In vitro efficacy of sodium perborate preparations used for intracoronal bleaching of discolored non‐vital teeth
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Abstract Bleaching materials containing 30% hydrogen peroxide have been used successfully for the treatment of discolored non–vital teeth. Intracoronal application of these materials was occasionally associated with the development of external root resorption. Extracted human teeth with intact crowns were discolored in vitro and bleached with three preparations of sodium perborate. These preparations included: sodium perborate with 30% hydrogen peroxide, sodium perborate with 3% hydrogen peroxide and sodium perborate with water. The bleaching materials were placed in the pulp chamber of the discolored teeth and sealed with IRM for 14 days. They were replaced with fresh preparations after 3 and 7 days. The coronal tooth shades were evaluated after 3, 7 and 14 days and a comparison of the bleaching success of the groups was made at each interval. It was found that after 14 days and three bleachings there was no significant difference in success between the groups. It is therefore recommended that sodium perborate be used in combination with water rather than with hydrogen peroxide to reduce the risk of post‐bleaching external root resorption.Keywords:
Sodium perborate
Sodium hypochlorite
Carbamide peroxide
Everyone wants whiter teeth to make them feel younger and to provide beautiful smiles with the accompanying increase in self-esteem. Bleaching is an established, simple, cost-effective and conservative method for improving the color of the discolored teeth. Aim: The aim of this in vitro study was to compare the bleaching efficacy of 10% carbamide peroxide, 10% hydrogen peroxide and 2g sodium perborate as bleaching agents on the artificially discolored human primary maxillary central incisors. Materials and Methods: Forty extracted human primary central incisors with intact crowns were selected for the study. Pulpectomy was performed and each tooth was artificially stained with 2 ml of fresh human blood and centrifuged. The teeth were randomly divided into four experimental groups of 10 teeth each and the baseline color evaluation was performed. 0.04 ml of the bleaching agent is syringed into the access cavity of the tooth and, in the control group, 0.04 ml of distilled water was syringed into the access cavity and it was sealed with IRM and placed at 37°C in an incubator throughout the experiment. The color of the bleached teeth was determined at 0, 7 and 14 days. The data obtained were analyzed using ANOVA and Turkey's test. Results: There was statistical significance (P = 0.00) among the carbamide peroxide, sodium perborate, hydrogen peroxide and control groups after 7 and 14 days and a significance of P = 0.013 among the carbamide peroxide, sodium perborate and hydrogen peroxide after two bleaching sessions (day 14) was seen. Conclusions: The bleaching efficacy of 10% hydrogen peroxide gel was more effective than 10% carbamide peroxide and sodium perborate in bleaching the artificially discolored primary teeth.
Sodium perborate
Carbamide peroxide
Distilled water
Tooth discoloration
Bleach
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Introduction: Intracoronal bleaching is the simplest, least invasive, and least expensive means available to lighten non-vital discolored teeth. The objective of the study: To evaluate the intra coronal bleaching efficacy of 35% Carbamide peroxide relative to 35% Hydrogen peroxide and Sodium perborate using artificially stained extracted human teeth. Materials and Methods: Eighty extracted human permanent maxillary and mandibular anterior teeth and single-rooted premolars were artificially stained using whole human blood and root canal treatment was completed. They were bleached twice 7 days apart using: Group I (n=20) – 35% Carbamide peroxide gel, Group II (n=20) – 35% Hydrogen peroxide gel, Group III (n=20) – 2 gm Sodium perborate mixed with per ml of distilled water, Group IV (n=20)– Distilled water only (control). Evaluation of shade was performed on day 0,7,14. Results: On day 7, In Groups I and Group II, there was a reduction in the shade by 2 vita tab positions, whereas Group IIIlightened by 1-tab position only. On day 14, CP and HP lightened by overall 3-tab positions and SP by 2-tab positions. There were no statistical differences between the groups on day 7 and day 14. Conclusion: 35% Carbamide peroxide, 35% Hydrogen peroxide and Sodiumperborate were equally effective for Intra coronal bleaching.
Carbamide peroxide
Sodium perborate
Distilled water
Peroxide
Anterior teeth
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To evaluate the effect of peroxide-based bleaching agents on teeth stained with AH26 sealer (Dentsply De Trey, Konstanz, Germany), using digital images and computer analysis.Thirty-five maxillary central incisors were root filled, and the internal walls of the access cavity were coated with AH26 sealer. Internal bleaching commenced 4 months after the root fillings. In three experimental groups (n = 10), the teeth were bleached for 21 days using 45% carbamide peroxide (CP) gel, 45% sodium perborate + carbamide peroxide (SP + CP) or sodium perborate + distilled water (SP + W). No bleaching was undertaken in the control group. Digital images of each specimen were made before treatment, 4 months after endodontic treatment and 2 weeks after bleaching. Colour differences (∆E) were calculated by determining L*a*b* values using digital images and imaging software. Differences between the original colour and sealer-stained teeth, between sealer-stained and bleached teeth and between original colour and bleached teeth were calculated. Data were analysed using one-way anova and Duncan tests (α = 0.05).Colour differences between baseline and sealer staining were in the range of 8.1-9.9, but differences between the groups were not significant. After bleaching, the degree of lightening was essentially identical for the carbamide peroxide and sodium perborate + carbamide peroxide groups, but was significantly greater (P < 0.05) in these two groups than in the sodium perborate + water group.For bleaching AH26 sealer-stained teeth, carbamide peroxide gel and carbamide peroxide gel mixed with sodium perborate were equally effective and significantly better than sodium perborate mixed with water.
