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Woo, Kim, Jeong, Song, Goo, Jeon, and Choi: Comparison of the whitening effect of toothpastes containing 0.25% hydroxyapatite and 0.75% hydrogen peroxide
Original Article

J Korean Acad Oral Health 2014;38(1):3-9.

Published online: 12 March 2014

DOI: https://doi.org/10.11149/jkaoh.2014.38.1.3

Comparison of the whitening effect of toothpastes containing 0.25% hydroxyapatite and 0.75% hydrogen peroxide

Gyeong-Ji Woo1, Eun-Kyong Kim1, Seong-Hwa Jeong2, Keun-Bae Song1, Hyo-Jin Goo3, Eun-Suk Jeon4, Youn-Hee Choi1

1Department of Preventive Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea

2Faculty of Health Science, Daegu Haany University, Gyeongsan, Korea

3Department of Dental Hygiene, Masan University, Changwon, Korea

4Department of Dental Hygiene, Choonhae College of Health Sciences, Ulsan, Korea

Corresponding Author: Youn-Hee Choi Department of Preventive Dentistry, Kyungpook National University School of Dentistry, 2177 Dalgubeol-daero, Jung-gu, Daegu 700-412, Korea Tel: +82-53-660-6871 Fax: +82-53-423-2947 E-mail: cyh1001@knu.ac.kr

Received 13 December 2013       Revised 27 February 2014       Accepted 28 February 2014

Copyright © 2014 Journal of Korean Academy of Oral Health

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 aim of this study was to compare the tooth bleaching effect of two whitening materials in toothpaste i.e., hydroxyapatite and hydrogen peroxide on. In a randomized, double blinded controlled clinical trial, 85 participants with tooth colorations were assigned to use one of three toothpastes containing either hydroxyapatite (0.25%), hydrogen peroxide (0.75%), or no active ingredient (placebo). The patients were examined at baseline and 1, 2, and 3 months after usage.

Methods

The patients underwent an oral examination, tooth shade measurement, and a subjective evaluation. During the oral examination, the patient’s oral health status was determined. ShadeEye NCC and Vita classical shade guide were used to determine the tooth color. Further, the patients were asked to assess the color of their own teeth using a visual analog scale (VAS) scale (range, 1-5).

Results

According to the CIELAB system, a significantly greater color change (Δb*) was observed in the hydrogen peroxide group (2.10±1.54) than in the hydroxyapatite (1.50±1.09) and control (0.94± 0.75) groups after 3 months of toothpaste usage (P<0.002). The ΔE*color change was not statistically significant among the 3 groups at each time point (P>0.05). The subjective evaluation results of the hydroxyapatite (P=0.023) and hydrogen peroxide (P=0.047) groups were statistically significant at each time point.

Conclusions

The hydrogen peroxide-containing toothpaste caused significant lightening of tooth coloration than the hydroxyapatite and placebo toothpastes.

Keywords: Hydrogen peroxide, Hydroxyapatite, Tooth bleaching, Tooth shade, Whitening toothpaste

