Clinical Oral Investigations

, Volume 15, Issue 5, pp 673–680 | Cite as

Effect of carbamide peroxide and hydrogen peroxide on enamel surface: an in vitro study

  • Thaer AbouassiEmail author
  • Martin Wolkewitz
  • Petra Hahn
Original Article


The aim of the study was to investigate changes in the micromorphologyl and microhardness of the enamel surface after bleaching with two different concentrations of hydrogen peroxide (HP) and carbamide peroxide (CP). Bovine enamel samples were embedded in resin blocks, and polished. Specimens in the experimental groups (n = 10) were treated with bleaching gels containing 10% CP, 35% CP, 3.6% HP, and 10% HP, respectively, for 2 h every second day over a period of 2 weeks. The gels had the identical composition and pH and differed only in their HP or CP content. The roughness and morphology of the enamel surface were analyzed using laser profilometry and SEM. Microhardness was measured using a Knoop hardness tester. The data were evaluated statistically. Specimens in the 10% HP group showed significantly higher roughness after bleaching compared to the control group (ΔRa, p = 0.01). Bleaching with 35% CP showed only a tendency to increase roughness (ΔRa, p = 0.06). Application of 10% CP or 3.6% HP had no significant influence on Ra. Enamel microhardness was significantly higher after application of 10% HP compared to the control (ΔMic = 8 KHN, p = 0.0002) and 35% CP (ΔMic = 20KHN, p = 0.01) groups. In summary, application of CP and HP showed only small quantitative and qualitative differences. In addition, the influence of bleaching procedure on the morphology and hardness of the enamel surface depended on the concentration of the active ingredients.


Bleaching Enamel surface Roughness Microhardness Hydrogen peroxide Carbamide peroxide 



The bleaching materials used in this study were provided by Ultradent® Products Inc (South Jordan, UT, USA).

