Abstract
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.
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References
Dey S, Pandey V, Kumar A, Awasthi N, Sahu A, Pujari SC. In vitro comparison of impact of different bleaching agents on the microhardness of enamel. J Contemp Dent Pract. 2016;17:258–62.
Matis BA, Wang G, Matis JI, Cook NB, Eckert GJ. White diet: is it necessary during tooth whitening? Oper Dent. 2015;40:235–40.
Kershaw S, Newton JT, Williams DM. The influence of tooth colour on the perceptions of personal characteristics among female dental patients: comparisons of unmodified, decayed and ‘whitened’ teeth. Br Dent J. 2008;204:256–57.
Klaric E, Rakic M, Sever I, Milat O, Par M, Tarle Z. Enamel and dentin microhardness and chemical composition after experimental light-activated bleaching. Oper Dent. 2015;40:32–41.
Ghanbarzadeh M, Ahrari F, Akbari M, Hamzei H. Microhardness of demineralized enamel following home bleaching and laser-assisted in office bleaching. J Clin Exp Dent. 2015;7:405–09.
Cardoso PC, Reis A, Loguercio A, Vieira LC, Baratieri LN. Clinical effectiveness and tooth sensitivity associated with different bleaching times for a 10 percent carbamide peroxide gel. J Am Dent Assoc. 2010;141:1213–220.
Carey CM. Tooth whitening: what we now know. J Evid Based Dent Pract. 2014;14:70–6.
Fugaro JO, Nordahl I, Fugaro OJ, Matis BA, Mjör IA. Pulp reaction to vital bleaching. Oper Dent. 2004;29:363–68.
ten Cate JM, van Loveren C. Fluoride mechanisms. Dent Clin North Am. 1999;43:713–42.
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.
Jeong SH, Jang SO, Kim KN, Kwon HK, Park YD, Kim BI. Remineralization potential of new toothpaste containing nano-hydroxyapatite. Key Eng Mater. 2006;309:537–40.
Goldberg M, Grootveld M, Lynch E. Undesirable and adverse effects of tooth-whitening products: a review. Clin Oral Investig. 2010;14:1–10.
Alessandri Bonetti G, Zanarini M, Incerti Parenti S, Lattuca M, Marchionni S, Gatto MR. Evaluation of enamel surfaces after bracket debonding: an in-vivo study with scanning electron microscopy. Am J Orthod Dentofacial Orthop. 2011;140:696–702.
Coceska E, Gjorgievska E, Coleman NJ, Gabric D, Slipper IJ, Stevanovic M, Nicholson JW. Enamel alteration following tooth bleaching and remineralization. J Microsc. 2016;262:232–44.
Lucchese A, Pilolli GP, Petruzzi M, Crincoli V, Scivetti M, Favia G. Analysis of collagen distribution in human crown dentin by confocal laser scanning microscopy. Ultrastruct Pathol. 2008;32:107–11.
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.
Grassia V, Gentile E, Di Stasio D, Jamilian A, Matarese G, D’Apuzzo F, Santoro R, Perillo L, Serpico R, Lucchese A. In vivo confocal microscopy analysis ofenamel defects after orthodontic treatment: A preliminary study. Ultrastruct Pathol. 2016;40:317–23.
Contaldo M, Serpico R, Lucchese A. In vivo imaging of enamel by reflectance confocal microscopy (RCM): non-invasive analysis of dental surface. Odontology. 2014;102:325–29.
Contaldo M, Di Stasio D, Santoro R, Laino L, Perillo L, Petruzzi M, Lauritano D, Serpico R, Lucchese A. Non-invasive in vivo visualization of enamel defects by reflectance confocal microscopy (RCM). Odontology. 2015;103:177–84.
Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis. Nat Methods. 2012;9:671–75.
Mostaço-Guidolin LB, Ko AC, Wang F, Xiang B, Hewko M, Tian G, Major A, Shiomi M, Sowa MG. Collagen morphology and texture analysis: from statistics to classification. Sci Rep. 2013;3:2190.
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.
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.
Parreiras SO, Vianna P, Kossatz S, Loguercio AD, Reis A. Effects of light activated in-office bleaching on permeability, microhardness, and mineral content of enamel. Oper Dent. 2014;39:225–30.
Borges AB, Zanatta RF, Barros AC, Silva LC, Pucci CR, Torres CR. Effect of hydrogen peroxide concentration on enamel color and microhardness. Oper Dent. 2015;40:96–101.
Matis BA, Cochran MA, Eckert G. Review of the effectiveness of various tooth whitening systems. Oper Dent. 2009;34:230–35.
Markovic L, Fotouhi K, Lorenz H, Jordan RA, Gaengler P, Zimmer S. Effects of bleaching agents on human enamel light reflectance. Oper Dent. 2010;35:405–11.
Dahl T, He GX, Samuels G. Effect of hydrogen peroxide on the viscosity of a hydroxyethylcellulose-based gel. Pharm Res. 1998;15:1137–140.
Lucchese A, Gentile E, Romano A, Maio C, Laino L, Serpico R. The potential role of in vivo reflectance confocal microscopy for evaluating oral cavity lesions: a systematic review. J Oral Pathol Med. 2016;45:723–29.
Acknowledgements
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.
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De Rosa, A., Di Stasio, D., Lauritano, D. et al. Non-invasive analysis of bleaching effect of hydrogen peroxide on enamel by reflectance confocal microscopy (RCM): study of series of cases. Odontology 107, 285–290 (2019). https://doi.org/10.1007/s10266-019-00416-8
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DOI: https://doi.org/10.1007/s10266-019-00416-8