Sodium perborate
Carbamide peroxide
Peroxide
Anterior teeth
Bleach
Tooth discoloration
Distilled water
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The objective of this study was to compare the efficacy and safety of 35% Carbamide peroxide (CP) and Sodium perborate (SP) as intracoronal bleaching agents in discoloured non-vital teeth. This prospective study was done at the Restorative Dentistry Department, University of Benin Teaching Hospital, Benin City, Nigeria. Seventy-six patients, each with a discoloured non-vital tooth were matched for shade and randomized into two groups and bleached with 35% CP and SP respectively. The teeth were bleached and evaluated at 5-day intervals. The shades of the bleached teeth were determined using the Vitapan classical shade guide® (Zahn Fabrick, Bad Sackingen, Germany). At baseline, 46 (60.5%) teeth had the darkest shade 16(C4) while 2 (2.6%) teeth had the lightest shade 10 (D4). In the first bleaching session, teeth bleached by 35% CP showed more Shade guide units (Sgu) movement towards lighter shades than SP (p< 0.05). At the third bleaching session the mean Sgu movement for both reagents was 3 but SP showed a significant bleaching effect over 35% CP. At the final evaluation SP and CP had bleached 78.9% and 73.7% of teeth respectively to their desired shades; with a satisfaction of 76.8% (p=0.004). At six months recall, relapse was observed in 3(8.8%) teeth treated with CP and none inthose treated with SP. This study demonstrated that over a longer bleaching period; Sodium perborate is safe and has a better bleaching efficacy than 35% Carbamide peroxide.
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Carbamide peroxide
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Dental bleaching represents an effective, conservative, and relatively low-cost method for improving the appearance of discolored pulpless teeth. Among the bleaching techniques, the walking bleach technique with sodium perborate associated with water or hydrogen peroxide stands out because of its esthetic results and safety. A modified walking bleach technique with the use of 37% carbamide peroxide as the bleaching agent is presented. Additionally, the adverse effects of dental bleaching in the following restorative procedures are discussed, showing the advantages with the use of 37% carbamide peroxide.
Bleach
Carbamide peroxide
Sodium perborate
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Background and objective: The aim of this study is to compare the bleaching effect of photon-induced photoacoustic streaming (PIPS) using carbamide peroxide or sodium perborate-20% hydrogen peroxide (H2O2) compared with walking-bleaching techniques using sodium perborate-20% H2O2 or carbamide peroxide without PIPS on artificially colored teeth. Materials and methods: Root canal treatments of 85 extracted human maxillary central incisors were completed and artificially stained using sheep's blood. Teeth were randomly grouped into five groups according to the bleaching techniques to be tested: Group 1: walking bleaching with carbamide peroxide; Group 2: walking bleaching with sodium perborate-20% H2O2; Group 3: PIPS+carbamide peroxide; Group 4: PIPS+sodium perborate-20% H2O2; and Group 5: control. Experimental specimens were bleached for 3 weeks. Buccal surfaces of the crowns were used for spectrophotometric measurements, limited with a 7-mm external diameter rounded strip, before bleaching and on days 7, 14, and 21. The total change in color (ΔE*) were analyzed with Welch's ANOVA at a significance level of p = 0.05 and Tamhane post-hoc test was used for multiple comparisons. Results: Starting from the second week, Group 4 showed significantly better bleaching effect compared with the other groups (p < 0.05). The other experimental groups also have bleaching effects, but there was no statistically significant difference between Group 1, Group 2, and Group 3 (p > 0.05). Conclusions: Sodium perborate-20% H2O2 activated with PIPS gave a bleaching effect superior to that of walking-bleaching techniques or PIPS using with carbamide peroxide.
Sodium perborate
Carbamide peroxide
Sodium ascorbate
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Efficacy of Carbamide Peroxide and Sodium Perborate as Bleaching Agent in Non-Vital Discolored Teeth
To estimate the effectiveness of sodium perborate with carbamide-peroxide (urea peroxide) to remove the staining of non-vital discolored teeth. Comparative cross sectional study. Dental department of operative dentistry, LUMHS, Jamshoro Sindh, Pakistan, from December 15-12-2014 to June 15-6-2015. A total of 160 single rooted teeth with intact clinical crowns have been collected. Using human blood, the teeth were discolored. With the vita shade guide, shades of discolored teeth were taken. Each tooth was handled with the root canal. 2 mm of root-canal-filling material cleaned under the junction of cement-enamel. In addition, it was then coated with glass ionomer cement 1 mm thickness. Teeth were divided randomly into two groups based on bleaching content used in the pulp chamber; group-A (C.P): 16% Carbamide-peroxide. Group-B (S.P): tetra-hydrate sodium-perborate mixed with distilled water. After 21days, the results were checked for efficacy. The analysis included a total of 160 teeth extracted (80 teeth extracted in each group). In group A, 78 (51.7%) found effectiveness compared to 73 (48.3%) in group B. The experimental groups showed statistically similar bleaching results at the end of twenty one days and p value found to be not significantly different (p=0.078). With a significant result, intracoronal bleaching of non-vital colored teeth is less invasive, comparatively safe and effective to remove the staining of non-vital discolored teeth.
