Whitening toothpastes effect on enamel surface morphology, chemical profile and color: An In Vitro study / Efecto de las pastas dentales blanqueadoras sobre la morfología, el perfil químico y el color de la superficie del esmalte: un estudio In Vitro

Abstract To assess the effect of different whitening toothpastes on enamel surface morphology, chemical profile and their whitening efficiency. Sixty teeth were divided into 5 groups (12 teeth/group); Gp I: brushed with no toothpaste. Gp II: brushed with Pearl-based toothpaste. Gp III: brushed with Charcoal- based toothpaste. Gp IV: brushed with Alumina-based toothpaste. Gp V: brushed with salt and lemon- based toothpaste. Each tooth was brushed with a bean sized toothpaste wetted with distilled water twice daily by using standard electronic toothbrush for four weeks. Enamel surface morphology, chemical profile and color of each tooth were investigated. Chemical profile results and color measurements were analyzed statistically. Gp I revealed normal enamel surface morphology and chemical profile. Gp II and Gp III demonstrated surface morphology close to Gp I with insignificant reduction in mineral content. Gp IV showed obvious shallowing of perikymata ridges, exposure of fish-scale appearance, with pits and depressions, alongside to the significant reduction in mineral content. Gp V presented the most enamel surface alteration with widening of prism sheath and depressions all over the surface, besides the highest significant reduction in mineral content. Gp V, followed by Gp IV, demonstrated the highest color and whiteness changes, followed by Gp III, then Gp II, while the lowest value was in Gp I. Salt & lemon-based toothpaste, followed by Alumina-based, exerted the most considerable changes in the morphology and chemical profile of the enamel surface, beside to the higher whitening effects on teeth than the others.

Resumen El objetivo del presente estudio fue evaluar el efecto de diferentes pastas dentales blanqueadoras sobre la morfología y el perfil químico de la superficie del esmalte y su eficacia blanqueadora. Sesenta dientes se dividieron en 5 grupos (12 dientes/grupo); Grupo I: cepillado sin pasta de dientes. Grupo II: cepillado con pasta de dientes a base de perlas. Grupo III: cepillado con pasta de dientes a base de carbón. Grupo IV: cepillado con pasta de dientes a base de Alúmina. Grupo V: cepillado con sal y pasta de dientes a base de limón. Cada diente se cepilló con una pasta de dientes del tamaño de un frijol humedecida con agua destilada dos veces al día utilizando un cepillo de dientes electrónico estándar durante cuatro semanas. Se investigaron la morfología de la superficie del esmalte, el perfil químico y el color de cada diente. Los resultados del perfil químico y las mediciones de color se analizaron estadísticamente. El Grupo I reveló una morfología de la superficie del esmalte y un perfil químico normales. Los Grupos II y III demostraron una morfología de superficie cercana a la del Grupo I con una reducción insignificante en el contenido mineral. El grupo IV mostró una evidente reducción de las crestas perikymatas, exposición de apariencia de escamas de pez, con hoyos y depresiones, junto con una reducción significativa en el contenido mineral. El grupo V presentó la mayor alteración de la superficie del esmalte con ensanchamiento de la vaina del prisma y depresiones en toda la superficie, además de una significativa reducción en el contenido mineral. El grupo V, seguido del grupo IV, demostró los mayores cambios de color y blancura, seguido del grupo III, luego el grupo II, mientras que el valor más bajo se presentó en el grupo I. Las pastas dentales a base de sal y limón, seguidas de las de alúmina, ejercieron los cambios más considerables en la morfología y el perfil químico de la superficie del esmalte, además de tener mayores efectos blanqueadores sobre los dientes que las demás.

