Effect of carbamide peroxide bleaching on enamel characteristics and susceptibility to further discoloration

Fadi AL Farawati, Shu Min Hsu, Edgar O'Neill, Dan Neal, Arthur Clark, Josephine Esquivel-Upshaw

Research output: Contribution to journalArticle

Abstract

Statement of problem: Whether tooth whitening alters the surface topography of enamel causing an increase in surface roughness that could increase susceptibility to restaining is unclear. Purpose: The purpose of this in vitro study was to evaluate whether immersing enamel in common solutions produces a color change of ΔE greater than 2; whether the highest concentration carbamide peroxide bleaching agent produces the greatest ΔE; whether bleaching increases the susceptibility to further staining by common solutions; and whether morphologic changes to the enamel surface are observed after staining and bleaching as evidenced by scanning electron microscopy (SEM) analysis and energy-dispersive X-ray spectroscopy (EDS). Material and methods: Forty-five extracted human teeth were immersed in 5 solutions (wine, coffee, tea, soda, and water) for 15 days at 80°C, and the change in ΔE was assessed with a colorimeter. The teeth were bleached using different concentrations of carbamide peroxide (20%, 35%, and 44%) and ΔE was measured at different time intervals. The teeth were then restained with the same solutions. The ΔE after initial staining was compared with the ΔE after bleaching and restaining of the same teeth. SEM was performed at baseline, after staining, bleaching, and restaining to evaluate the changes in the enamel surface topography. EDS was used to determine the elemental composition of tooth surfaces after restaining. Results: All liquids caused a ΔE greater than 2 after 15 days. The concentration of bleaching agent was not significantly associated with ΔE for any stain types. No significant difference was found in the rate of staining between initial staining and restaining after bleaching. However, a significant effect of time was found for the staining, where the overall ΔE increased by 0.34 for each day in the solution (P<.001). SEM images showed no major changes to enamel topography after bleaching. However, a coating was noted on teeth stained with wine and tea, which had different elemental compositions when compared with the tooth surface. Conclusions: Based on SEM observation, bleaching teeth with carbamide peroxide does not increase the susceptibility of enamel to staining and does not alter the topography of the enamel. Using higher bleaching concentrations did not increase tooth whitening as a function of time.

Original languageEnglish (US)
Pages (from-to)340-346
Number of pages7
JournalJournal of Prosthetic Dentistry
Volume121
Issue number2
DOIs
StatePublished - Feb 1 2019

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Dental Enamel
Tooth
Staining and Labeling
Tooth Bleaching
Electron Scanning Microscopy
Bleaching Agents
Tea
Wine
Carbonated Water
X-Ray Emission Spectrometry
carbamide peroxide
Coffee
Coloring Agents
Color
Observation

ASJC Scopus subject areas

  • Oral Surgery

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Effect of carbamide peroxide bleaching on enamel characteristics and susceptibility to further discoloration. / AL Farawati, Fadi; Hsu, Shu Min; O'Neill, Edgar; Neal, Dan; Clark, Arthur; Esquivel-Upshaw, Josephine.

In: Journal of Prosthetic Dentistry, Vol. 121, No. 2, 01.02.2019, p. 340-346.

Research output: Contribution to journalArticle

AL Farawati, Fadi ; Hsu, Shu Min ; O'Neill, Edgar ; Neal, Dan ; Clark, Arthur ; Esquivel-Upshaw, Josephine. / Effect of carbamide peroxide bleaching on enamel characteristics and susceptibility to further discoloration. In: Journal of Prosthetic Dentistry. 2019 ; Vol. 121, No. 2. pp. 340-346.
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abstract = "Statement of problem: Whether tooth whitening alters the surface topography of enamel causing an increase in surface roughness that could increase susceptibility to restaining is unclear. Purpose: The purpose of this in vitro study was to evaluate whether immersing enamel in common solutions produces a color change of ΔE greater than 2; whether the highest concentration carbamide peroxide bleaching agent produces the greatest ΔE; whether bleaching increases the susceptibility to further staining by common solutions; and whether morphologic changes to the enamel surface are observed after staining and bleaching as evidenced by scanning electron microscopy (SEM) analysis and energy-dispersive X-ray spectroscopy (EDS). Material and methods: Forty-five extracted human teeth were immersed in 5 solutions (wine, coffee, tea, soda, and water) for 15 days at 80°C, and the change in ΔE was assessed with a colorimeter. The teeth were bleached using different concentrations of carbamide peroxide (20{\%}, 35{\%}, and 44{\%}) and ΔE was measured at different time intervals. The teeth were then restained with the same solutions. The ΔE after initial staining was compared with the ΔE after bleaching and restaining of the same teeth. SEM was performed at baseline, after staining, bleaching, and restaining to evaluate the changes in the enamel surface topography. EDS was used to determine the elemental composition of tooth surfaces after restaining. Results: All liquids caused a ΔE greater than 2 after 15 days. The concentration of bleaching agent was not significantly associated with ΔE for any stain types. No significant difference was found in the rate of staining between initial staining and restaining after bleaching. However, a significant effect of time was found for the staining, where the overall ΔE increased by 0.34 for each day in the solution (P<.001). SEM images showed no major changes to enamel topography after bleaching. However, a coating was noted on teeth stained with wine and tea, which had different elemental compositions when compared with the tooth surface. Conclusions: Based on SEM observation, bleaching teeth with carbamide peroxide does not increase the susceptibility of enamel to staining and does not alter the topography of the enamel. Using higher bleaching concentrations did not increase tooth whitening as a function of time.",
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AU - AL Farawati, Fadi

