Sunscreens Part 2: Regulation and Safety.

The second part of this CME article discusses sunscreen regulation and safety considerations for humans and the environment. First, we provide an overview of the history of the United States Food and Drug Administration's regulation of sunscreen. Recent Food and Drug Administration studies clearly demonstrate that organic ultraviolet filters are systemically absorbed during routine sunscreen use, but to date there is no evidence of associated negative health effects. We also review the current evidence of sunscreen's association with vitamin D levels and frontal fibrosing alopecia, and recent concerns regarding benzene contamination. Finally, we review the possible environmental effects of ultraviolet filters, particularly coral bleaching. While climate change has been shown to be the primary driver of coral bleaching, laboratory-based studies suggest that organic ultraviolet filters represent an additional contributing factor, which led several localities to ban certain organic filters.

An In Vitro Study on the Effects of Hydrogen Peroxide-Based Bleaching Agents on Enamel: Field Emission Scanning Electron Microscopy (FESEM) With Energy Dispersive Spectroscopy (EDS) Evaluation.

Aim and objective The aim of the present in vitro study is to evaluate the morphological and elemental alterations in enamel following bleaching with hydrogen peroxide-based bleaching agents of different concentrations and pH values when exposed to different treatment times. Materials and method Twenty extracted maxillary central incisors were selected for the study. Tooth samples were prepared by sectioning the tooth cervico-incisally into two halves. The teeth were divided into different groups based on the bleaching protocol and bleaching agent applied: Group IA, Group IB, Group IIA, and Group IIB. Group IA received a 35% hydrogen peroxide-based bleaching agent of pH 6 for 10 minutes with light application. Group IB received a 35% hydrogen peroxide-based bleaching agent of pH 6 for 30 minutes with light activation. Group IIA received a 40% hydrogen peroxide-based bleaching agent of pH 8.5 for 10 minutes with chemical activation. Group IIB received a 40% hydrogen peroxide-based bleaching agent of pH 8.5 for 30 minutes with chemical activation. The morphology of the enamel before and after the application of the bleaching agent was evaluated using field emission scanning electron microscopy. The elemental analysis of enamel between the control and test samples was done with the help of energy dispersive spectroscopy. Results Paired t-test was used to analyze the data obtained from the study. The test samples showed erosive alterations in enamel surface morphology and also a decrease in the concentration of minerals when compared to the corresponding control groups. Conclusions The present study evidences the erosive potential of hydrogen peroxide-based bleaching agents. It can be concluded that bleaching agents containing high concentrations of hydrogen peroxide with acidic pH can cause mineral loss and surface erosion of enamel which is extremely detrimental to the tooth integrity.

Production and Characterization of Nanocellulose from Maguey (Agave cantala) Fiber.

Plant fibers have been studied as sources of nanocellulose due to their sustainable features. This study investigated the effects of acid hydrolysis parameters, reaction temperature, and acid concentration on nanocellulose yield from maguey (Agave cantala) fiber. Nanocellulose was produced from the fibers via the removal of non-cellulosic components through alkali treatment and bleaching, followed by strong acid hydrolysis for 45 min using sulfuric acid (H2SO4). The temperature during acid hydrolysis was 30, 40, 50, and 60 °C, and the H2SO4 concentration was 40, 50, and 60 wt. % H2SO4. Results showed that 53.56% of raw maguey fibers were isolated as cellulose, that is, 89.45% was α-cellulose. The highest nanocellulose yield of 81.58 ± 0.36% was achieved from acid hydrolysis at 50 °C using 50 wt. % H2SO4, producing nanocellulose measuring 8-75 nm in diameter and 72-866 nm in length, as confirmed via field emission scanning electron microscopy (FESEM) and transmission electron microscopy (TEM) analysis. Fourier-transform infrared spectroscopy (FTIR) analysis indicated the chemical transformation of fibers throughout the nanocellulose production process. The zeta potential analysis showed that the nanocellulose had excellent colloidal stability with a highly negative surface charge of -37.3 mV. Meanwhile, X-ray diffraction (XRD) analysis validated the crystallinity of nanocellulose with a crystallinity index of 74.80%. Lastly, thermogravimetric analysis (TGA) demonstrated that the inflection point attributed to the cellulose degradation of the produced nanocellulose is 311.41 °C.

Effect of Bleaching Agents on Healthy Enamel, White Spots, and Carious Lesions: A Systematic Review and Meta-Analysis.

