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Enamel Surface and Elemental Changes Following In Vitro Bleaching: A SEM-EDS Approach.

Berivan Laura Rebeca Buzatu1,2,3, Ramona Dumitrescu2,3, Magda Mihaela Luca4

  • 1Faculty of Dental Medicine, Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.

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PubMed
Summary

In-office bleaching alters tooth enamel, with light-activated hydrogen peroxide causing significant mineral loss. BlancOne Ultra+ showed the most severe enamel changes compared to other dental bleaching agents.

Keywords:
X-Ray microanalysiselectronhydrogen peroxide/pharmacologymicroscopyscanningtooth bleachingtooth enamel/chemistry

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Area of Science:

  • Dental Materials Science
  • Biomaterials
  • Surface Chemistry

Background:

  • Chairside bleaching procedures can impact tooth enamel's surface morphology and mineral composition.
  • Understanding these changes is crucial for predicting clinical outcomes and ensuring long-term dental health.

Purpose of the Study:

  • To compare the in vitro effects of three different in-office bleaching protocols on human tooth enamel.
  • To evaluate surface alterations and elemental composition changes using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS).

Main Methods:

  • Forty-two human premolars/molars were divided into control and three experimental groups.
  • Experimental groups received Opalescence Quick (45% carbamide peroxide), Opalescence Boost (40% hydrogen peroxide), or BlancOne Ultra+ (35% hydrogen peroxide with light activation).
  • SEM analyzed surface topography, and EDS quantified elemental percentages (O, Ca, P, C).

Main Results:

  • All bleaching protocols induced surface alterations and elemental shifts in enamel.
  • BlancOne Ultra+ exhibited the most severe demineralization, with significant decreases in calcium (Ca) and phosphorus (P) levels.
  • Opalescence Quick showed moderate surface changes, while Opalescence Boost resulted in superficial restructuring with variable mineral content.
  • Significant differences in Ca and P content were observed across all bleached groups (p < 0.001).

Conclusions:

  • All tested in-office bleaching agents alter enamel surface and composition, with a severity gradient: BlancOne Ultra+ > Opalescence Boost > Opalescence Quick.
  • High-concentration, light-activated hydrogen peroxide agents cause the most substantial calcium and phosphorus loss.
  • Clinical recommendations include considering neutral-pH, non-activated, or chemically activated systems and prioritizing immediate post-bleaching remineralization, especially before restorative procedures.