Assessment of a novel bleaching agent formula containing 35% hydrogen peroxide and titanium tetrafluoride: an in vitro study

This study developed experimental gels containing titanium tetrafluoride (TiF4) combined with commercial 35% hydrogen peroxide (HP), and evaluated bleaching efficacy and pH of the gels, and mineral content and morphology of enamel submitted to these treatments. In phase-1, different stock gels mixed with TiF4 were combined with HP. In phase-2, the selected gels were tested on enamel/ dentin specimens (n=8): HP; HP and Natrosol+TiF4 (HPnT); HP and Natrosol+Chemygel+TiF4 (HPncT); HP and Aristoflex+TiF4 (HPaT). Bleaching was performed in four sessions (3x15min-application/session). Color (CIEL*a*b*) and whiteness index (WID) were measured after each session, whereas whiteness index differences (Delta WID), color alteration (CIELab-Delta E, CIEDE2000-Delta E-00), enamel morphology and pH, at end of bleaching therapy. The change in Knoop microhardness (Delta KHN) was compared before and after bleaching. Data were analyzed by two-way repeated measures ANOVA and Bonferroni (CIEL*, a*, b*), one-way ANOVA and Tukey (AWI(D), Delta E, Delta E-00), and LSD (Delta KHN) tests (alpha=5%). SEM and pH measurements were submitted to descriptive analysis. No differences were observed in lightness (L*) or WID among the groups (p > 0.05), but HP exhibited lower b* values (p<0.05), higher Delta WID than HPnT, and the highest Delta E among the groups (p < 0.05). No differences in Delta E-00 were observed between HP and HPncT (p > 0.05), and HPncT showed higher Delta KHN than HP (p < 0.05). HP presented pH values closer to neutral (6.9), whereas experimental agents showed acidic pH values (2.3-3.9). No morphological changes were observed in HP or HPncT groups. HPncT was able to bleach the enamel and maintain enamel microhardness and surface integrity, even at low pH.