This systematic review examines studies focusing on tooth bleaching and its effects on healthy enamel or incipient caries and bacterial adhesion. The aim is to explore the impact of different bleaching agents on incipient caries lesions and healthy enamel. Clinical studies, in vitro studies, and observational studies that compared at least two groups were included. A search strategy was used to select studies from the MEDLINE via Pubmed and Scopus databases. Two evaluators performed data extraction, screening, and quality assessment independently. Only studies written in English were included. From 968 initial records, 28 studies were selected for a full-text evaluation. Of these, 7 studies were classified as cluster 1 (bacterial adherence on teeth), 12 studies as cluster 2 (no bacteria involved), 4 studies as cluster 3 (no teeth deployment), and 5 clinical studies were cluster 4. Of the selected studies, 6 (21.4%) supported increased bacterial attachment capacity and cariogenic dynamics, 4 (14.3%) decreased adhesion and cariogenic activity, 7 (25%) showed no difference, and 11 (39.3%) followed a different methodological approach and could not be categorized. The risk of bias appeared to be high, mainly because of the different methodologies in the studies, so we cannot reach a confident conclusion. Nevertheless, as far as carbamide peroxide bleaching is concerned, there does not seem to be a clinically significant alteration, neither in microorganism counts nor in enamel microstructure.

Effect of Bleaching on Resin-Infiltration-Masked Artificial White Spots In Vitro.

Resin infiltration is an effective method to mask vestibular white spots. If needed, external bleaching is usually recommended before infiltration, whilst in clinical practice, this sequence may not always be feasible. This in vitro study evaluated the effect of bleaching after resin infiltration regarding surface roughness and color using bovine incisors. Unlike for the untreated specimens (control, n = 25), artificial caries lesions were created within the test group (n = 25) using a demineralization solution at 37 °C for five days (pH = 4.95). The lesions were subsequently infiltrated using a resin infiltrant (Icon, DMG, Hamburg, Germany), followed by polishing. Afterwards, all specimens were bleached with a 10% carbamide peroxide gel (Opalescence, Ultradent, South Jordan, UT, USA) for 8 h/day over a ten-day period. Between bleaching treatments, specimens were stored in an opaque container with moistened paper tissues at 37 °C. Surface roughness was measured using a profilometer, and color in the L*a*b* space was assessed spectrophotometrically before and after bleaching. Bleaching increased the L*-values of both infiltrated (mean ± SD; ΔL* = 3.52 ± 1.98) and untreated (control) specimens (ΔL* = 3.53 ± 2.30) without any significant difference between the groups (p = 0.983). Bleaching also induced a significant increase in the mean surface roughness of both infiltrated (p < 0.001) and untreated (p = 0.0134) teeth. In terms of clinical relevance; it can be concluded that bleaching resin-infiltrated enamel is as effective as bleaching sound enamel.

AI-2 quorum sensing signal disrupts coral symbiotic homeostasis and induces host bleaching.

Symbiotic microorganisms play critical ecophysiological roles that facilitate the maintenance of coral health. Currently, information on the gene and protein pathways contributing to bleaching responses is lacking, including the role of autoinducers. Although the autoinducer AI-1 is well understood, information on AI-2 is insufficient. Here, we observed a 3.7-4.0 times higher abundance of the AI-2 synthesis gene luxS in bleached individuals relative to their healthy counterparts among reef-building coral samples from the natural environment. Laboratory tests further revealed that AI-2 contributed significantly to an increase in coral bleaching, altered the ratio of potential probiotic and pathogenic bacteria, and suppressed the antiviral activity of specific pathogenic bacteria while enhancing their functional potential, such as energy metabolism, chemotaxis, biofilm formation and virulence release. Structural equation modeling indicated that AI-2 influences the microbial composition, network structure, and pathogenic features, which collectively contribute to the coral bleaching status. Collectively, our results offer novel potential strategies for coral conservation based on a signal manipulation approach.

The effect of oxidative degradation of Dopa-melanin on its basic physicochemical properties and photoreactivity.

