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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Physiol. | doi: 10.3389/fphys.2019.00919

Comparison of bleaching products with up to 6% and with more than 6% hydrogen peroxide: whitening efficacy using BI and WID and side effects – an in vitro study

 Bledar Lilaj1, Rinet Dauti1,  Martina Schmid-Schwap1, Alexander Franz1,  Fabian Kanz2, Andreas Moritz1,  Andreas Schedle1* and  Barbara Cvikl1
  • 1University Clinic of Dentistry, Medical University of Vienna, Austria
  • 2Department of Forensic Medicine, Medical University of Vienna, Austria

The aim of this study was to evaluate the effect of bleaching agents containing different concentrations of hydrogen peroxide (HP) on color-change and on enamel-surface in bovine teeth. Furthermore the influence on cell viability and proliferation was investigated.
240 teeth were randomly assigned into four groups, (home bleaching ≤ 6%, in-office bleaching ≤ 6%, in-office bleaching > 6% HP and control group). Bleaching was performed after artificial staining and the bleached index BI as well as the whiteness index WID was measured at several time points. Chemical analysis for HP concentrations and the pH of the bleaching products was done. Furthermore, enamel surfaces of randomly selected specimens were analyzed using scanning electron microscopy (SEM) and cytotoxicity of the tested bleaching products was evaluated in vitro using dental pulp cells and L929 cells.
A statistically significant whitening effect was observed in almost all products. As expected all investigated products resulted in decreased cell viability, however with different values of LC50 (median lethal concentration). SEM analysis showed an analogue of enamel alterations with decreasing pH, increasing exposure time, and increasing HP concentration.
Bleaching agents containing a low HP concentration are considered to be effective and to have less damaging effects on enamel and tested cells.

Keywords: Bleached index BI, Cytotoxicity, Enamel surface morphology, Hydrogen Peroxide, SEM, Tooth Bleaching, whiteness index WID

Received: 21 Feb 2019; Accepted: 05 Jul 2019.

Edited by:

Giovanna Orsini, Marche Polytechnic University, Italy

Reviewed by:

Harald Osmundsen, University of Oslo, Norway
Alessandra Pisciotta, University of Modena and Reggio Emilia, Italy  

Copyright: © 2019 Lilaj, Dauti, Schmid-Schwap, Franz, Kanz, Moritz, Schedle and Cvikl. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Andreas Schedle, Medical University of Vienna, University Clinic of Dentistry, Vienna, 1090, Vienna, Austria,