Qualitative Characterization of the Abrasive Component of Charcoal-Containing Toothpastes and the Effect on Dentin Roughness / Caracterización Cualitativa del Componente Abrasivo de las Pastas Dentales que Contienen Carbón Vegetal y la Rugosidad de la Dentina

This study investigated the effect of commercially available whitening toothpastes containing charcoal on dentin. Nine charcoal-containing toothpastes were compared with 3 whitening toothpastes (positive control) and distilled water (negative control). Periodontally hopeless molars were cleaned and washed and the occlusal table removed to expose dentin. The teeth were mounted in auto-polymerizing resin and exposed dentine surfaces polished with water-cooled decreasing grits of silica carbide paper up to 1500 grit. Baseline average roughness (Ra) measurements were taken. Specimens were then mounted in an automatic tooth-brushing machine and brushed for 5000 cycles. Repeat Ra measurements were taken. Specimens were brushed in 5000-cycle increments up to 25,000 cycles with Ra measurements being taken at each time point. Between abrasive challenges specimens were stored in distilled water. All toothpaste samples were sputter coated and examined under a scanning electron microscope to qualify the shape and size of the abrasive components of the formulations. Data were analyzed using a two-way analysis of variance with post hoc Bonferroni. The results demonstrated that the abrasive effect, in terms of increasing Ra, on dentin was noted as early as 5000 cycles for all the tested toothpastes (p<0.05). The effect of continued brushing showed an overall cumulative effect on dentine roughness up to 25000 cycles. When toothpastes were compared between groups at each time-point, dentin specimens brushed with Pursito were statistically similar to the control group. At 25,000 cycles all dentin samples were significantly rougher compared to Pursito and the control groups. It may be concluded that all the tested toothpastes have an abrasive effect on dentin surfaces.

Este estudio investigó el efecto sobre la dentina de las pastas dentales blanqueadoras disponibles en el mercado que contienen carbón vegetal. Se compararon nueve dentífricos que contenían carbón vegetal con 3 dentífricos blanqueadores (control positivo) y agua destilada (control negativo). Los molares sin material periodontal se limpiaron y lavaron y se retiró la tabla oclusal para exponer la dentina. Los dientes se montaron en resina autopolimerizable y las superficies expuestas de la dentina se pulieron con papel de carburo de sílice de grano decreciente enfriado con agua hasta grano 1500. Se tomaron medidas de rugosidad promedio (Ra) de referencia. Luego, las muestras se montaron en una máquina automática de cepillado de dientes y se cepillaron durante 5000 ciclos. Se tomaron medidas repetidas de Ra. Las muestras se cepillaron en incrementos de 5000 ciclos hasta 25 000 ciclos y se tomaron medidas de Ra en cada punto de tiempo. Entre periodos abrasivos, las muestras se almacenaron en agua destilada. Todas las muestras de pasta de dientes se recubrieron por pulverización catódica y se examinaron bajo un microscopio electrónico de barrido para calificar la forma y el tamaño de los componentes abrasivos de las formulaciones. Los datos se analizaron utilizando un análisis de varianza de dos vías de Bonferroni post hoc. Los resultados demostraron que el efecto abrasivo, en términos de aumento de Ra, sobre la dentina se notó ya en 5000 ciclos para todas las pastas dentales probadas (p<0,05). El efecto del cepillado continuo mostró un efecto acumulativo general sobre la rugosidad de la dentina hasta 25.000 ciclos. Cuando se compararon las pastas dentales entre los grupos en cada momento, las muestras de dentina cepilladas con Pursito fueron estadísticamente similares al grupo de control. A los 25.000 ciclos, todas las muestras de dentina eran significativamente más ásperas en comparación con Pursito y los grupos controles. Se puede concluir que todas las pastas dentales probadas tienen un efecto abrasivo sobre las superficies dentinarias.

Effect of Whitening Toothpastes with Different Active Agents on the Abrasive Wear of Dentin Following Tooth Brushing Simulation.

The aim of this research was to evaluate the abrasive dentin wear that can be induced by three commercial whitening toothpastes following a tooth-brushing simulation (TBS) corresponding to a three-month period. Sixty human canines were selected, and the roots were separated from the crowns. Then the roots were randomly divided into six groups (n = 10) and were submitted to TBS using the following slurries: Group 1-deionized water (RDA = 5); Group 2-ISO dentifrice slurry (RDA = 100); Group 3-a regular toothpaste (RDA = 70); Group 4-a charcoal-containing whitening toothpaste; Group 5-a whitening toothpaste containing blue covasorb and hydrated silica; and Group 6-a whitening toothpaste containing microsilica. Following TBS, surface loss and surface roughness changes were evaluated using confocal microscopy. Additionally, surface morphology and mineral content changes were observed using scanning electron microscopy and energy-dispersive X-ray spectroscopy. The deionized water group presented the lowest surface loss (p < 0.05), while the charcoal-containing toothpaste presented the highest surface loss, followed by ISO dentifrice slurry (p < 0.001). Blue-covasorb-containing and regular toothpastes did not present statistically significant differences (p = 0.245), and neither didmicrosilica-containing toothpaste or ISO dentifrice slurry (p = 0.112). The surface height parameters and surface morphology changes of the experimental groups followed the surface loss patterns, while no differences were detected in mineral content after TBS.Although the charcoal-containing toothpaste exhibited the highest abrasive wear to dentin, according to ISO 11609, all the tested toothpastes exhibited appropriate abrasive behavior towards dentin.