Melanin, particularly eumelanin, is commonly viewed as an efficient antioxidant and photoprotective pigment. Nonetheless, the ability of melanin to photogenerate reactive oxygen species and sensitize the formation of cyclobutane pyrimidine dimers may contribute to melanin-dependent phototoxicity. The phototoxic potential of melanin depends on a variety of factors, including molecular composition, redox state, and degree of aggregation. Using complementary spectroscopic and analytical methods we analyzed the physicochemical properties of Dopa-melanin, a synthetic model of eumelanin, subjected to oxidative degradation induced by aerobic photolysis or exposure to 0.1 M hydrogen peroxide. Both modes of oxidative degradation were accompanied by dose-dependent bleaching of melanin and irreversible modifications of its paramagnetic, ion- and electron-exchange and antioxidant properties. Bleached melanin exhibited enhanced efficiency to photogenerate singlet oxygen in both UVA and short-wavelength visible light. Although chemical changes of melanin subunits, including a relative increase of DHICA content and disruption of melanin polymer induced by oxidative degradation were considered, these two mechanisms may not be sufficient for a satisfactory explanation of the elevated photosensitizing ability of the bleached eumelanin. This study points out possible adverse changes in the photoprotective and antioxidant properties of eumelanin that could occur in pigmented tissues after exposure to high doses of intense solar radiation.

Bleaching efficacy of in-office dental bleaching with different application protocols: a single-blind randomized controlled trial.

OBJECTIVE: This randomized controlled trial aimed to evaluate the equivalence in the color change, adverse effects, self-perception (AS) and the impact on oral condition (IO) of participants submitted to different application protocols of in-office dental bleaching. MATERIALS AND METHODS: 165 participants were bleached with a 35% hydrogen peroxide gel (Total Blanc Office One-Step, DFL), according to the following protocols: (1) 2 applications of 20-min each (2 × 20 min); (2) 1 × 40-min and; (3) 1 × 30-min. The color change was evaluated with the Vita Easyshade spectrophotometer, Vita Classical and Vita Bleachedguide scales. The intensity and risk of tooth sensitivity (TS) and gingival irritation (GI) were recorded using a 0-10 visual analogue scale (VAS). AS and IO was assessed before and after the bleaching procedure using the Orofacial Aesthetic Scale and Oral Health Impact Profile-14, respectively. RESULTS: Equivalent color change were observed (p < 0.001), with no significant difference between groups. The group 2 × 20 min presented the highest risk of TS (76%, 95% CI 63 to 85), compared to the 1 × 30 min (p < 0.04). The intensity of TS and GI and the risk of GI was similar between groups (p > 0.31). Irrespectively of the group (p = 0.32), significant improvements were observed for all items of AS and IO after bleaching (p < 0.02). CONCLUSIONS: The 1 × 30 min protocol produced equivalent color change to the other bleaching protocols with reduced risk of TS and shorter application time. CLINICAL RELEVANCE: A more simplified application regimen of a single application of 30 min yields effective bleaching and patient satisfaction while minimizing undesirable side effects and improving patient satisfaction.

Quality evaluation and identification of Houttuynia cordata bleached with sodium metabisulfite based on whole spectrum metabolomics.

Houttuynia Cordata (HC) is a widely distributed plant in Asia and is used extensively for both food and medicinal purposes. A preliminary investigation found that HC is often bleached with sodium metabisulfite solution during its field processing, leading to health risks. In this study, the effects of sodium metabisulfite on the quality of HC were comprehensively evaluated using volatile and non-volatile targeted metabolomic methods. The results revealed a positive correlation between the extent of chemical composition changes and the bleaching time. These notable changes mainly occurred at the initial stage of bleaching. Subsequently, an untargeted UPLC/Q-TOF MS method was used to explore the potential chemical bleaching markers in bleached HC. The marker 1-hydroxy-3-oxodecane-1-sulfonic acid was subsequently prepared, isolated, and identified. Market sample verification further validated the accuracy and effectiveness of this marker.

Comparative evaluation of bond strength of diode and neodymium-doped:Yttrium aluminum garnet-assisted bleached enamel with nanofilled composite: An in vitro study.

Background: The world of esthetic dentistry is constantly making efforts toward the management of tooth staining. Laser-assisted bleaching is needed before adhesive restorations and has become common and advantageous as it accelerates bleaching action, reduces postoperative sensitivity, and promotes recrystallization of enamel. Aim: The study aimed to evaluate and compare the bond strength of diode (Biolace: EpicX) and neodymium-doped:yttrium aluminum garnet (Nd:YAG) (LightWalker, Fotona, Slovenia) assisted bleached (Pola Office, SDI) enamel with nanofilled composite (GC Solare Sculpt). Materials and Methods: The samples were divided into three groups (n = 11): Group A - Conventionally bleached enamel, Group B - Diode laser-assisted bleached enamel, Group C - Nd:YAG laser-assisted bleached enamel. After storing samples in Artificial Saliva for 2 weeks, bonding was performed, and nanofilled composite resin was applied through an incremental method. Samples were subjected to shear bond strength (SBS) analysis. Conclusion: The use of Nd:YAG laser on bleached enamel significantly increases the bond strength with nanofilled composite resin.

