1 Division of Prosthodontics, UCL Eastman Dental Institute, University College London, London, UK.
2 Division of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London, London, UK.
J Dent Res. 2019 Apr;98(4):443-449. doi: 10.1177/0022034518822826. Epub 2019 Jan 25.
Carbamide peroxide (CP) is widely used as a tooth-whitening agent in self-administered tooth-bleaching products. In this study, the effects of 5% and 10% CP on dentinal collagen structure and chemical properties were evaluated in vitro. Thirty-five intact teeth were exposed to 2 whitening protocols (2 or 4 h daily) with either 5% or 10% CP gel for 1 wk. Shade changes before and after the whitening protocol were captured colorimetrically using a spectroshade. Collagen scaffold models and demineralized dentine disc samples were prepared and exposed to CP droplets (5% or 10%). Structural changes were investigated using electron microscopy. Finally, mineralized dentine disc samples were prepared postbleaching to assess chemical changes resulting from CP exposure in dentinal collagen using Raman spectroscopy. Results showed a difference in tooth shade when exposed to 5% and 10% CP whitening protocols, with a significantly ( P ≤ 0.01) greater change reported for the 10% CP/4-h group. Imaging of the collagen scaffold model following exposure to CP showed a gelatinization process indicating that the free radical by-products from CP are able to disrupt the quaternary structure of noncrosslinked collagen. The most significant damage on the collagen scaffold was seen for the 10% CP exposure for 4 h. Imaging of the demineralized discs displayed the same glassy amorphous layer appearance as found in the collagen scaffold. Raman spectra of the mineralized dentine discs showed a significant decrease ( P ≤ 0.01) in the integrated area of amide I and amide III values in the 4 test groups following CP application. Amide I was more affected as both the exposure time and concentration of CP increased. Despite the claimed safety of whitening agents, this in vitro study concludes that even low concentrations of CP result in a deleterious change in dentinal collagen.
过氧脲(CP)作为一种牙齿增白剂被广泛应用于自行牙齿漂白产品中。在本研究中,我们评估了 5%和 10%CP 对牙本质胶原结构和化学性质的体外影响。35 颗完整的牙齿分别暴露于两种漂白方案(每天 2 小时或 4 小时)中,使用 5%或 10%CP 凝胶,为期 1 周。使用分光光度计比色法在漂白方案前后记录颜色变化。制备胶原支架模型和脱矿牙本质盘样本,并暴露于 5%或 10%CP 液滴。使用电子显微镜研究结构变化。最后,在漂白后制备矿化牙本质盘样本,以使用拉曼光谱法评估 CP 暴露于牙本质胶原后导致的化学变化。结果显示,当暴露于 5%和 10%CP 漂白方案时,牙齿颜色有差异,10%CP/4 小时组的变化明显更大(P≤0.01)。CP 暴露后对胶原支架模型成像显示胶原材料的凝胶化过程表明,CP 的自由基副产物能够破坏非交联胶原的四级结构。在 4 小时 10%CP 暴露下,胶原支架上的损伤最大。脱矿牙本质盘的成像显示出与胶原支架相同的玻璃状无定形层外观。矿化牙本质盘的拉曼光谱显示,在 CP 应用后,4 个测试组的酰胺 I 和酰胺 III 值的积分面积均显著降低(P≤0.01)。随着 CP 暴露时间和浓度的增加,酰胺 I 受到的影响更大。尽管宣称美白剂是安全的,但本体外研究得出结论,即使是低浓度的 CP 也会导致牙本质胶原的有害变化。