Evaluation of the effects of whitening mouth rinses combined with conventional tooth bleaching treatments

Jaqueline Costa Favaro; Omar Geha; Ricardo Danil Guiraldo; Murilo Baena Lopes; Andreza Maria Fábio Aranha; Sandrine Bittencourt Berger

doi:10.5395/rde.2018.44.e6

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Favaro, Geha, Guiraldo, Lopes, Aranha, and Berger: Evaluation of the effects of whitening mouth rinses combined with conventional tooth bleaching treatments

Research Article

Restor Dent Endod 2019;44(1):e6.

Published online: 4 February 2019

DOI: https://doi.org/10.5395/rde.2018.44.e6

Evaluation of the effects of whitening mouth rinses combined with conventional tooth bleaching treatments

Jaqueline Costa Favaro¹, Omar Geha¹, Ricardo Danil Guiraldo¹, Murilo Baena Lopes¹, Andreza Maria Fábio Aranha², Sandrine Bittencourt Berger^1,^*

¹Department of Restorative Dentistry, School of Dentistry, University of North Parana, Londrina, PR, Brazil

²Department of Dental Sciences, School of Dentistry, University of Cuiabá, Cuiabá, MT, Brazil

^*Correspondence to Sandrine Bittencourt Berger, DDS, MS, PhD Associate Professor, Department of Restorative Dentistry, School of Dentistry, University of North Parana, Rua Marselha, 183, Londrina, PR 86041-140, Brazil. E-mail: berger.sandrine@gmail.com

Received 24 September 2018 Revised 8 December 2018 Accepted 12 January 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The aim of the present study was to evaluate the effect of whitening mouth rinses alone and in combination with conventional whitening treatments on color, microhardness, and surface roughness changes in enamel specimens.

Materials and Methods

A total of 108 enamel specimens were collected from human third molars and divided into 9 groups (n = 12): 38% hydrogen peroxide (HP), 10% carbamide peroxide (CP), 38% HP + Listerine Whitening (LW), 10% CP + LW, 38% HP + Colgate Plax Whitening (CPW), 10% CP + CPW, LW, CPW, and the control group (CG). The initial color of the specimens was measured, followed by microhardness and roughness tests. Next, the samples were bleached, and their color, microhardness, and roughness were assessed. Data were analyzed through 2-way analysis of variance (ANOVA; microhardness and roughness) and 1-way ANOVA (color change), followed by the Tukey post hoc test. The Dunnett test was used to compare the roughness and microhardness data of the CG to those of the treated groups.

Results

Statistically significant color change was observed in all groups compared to the CG. All groups, except the LW group, showed statistically significant decreases in microhardness. Roughness showed a statistically significant increase after the treatments, except for the 38% HP group.

Conclusions

Whitening mouth rinses led to a whitening effect when they were used after conventional treatments; however, this process caused major changes on the surface of the enamel specimens.

Keywords: Dental enamel, Tooth bleaching, Tooth bleaching agents, Whitening mouth rinse

References

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Figure 1.

Schematic illustration of the experimental design.

T0, at the beginning of the study (baseline); T1, after bleaching treatment; HP, hydrogen peroxide (38% HP; Opalescence Boost, Ultradent Products Inc., South Jordan, UT, USA); CP, carbamide peroxide (10% CP; Opalescence 10% PF, Ultradent Products Inc.); LW, Listerine Whitening (Johnson & Johnson do Brasil Indústria e Comércio de Produtos para Saúde Ltda, São Paulo, SP, Brazil); CPW, Colgate Plax Whitening (Colgate-Palmolive Ind. Ltda., São Paulo, SP, Brazil); CG, control group.

Table 1.

