IADR Abstract Archives
Effects of Desensitizing Agents on Enamel Microstructure of Whitened Teeth
Objectives: To detect changes in enamel surface microstructure of teeth treated with whitening products with and without post-treatment desensitizing therapy.
Methods: Fourteen human extracted mandibular incisors in artificial saliva were assigned to one of seven groups (2 per group): CON = control, BST = 40% hydrogen peroxide (Opalescence© Boost PF), BST+EZ = BST plus UltraEZ Desensitizing Gel (Opalescence), C3D = Crest© 3DWhite Whitestrips (Procter and Gamble), C3D+WT = C3D plus Enamel Strengthening Serum Therapy (Procter and Gamble), HP = 25% hydrogen peroxide plus light activation (Philips Zoom!© gel, WhiteSpeed©, high intensity), HP+ ACP = HP plus Relief ACP© gel (Philips). All whitening treatments were completed based on manufacturers’ directions of use. Post-treatment samples were imaged using Scanning Electron Microscopy (SEM) to determine qualitative structural changes. Three experienced dentists served as blinded observers who independently rated the SEM images to determine if changes in the enamel were greater than normal expected wear. Statistical analysis of inter-observer agreement was conducted using Cohen’s kappa (κ).
Results: Observer 1 and Observer 2 as well as Observer 1 and Observer 3 yielded moderate agreement (κ=.472), while Observer 2 and Observer 3 yielded fair agreement (κ=.378). The majority of observers reported no increased enamel changes compared to normal wear for BST+EZ and HP+ACP (67% and 83%, respectively), while C3D+WT showed the majority of observers reporting increased changes in enamel compared to normal wear (67%). The only whitening group to have all three observers report increased enamel changes compared to normal wear for both samples was C3D (100%) (Figure 1).
Conclusions: Whitening protocols that utilize a post-treatment desensitizing therapy containing either calcium phosphate (UltraEZ) or potassium nitrate (Relief ACP) appear to have decreased enamel degradation compared to sodium fluoride (Enamel Strengthening Serum); however, more analysis is needed.
Methods: Fourteen human extracted mandibular incisors in artificial saliva were assigned to one of seven groups (2 per group): CON = control, BST = 40% hydrogen peroxide (Opalescence© Boost PF), BST+EZ = BST plus UltraEZ Desensitizing Gel (Opalescence), C3D = Crest© 3DWhite Whitestrips (Procter and Gamble), C3D+WT = C3D plus Enamel Strengthening Serum Therapy (Procter and Gamble), HP = 25% hydrogen peroxide plus light activation (Philips Zoom!© gel, WhiteSpeed©, high intensity), HP+ ACP = HP plus Relief ACP© gel (Philips). All whitening treatments were completed based on manufacturers’ directions of use. Post-treatment samples were imaged using Scanning Electron Microscopy (SEM) to determine qualitative structural changes. Three experienced dentists served as blinded observers who independently rated the SEM images to determine if changes in the enamel were greater than normal expected wear. Statistical analysis of inter-observer agreement was conducted using Cohen’s kappa (κ).
Results: Observer 1 and Observer 2 as well as Observer 1 and Observer 3 yielded moderate agreement (κ=.472), while Observer 2 and Observer 3 yielded fair agreement (κ=.378). The majority of observers reported no increased enamel changes compared to normal wear for BST+EZ and HP+ACP (67% and 83%, respectively), while C3D+WT showed the majority of observers reporting increased changes in enamel compared to normal wear (67%). The only whitening group to have all three observers report increased enamel changes compared to normal wear for both samples was C3D (100%) (Figure 1).
Conclusions: Whitening protocols that utilize a post-treatment desensitizing therapy containing either calcium phosphate (UltraEZ) or potassium nitrate (Relief ACP) appear to have decreased enamel degradation compared to sodium fluoride (Enamel Strengthening Serum); however, more analysis is needed.
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