Effect of Hydrogen and Carbamide Peroxide in Bleaching, Enamel Morphology, and Mineral Composition: In vitro Study

The aim of the study was to evaluate the bleaching effect, morphological changes, and variations in calcium (Ca) and phosphate (P) in the enamel with hydrogen peroxide (HP) and carbamide peroxide (CP) after the use of different application regimens.

Four groups of five teeth were randomly assigned, according to the treatment protocol: HP 37.5% applied for 30 or 60 minutes (HP30, HP60), CP 16% applied for 14 or 28 hours (CP14, CP28). Changes in dental color were evaluated, according to the following formula: ΔE = [(L_a-L_b)²+(a_a-a_b)² + (b_a-b_b)²]^1/2. Enamel morphology and Ca and P compositions were evaluated by confocal laser scanning microscope and environmental scanning electron microscopy.

ΔE HP30 was significantly greater than CP14 (10.37 ± 2.65/8.56 ± 1.40), but not between HP60 and CP28. HP60 shows greater morphological changes than HP30. No morphological changes were observed in the groups treated with CP. The reduction in Ca and P was significantly greater in HP60 than in CP28 (p < 0.05).

Both formulations improved tooth color; HP produced morphological changes and Ca and P a gradual decrease, while CP produced no morphological changes, and the decrease in mineral component was smaller.

CP 16% applied during 2 weeks could be equally effective and safer for tooth whitening than to administer two treatment sessions with HP 37.5%.