Hydrogen peroxide-based products alter inflammatory and tissue damage-related proteins in the gingival crevicular fluid of healthy volunteers: a randomized trial.

Hydrogen peroxide (H2O2)-based products are effective in tooth whitening; however, their safety is controversial as they may harm patient tissues/cells. These effects are suggested to be concentration-dependent; nonetheless, to date, there are no reports on H2O2-mediated oxidative damage in the gingival tissue, and neither whether this can be detected in gingival crevicular fluid (GCF) samples. We hypothesize that H2O2 whitening products may cause collateral oxidative tissue damage following in office application. Therefore, H2O2 and nitric oxide (NO) levels were investigated in GCF samples obtained from patients undergoing dental bleaching with H2O2 at different concentrations, in a randomized, double-blind, split-mouth clinical trial. A proteomic analysis of these samples was also performed. H2O2-based whitening products promoted inflammation which was detected in GCF samples and lasted for longer following 35% H2O2 bleaching. This included time-dependent changes in NO levels and in the abundance of proteins associated with NO synthesis, oxidative stress, neutrophil regulation, nucleic acid damage, cell survival and/or tissue regeneration. Overall, H2O2-based products used in office promote inflammation irrespective of their concentration. As the inflammation caused by 35% H2O2 is longer, patients may benefit better from using lower concentrations of this bleaching product, as they may result in less tissue damage.

Dentin erosion by whitening mouthwash associated to toothbrushing abrasion: a focus variation 3D scanning microscopy study.

The aim of this study was to determine the erosive potential of hydrogen peroxide (HP) containing mouthwash on dentin assessed by Focus variation three-dimensional (3D) microscopy. Twenty dentin slabs were selected and randomly allocated into two groups (n = 10): DW--Distilled water (pH = 7.27) and HP-1.5% (pH = 3.78). Each specimen was cyclically demineralized (4 × 60 s/day, 10 days) with HP or DW and brushed 3×/day (200 g, 150 strokes--toothpaste with 1,450 ppmF as NaF). Between the challenges, the specimens were exposed to artificial saliva. Afterward, dentin loss was analyzed using focus variation 3D microscopy, and the data were submitted to unpaired t-test (α = 0.05). Statistically significant difference was found between the mean wear rate (µm, ±SD) of HP (1.98 ± 0.51) and DW (1.45 ± 0.39). The results suggest that the use of HP-containing mouthwash associated to brushing may increase the risk of tissue loss and focus variation 3D microscopy may be used as a technique for quantifying dental wear.

High-resolution 1H NMR investigations of the oxidative consumption of salivary biomolecules by oral rinse peroxides.

BACKGROUND: A multicomponent evaluation of the oxidative consumption of salivary biomolecules by a tooth-whitening oral rinse preparation has been performed using high-resolution proton ((1)H) nuclear magnetic resonance spectroscopy (NMR). METHODS: Unstimulated human saliva samples (n = 12) were treated with aliquots of the oral rinse tested and 600 MHz (1)H NMR spectra acquired on these samples demonstrated that hydrogen peroxide (H(2)O(2)) and/or peroxodisulphate (S(2)O(8) (2-)) present in this product gave rise to the oxidative decarboxylation of the salivary electron-donor pyruvate (to acetate and CO(2)), and also oxidized methionine (a precursor to volatile sulphur compounds responsible for oral malodour), and malodourous trimethylamine to methionine sulphoxide and trimethylamine-N-oxide, respectively (reductions observed in the salivary concentrations of each biomolecular peroxide-scavenging agent were all extremely statistically significant, p < 0.005). RESULTS: Experiments conducted on chemical model systems confirmed the consumption of pyruvate by this product, and also revealed that the amino acids cysteine and methionine were oxidatively transformed to cystine and methionine sulphoxide, respectively. CONCLUSIONS: High-field (1)H NMR analysis provides much valuable molecular information regarding the fate of tooth-whitening oxidants in human saliva and permits an assessment of the mechanisms of action of oral healthcare products containing these agents. The biochemical and potential therapeutic significance of the results obtained are discussed.

Effects of fluoride or nanohydroxiapatite on roughness and gloss of bleached teeth.

OBJECTIVES: The aim of this study was to describe roughness and gloss alterations of enamel after treatment with 38% hydrogen peroxide (HP) and after polishing with 2% neutral sodium fluoride (SF) or a dental tooth paste containing nanohydroxiapatite particles (nHA) using power spectral density (PSD) description, roughness parameters (Ra, RMS, and Z range) and gloss analysis. METHODS: An atomic force microscope (AFM) and a spectrophotometer were used to analyze eighteen specimens of upper incisors. After initial analyses, all specimens were bleached with 38% HP for 135 min. The specimens were analyzed after bleaching. Nine specimens were polished with SF (Group Fluor) and the other nine specimens were polished with nHA (Group nHA), then all specimens were analyzed after polishing. Roughness and gloss were analyzed with ANOVA and Tukey's t-test. RESULTS: No statistical difference was found for Ra and RMS among initial, after bleaching and after polishing in both groups. For Z range, Group nHA showed a significant decrease after polishing. Bleaching with 38% HP did not increase the PSD in the spatial frequency of the visible light spectrum range in both groups. After polishing, nHA group showed a decrease in PSD for all morphological wavelengths. Gloss did not show statistical difference after bleaching in both groups. Gloss showed significant increase after polishing with nHA. SIGNIFICANCE: bleaching treatment with 38% HP didn't alter enamel surface roughness or gloss. PSD analyses were very suitable to identifying the morphological changes on the surfaces.