Effect of Three Bleaching Protocols on Tooth Discoloration Caused by Hemoglobin.

This study assessed the efficacy of different combinations of oxalic acid, 35% hydrogen peroxide, and 5.25% sodium hypochlorite (NaOCl) for bleaching of tooth discolorations caused by hemoglobin. In this in vitro study, 40 sound extracted human premolars were disinfected and decoronated. Their primary color parameters were measured (T1). The teeth were then centrifuged with human blood for 3 days, rinsed, polished, and their color parameters were measured again (T2). They were randomly divided into 4 groups (N=10) and treated as follows: Group A: in-office bleaching with Pola-Office Plus followed by 30 seconds of light-curing, group B: 0.24 M oxalic acid for 5 minutes followed by in-office bleaching, group C: 5.25% NaOCl for 5 minutes followed by in-office bleaching, and group D: 0.24 M oxalic acid (5 minutes) followed by 5.25% NaOCl (5 minutes) and subsequent application of in-office bleaching gel. The color parameters of the teeth were measured again (T3). Data were analyzed by one-way ANOVA and paired sample t-test (alpha=0.05). T2-T3 ∆E in groups B and D was significantly higher than that in group A (P<0.05); the difference between groups B and D was not significant. The mean ∆E and ∆L in group C were not significantly different from those in group A (P>0.05). ∆L significantly and equally increased in groups B and D after bleaching. Application of oxalic acid followed by in-office bleaching gel is more effective than the bleaching gel alone for correction of tooth discolorations caused by hemoglobin.