Carbamide peroxide
Sodium perborate
Distilled water
Anterior teeth
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Background: Acrylic resin bases attract stains and odor producing organic and inorganic deposits. The use of chemical denture cleanser soaks is the most popular method of denture cleansing. Aim: To compare the efficacy of 2 different denture cleansers in removing tea, coffee, turmeric and paan stains from heat cured clear acrylic resins. Materials and Methods: Two hundred heat cured clear acrylic samples were prepared. The samples were divided into four groups and stored in tea, coffee, turmeric and paan at 37°C for 10 days. Stained samples were subjected to immersion in the commercially available denture cleansers sodium perborate (Clinsodent), sodium hypochlorite (VI-Clean) and distilled water (control). Optical density (OD) values were measured before and after 20 minutes and 8 hours of immersion in the cleansers. The data were analyzed statistically using Fischer′s test (one way ANOVA) and multiple comparisons were done by Bonferroni test. Results: Both Clinsodent and VI-clean were found to be least effective in removal of coffee stains and best for removing turmeric stains. Conclusion: It is necessary for the dental professional to ensure that the denture wearing public knows how to select the appropriate denture cleanser so as to improve denture home care protocol.
Cleanser
Sodium hypochlorite
Sodium perborate
Acrylic resin
Distilled water
Bleach
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Abstract Aim To evaluate the bleaching efficacy of 35% carbamide peroxide, 35% hydrogen peroxide and sodium perborate for intracoronal bleaching of root filled discoloured teeth. Methodology Extracted premolars were artificially stained using whole blood then root canal treatment was performed. After obturation, a 2 mm intermediate base was placed 1 mm below the buccal amelo‐cemental junction. Intracoronal bleaching was performed in 11 teeth per group, using either 35% carbamide peroxide gel (group CP), 35% hydrogen peroxide gel (group HP) or sodium perborate mixed with distilled water (group SP). The bleaching agents were replaced after 7 days. The shade of the teeth was evaluated at day 0, 7 and 14. The results were analysed using Kruskal–Wallis one‐way analysis of variance and Mann–Whitney U ‐test. Results At the end of 7 days, both groups CP and HP lightened by 8 ± 3 Vita tab positions, respectively, whereas group SP lightened by 5 ± 3 tab positions ( P < 0.05). At the end of the second bleaching period at day 14, group CP and HP lightened by a further 2 ± 2 and 2 ± 3 tab positions, respectively, whereas group SP lightened by a further 3 ± 4 tab positions. There were no statistical differences between groups at day 14. Conclusions Thirty‐five per cent carbamide peroxide and 35% hydrogen peroxide were equally effective for intracoronal bleaching, and significantly better than sodium perborate after 7 days. After 14 days, there were no significant differences between the groups. Thirty‐five per cent carbamide peroxide can be recommended as an equally effective alternative to hydrogen peroxide for intracoronal bleaching.
Sodium perborate
Carbamide peroxide
Distilled water
Peroxide
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To evaluate the efficacy of 16% carbamide peroxide gel (CP16%), tetrahydrate sodium perborate (SP) and mixture (CP16% + SP), in walking bleaching of non-vital discolored teeth.Sixty single-rooted human premolars with intact crowns were used and initial color was assessed using Vita shade guide and standardized photos. The teeth were stained using rabbit fresh blood for 18 days and photos of discolored teeth and color evaluation were performed. The teeth were divided into 4 groups (n= 15), according to bleaching agent used: G1) CP16% gel; G2) CP16% gel + SP; G3) SP + distilled water; G4: control. The bleaching agents were replaced twice at 7-day intervals for 21 days. All teeth were evaluated by two endodontists at days 0, 7, 14 and 21 and the color changes were assessed using Vita shade guide and standardized photos. The results were analyzed by Kruskal-Wallis and Dunn's tests (p=0.05).The experimental groups presented statistically similar bleaching results (p>0.05) at the end of 7, 14 and 21 days. These groups presented significantly higher bleaching efficacy than control group (G4) (p<0.05). The mixture CP16% + SP promoted return of original color in 100% of teeth at the end of 21 days.It was concluded that three bleaching agents were effective in bleaching of stained teeth with blood products, especially at the end of 21 days.
Sodium perborate
Carbamide peroxide
Peroxide
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