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Fig. 1.
Color changes Δb* of total tooth.
jkaoh-38-3f1.tif
Fig. 2.
Participants’ subjective evaluation.
jkaoh-38-3f2.tif
Table 1.
Toothpaste primary ingredients
Hydroxyapatite toothpaste - Hydroxyapatite (0.5 g/100 g, 5,000 ppm) - Sodium fluoride (0.1 g/100 g, 1,000 ppm)
- Allantoin - Xylitol
- Sodium saccharin - Sodium lauryl sulfate
Hydrogen peroxide toothpaste - Methyl r-Hydroxybenzoate - 35% hydrogen peroxide solution (2.14 g/100 g)
- Silicon dioxide (0.22 g/100 g) - Tocopheryl acetate
Placebo control toothpaste - Sodium fluoride (0.1 g/100 g, 1,000 ppm) - Tocopheryl acetate
- Hydrated silicon dioxide
Table 2.
Examinator's Cohen's Kappa index
Examinator Cohen’s Kappa index
A 0.879
B 0.909
C 0.748
D 0.894
E 0.814
F 0.829
G 0.854
Table 3.
Participants' demographic characteristics and dietary habit (N (%))
HA group HP group Control group P-value*
Age
20s 20 (64.5) 20 (76.9) 24 (85.7) 0.177
30s 11 (35.5) 6 (23.1) 4 (14.3)
Gender
Male 23 (74.2) 15 (57.7) 16 (57.1) 0.302
Female 8 (25.8) 11 (42.3) 12 (42.9)
Smoking
Current smoker 5 (16.7) 4 (15.4) 3 (10.7) 0.925
Ex-smoker Never 2 (6.7) 1 (3.8) 1 (3.6)
Never 23 (76.7) 21 (80.8) 24 (85.7)
Fruit and vegetable
1-2 per 1 month 2 (6.7) 2 (7.7) 2 (7.1) 0.695
1-2 per 1 week 20 (66.7) 21 (80.8) 19 (67.9))
1-2 per 1 day 8 (26.7) 3 (11.5) 7 (25.0)
Coffee
1-2 per 1 month 6 (20.0) 4 (15.4) 2 (7.1) 0.431
1-2 per 1 week 9 (30.0) 7 (26.9) 13 (46.4)
1-2 per 1 day 15 (50.0) 15 (57.7) 13 (46.4)
Caffeinated tea
1-2 per 1 month 14 (46.7) 16 (61.5) 13 (46.4) 0.532
1-2 per 1 week 15 (50.0) 8 (30.8) 12 (42.9)
1-2 per 1 day 1 (3.3) 2 (7.7) 3 (10.7)
Total 31 (100.0) 26 (100.0) 28 (100.0)

Total<85 because of non-respondents. *Chi-square test.

Table 4.
Color changes ΔE* of total tooth among the group at each time
After 1 mon After 2 mon After 3 mon P-value*
#13
HA 1.97±1.43 3.62±2.44 2.00±1.26 <0.001
HP 1.56±1.06 3.19±2.24 2.01±1.46
Control 1.80±1.55 3.05±2.66 2.01±1.71
P-value† 0.535 0.652 0.999
#12
HA 2.15±1.39 2.86±1.82 2.47±2.01 0.085
HP 1.85±1.53 2.72±1.73 2.16±1.60
Control 2.04±3.55 2.65±2.07 2.02±1.30
P-value† 0.895 0.912 0.569
#11
HA 2.04±1.19 2.41±1.66 1.96±1.59 0.009
HP 1.74±1.14 2.58±1.76 2.20±1.43
Control 1.47±1.26 2.46±1.85 1.88±1.05
P-value† 0.201 0.935 0.680
#21
HA 1.75±1.13 2.12±1.61 1.86±1.32 0.037
HP 1.47±1.08 2.45±1.95 2.00±1.78
Control 1.58±1.17 2.06±1.55 1.79±1.00
P-value† 0.651 0.661 0.843
#22
HA 1.64±1.24 2.02±1.53 1.70±1.22 0.045
HP 1.51±1.24 2.11±1.78 1.92±1.21
Control 1.21±1.01 1.79±1.57 1.68±1.28
P-value† 0.359 0.757 0.730
#23
HA 1.38±1.07 1.78±1.63 1.71±1.40 0.053
HP 1.35±0.98 2.27±1.80 1.75±1.08
Control 1.62±1.23 1.84±1.56 1.78±1.01
P-value† 0.606 0.503 0.978
Total
HA 1.66±0.92 2.31±1.50 1.72±1.31 0.006
HP 1.32±0.99 2.10±1.86 1.78±1.17
Control 1.29±1.12 1.89±1.56 1.53±0.93
P-value† 0.304 0.608 0.712

Values are Mean±Standard deviation. *Indicates statistical significance different among experimental time repeated measures ANOVA procedure.

† Indicates statistical significance different among the group at each time by one-way ANOVA procedure.

Table 5.
Total tooth of Vita classical shade guide
Baseline After 1 mon After 2 mon After 3 mon P-value*
HA 8.06±1.39 8.04±1.39 7.89±1.16 7.87±1.33 0.097
HP 6.98±2.10 7.38±1.79 7.20±1.85 7.21±1.86
Control 7.93±2.11 7.83±1.96 7.92±2.04 7.86±1.96
P-value† 0.110 0.464 0.403 0.622

Values are Mean±Standard deviation. *Indicates statistical significance different among experimental time repeated measures ANOVA procedure.

† Indicates statistical significance different among the group at each time by one-way ANOVA procedure.

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