

Values are mean±S.D. (Critical remarks of color difference by NBS system). Group IV was measured at only after 2 week of treatment.

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