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A new three-component formulation for the efficient whitening of teeth (Carbamide Plus)

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Abstract

Objectives

This study aimed to develop and characterise a new three-component dental whitening formulation which is as effective as the currently used carbamide peroxide but at significantly lower hydrogen peroxide concentrations.

Materials and methods

The new formulation (Carbamide Plus) was prepared containing hydrogen peroxide, urea, and sodium tripolyphosphate and compared directly with carbamide peroxide (containing just hydrogen peroxide and urea). To evaluate the clinical effectiveness of 5 % Carbamide Plus, a randomised double-blind placebo-controlled clinical trial was conducted comparing the tooth colour of 33 patients using L*a*b* scores at baseline and after a 2-week whitening treatment. The behaviour of the three components in solution was determined by 1H and 31P NMR spectroscopy and pH dilution experiments.

Results

This clinical trial revealed that 5 % whitening gels containing Carbamide Plus were as effective as those containing 10 % carbamide peroxide. 1H and 31P NMR spectroscopy revealed strong intermolecular interactions between hydrogen peroxide and both urea and sodium tripolyphosphate (STPP) with little apparent interaction between urea and STPP.

Conclusions

In this manuscript, we postulate that this increased whitening efficiency is due to a marked increase in local pH upon dilution which destabilises the hydrogen peroxide and expedites the whitening process. We postulate Carbamide Plus to be a three-component adduct with two molecules of carbamide peroxide binding to a central STPP unit with no direct interaction between STPP and urea. There were no statistically significant differences between Carbamide Plus and 10 % carbamide peroxide in tooth-whitening achieved at 2 weeks. These results were recorded following 2 weeks of 2-h daily wear of at-home trays.

Clinical relevance

Carbamide Plus offers the potential of using significantly lower levels of hydrogen peroxide concentration to achieve similar dental whitening effects.

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Acknowledgments

The authors acknowledge SMT Ltd and the Department of Learning (DEL) in Northern Ireland for a DEL CAST studentship. Dr. McDonald acknowledges part funding by SMT of the clinical trial.

Conflict of interest

Prof. Callan reports grants from null, during the conduct of the study.

Author information

Authors and Affiliations

  1. School of Pharmacy and Pharmaceutical Sciences, University of Ulster, Coleraine, Northern Ireland, BT52 1SA, UK

    Barry W. Hyland, Bridgeen McCaughan & John F. Callan

  2. Unit of Prosthodontics, UCL Eastman Dental Institute, 256 Grays Inn Rd., London, WC1X8LD, UK

    Ailbhe McDonald, Nicholas Lewis & Christopher Tredwin

  3. Unit of Biostatistics, UCL Eastman Dental Institute, 256 Grays Inn Rd., London, WC1X8LD, UK

    Aviva Petrie

  4. SMT Research Ltd., 35 Crescent Business Park, Enterprise Crescent, Lisburn, County Antrim, Nothern Ireland, UK

    Sean Hall & Chris Todd

Authors
  1. Barry W. Hyland
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  2. Ailbhe McDonald
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  3. Nicholas Lewis
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  4. Christopher Tredwin
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  5. Aviva Petrie
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  6. Sean Hall
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  7. Chris Todd
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  8. Bridgeen McCaughan
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  9. John F. Callan
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Corresponding authors

Correspondence to Ailbhe McDonald or John F. Callan.

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Hyland, B.W., McDonald, A., Lewis, N. et al. A new three-component formulation for the efficient whitening of teeth (Carbamide Plus). Clin Oral Invest 19, 1395–1404 (2015). https://doi.org/10.1007/s00784-014-1352-9

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  • DOI: https://doi.org/10.1007/s00784-014-1352-9

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