Objective: To investigate the effect of permeable resin on the surface structure, microhardness and color of tooth enamel after bleaching. Methods: Premolars extracted for orthodontic needs were selected (provided by the Department of Oral and Maxillofacial surgery of the first affiliated Hospital of Zhengzhou University) and randomly divided into A, B and C 3 groups. Each group was randomly divided into control subgroup, resin subgroup, bleaching subgroup and combined subgroup. Samples in the control subgroup did not receive any treatment. Those in the bleaching subgroup and combined subgroup were treated with cold light whitening. Those in the resin group and combined group were treated with permeable resin. Samples in the group A were observed by scanning electron microscope immediately after treatment and 2 weeks after treatment, and the microhardness of samples in the group B was measured before treatment, immediately after treatment and 2 weeks after treatment (the sample size of each time point was 8 in each subgroup). In group C, chromaticity was measured and chromatic aberration (ΔE value) was calculated before treatment, immediately after treatment and 1 and 2 weeks after treatment (10 samples in each subgroup). Results: Scanning electron microscope showed that the enamel surface of the resin subgroup and the combined group was smooth immediately after treatment, which was basically the same as that of the control subgroup, but covered with resin, and microporous defects and mineral deposits could be seen on the surface of the bleaching subgroup. Two weeks after treatment, the enamel surface of each subgroup was smooth, there was no obvious difference. Immediately after treatment, the microhardness of the control subgroup, resin subgroup, bleaching subgroup and combined subgroup were (354±33), (364±21), (411±30) and (350±17) HV, respectively (F=9.39,P<0.05). The microhardness of the bleaching subgroup was significantly higher than that of the other subgroups (P<0.05). There was no significant difference in microhardness among the four subgroups before treatment and 2 weeks after treatment (F=0.34, 2.75, P>0.05). Immediately after treatment, the ΔE values of the control subgroup, resin subgroup, bleaching subgroup and combined subgroup were 0.00±0.00, 2.29±1.86, 7.20±1.94 and 8.00±0.88, respectively (F=74.21,P<0.05); except that there was no significant difference between bleaching subgroup and combined subgroup (P>0.05), there were significant differences among the other subgroups (P<0.05). There was no significant difference in ΔE value among control subgroup, resin subgroup and bleaching subgroup at each time point (F=1.66, 0.30, 0.96, P>0.05). The difference in the combined subgroup immediately after treatment was significantly higher than that at 1 and 2 weeks after treatment (t=4.73, 4.23,P<0.05), but there was no significant difference between 1 and 2 weeks after treatment (t=0.75, P>0.05), and the color tended to be stable. Conclusions: When whitening healthy enamel, simple cold light whitening or cold light whitening combined with permeation resin can achieve whitening effect.
Color ; Dental Enamel ; Hardness ; Humans ; Hydrogen Peroxide/pharmacology* ; Tooth Bleaching/adverse effects* ; Tooth Bleaching Agents/pharmacology*

Tooth bleaching agents contain powerful oxidizing agents, which serve as the main part of bleaching agents because of its release of effective bleaching component. It has been a hot topic whether tooth bleaching agents exert negative influence on oral health. In order to provide train of thoughts and reference for further clinical researches and treatments, this review paper focuses on bleaching agents' effects on the growth of oral microbes and the formation of biofilms.
Bacteria ; drug effects ; growth & development ; Biofilms ; drug effects ; growth & development ; Humans ; Hydrogen Peroxide ; Mouth ; microbiology ; Oral Health ; Oxidants ; pharmacology ; Tooth Bleaching ; Tooth Bleaching Agents ; pharmacology

This in vitro study aims to evaluate the crystal and surface microstructure of dental enamel after cold-light bleaching treatment. Twelve sound human premolars were cross-split into four specimens, namely, mesio-buccal (Group LP), disto-buccal (Group P), mesio-lingual (Group NP) and disto-lingual (Group L) specimens. These four groups were treated using the standard cold-light bleaching procedure, a bleaching agent, a peroxide-free bleaching agent and cold-light, respectively. Before and after treatment, all specimens were analyzed by high-resolution, micro-area X-ray diffraction and scanning electron microscopy. Using a spectrometer, tooth color of all specimens was measured before and after treatment. The phase of the enamel crystals was identified as hydroxyapatite and carbonated hydroxyapatite. After treatment, specimens in Groups LP and P showed significantly weaker X-ray diffraction peaks, significant reduction in crystal size and crystallinity, significant increase in L* but decrease in a* and b*, and obvious alterations in the surface morphology. However, specimens in Groups NP and L did not show any significant changes. The cold-light bleaching treatment leads to demineralization in the enamel surface. The acidic peroxide-containing bleaching agent was the major cause of demineralization, whereas cold-light did not exhibit significant increase or decrease effect on this demineralization.
Color ; Crystallography ; Dental Enamel ; drug effects ; radiation effects ; ultrastructure ; Durapatite ; radiation effects ; Humans ; Hydrogen Peroxide ; pharmacology ; Hydrogen-Ion Concentration ; Lighting ; instrumentation ; Materials Testing ; Microscopy, Electron, Scanning ; Silicon Dioxide ; pharmacology ; Spectrum Analysis ; Tooth Bleaching ; methods ; Tooth Bleaching Agents ; classification ; pharmacology ; Tooth Demineralization ; pathology ; X-Ray Diffraction

OBJECTIVETo investigate the effects of three differently concentrated at-home bleaching agents on the structure and the structure-related mechanical properties of human enamel.

