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.

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Publication Details

Journal
Dentistry Journal
Published
2025-10-22
DOI
https://doi.org/10.3390/dj13110486
Primary Topic
Dental Erosion and Treatment
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article
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article

In Vitro Comparison of Three Chairside Bleaching Protocols: Effects on Enamel Microhardness, Colour, and Qualitative Cytotoxicity Risk

Atena Găluşcan, Roxana Buzatu, Octavia Bălean, Daniela Jumanca et al.
Dentistry Journal
Dental Erosion and Treatment
article

In Vitro Comparison of Three Chairside Bleaching Protocols: Effects on Enamel Microhardness, Colour, and Qualitative Cytotoxicity Risk

Atena Găluşcan, Roxana Buzatu, Octavia Bălean, Daniela Jumanca, Ramona Dumitrescu, Vlad Tiberiu Alexa, Vanessa Bolchis, Berivan Laura Rebeca Buzatu, Magda Mihaela Luca
article en

Abstract

<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.

Dentistry JournalVol. 13(11)
Victor Babeș University of Medicine and Pharmacy Timișoara (RO)
Openalex Percentile: Top 68%
Dental Erosion and Treatment
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