Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil.
Department of Restorative Dentistry, School of Dentistry, University Center of the State of Pará (CESUPA), Brazil.
Histol Histopathol. 2024 Oct;39(10):1229-1243. doi: 10.14670/HH-18-726. Epub 2024 Feb 28.
The use of bleaching agents to remove stains is one of the main dental procedures to improve the aesthetics of teeth. This review presents the main agents used for tooth whitening, existing clinical protocols, and the structural changes that may occur through their use. The main bleaching agents consist of hydrogen peroxide and carbamide peroxide, which are used in bleaching techniques for vital teeth. These techniques can be performed in the office by a professional or by the individual in a home en-vironment under professional guidance. Bleaching agents come in a variety of concentrations and there are over-the-counter products available on the market with lower concentrations of hydrogen peroxide. Due to the chemical characteristics of the agents, changes in the organic and inorganic content of the tooth structure can be observed. These changes are related to morphological changes characterized by in-creased permeability and surface roughness, such changes compromise the mechanical resistance of the tooth. Furthermore, bleaching agents can promote molecular changes after reaching the dental pulp, resulting in oxidative stress of pulp cells and the release of pro-inflammatory mediators. Despite the bleaching effectiveness, tooth sensitivity is considered the main side effect of use. Therefore, among the heterogeneity of protocols, those that used the bleaching agent for a prolonged time and in lower con-centrations presented more harmful effects on the tooth structure.
使用漂白剂去除污渍是改善牙齿美观的主要牙科程序之一。本综述介绍了用于牙齿美白的主要试剂、现有的临床方案以及通过使用这些试剂可能发生的结构变化。主要的漂白剂由过氧化氢和过氧脲组成，用于活髓牙齿的漂白技术。这些技术可以由专业人员在办公室进行，也可以在专业指导下由个人在家庭环境中进行。漂白剂有多种浓度，市场上有非处方产品，其过氧化氢浓度较低。由于试剂的化学特性，可以观察到牙体结构中有机和无机含量的变化。这些变化与特征为渗透性和表面粗糙度增加的形态变化有关，这些变化会降低牙齿的机械强度。此外，漂白剂到达牙髓后会引发分子变化，导致牙髓细胞氧化应激和促炎介质的释放。尽管漂白效果显著，但牙齿敏感被认为是使用的主要副作用。因此，在不同的方案中，那些使用漂白剂时间更长、浓度更低的方案对牙体结构的有害影响更大。