Tooth color change promoted by different whitening toothpastes under alternate cycles of staining and brushing.

OBJECTIVES: To compare the effect of whitening toothpastes with different mechanisms of action on discolored teeth subjected to additional staining/or not. METHODS: One hundred twenty tooth specimens were stained for 14 days (staining broth under constant agitation and pH=7) and then allocated into the groups of toothpastes with different whitening ingredients (n=10): 1. Regular - Colgate Total 12 Clean Mint; 2. CLWI - Colgate Luminous White Instant (blue pigment); 3. CLWA - Colgate Luminous White Advanced Expert (hydrogen peroxide); 4. CLWAC - Colgate Luminous White Activated Charcoal (activated charcoal); 5. OB3D - Oral-B 3D WHITE Brilliant Fresh (abrasive); 6. TW - Teeth Whitening (charcoal powder). Specimens were submitted to two experimental models: A. Daily staining-toothbrush cycling: staining solution (5min), toothbrushing (45 strokes) and artificial saliva (3h), 2x/day, for 5 days; B. Only toothbrushing (30.000 brushing strokes). Color change was determined with a spectrophotometer (CIEDE2000 and Whiteness Index for Dentistry - WID) and statistically analyzed (α=0.05). RESULTS: For both models, ΔE00 and Δa did not differ significantly between the whitening toothpastes and the regular. All groups showed a decrease in tooth yellowness (-Δb) and an increase in WID. Group Teeth Whitening exhibited a decrease in luminosity (-ΔL). In model A, Groups did not differ significantly from the Regular in terms of ΔL (p=0.35) and Δb (p=0.74). Groups CLWI and OB3D exhibited a decrease in luminosity. Reduced redness (-Δa) occurred only in Group CLWI. In Model B, Groups OB3D (p=0.021) and CLWA (p=0.001) exhibited higher change in luminosity than in Group Teeth Whitening. All exhibited increased redness (+Δa) and lightness (+ΔL), except the Regular, CLWAC, and Teeth Whitening. Group OB3D had a significantly higher change in Δb than the Regular (p=0.021). CONCLUSIONS: Irrespective of the mechanism of action, all toothpastes reduced tooth yellowness and promoted similar overall color change. Exposure of the teeth to additional staining during the toothbrushing cycles did not influence the effect of the whitening toothpastes. CLINICAL SIGNIFICANCE: Whitening toothpastes should be tested in conditions that more closely simulate their use in a clinical scenario, in which alternate cycles of staining and brushing occur on a daily basis. However, even in such conditions, they were unable to promote a color change that differed from that of a regular toothpaste.

Evaluation of Charcoal and Sea Salt-Lemon-based Whitening Toothpastes on Color Change and Surface Roughness of Stained Teeth.

