Does the Use of a "Walking Bleaching" Technique Increase Bone Resorption Markers?

Area of Science:

• Endodontics
• Periodontology
• Dental Materials Science

Background:

• Nonvital tooth discoloration is a common esthetic concern.
• Walking bleaching is a standard technique for nonvital tooth whitening.
• Potential periodontal side effects of bleaching agents require investigation.

Purpose of the Study:

• To compare the effects of 35% hydrogen peroxide and 37% carbamide peroxide on periodontal markers during nonvital tooth bleaching.
• To evaluate nuclear factor kappa B-ligand (RANK-L) and interleukin 1β (IL-1β) levels in gingival crevicular fluid.

Main Methods:

• A randomized clinical trial involving 50 volunteers with discolored nonvital teeth.
• Teeth were treated with either 35% hydrogen peroxide or 37% carbamide peroxide using the walking bleaching technique (four sessions).
• Gingival crevicular fluid was sampled at multiple time points to quantify RANK-L and IL-1β via ELISA.

Main Results:

• Both hydrogen peroxide and carbamide peroxide significantly increased RANK-L and IL-1β levels compared to baseline (p<0.05).
• No significant differences were observed between the two bleaching agents regarding the increase in these periodontal biomarkers.
• Tooth color improvement was significant for both treatment groups (p<0.05).

Conclusions:

• Nonvital tooth bleaching, regardless of the agent used (hydrogen peroxide or carbamide peroxide), leads to a significant increase in periodontal inflammatory and resorption markers.
• The walking bleaching technique effectively whitens nonvital teeth while inducing transient changes in periodontal tissue markers.