Information about the materials used in the present study

Product	Manufacturer/batch	Composition	Classification	pH
Opalescence Boost (38% HP)	Ultradent Products Inc., South Jordan, UT, USA/DO 19U	Gel: Hydrogen peroxide Activator: Potassium hydroxide, 1.1% fluoride, and 3% potassium nitrate	Whitening gel	6.88
Opalescence 10% PF (10% CP)	Ultradent Products Inc., South Jordan, UT, USA/D014W	Carbamide peroxide, potassium nitrate, 0.11% fluoride ion, carbopol, glycerin, flavor	Whitening gel	6.5
Listerine Whitening (LW)	Johnson & Johnson do Brasil Indústria e Comércio de Produtos para Saúde Ltda, São Paulo City, São Paulo, Brazil/0285C	Water, alcohol (8%), hydrogen peroxide, sodium phosphate, poloxamer 407, sodium lauryl sulfate, sodium citrate, mint flavor, menthol, eucalyptol, sodium saccharin, sucralose	Mouth rinse	5.38
Colgate Plax Whitening (CPW)	Colgate-Palmolive Ind. Ltda. São Paulo City, São Paulo, Brazil/5260BR121C	Water, ethyl alcohol, hydrogen peroxide, sorbitol, poloxamer 338, polysorbate 20, methyl salicylate, menthol, sodium saccharin, CL 42090	Mouth rinse	3.42
Control group	–	Distilled water	–	7.0

Table 2.

Application protocols of the bleaching agents in the experimental groups depending on treatment and application time

Group	Bleaching agent	Application protocol^*
38% HP	Opalescence Boost	3 sessions (3 applications, 15 min each), 1-week interval between sessions
10% CP	Opalescence 10% PF	6 hr/day, 15 days
38% HP + LW	Opalescence Boost + Listerine Whitening	3 sessions 38% HP + LW: 1 min × 2 times/day, 12 weeks^*
10% CP + LW	Opalescence 10% PF + Listerine Whitening	10% CP, 6 hr/day, 15 days; LW, 1 min × 2 times/day, 12 weeks
38% HP + CPW	Opalescence Boost + Colgate Plax Whitening	3 sessions with 38% HP; CPW, 2 min × 2 times/day, 12 weeks
10% CP + CPW	Opalescence 10% PF + Colgate Plax Whitening	10% CP, 6 hr/day, 15 days; CPW, 2 min × 2 times/day, 12 weeks
LW	Listerine Whitening	1 min × 2 times/day, 12 weeks
CPW	Colgate Plax Whitening	2 min × 2 times/day, 12 weeks
CG	Distilled water	Immersion for 12 weeks

HP, hydrogen peroxide (38% HP; Opalescence Boost, Ultradent Products Inc., South Jordan, UT, USA); CP, carbamide peroxide (10% CP; Opalescence 10% PF, Ultradent Products Inc.); LW, Listerine Whitening (Johnson & Johnson do Brasil Indústria e Comércio de Produtos para Saúde Ltda, São Paulo, SP, Brazil); CPW, Colgate Plax Whitening (Colgate-Palmolive Ind. Ltda., São Paulo, SP, Brazil); CG, control group.

^* According to the manufacturer's instructions.

Table 3.

Color changes (Δ E) of the enamel specimens after various experimental bleaching protocols

Treatment	Δ L	Δ a	Δ b	Δ E
38% HP	6.74 ± 2.35	−1.44 ± 0.82	−5.98 ± 2.38	9.51 ± 2.20 ^bc*
10% CP	8.86 ± 3.67	−1.72 ± 0.95	−8.95 ± 4.27	13.15 ± 4.5 ^ab*
38% HP + LW	4.66 ± 3.28	−2.13 ± 1.42	−10.10 ± 5.25	12.02 ± 4.70 ^b*
10% CP + LW	3.11 ± 2.98	−2.05 ± 1.03	−7.86 ± 5.87	9.75 ± 4.70 ^bc*
38% HP + CPW	5.02 ± 6.67	−3.03 ± 1,86	−15.17 ± 3.49	17.84 ± 4.30 ^a*
10% CP + CPW	7.75 ± 4.91	−1.81 ± 1.40	−10.72 ± 4.03	14.20 ± 4.40 ^ab*
LW	3.48 ± 3.66	−1.40 ± 0.82	−1.73 ± 3.50	6.08 ± 2.50 ^cd*
CPW	3.48 ± 3.66	−1.40 ± 0.82	−1,73 ± 3.50	3.66 ± 2.00 ^d*
CG	0.88 ± 0.59	0.25 ± 0.52	0.44 ± 0.58	1.30 ± 0.59