AIM: To compare the efficacy of two naturally based commercially available whitening toothpastes charcoal and sea salt-lemon on stain removal of teeth in terms of color change and surface roughness. MATERIALS AND METHODS: Twenty-seven intact bovine incisors were selected and randomly allocated into three main groups (n = 9) according to the tested toothpaste [I: Signal Complete 8 Charcoal; II: sea salt-lemon essence Closeup natural smile; and III: Signal Complete 8 Original (control)]. Following 4 successive days of staining protocol, each specimen in its corresponding group was brushed with the toothpaste using toothbrush simulator apparatus for three brushing cycles. Color assessment using Vita Easyshade spectrophotometer and surface roughness (Ra) measurement using contact type profilometer were performed for each specimen at baseline, after staining, and after each tooth brushing cycle. RESULTS: Nonparametric color data and parametric surface roughness data were analyzed. The color difference (ΔE) from after-staining protocol to different tooth brushing cycles (1,2,3) showed no significant difference on each cycle between the tested groups (p >0.05). While for color difference (ΔE) from baseline to the last tooth brushing cycle 3, the difference between groups was statistically significant where group II, sea salt-lemon-based toothpaste, had a significantly lowest (ΔE 00) value (p <0.001) indicating more whitening effect in relation to others. However, a significant increase in surface roughness was present in all tested groups (p <0.001); meanwhile, there was no significant difference between tested groups (p >0.05). CONCLUSION: After three tooth brushing cycles, none of the natural whitening toothpastes or conventional toothpastes produced had effective whitening results nor completely removed the stains back to the initial baseline tooth color. Sea salt-lemon-based whitening toothpaste had a whitening effect better than the charcoal-based toothpaste. All of the tested toothpastes increased the degree of surface roughness. CLINICAL RELEVANCE: Charcoal and sea salt-lemon-based whitening toothpastes do not guarantee to whiten nor completely remove the stains back to normal and their effects on enamel surface roughness should be highly clinically considered and managed.

Determination of the whitening effect of toothpastes on human teeth / Determinación del efecto blanqueador de los dentífricos en dientes humanos

Abstract The desire of individuals to have whiter teeth increases the interest in tooth whitening products. Our aim was to in vitro study the whitening effect of hydrogen peroxide, blue covarine and active charcoal containing whitening toothpastes on human teeth. A total of 40 extracted human incisor teeth were used in the study. To measure the whitening effect of toothpastes, the teeth were divided into four subgroups and placed in the phantom tooth jaw model. Then, daily brushing was done with an electric toothbrush. The colors of the teeth were measured initially using the spectrophotometer (single point and bleached shade mode) and at the end of 7th, 14th and 28th days. Whitening effectiveness of toothpastes were studied according to CIEDE2000 formula (ΔE00) and shade guide units (SGU). One- way analysis of variance (ANOVA) and Tukey test were used in the statistical analysis of the data. (p0.05). Blue covarine containing toothpaste had statistically the lowest whitening effect (p<0.05). All toothpastes showed a whitening effect on the teeth after 7 days of use. Activated charcoal containing toothpaste showed more whitening effect after 28 days of use than hydrogen peroxide, blue covarine and traditional toothpaste.

Resumen El deseo de los individuos de tener unos dientes más blancos aumenta el interés por los productos de blanqueamiento dental. Nuestro objetivo fue estudiar el efecto blanqueador de las pastas dentales blanqueadoras que contienen peróxido de hidrógeno, covarina azul y carbón activo en dientes humanos in vitro. En el estudio se utilizaron un total de 40 dientes incisivos humanos extraídos. Para medir el efecto blanqueador de los dentífricos, los dientes se dividieron en cuatro subgrupos y se colocaron en el modelo de diente fantasma en mandíbula. A continuación, se realizó un cepillado diario con un cepillo eléctrico. El color de los dientes se midió inicialmente con un espectrofotómetro (modo de punto único y tono blanqueado) y al final de los días 7, 14 y 28. Se estudió la eficacia blanqueadora de los dentífricos según la fórmula CIEDE2000 (ΔE00) y las unidades de guía de color (SGU). En el análisis estadístico de los datos se utilizó el análisis de varianza de una vía (ANOVA) y la prueba de Tukey. (p0,05). El dentífrico que contiene covarina azul tuvo estadísticamente el menor efecto blanqueador (p<0,05). Todos los dentífricos mostraron un efecto blanqueador en los dientes después de 7 días de uso. Los dentífricos con carbón activado mostraron un mayor efecto blanqueador tras 28 días de uso que el peróxido de hidrógeno, la covarina azul y el dentífrico tradicional.

Impact of desensitizing/whitening toothpastes on tooth color change after abrasion and erosion-abrasion.