Full Thickness Macular Hole in Aesthetician Occurring Due to Accidental Self-exposure to Cosmetic Laser Machine Trying to Take Special Precautions Against COVID-19.

A 25-year-old aesthetician was operating Q-switch pulse (SPECTRA) cosmetic laser machine of 1,064 nm wavelength, for the purpose of skin bleaching. The probe suddenly slipped over the plastic sheet that had been placed to avoid COVID-19 exposure after which she complained of sudden loss of vision. She was diagnosed as having vitreous hemorrhage in her right eye and was treated conservatively for one month. She then complained of central scotoma and was diagnosed to have developed a full-thickness macular hole, for which she was advised vitrectomy surgery. The purpose of this case report is to emphasize the importance of taking precautions during the COVID-19 era and while doing that making sure how to handle the machines so as not to inflict any accidental injury to the operating physician. Macular Holes following skin bleaching with Nd:YAG laser occurring in operating aesthetician is rare as compared to that occurring in the patients.

A methodological exploration of distinguishing hair quality based on hair proteomics.

Hair is an advantageous biological sample due to its recordable, collectable, and storable nature. Hair's primary components are keratin and keratin-associated proteins. Owing to its abundance of cystine, keratin possesses impressive mechanical strength and chemical stability, formed by creating disulfide bonds as crosslinks within the protein peptide chain. Furthermore, keratin is cross-linked with keratin-associated proteins to create a complex network structure that provides the hair with strength and rigidity. Protein extraction serves as the foundation for hair analysis research. Bleaching hair causes damage to the structure between keratin and keratin-associated proteins, resulting in texture issues and hair breakage. This article outlines various physical treatment methods and lysate analysis that enhance the efficiency of hair protein extraction. The PLEE method achieves a three-fold increase in hair protein extraction efficiency when using a lysis solution containing SDS and combining high temperatures with intense shaking, compared to previous methods found in literature. We utilized the PLEE method to extract hair from both normal and damaged groups. Normal samples identified 156-157 proteins, including 51 keratin and keratin-associated proteins. The damaged group consisted of 155-158 identified proteins, of which 48-50 were keratin and keratin-associated proteins. Bleaching did not cause any notable difference in the protein identification of hair. However, it did reduce coverage of keratin and keratin-associated proteins significantly. Our hair protein extraction method provides extensive coverage of the hair proteome. Our findings indicate that bleaching damage results in subpar hair quality due to reduced coverage of protein primary sequences in keratin and keratin-associated proteins.

Therapeutic solutions for discoloration of calcified teeth based on CBCT diagnosis.

Single tooth orange discoloration secondary to root canal calcification occurs as a consequence of dental trauma, orthodontic treatment, or for unknown rea- sons. A correct case history must be compiled and a CBCT study carried out in order to establish the diag- nosis and define the best treatment plan in each case. The aim of the present study was to offer a therapeutic protocol involving a clinical decision-making tree dia- gram based on the presence or absence of apical dis- ease and the degree of canal calcification. Dental bleaching and the use of ceramic veneers allow es- thetic restoration in such cases.

Comparative Clinical Study of Two Tooth Whitening Protocols. A Randomized Clinical Trial. Part 2.

This study aimed to clinically evaluate the efficacy of two different home whitening protocols and to determine which is more effective: applying the whitening gel every 48 hours or every 72 hours for 6 weeks. The differences in terms of tooth sensitivity are also analyzed. A sample of 72 patients was randomly divided into 3 groups of 24 (N=24). Group A: 16% carbamide peroxide applied every 48h for 6 weeks. Group B: 16% carbamide peroxide applied every 72h for 6 weeks. Group C (control group): a placebo gel without peroxide (glycerin gel) was applied every 48h for 6 weeks. To compare the groups, color measurements were made using a spectrophotometer and ANOVA test and Bonferroni test was used. The confidence level was set at 95% (p ≤ 0.05) and no statistically significant differences between applying 16% carbamide peroxide every 48h or every 72h for 6 weeks (p> 0.05) were found. The study concluded that carbamide peroxide 16% is equally effective applied with both protocols, obtaining the same results.

Should I stay or should I go? Coral bleaching from the symbionts' perspective.

