Journal List > Restor Dent Endod > v.44(1) > 1116526

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

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.

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.
rde-44-e6f1.tif
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).

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.

* 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 (%)
T0 T1
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).

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.

* 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 (%)
T0 T1
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

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).

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.

* 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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