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

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Abstract

Objectives

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).

Results

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).

Conclusion

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).

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Funding

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.

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Authors and Affiliations

  1. Department of Endodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil

    Jéssica Galbiati Barbosa, Francine Benetti, Marina Carminatti, Anna Beatriz Dias da Silva, Isabela Nakahara Ikeda Lopes & Luciano Tavares Angelo Cintra

  2. Restorative Dentistry, School of Dentistry, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil

    Francine Benetti

  3. Department of Restorative Dentistry, São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil

    Marjorie de Oliveira Gallinari & André Luiz Fraga Briso

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  1. Jéssica Galbiati Barbosa
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Correspondence to Luciano Tavares Angelo Cintra.

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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.

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Barbosa, J.G., Benetti, F., de Oliveira Gallinari, M. et al. Bleaching gel mixed with MI Paste Plus reduces penetration of H2O2 and damage to pulp tissue and maintains bleaching effectiveness. Clin Oral Invest 24, 1299–1309 (2020). https://doi.org/10.1007/s00784-019-03009-5

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