Coral bleaching, the stress-induced breakdown of coral-algal symbiosis, threatens reefs globally. Paradoxically, despite adverse fitness effects, corals bleach annually, even outside of abnormal temperatures. This generally occurs shortly after the once-per-year mass coral spawning. Here, we propose a hypothesis linking annual coral bleaching and the transmission of symbionts to the next generation of coral hosts. We developed a dynamic model with two symbiont growth strategies, and found that high sexual recruitment and low adult coral survivorship and growth favour bleaching susceptibility, while the reverse promotes bleaching resilience. Otherwise, unexplained trends in the Indo-Pacific align with our hypothesis, where reefs and coral taxa exhibiting higher recruitment are more bleaching susceptible. The results from our model caution against interpreting potential shifts towards more bleaching-resistant symbionts as evidence of climate adaptation-we predict such a shift could also occur in declining systems experiencing low recruitment rates, a common scenario on today's reefs.

Bleaching versus color change resistant adhesive in the discoloration of bracket-bonded tooth surfaces: an in vitro study.

OBJECTIVES: The aim of this study was to compare the effect of office bleaching of teeth bonded with Transbond XTTM (3M Unitek, Monrovia, CA, USA) (TRXT) and the use of color change resistant Orthocem (FGM, Joinville, Brazil) in bracket bonding on coffee-induced enamel discoloration. MATERIALS AND METHODS: Eighty premolars were distributed in equal numbers (n = 20) to group 1 (TRXT + distilled water), group 2 (TRXT + coffee solution), group 3 (TRXT + coffee solution + bleaching), and group 4 (Orthocem + coffee solution). Color was measured using a SpectroShade Micro (MHT, International, Verona, Italy) device at the beginning (T0), after coloring (T1), after bleaching (T1B), and after debonding (T2). ΔE color change values were calculated as T1-T0, T1B-T0 and T2-T0 differences. The conformity of the data to the normal distribution was examined with the Shapiro-Wilk test. Multiple comparisons were made with Tamhane's T2 test and Tukey's HSD test using one-way analysis of variance in the comparison of normally distributed data, and multiple comparisons were made with Dunn's test using the Kruskal-Wallis H test for comparison of non-normally distributed data. The significance level was set at p < 0.050. RESULTS: A statistically significant (p < 0.001) difference was found between the T1-T0 and T2-T0 stages for group 1-4 ΔE values. A statistically significant (p < 0.001) difference was also found when the T1B-T0 ΔE values of group 3 were compared with the T1-T0 ΔE values of groups 1, 2, and 4. CONCLUSIONS: After coffee-induced enamel discoloration, bleaching of teeth bonded with TRXT produced acceptable color difference of the incisal, middle, and gingival regions of the crown. In teeth bonded with Orthocem, acceptable color difference was seen only in the middle of the crown. CLINICAL RELEVANCE: The presented study will guide the clinician on how enamel discoloration side effect of fixed orthodontic appliance can reduce.

A systematic review of robotic efficacy in coral reef monitoring techniques.

Coral reefs are home to a variety of species, and their preservation is a popular study area; however, monitoring them is a significant challenge, for which the use of robots offers a promising answer. The purpose of this study is to analyze the current techniques and tools employed in coral reef monitoring, with a focus on the role of robotics and its potential in transforming this sector. Using a systematic review methodology examining peer-reviewed literature across engineering and earth sciences from the Scopus database focusing on "robotics" and "coral reef" keywords, the article is divided into three sections: coral reef monitoring, robots in coral reef monitoring, and case studies. The initial findings indicated a variety of monitoring strategies, each with its own advantages and disadvantages. Case studies have also highlighted the global application of robotics in monitoring, emphasizing the challenges and opportunities unique to each context. Robotic interventions driven by artificial intelligence and machine learning have led to a new era in coral reef monitoring. Such developments not only improve monitoring but also support the conservation and restoration of these vulnerable ecosystems. Further research is required, particularly on robotic systems for monitoring coral nurseries and maximizing coral health in both indoor and open-sea settings.

In vitro evaluation of the effect of addition of biomaterials to carbamide peroxide on the bleaching efficacy and microhardness of enamel.

