Non-invasive analysis of bleaching effect of hydrogen peroxide on enamel by reflectance confocal microscopy (RCM): study of series of cases
Abstract
The
aim of this study is to evaluate in vivo the effects of in-office tooth
whitening hydrogen peroxide (HP) agent on enamel-microstructured
surface by a reflectance confocal microscopy (RCM). Ten healthy
volunteers assisted at the Dental School presenting teeth with vital
pulp were selected. The 35% HP whiteness product was applied in two
visits on discolored teeth, 1-week interval between, via 20-min
applications. A commercially available hand-held RCM (Vivascope3000®,
Lucid, Rochester, NY, USA) was used to image in vivo the dental surface
of the selected tooth of each volunteer. Twenty upper central incisors’
vestibular surfaces were imaged, before bleaching (T0), immediately
after (T1) and 1 week later (T2). The peculiar structure of the enamel
was seen at T0. After bleaching, white reflective circular bodies were
found all over the teeth surfaces, which disappear 1 week later (T2).
When the HP gel® was imaged, the same white circular areas
were observed. Going deeper, the regular enamel architecture was
preserved. Textural analysis of the images in T0 and T2 was performed:
GLCM parameters were extracted. Mann–Whitney U test was performed to
evaluate statistical differences between two groups of data (p > 0.05).
Finally, 35 prisms were randomly selected from T0 and T2 image and
diameters were measured; a paired t test was performed (p = 0.381).
The RCM is a promisor tool for investigating the features of enamel in
vivo, immediately after bleaching procedures, as well as longitudinally.
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