In Vitro Comparison of Three Chairside Bleaching Protocols: Effects on Enamel Microhardness, Colour, and Qualitative Cytotoxicity Risk
<b>Background and Objectives:</b> The rapid increase of whitening products use raises questions about enamel safety. We compared three high-concentration protocols-Opalescence Quick (45% carbamide peroxide ≈ 15% H<sub>2</sub>O<sub>2</sub>), Opalescence Boost (40% H<sub>2</sub>O<sub>2</sub>), and BlancOne Ultra (35% H<sub>2</sub>O<sub>2</sub> + LED)-under controlled conditions to balance color change (ΔE) with enamel integrity (microhardness, FTIR). We also constructed a qualitative cytotoxicity risk profile from published data; no biological assays were performed in this study. <b>Methods:</b> Seventy-two matched half-crowns were randomized to Control or one of the three protocols. Outcomes were a change in Vickers microhardness, spectrophotometric color difference, and FTIR carbonate-to-phosphate ratio after 24 h in artificial saliva. We also compiled a qualitative cytotoxicity risk profile from published evidence; no biological assays were performed. One-way ANOVA with Tukey HSD on Δ-scores, Shapiro-Wilk and Levene's tests for assumptions, Welch's <i>t</i>-tests for tooth-class comparisons, and Pearson correlation between ΔE and ΔMH. <b>Results:</b> All active protocols produced clearly visible whitening (mean ΔE 5.7-6.3). Hydrogen-peroxide gels showed greater hardness loss and carbonate depletion than the carbamide-peroxide gel under similar contact time. The association between greater shade change and hardness loss was moderate and not predictive for individuals. <b>Conclusions:</b> Under harmonized conditions, all systems whitened effectively. Pursuing changes beyond ~6 units offered little extra benefit while increasing enamel impact. Carbamide-based Opalescence Quick achieved comparable aesthetics with lower acute enamel effects. Clinicians should individualize exposure time and pair in-office whitening with short-term remineralising care. Cytotoxicity comments are qualitative and literature-based only.
Authors
- Atena Găluşcan (ORCID: https://orcid.org/0000-0001-6046-2336)
- Roxana Buzatu (ORCID: https://orcid.org/0000-0003-0653-0996)
- Octavia Bălean (ORCID: https://orcid.org/0000-0002-9946-2517)
- Daniela Jumanca (ORCID: https://orcid.org/0000-0003-2705-5020)
- Ramona Dumitrescu (ORCID: https://orcid.org/0000-0002-6548-9607)
- Vlad Tiberiu Alexa (ORCID: https://orcid.org/0000-0003-3920-6869)
- Vanessa Bolchis (ORCID: https://orcid.org/0009-0000-1686-0150)
- Berivan Laura Rebeca Buzatu
- Magda Mihaela Luca
Institutions
- Victor Babeș University of Medicine and Pharmacy Timișoara (RO)
Publication Details
- Journal
- Dentistry Journal
- Published
- 2025-10-22
- DOI
- https://doi.org/10.3390/dj13110486
- Primary Topic
- Dental Erosion and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00