Bleaching gel mixed with MI Paste Plus reduces penetration of H2O2 and damage to pulp tissue and maintains bleaching effectiveness

  • Jéssica Galbiati Barbosa
  • Francine Benetti
  • Marjorie de Oliveira Gallinari
  • Marina Carminatti
  • Anna Beatriz Dias da Silva
  • Isabela Nakahara Ikeda Lopes
  • André Luiz Fraga Briso
  • Luciano Tavares Angelo CintraEmail author
Original Article



MI Paste Plus remineralizer (Rem) strengthens dental structures after bleaching. We investigated the effect of Rem on the penetration of hydrogen peroxide (H2O2), bleaching effectiveness, and pulp inflammation after bleaching.

Materials and methods

Bovine disks were grouped as follows (n = 10): control (untreated), bleached (Ble; 35% H2O2, 30 min), Ble-Rem (H2O2 followed by Rem, 30 min), Rem-Ble (Rem followed by H2O2), Rem-Ble-Rem (Rem before and after H2O2), and Ble+Rem (mixture of Rem with H2O2, 1:1, 30 min). The penetration of H2O2 was quantified and bleaching efficacy was analyzed. Upper rat molars (n = 10) received the same treatments at random. The rats were euthanized after two days and 30 days, and their jaws were removed for histological analysis. Statistical tests were performed (P < 0.05).


The bleached groups, except Ble+Rem (P > 0.05), showed significant H2O2 penetration compared with control (P < 0.05). Color alteration analysis showed that ΔL and ΔE were significantly higher in the bleached groups than those in control (P < 0.05); the Δb of the bleached groups differed from that of control at 24 h (P < 0.05). At two days, necrosis or inflammation was observed in the bleached groups compared with control (P < 0.05), except Ble+Rem, which was similar to control (P > 0.05). At 30 days, tertiary dentin formation was significant in the bleached groups (P < 0.05), except Ble+Rem (P > 0.05).


The mixture of MI Paste Plus and bleaching gel reduces H2O2 penetration and pulp damage and maintains bleaching effectiveness.

Clinical relevance

Because bleaching can damage dental tissues, we studied a new bleaching protocol that reduces damage to the pulp tissue while maintaining bleaching efficiency: a single application of 30 min of MI Paste Plus mixed with 35% H2O2 bleaching gel (1:1).


Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) Dental bleaching Hydrogen peroxide MI Paste Plus Pulp inflammation 



This study was supported by a grant (2015/10984-3) from the Fundação de Amparo à Pesquisa do Estado de São Paulo, São Paulo, SP, Brazil.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants by any of the authors. The in vitro (CEUA 00568) and in vivo (CEUA 00631) studies using rat molars were approved by the ethics committee of the institution where the study was performed and conducted in accordance with its ethical standards.

Informed consent

For this type of study, informed consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Jéssica Galbiati Barbosa
    • 1
  • Francine Benetti
    • 1
    • 2
  • Marjorie de Oliveira Gallinari
    • 3
  • Marina Carminatti
    • 1
  • Anna Beatriz Dias da Silva
    • 1
  • Isabela Nakahara Ikeda Lopes
    • 1
  • André Luiz Fraga Briso
    • 3
  • Luciano Tavares Angelo Cintra
    • 1
    Email author
  1. 1.Department of EndodonticsSão Paulo State University (Unesp), School of DentistryAraçatubaBrazil
  2. 2.Restorative Dentistry, School of Dentistry, UFMG - Universidade Federal de Minas GeraisBelo HorizonteBrazil
  3. 3.Department of Restorative DentistrySão Paulo State University (Unesp), School of DentistryAraçatubaBrazil

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