METHODSSixty enamel specimens were randomly divided into four groups and treated with 10% carbamide peroxide (CP), 15% CP, 20% CP and distilled water, respectively. The bleaching process was 8 h/day for 14 consecutive days. Baseline and final atomic force microscopy (AFM) surface detection, Raman spectroscopy, attenuated total reflectance-infrared spectroscopy (ATR-IR), microhardness and fracture toughness (FT) measurements were carried out before and after bleaching experiments.

RESULTSCP didn't change the morphology of enamel. Meanwhile, the three bleached groups and the control group had no significant difference in root mean square detection (P = 0.774), ν(2)CO(3)(2-) : ν(1)ν(3)PO(4)(3-) (P = 0.263) and microhardness (P = 0.829). The percentage of relative Raman intensity in the three bleached groups and the control group were (105.74 ± 11.34)%, (104.46 ± 8.83)%, (99.52 ± 9.32)% and (97.62 ± 7.46)%, respectively. There was no significant difference among them (P = 0.062). However, the percentage of laser-induced fluorescence in the three bleached groups and the control group were (20.86 ± 7.23)%, (22.14 ± 7.34)%, (21.10 ± 7.59)% and (100.78 ± 3.70)%, respectively. There was significant difference between either of the bleached groups and the control group (P < 0.001). Moreover, FT declined significantly in the three groups (P = 0.024, P = 0.005, P = 0.013) when compared with the control group.

CONCLUSIONSUnder in vitro condition, three differently concentrated at-home bleaching agents wouldn't induce the demineralization and the decline of microhardness on enamel. However, the decrease of FT on enamel seemed to be inevitable after bleaching.

Dental Enamel ; drug effects ; Dose-Response Relationship, Drug ; Hardness ; drug effects ; Humans ; Microscopy, Atomic Force ; Peroxides ; administration & dosage ; pharmacology ; Random Allocation ; Spectrophotometry, Infrared ; Spectrum Analysis, Raman ; Surface Properties ; Tooth Bleaching ; Tooth Bleaching Agents ; administration & dosage ; pharmacology ; Tooth Demineralization ; chemically induced ; Urea ; administration & dosage ; analogs & derivatives ; pharmacology

Tooth bleaching agents may weaken the tooth structure. Therefore, it is important to minimize any risks of tooth hard tissue damage caused by bleaching agents. The aim of this study was to evaluate the effects of applying 45S5 bioglass (BG) before, after, and during 35% hydrogen peroxide (HP) bleaching on whitening efficacy, physicochemical properties and microstructures of bovine enamel. Seventy-two bovine enamel blocks were prepared and randomly divided into six groups: distilled deionized water (DDW), BG, HP, BG before HP, BG after HP and BG during HP. Colorimetric and microhardness tests were performed before and after the treatment procedure. Representative specimens from each group were selected for morphology investigation after the final tests. A significant color change was observed in group HP, BG before HP, BG after HP and BG during HP. The microhardness loss was in the following order: group HP>BG before HP, BG after HP>BG during HP>DDW, BG. The most obvious morphological alteration of was observed on enamel surfaces in group HP, and a slight morphological alteration was also detected in group BG before HP and BG after HP. Our findings suggest that the combination use of BG and HP could not impede the tooth whitening efficacy. Using BG during HP brought better protective effect than pre/post-bleaching use of BG, as it could more effectively reduce the mineral loss as well as retain the surface integrity of enamel. BG may serve as a promising biomimetic adjunct for bleaching therapy to prevent/restore the enamel damage induced by bleaching agents.
Animals ; Biomimetic Materials ; analysis ; therapeutic use ; Cattle ; Ceramics ; analysis ; chemistry ; Chemical Phenomena ; Color ; Colorimetry ; Dental Enamel ; drug effects ; ultrastructure ; Electron Probe Microanalysis ; Glass ; analysis ; chemistry ; Hardness ; Hydrogen Peroxide ; pharmacology ; Hydrogen-Ion Concentration ; Microscopy, Electron, Scanning ; Protective Agents ; analysis ; therapeutic use ; Random Allocation ; Solubility ; Spectroscopy, Fourier Transform Infrared ; Time Factors ; Tooth Bleaching ; methods ; Tooth Bleaching Agents ; pharmacology ; Water ; chemistry ; X-Ray Diffraction