OBJECTIVE: To evaluate the impact of desensitizing toothpastes (D), their whitening versions (DW) and whitening toothpastes (W) on tooth color change. METHODS: Tooth specimens were allocated into 11 groups (n = 10): 1. Artificial saliva (control); 2. Sensodyne Repair & Protect (SRP-D); 3. Sensodyne Repair & Protect Whitening (SRP-DW); 4. Colgate Sensitive Pro-Relief (CSPR-D); 5. Colgate Sensitive Pro-Relief Real White (CSPR-DW); 6. Colgate Total 12 (CT12); 7. Colgate Total 12 Whitening (CT12-W); 8. Sensodyne True White (ST-W); 9. Curaprox Black Is White (CB-W); 10.Oral-B 3D White Perfection (OB3D-W) and 11. Erosion-only. They were submitted to two models: A. abrasion; B. erosion/abrasion. Color change (ΔE00 ), ΔL, Δa, and Δb were determined with a spectrophotometer. Data were statistically evaluated (α = 0.05). RESULTS: For both models, ∆E00 of D did not differ significantly from DW. An overall decrease in luminosity (-∆L) and increase (+∆b) in yellowness of the tooth occurred. In abrasion, all groups reduced redness (-∆a) and only SRP-DW differed from control (p = 0.016), but for ∆E00 , ∆L and ∆b, all toothpastes did not differ from the control. In erosion/abrasion, CB-W showed significantly lower ∆E00 and ∆b than the control (∆E00 : p = 0.026; ∆b: p = 0.005) and SRP-D (∆E00 : p = 0.028; ∆b: p = 0.025). Only SRP-DW, CSPR-DW, ST-W, CB-W, and erosion-only had increased redness (+∆a), but none differed from control. CONCLUSIONS: The toothpastes did neither promote whitening nor avoid the yellowish aspect of the tooth after abrasion and erosion-abrasion, regardless of their claim. CLINICAL SIGNIFICANCE: Desensitizing and/or whitening toothpastes induced similar changes on tooth color, without promoting whitening effect or reduction in its yellowish aspect.

Investigation the effects of whitening toothpastes on color change of resin-based CAD/CAM blocks.

INTRODUCTION: Some colorant foods and beverages cause undesired discoloration on dental restorations. The aim of this study was to investigate the effect of whitening kinds of toothpaste with different active ingredients on the color change of resin-based CAD/CAM blocks. MATERIAL AND METHODS: In the study, resin-based CAD/CAM block samples sized 1.5 × 7 × 12 mm, were prepared. Then, to simulate the time-dependent color change, the samples were immersed in coffee (Nescafe Classic, Nestlé) for 14 days. After the color change values of the samples colored in coffee were measured by spectrophotometer, the samples were brushed with different types of whitening toothpastes for 4 minutes. Statistical analysis of the color change (ΔE00 ) was performed using the one-way analysis of variance (ANOVA). RESULTS: Color differences occurring on all resin-based CAD/CAM blocks immersed in coffee for 14 days exceeded the 50%:50% perceptibility threshold (PT) (ΔE00 :0.8). There was no statistical significant difference between the whitening toothpastes containing activated charcoal, hydrogen peroxide (HP), blue covarine pigment, and microparticles in color improvement on resin-based CAD/CAM blocks (P > .05). CONCLUSION: It has been verified that the discoloration on resin-based CAD/CAM blocks exhibiting color difference above the PT after coffee immersion can be reduced by utilizing toothpastes containing whiteners. CLINICAL SIGNIFICANCE: Color changes that occur over time in resin-based CAD/CAM blocks can be a clinical problem. These color changes in the materials can be reduced below the PT level using whitening toothpastes.

Effect of Whitening Toothpastes and Brushing on Microhardness of Esthetic Restorative Materials.

OBJECTIVE: Whitening toothpastes are widely used. Hence, it is important to understand their effect on the surface properties of restorative materials. To evaluate the effect of three over-the-counter whitening toothpastes and toothbrushing simulation on microhardness of three restorative materials. STUDY DESIGN: Forty cylindrical (10×2mm) specimens were prepared from each restorative material and randomly assigned into four groups/10 each according to the whitening toothpastes used and distilled water (control). All specimens were measured for microhardness (Baseline-T1). The specimens were brushed with a soft brush using an in vitro tooth-brushing simulator with the assigned whitening toothpaste using the same setting for brushing cycles/load for all groups. Specimens were then measured for microhardness (T2) similar to baseline. RESULTS: The highest (mean±SD) microhardness after application of the whitening toothpastes and brushing was recorded for Intense White and Filtek Z250 XT (127.6±1.8), followed by Optic White and Fuji ll LC (73.9±0.9) and Optic White and Photac Fill (72.7±1.3). There was statistically significant difference for microhardness between pre- and post-application of the whitening toothpastes and brushing for all tested restorative materials (P=0.0001). The microhardness of Filtek Z250XT with 3D White post-application of the whitening toothpastes and brushing was lowest compared to other toothpastes and control (P=0.0001). CONCLUSION: Microhardness increased after application of the whitening toothpastes and toothbrushing simulation for all combination of tested restorative materials and whitening toothpastes. The microhardness of FIiltek Z250XT with 3D White post-application of the whitening toothpastes and brushing was lowest compared to other toothpastes and control.