Data are presented as means ± standard deviations. Values with different superscript letters were statistically different according to the Tukey test (p < 0.05).

^* Asterisk means that the value is statistically significantly different from the corresponding value in the control group according to the Dunnett test (p < 0.05).

Table 4.

Microhardness (KHN) values of the enamel specimens at baseline (T0), and after the bleaching treatments (T1), based on the bleaching protocols and evaluation time point (n = 12)

Treatment	Evaluation time point		Hardness loss (%)
Treatment	T0	T1	Hardness loss (%)
38% HP	328.33 ± 7.16 ^Aa	252.64 ± 23.18 ^Bb*	23.05
10% CP	324.65 ± 11.56 ^Aa	234.57 ± 7.68 ^Bbc*	27.75
38% HP + LW	320.59 ± 27.68 ^Aa	208.75 ± 25.01 ^Bc*	12.43
10% CP + LW	314.69 ± 26.51 ^Aa	226.75 ± 34.57 ^Bbc*	27.94
38% HP + CPW	315.94 ± 19.69 ^Aa	129.53 ± 21.48 ^Bd*	59.00
10% CP + CPW	328.72 ± 13.86 ^Aa	148.66 ± 36.66 ^Bd*	54.78
LW	318.52 ± 29.15 ^Aa	298.42 ± 21.56 ^Aa*	6.31
CPW	325.57 ± 15.06 ^Aa	242.28 ± 36.46 ^Bbc*	25.58
CG	326.46 ± 12.06

Data are presented as means ± standard deviations. Values with different uppercase superscript letters in each row were statistically significantly different for each treatment between the time points before (T0) and after (T1) treatment based on the Tukey test (p < 0.05). Values with different lowercase superscript letters in each column were statistically significantly different at each time point between the experimental treatment groups based on the Tukey test (p < 0.05).

^* Asterisk means that the value is statistically significantly different from the corresponding value in the control group according to the Dunnett test (p < 0.05).

Table 5.

Surface roughness (Ra; in μ m) values of the enamel specimens at baseline (T0) and after the bleaching treatments (T1) according to the experimental bleaching protocol and the evaluation time point (n = 12)

Treatment	Evaluation time point		Roughness change (%)
Treatment	T0	T1	Roughness change (%)
38% HP	0.037 ± 0.014 ^Aa	0.047 ± 0.024 ^Ac	127.03
10% CP	0.030 ± 0.008 ^Ba	0.050 ± 0.012 ^Ac	166.67
38% HP + LW	0.029 ± 0.008 ^Ba	0.183 ± 0.033 ^Aab*	631.03
10% CP + LW	0.027 ± 0.010 ^Ba	0.163 ± 0.037 ^Aab*	603.70
38% HP + CPW	0.031 ± 0.013 ^Ba	0.208 ± 0.115 ^Aa*	670.97
10% CP + CPW	0.044 ± 0.033 ^Ba	0.201 ± 0.019 ^Aab*	456.82
LW	0.025 ± 0.012 ^Ba	0.133 ± 0.027 ^Ab*	532.00
CPW	0.033 ± 0.021 ^Ba	0.194 ± 0.023 ^Aab*	587.88
CG	0.031 ± 0.0130

^* Asterisk means that the value is statistically significantly different from the corresponding value in the control group according to the Dunnett test (p < 0.05).

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