Background and Aim: Teeth bleaching, although considered safe and conservative, cause microscopic changes in the tooth structure. The aim of this study is to evaluate the bleaching efficacy of carbamide peroxide (CP) bleaching gel when modified with the incorporation of bioactive glass (BG) and hydroxyapatite (HA) and its effect on enamel microhardness. Materials and Methods: Forty-five maxillary incisors were decoronated, artificially stained and mounted in acrylic. The samples were divided into three groups of 15 each and subjected to the following bleaching protocol for 8 h/day at 37°C for 2 weeks: Group 1 - 16% CP, Group 2 - CP modified with BG, and Group 3 - CP modified with hydroxyapatite (HA). Spectrophotometric color assessment using CIE L*a*b* system and Vickers microhardness were assessed before and after bleaching. Data were analyzed using Student's paired t-test and one-way ANOVA followed by Tukey's post hoc analysis. Results: There was a significant change in color (L*a*b*) in all the three groups when compared to the baseline values. However, no significant difference in the total color change (ΔE) was observed between the three groups. Enamel microhardness reduced significantly in the CP group, whereas it increased in the BG and HA group after bleaching. Scanning electron microscopy images of BG and HA groups showed crystalline deposits suggesting mineral deposition. Conclusion: Addition of biomaterials can be a beneficial alternative to bleaching with CP alone, considering the increase in microhardness without hindering the bleaching action.

Metabolic signatures of two scleractinian corals from the northern South China sea in response to extreme high temperature events.

Coral bleaching events are becoming increasingly common worldwide, causing widespread coral mortality. However, not all colonies within the same coral taxa show sensitivity to bleaching events, and the current understanding of the metabolic mechanisms underlying thermal bleaching in corals remains limited. We used untargeted metabolomics to analyze the biochemical processes involved in the survival of two bleaching phenotypes of the common corals Pavona decussata and Acropora pruinosa, during a severe bleaching event in the northern South China Sea in 2020. During thermal bleaching, P. decussata and A. pruinosa significantly accumulated energy products such as succinate and EPA, antioxidants and inflammatory markers, and reduced energy storage substances like glutamate and thymidine. KEGG analysis revealed enrichment of energy production pathways such as ABC transporters, nucleotide metabolism and lipid metabolism, suggesting the occurrence of oxidative stress and energy metabolism disorders in bleached corals. Notably, heat stress exerted distinct effects on metabolic pathways in the two coral species, e.g., P. decussata activating carbohydrate metabolism pathways like glycolysis and the TCA cycle, along with amino acid metabolism pathways, whereas A. pruinosa significantly altered the content of multiple small peptides affected amino acid metabolism. Furthermore, the osmoregulatory potential of corals correlates with their ability to survive in heat-stress environments in the wild. This study provides valuable insights into the metabolic mechanisms linked to thermal tolerance in reef-building corals, contributes to the understanding of corals' adaptive potential to heat stress induced by global warming and lays the foundation for developing targeted conservation strategies in the future.

An experimental teeth bleaching agent containing casein phosphopeptide-amorphous calcium phosphate.

OBJECTIVES: This study was aimed to obtain an experimental bleaching agent by adding casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in order to eliminate the mineral loss on the tooth surface after bleaching and to evaluate the bleaching effectiveness. MATERIALS AND METHODS: In this study, experimental bleaching agents containing 1%, 3% CPP-ACP and without CPP-ACP were obtained. Bleaching effectiveness (color change), the effect of bleaching agents on mineral content (energy dispersive x-ray spectroscopy), surface morphology (scanning electron microscope), and surface hardness of enamel (Vicker's microhardness) before and after bleaching were evaluated. The obtained data were statistically analyzed. RESULTS: When the bleaching levels of the groups were compared, no statistically significant difference was observed between the control and 1% CPP-ACP groups (p > 0.05) while the addition of 3% CPP-ACP decreased significantly the effectiveness of the bleaching agent (p < 0.05). When the effects of experimental bleaching agents on surface hardness were examined, while the enamel surface hardness decreased statistically significantly after application in the control group (p < 0.05), no statistically significant change was observed in surface hardness after the application of 1% CPP-ACP containing bleaching agent (p > 0.05). However, a statistically significant increase was observed in surface hardness after the application of 3% CPP-ACP containing bleaching agent (p < 0.05). When the Ca and P ratio of the groups were compared, no statistically significant difference was observed between the control and 1% CPP-ACP groups (p > 0.05), while they increased significantly in 3% CPP-ACP group (p < 0.05). CONCLUSIONS: The addition of 1% CPP-ACP to the bleaching agent had positive effects on the mineral content and surface hardness of the enamel, and did not negatively affect the whitening effectiveness. CLINICAL SIGNIFICANCE: Adding CPP-ACP to the bleaching agent at appropriate concentrations can eliminate possible negative effects without compromising the effectiveness of the bleaching agent.