Role of desensitizing/whitening dentifrices in enamel wear.

OBJECTIVES: To analyze the impact of desensitizing (D) and/or whitening (W) dentifrices on erosion and erosion-abrasion. METHODS: Enamel specimens were allocated into 10 groups (n = 20): 1. Artificial saliva (control); 2. Sensodyne Repair&Protect (SRP-D); 3. Sensodyne Repair&Protect Whitening (SRP-W); 4. Colgate Sensitive Pro-Relief (CSPR-D); 5. Colgate Sensitive Pro-Relief Real White (CSPRR-W); 6. Colgate Total 12 (CT); 7. Colgate Total 12 Professional Whitening (CTP-W); 8. Sensodyne True White (ST-W); 9. Curaprox Black is White (CB-W); 10. Oral-B 3D White Perfection (OB3D-W). For abrasion (n = 10), 30,000 brushing strokes were performed and surface roughness (SR) was evaluated. Erosion-abrasion (n = 10) consisted of 1 % citric acid (2 min), artificial saliva (60 min); 6×/day; 5 days. Toothbrushing was carried out 2×/day (45 strokes). Surface loss (SL) was determined with an optical profilometer. Data were statistically analyzed (α = 0.05). RESULTS: Relative to SR, only OB3D-W had a significantly rougher surface than the control (p = 0.014). SRP-D, CSPR-D and ST-W showed no difference from the baseline. High SL was observed for ST-W, OB3D-W and CTP-W, without significant differences from the control. CT showed the lowest SL, not differing from SRP-D and SRP-W. There was a weak negative correlation between SL and concentration of free fluoride in the slurries, SL and SR, and SL and pH, all p > 0.05. CONCLUSIONS: Only one dentifrice increased surface roughness of enamel to a higher degree than brushing with saliva. Brushing with the test dentifrices did not cause higher enamel erosive wear than brushing with saliva. CLINICAL SIGNIFICANCE: This study enhances our knowledge on the effect of desensitizing and whitening dentifrices, indicating that they do not worsen enamel loss due to abrasion and they might be a safe option for individuals with erosive tooth wear.

[The color analysis of nanocomposite material before and after exposure to whitening toothpastes using a portable spectrophotometer]. / Opredelenie tsveta nanokompozitsionnogo materiala s pomoshch'iu portativnogo spektrofotometra do i posle vozdeistviia otbelivaiushchikh past.

PURPOSE: To determine the effect of whitening toothpastes on the color of a nanocomposite material using a spectrophotometer. MATERIAL AND METHODS: The study involved 50 samples from nanocomposite restoration material which were exposed under laboratory conditions to brushing with one of 4 types of toothpastes (control with no bleaching agents, peroxide paste with carbamide, abrasive and enzyme-based pastes). Using the parameters a, b and L obtained by spectrophotometry, delta E (ΔE) value was calculated. To determine the maximum and minimum A posteriori comparisons by the Scheffe method were used to influence the delta E parameter after exposure to the pastes. Oxygen-containing paste (OZPP) had a maximum effect on the increase of the ΔE parameter, ΔE=1.03 comparing to ΔE=0.20 in control toothpaste. The isolated effect of a toothbrush resulted in a large change in the parameter ΔE, compared to the effect of a controls. However, the ΔE does not indicate the clarification of the material, but only a change in color relative to the initial measurement. As a result of spectrophotometry and statistical data processing, it was found that all pastes had a sufficient effect on the color change for the device to determine, but this change was not noticeable to the human eye.