Non-invasive analysis of bleaching effect of hydrogen peroxide on enamel by reflectance confocal microscopy (RCM): study of series of cases
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The aim of this study is to evaluate in vivo the effects of in-office tooth whitening hydrogen peroxide (HP) agent on enamel-microstructured surface by a reflectance confocal microscopy (RCM). Ten healthy volunteers assisted at the Dental School presenting teeth with vital pulp were selected. The 35% HP whiteness product was applied in two visits on discolored teeth, 1-week interval between, via 20-min applications. A commercially available hand-held RCM (Vivascope3000®, Lucid, Rochester, NY, USA) was used to image in vivo the dental surface of the selected tooth of each volunteer. Twenty upper central incisors’ vestibular surfaces were imaged, before bleaching (T0), immediately after (T1) and 1 week later (T2). The peculiar structure of the enamel was seen at T0. After bleaching, white reflective circular bodies were found all over the teeth surfaces, which disappear 1 week later (T2). When the HP gel® was imaged, the same white circular areas were observed. Going deeper, the regular enamel architecture was preserved. Textural analysis of the images in T0 and T2 was performed: GLCM parameters were extracted. Mann–Whitney U test was performed to evaluate statistical differences between two groups of data (p > 0.05). Finally, 35 prisms were randomly selected from T0 and T2 image and diameters were measured; a paired t test was performed (p = 0.381). The RCM is a promisor tool for investigating the features of enamel in vivo, immediately after bleaching procedures, as well as longitudinally.
KeywordsBleaching Hydrogen peroxide Confocal laser scanning microscopy In vivo imaging Image analysis
We want to acknowledge all the patients involved in the present study for their kindly collaboration and indirect support to this study with their smiles. Conceived and designed the experiments: AL, DD, DA, IA. Performed the clinical examination: AL, DD, DA. Performed the experiments: AL, DD. Analyzed the data: AL, DD, DA, SR, MA. Wrote this paper: DD, DA, AL, SR, DL, IA. Performed the statistical analysis: DD.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 8.Fugaro JO, Nordahl I, Fugaro OJ, Matis BA, Mjör IA. Pulp reaction to vital bleaching. Oper Dent. 2004;29:363–68.Google Scholar
- 9.ten Cate JM, van Loveren C. Fluoride mechanisms. Dent Clin North Am. 1999;43:713–42.Google Scholar
- 10.Gjorgievska ES, Nicholson JW. A preliminary study of enamel remineralization by dentifrices based on Recaldent (CPP-ACP) and Novamin(calcium-sodium phosphosilicate). Acta Odontol Latinoam. 2010;23:234–39.Google Scholar
- 16.Pilolli GP, Lauritano D, Lucchese A, Di Stasio D, Petruzzi M, Marrone G, Serpico R, Favia G. In vitro analysis of marginal adaptation and resistance of different dental composites: stereo and scanning electron microscopic evaluation. J Biol Regul Homeost Agents. 2015;29:82–8.Google Scholar
- 22.Tay LY, Kose C, Herrera DR, Reis A, Loguercio AD. Long-term efficacy of in-office and at-home bleaching: a 2-year double-blind randomized clinical trial. Am J Dent. 2012;25:199–204.Google Scholar
- 23.Torres CR, Crastechini E, Feitosa FA, Pucci CR, Borges AB. Influence of pH on the effectiveness of hydrogen peroxide whitening. Oper Dent. 2014;39:61–8.Google Scholar