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Burrows S (2009) A review of the efficacy of tooth bleaching. Dent Update 36:537–538, 541–544, 547–548Google Scholar
  2. 2.
    Matis BA, Cochran MA, Eckert G (2009) Review of the effectiveness of various tooth whitening systems. Oper Dent 34:230–235PubMedCrossRefGoogle Scholar
  3. 3.
    Tredwin CJ, Naik S, Lewis NJ, Scully C (2006) Hydrogen peroxide tooth whitening (bleaching) products: review of adverse effects and safety issues. Br Dent J 200:371–376. doi: 10.1038/sj.bdj.4813423 PubMedCrossRefGoogle Scholar
  4. 4.
    Dahl JE, Pallesen U (2003) Tooth bleaching—a critical review of the biological aspects. Crit Rev Oral Biol Med 14:292–304. doi: 10.1177/154411130301400406 PubMedCrossRefGoogle Scholar
  5. 5.
    Markovic L, Jordan RA, Lakota N, Gaengler P (2007) Micromorphology of enamel surface after vital tooth bleaching. J Endod 33:607–610. doi: 10.1016/j.joen.2007.01.011 PubMedCrossRefGoogle Scholar
  6. 6.
    Yazici AR, Khanbodaghi A, Kugel G (2007) Effects of an in-office bleaching system (ZOOM) on pulp chamber temperature in vitro. J Contemp Dent Pract 8:19–26PubMedGoogle Scholar
  7. 7.
    Seghi RR, Denry I (1992) Effects of external bleaching on indentation and abrasion characteristics of human enamel in vitro. J Dent Res 71:1340–1344. doi: 10.1177/00220345920710061201 PubMedCrossRefGoogle Scholar
  8. 8.
    Goldberg M, Grootveld M, Lynch E (2010) Undesirable and adverse effects of tooth whitening products: a review. Clin Oral Investig 14:1–10. doi: 10.1007/s00784-009-0302-4 PubMedCrossRefGoogle Scholar
  9. 9.
    Wiegand A, Vollmer D, Foitzik M, Attin R, Attin T (2005) Efficacy of different whitening modalities on bovine enamel and dentin. Clin Oral Investig 9:91–97. doi: 10.1007/s00784-004-0291-2 PubMedCrossRefGoogle Scholar
  10. 10.
    Borges AB, Samezima LY, Fonseca LP, Yui KC, Borges AL, Torres CR (2009) Influence of potentially remineralizing agents on bleached enamel microhardness. Oper Dent 34:593–597. doi: 10.2341/08-081-L PubMedCrossRefGoogle Scholar
  11. 11.
    Zantner C, Beheim-Schwarzbach N, Neumann K, Kielbassa AM (2007) Surface microhardness of enamel after different home-bleaching procedures. Dent Mater 23:243–250. doi: 10.1016/ PubMedCrossRefGoogle Scholar
  12. 12.
    Yu H, Li Q, Hussain M, Wang Y (2008) Effects of bleaching gels on the surface microhardness of tooth-colored restorative materials in situ. J Dent 36:261–267. doi: 10.1016/j.jdent.2008.01.008 PubMedCrossRefGoogle Scholar
  13. 13.
    de Magalhaes MT, Basting RT, de Almeida ER, Pelino JE (2009) Diode laser effect on enamel microhardness after dental bleaching associated with fluoride. Photomed Laser Surg. doi: 10.1089/pho.2008.2440 Google Scholar
  14. 14.
    Ren YF, Amin A, Malmstrom H (2009) Effects of tooth whitening and orange juice on surface properties of dental enamel. J Dent 37:424–431. doi: 10.1016/j.jdent.2009.01.011 PubMedCrossRefGoogle Scholar
  15. 15.
    Dutra RA, Branco JR, Alvim HH, Poletto LT, Albuquerque RC (2009) Effect of hydrogen peroxide topical application on the enamel and composite resin surfaces and interface. Indian J Dent Res 20:65–70PubMedCrossRefGoogle Scholar
  16. 16.
    Moraes RR, Marimon JL, Schneider LF, Correr Sobrinho L, Camacho GB, Bueno M (2006) Carbamide peroxide bleaching agents: effects on surface roughness of enamel, composite and porcelain. Clin Oral Investig 10:23–28. doi: 10.1007/s00784-005-0016-1 PubMedCrossRefGoogle Scholar
  17. 17.
    Cobankara FK, Unlu N, Altinoz HC, Fusun O (2004) Effect of home bleaching agents on the roughness and surface morphology of human enamel and dentine. Int Dent J 54:211–218PubMedCrossRefGoogle Scholar
  18. 18.
    Attin T, Muller T, Patyk A, Lennon AM (2004) Influence of different bleaching systems on fracture toughness and hardness of enamel. Oper Dent 29:188–195PubMedGoogle Scholar
  19. 19.
    Mondelli RF, De Azevedo JF, Francisconi PA, Ishikiriama SK, Mondelli J (2009) Wear and surface roughness of bovine enamel submitted to bleaching. Eur J Esthet Dent 4:396–403PubMedGoogle Scholar
  20. 20.
    Sulieman M, Addy M, Macdonald E, Rees JS (2004) A safety study in vitro for the effects of an in-office bleaching system on the integrity of enamel and dentine. J Dent 32:581–590. doi: 10.1016/j.jdent.2004.06.003 PubMedCrossRefGoogle Scholar
  21. 21.
    Mahringer C, Fureder M, Kastner M, Ebner A, Hinterdorfer P, Vitkov L, Hannig M, Kienberger F, Schilcher K (2009) Examination of native and carbamide peroxide-bleached human tooth enamel by atomic force microscopy. Ultrastruct Pathol 33:189–196. doi: 10.3109/01913120903275634 PubMedCrossRefGoogle Scholar
