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Effects of pH and application technique of in-office bleaching gels on hydrogen peroxide penetration into the pulp chamber

Abstract:

Objective: This in vitro study aimed to quantify the penetration of hydrogen peroxide (HP) into the pulp chamber in teeth submitted to in-office bleaching with varied pH and application techniques. The color change and pH of the in-office bleaching product during application was also evaluated. Methods and Materials: Ninety-six human premolars were used and randomly divided into 10 groups (n=9) according to the following combination of factors: pH of in-office bleaching agents (two neutral/alkaline pH: Opalescence Boost 38% and Whiteness HP Blue 35% and three acidic pH: Whiteness HP Maxx 35%, Lase Peroxide Sensy 35%, and Total Blanc Office 35%) and application modes (for 3 3 15 minutes [3315] and 1 3 45 minutes [1345]). An additional group of non-bleached teeth (control; n=6) was added. First, all teeth were sectioned 3 mm from the cementoenamel junction and the pulp tissue was removed. An acetate buffer was placed in the pulp chamber of all teeth. After bleaching, this solution was transferred to a glass tube in which HP was allowed to react with other components, resulting in a pink solution. The optical density of this pink solution was measured using ultraviolet-visible spectroscopy and converted into amount of HP. Color change before and 1 week after bleaching was evaluated using a digital spectrophotometer. A pH meter with a 6-mm circular and flat surface was used in contact with the enamel surface to quantify the pH of the bleaching gels during application. Data were analyzed using two-way analysis of variance and Tukey tests (a=0.05). Results: Overall, lower mean HP penetration values were observed for Opalescence Boost 38% and Whiteness HP Blue 35% compared with other bleaching gels (p,0.05). Opalescence Boost 38% and Whiteness HP Blue 35% were not influenced by the application technique (p.0.05). However, lower mean HP penetration values were observed for Whiteness HP Maxx 35%, Total Blanc Office 35%, and Lase Peroxide Sensy 35% when using the 3315 application technique compared with the 1345 technique (p,0.05). Significant whitening was detected and no significant difference of color change was observed between groups (p.0.54). The pH did not change during the 3315 application technique; however, all acidic bleaching gels significantly decreased in pH when applied for 1345 (p,0.01). Conclusions: The amount of HP that reaches the pulp chamber was lower when neutral/alkaline pH gels were used, independently of the application technique. When considering acidic pH gels, it is preferable to use the 3315 application technique, mainly because longer application time (1345) results in lower pH. No difference was observed between groups with regards to color change.