AU - Hsu, Shu Min

AU - O'Neill, Edgar

AU - Neal, Dan

AU - Clark, Arthur

AU - Esquivel-Upshaw, Josephine

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N2 - Statement of problem: Whether tooth whitening alters the surface topography of enamel causing an increase in surface roughness that could increase susceptibility to restaining is unclear. Purpose: The purpose of this in vitro study was to evaluate whether immersing enamel in common solutions produces a color change of ΔE greater than 2; whether the highest concentration carbamide peroxide bleaching agent produces the greatest ΔE; whether bleaching increases the susceptibility to further staining by common solutions; and whether morphologic changes to the enamel surface are observed after staining and bleaching as evidenced by scanning electron microscopy (SEM) analysis and energy-dispersive X-ray spectroscopy (EDS). Material and methods: Forty-five extracted human teeth were immersed in 5 solutions (wine, coffee, tea, soda, and water) for 15 days at 80°C, and the change in ΔE was assessed with a colorimeter. The teeth were bleached using different concentrations of carbamide peroxide (20%, 35%, and 44%) and ΔE was measured at different time intervals. The teeth were then restained with the same solutions. The ΔE after initial staining was compared with the ΔE after bleaching and restaining of the same teeth. SEM was performed at baseline, after staining, bleaching, and restaining to evaluate the changes in the enamel surface topography. EDS was used to determine the elemental composition of tooth surfaces after restaining. Results: All liquids caused a ΔE greater than 2 after 15 days. The concentration of bleaching agent was not significantly associated with ΔE for any stain types. No significant difference was found in the rate of staining between initial staining and restaining after bleaching. However, a significant effect of time was found for the staining, where the overall ΔE increased by 0.34 for each day in the solution (P<.001). SEM images showed no major changes to enamel topography after bleaching. However, a coating was noted on teeth stained with wine and tea, which had different elemental compositions when compared with the tooth surface. Conclusions: Based on SEM observation, bleaching teeth with carbamide peroxide does not increase the susceptibility of enamel to staining and does not alter the topography of the enamel. Using higher bleaching concentrations did not increase tooth whitening as a function of time.

AB - Statement of problem: Whether tooth whitening alters the surface topography of enamel causing an increase in surface roughness that could increase susceptibility to restaining is unclear. Purpose: The purpose of this in vitro study was to evaluate whether immersing enamel in common solutions produces a color change of ΔE greater than 2; whether the highest concentration carbamide peroxide bleaching agent produces the greatest ΔE; whether bleaching increases the susceptibility to further staining by common solutions; and whether morphologic changes to the enamel surface are observed after staining and bleaching as evidenced by scanning electron microscopy (SEM) analysis and energy-dispersive X-ray spectroscopy (EDS). Material and methods: Forty-five extracted human teeth were immersed in 5 solutions (wine, coffee, tea, soda, and water) for 15 days at 80°C, and the change in ΔE was assessed with a colorimeter. The teeth were bleached using different concentrations of carbamide peroxide (20%, 35%, and 44%) and ΔE was measured at different time intervals. The teeth were then restained with the same solutions. The ΔE after initial staining was compared with the ΔE after bleaching and restaining of the same teeth. SEM was performed at baseline, after staining, bleaching, and restaining to evaluate the changes in the enamel surface topography. EDS was used to determine the elemental composition of tooth surfaces after restaining. Results: All liquids caused a ΔE greater than 2 after 15 days. The concentration of bleaching agent was not significantly associated with ΔE for any stain types. No significant difference was found in the rate of staining between initial staining and restaining after bleaching. However, a significant effect of time was found for the staining, where the overall ΔE increased by 0.34 for each day in the solution (P<.001). SEM images showed no major changes to enamel topography after bleaching. However, a coating was noted on teeth stained with wine and tea, which had different elemental compositions when compared with the tooth surface. Conclusions: Based on SEM observation, bleaching teeth with carbamide peroxide does not increase the susceptibility of enamel to staining and does not alter the topography of the enamel. Using higher bleaching concentrations did not increase tooth whitening as a function of time.

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