Effectiveness and SEM-EDX analysis following bleaching with an experimental bleaching gel containing titanium dioxide...

The aim of this study was to evaluate the bleaching effectiveness and mineral alterations following the use of experimental bleaching gels that included 6% hydrogen peroxide (HP), titanium dioxide (TiO₂) and/or chitosan in comparison with the routinely used 35% HP bleaching gel. Thirty-six maxillary anterior teeth were divided into three groups according to bleaching agent as follows: Group 1: 6% HP + TiO₂, Group 2: 6% HP + TiO₂ + chitosan, Group 3: 35% HP. Tooth colour was measured with a spectrophotometer before bleaching and after sessions one and two on days 14 and 30, respectively. Colour changes were assessed with the CIEDE2000 and CIELab formulas. Mineral analysis was performed with a scanning electron microscopy-energy dispersive X-ray (SEM-EDX) device before and 14 days after application. The enamel surfaces of randomly selected samples from each group were analysed by SEM. Two-way ANOVA was used to compare differences between groups. All tested materials resulted in significantly increased bleaching compared to the initial colour values (p < 0.05). Group 3 showed significantly more whitening compared to the other groups after the first and second sessions (p < 0.05). However, Group 2 presented prolonged whitening efficiency and reached a bleaching level similar to the 35% HP treatment after 14 and 30 days. The results of the CIEDE2000 and CIELab formulas were found to be correlated (r > 0.6). The increases in Ca were similar in Groups 2 and 3 (p > 0.05) and were significantly higher than that in Group 1 (p < 0.05). p was similarly decreased among all groups (p > 0.05). The combination of 6% HP, chitosan and TiO₂ appears to constitute a promising material for tooth whitening, showing good bleaching efficiency and acceptable mineral alterations.