  22. 22.
    Faraoni-Romano JJ, Da Silveira AG, Turssi CP, Serra MC (2008) Bleaching agents with varying concentrations of carbamide and/or hydrogen peroxides: effect on dental microhardness and roughness. J Esthet Restor Dent 20:395–402. doi: 10.1111/j.1708-8240.2008.00216.x PubMedCrossRefGoogle Scholar
  23. 23.
    Sasaki RT, Arcanjo AJ, Florio FM, Basting RT (2009) Micromorphology and microhardness of enamel after treatment with home-use bleaching agents containing 10% carbamide peroxide and 7.5% hydrogen peroxide. J Appl Oral Sci 17:611–616. doi: 10.1590/S1678-77572009000600014 PubMedCrossRefGoogle Scholar
  24. 24.
    Klimek J, Hellwig E, Ahrens G (1982) Effect of plaque on fluoride stability in the enamel after amine fluoride application in the artificial mouth. Dtsch Zahnärztl Z 37:836–840PubMedGoogle Scholar
  25. 25.
    Plotino G, Buono L, Grande NM, Pameijer CH, Somma F (2008) Nonvital tooth bleaching: a review of the literature and clinical procedures. J Endod 34:394–407. doi: 10.1016/j.joen.2007.12.020 PubMedCrossRefGoogle Scholar
  26. 26.
    Haywood VB, Heymann HO (1989) Nightguard vital bleaching. Quintessence Int 20:173–176PubMedGoogle Scholar
  27. 27.
    Efeoglu N, Wood DJ, Efeoglu C (2007) Thirty-five percent carbamide peroxide application causes in vitro demineralization of enamel. Dent Mater 23:900–904. doi: 10.1016/ PubMedCrossRefGoogle Scholar
  28. 28.
    Worschech CC, Rodrigues JA, Martins LR, Ambrosano GM (2006) Brushing effect of abrasive dentifrices during at-home bleaching with 10% carbamide peroxide on enamel surface roughness. J Contemp Dent Pract 7:25–34PubMedGoogle Scholar
  29. 29.
    Worschech CC, Rodrigues JA, Martins LR, Ambrosano GM (2003) In vitro evaluation of human dental enamel surface roughness bleached with 35% carbamide peroxide and submitted to abrasive dentifrice brushing. Pesqui Odontol Bras 17:342–348. doi: S1517-74912003000400009 PubMedCrossRefGoogle Scholar
  30. 30.
    Cairns AM, Watson M, Creanor SL, Foye RH (2002) The pH and titratable acidity of a range of diluting drinks and their potential effect on dental erosion. J Dent 30:313–317. doi: 10.1016/S0300-5712(02)00044-1 PubMedCrossRefGoogle Scholar
  31. 31.
    Kocher T, Langenbeck N, Rosin M, Bernhardt O (2002) Methodology of three-dimensional determination of root surface roughness. J Periodontal Res 37:125–131. doi: 10.1034/j.1600-0765.2002.00341.x PubMedCrossRefGoogle Scholar
  32. 32.
    Field J, Waterhouse P, German M (2010) Quantifying and qualifying surface changes on dental hard tissues in vitro. J Dent 38:182–190. doi: 10.1016/j.jdent.2010.01.002 PubMedCrossRefGoogle Scholar
  33. 33.
    Jiang T, Ma X, Wang Y, Tong H, Shen X, Hu Y, Hu J (2008) Investigation of the effects of 30% hydrogen peroxide on human tooth enamel by Raman scattering and laser-induced fluorescence. J Biomed Opt 13:014019. doi: 10.1117/1.2870114 PubMedCrossRefGoogle Scholar
  34. 34.
    Oltu U, Gurgan S (2000) Effects of three concentrations of carbamide peroxide on the structure of enamel. J Oral Rehabil 27:332–340. doi: 10.1046/j.1365-2842.2000.00510.x PubMedCrossRefGoogle Scholar
  35. 35.
    Arends J, Jongebloed WL, Goldberg M, Schuthof J (1984) Interaction of urea and human enamel. Caries Res 18:17–24PubMedCrossRefGoogle Scholar
  36. 36.
    Cavalli V, Arrais CA, Giannini M, Ambrosano GM (2004) High-concentrated carbamide peroxide bleaching agents effects on enamel surface. J Oral Rehabil 31:155–159. doi: 10.1111/j.1365-2842.2004.01138.x PubMedCrossRefGoogle Scholar
  37. 37.
    Hegedus C, Bistey T, Flora-Nagy E, Keszthelyi G, Jenei A (1999) An atomic force microscopy study on the effect of bleaching agents on enamel surface. J Dent 27:509–515. doi: 10.1016/S0300-5712(99)00006-8 PubMedCrossRefGoogle Scholar
  38. 38.
    Shannon H, Spencer P, Gross K, Tira D (1993) Characterization of enamel exposed to 10% carbamide peroxide bleaching agents. Quintessence Int 24:39–44PubMedGoogle Scholar
  39. 39.
    Rodrigues JA, Erhardt MCG, Marchi GM, Pimenta LAF, Ambrosano GMB (2003) Association effect of in-office and nightguard vital bleaching on dental enamel microhardness. Braz J Oral Sci 2:365–369Google Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Department of Operative Dentistry and PeriodontologyUniversity of FreiburgFreiburgGermany
  2. 2.Institute of Medical Biometry and Medical InformaticsUniversity of FreiburgFreiburgGermany
  3. 3.FreiburgGermany

Personalised recommendations