In-office tooth bleaching with chitosan-enriched hydrogen peroxide gels: in vitro results.

OBJECTIVE: This study aimed to evaluate the effects of adding chitosan to 35% hydrogen peroxide gels (for in-office bleaching), with or without calcium gluconate, on tooth properties and bleaching efficacy. METHODS: Bovine enamel/dentin specimens (4 × 4 × 2.5 mm) were randomly allocated into groups (n = 10): negative control (unbleached), bleaching with 35% hydrogen peroxide gel (35% HP, commercial gel); 35% HP with 2% chitosan (% wt) (35% HP + chitosan), 35% HP and calcium (35% HP + Ca, commercial gel), and 35% HP + Ca + 2% chitosan. Variation of surface profile (ΔRa) and color analyses (ΔL*, Δa*, Δb*, ΔE*ab, ΔE00, and ΔWID) were performed comparing specimens at baseline (initial) and 24 h after of storage in artificial saliva (final). Surface microhardness (KHN) values and scanning electron microscopy (SEM) images were obtained on conclusion. The data were analyzed by ANOVA and Tukey's tests (KHN), generalized linear models (ΔL*, ΔEab, ΔE00, ΔWID, ΔRa), and Kruskal-Wallis and Dunn tests (Δa*, Δb*) (α = 0.05). RESULTS: Considering ΔL*, Δa*, Δb*, ΔE*ab, ΔE00, and ΔWID values, the bleached groups differed from negative control. For ΔRa, chitosan-based groups showed lower variation in surface roughness compared to 35% HP, without significant difference from negative control. For KHN, chitosan groups did not differ from negative control (unbleached control = chitosan groups > 35% HP + Ca > 35% HP). For SEM, slight surface changes were observed in all bleached groups, but the intensity varied according to gel used (35% HP > gels with Ca > gels with chitosan). CONCLUSION: Chitosan-enriched hydrogen peroxide gels can reduce negative impacts on tooth properties without affecting bleaching efficacy. CLINICAL RELEVANCE: Although commercial gels containing remineralizing agents such as calcium reduce the negative effects on the properties of teeth, the addition of chitosan appears to be a promising approach to preservation of dental properties without interfering in bleaching efficacy.