Tooth whitening with hydrogen/carbamide peroxides in association with a CPP-ACP paste at different proportions.

BACKGROUND: Different enhanced peroxide formulations have been developed to overcome mineral loss during tooth whitening. This study investigated the impact on tooth whitening from combining a CPP-ACP paste with home peroxide agents at several proportions. METHODS: Ninety bovine incisors were randomly allocated into nine groups (n = 10) and exposed to 7.5% hydrogen peroxide (HP), 16% carbamide peroxide (CP), a CPP-ACP paste (Tooth Mousse/MI Paste, GC Corporation, Tokyo, Japan) and blends of HP/CP:MI at three proportions (1:1, 2:1 and 1:2). Tooth whitening was performed for 14 days and its effectiveness was measured by a spectrophotometer utilizing the CIE L*a*b* system (ΔE, ΔL*, Δa* and Δb*). Colour readings were measured at baseline (T0), 7 days of bleaching (T7), 14 days of bleaching (T14) and 7 days after the end of bleaching (T21). Data were analysed by two-way ANOVA for paired averages followed by the Tukey's test and Pearson's correlation at 5%. RESULTS: Although CP produced the greatest colour change (ΔE), all whitening protocols were considered to be effective regardless of the CPP-ACP presence. In general, greater changes in ΔE, ΔL*, Δa* and Δb* were detected at T14, with T21 exhibiting similar results to those at T7. A greater number of strong correlations with ΔE values was found for a* (11/15). CONCLUSIONS: Within the limitations of this study, the results indicate that the CPP-ACP paste did not affect tooth whitening efficacy.

Efficacy of a novel at-home bleaching technique with carbamide peroxides modified by CPP-ACP and its effect on the microhardness of bleached enamel.

This study was designed to evaluate in vitro the efficacy of a novel at-home bleaching technique using 10% or 16% carbamide peroxide modified by casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and its influence on the microhardness of bleached enamel. A total of 40 bovine incisors were divided into four groups (n=10) according to the bleaching agent used: 10% carbamide peroxide only; a blend of 10% carbamide peroxide and a CPP-ACP paste; 16% carbamide peroxide only; and a blend of 16% carbamide peroxide and a CPP-ACP paste. During the 14-day bleaching regimen, the samples were stored in artificial saliva. The Vickers microhardness and color of the teeth were assessed at baseline (T0) and immediately after the bleaching regimen (T14) using a microhardness tester and a spectrophotometer, respectively. The degree of color change was determined by the Commission Internationale de l'Eclariage (CIE) L*a*b* system (ΔE, ΔL*, Δa*, and Δb*) and Vita shade guide parameters. The data were analyzed by analysis of variance and the Tukey test (p<0.05). The teeth that were bleached with a blend of peroxide (10% or 16%) and the CPP-ACP paste presented increased microhardness values at T14 compared with T0, whereas the samples that were bleached with peroxide only did not show any differences in their microhardness values. All of the bleaching agents were effective at whitening the teeth and did not show a statistically significant difference using the CIEL*a*b* system (ΔE, ΔL*, Δa*, and Δb*) or the Vita shade guide parameters. The use of a CPP-ACP paste with carbamide peroxide bleaching agents increased the bleached enamel's microhardness and did not have an influence on whitening efficacy.