Role of hydroxyapatite during tooth whitening
DOI:
https://doi.org/10.17533/udea.rfo.v38n1e359744Keywords:
hydroxyapatite, tooth bleaching, dentin sensitivityAbstract
Hydroxyapatite (HAp) is a biocrystal considered a multifunctional biomimetic active ingredient, which has currently gained wide acceptance in the biomedical area; in addition, it is used in the dental area through commercially available products containing synthetic hydroxyapatite in powder form with different particle sizes, such as desensitizers, toothpastes, and mouthwashes. There is also evidence of its applicability in tooth whitening, since the treatment has disadvantages, one of the main ones being the affectation of the mineralized substance of tooth enamel and tooth sensitivity. Based on the previous statement, studies have shown that the microscopic effects on the surface enamel associated with whitening could be repaired with the use of products based on HAp crystals. Therefore, the aim of this literature review was to report on the role of hydroxyapatite during tooth whitening, considering three general aspects: its remineralizing, desensitizing, and whitening effects.
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References
Enax J, Epple M. Synthetic hydroxyapatite as a biomimetic oral care agent. Oral Health Prev Dent. 2018; 16(1): 7-19. DOI: https://doi.org/10.3290/j.ohpd.a39690
Kutuk ZB, Ergin E, Cakir FY, Gurgan S. Effects of in-office bleaching agent combined with different desensitizing agents on enamel. J Appl Oral Sci. 2018; 27. DOI: https://doi.org/10.1590/1678-7757-2018-0233
Joiner A, Luo W. Tooth colour and whiteness: a review. J Dent. 2017; 67: S3-10. DOI: https://doi.org/10.1016/j.jdent.2017.09.006
Kensche A, Holder C, Basche S, Tahan N, Hannig C, Hannig M. Efficacy of a mouthrinse based on hydroxyapatite to reduce initial bacterial colonisation in situ. Arch Oral Biol. 2017; 80: 18-26. DOI: https://doi.org/10.1016/j.archoralbio.2017.03.013
Schlagenhauf U, Kunzelmann KH, Hannig C, May TW, Hösl H, Gratza M, et al. Impact of a non-fluoridated microcrystalline hydroxyapatite dentifrice on enamel caries progression in highly caries-susceptible orthodontic patients: a randomized, controlled 6-month trial. J Investig Clin Dent. 2019; 10(2): e12399. DOI: https://doi.org/10.1111/jicd.12399
Hiller KA, Buchalla W, Grillmeier I, Neubauer C, Schmalz G. In vitro effects of hydroxyapatite containing toothpastes on dentin permeability after multiple applications and ageing. Sci Rep. 2018; 8(1): 4888. DOI: https://doi.org/10.1038/s41598-018-22764-1
Harks I, Jockel-Schneider Y, Schlagenhauf U, May TW, Gravemeier M, Prior K, et al. Impact of the daily use of a microcrystal hydroxyapatite dentifrice on de novo plaque formation and clinical/microbiological parameters of periodontal health. A Randomized Trial. PloS One. 2016; 11(7): e0160142. DOI: https://doi.org/10.1371/journal.pone.0160142
Cieplik F, Rupp CM, Hirsch S, Muehler D, Enax J, Meyer F, et al. Ca2+ release and buffering effects of synthetic hydroxyapatite following bacterial acid challenge. BMC Oral Health. 2020; 20(1): 85. DOI: https://doi.org/10.1186/s12903-020-01080-z
Enax J, Fabritius HO, Fabritius-Vilpoux K, Amaechi BT, Meyer F. Modes of action and clinical efficacy of particulate hydroxyapatite in preventive oral health care: state of the art. Open Dent J. 2019; 13(1): 274-87. DOI: http://dx.doi.org/10.2174/1874210601913010274
Chaughule RS. Dental applications of nanotechnology. Switzerland: Springer Nature; 2018.
Genovesi AM, Marconcini S, Lelli M, Giammarinaro E, Barone A, Covani U. In vitro comparison of three desensitizing prophylaxis pastes: a morphological analysis. J Oral Hyg Health. 2015; 03: 186. DOI: http://dx.doi.org/10.4172/2332-0702.1000186
Gillam DG. Dentine hypersensitivity. London: Springer International Publishing; 2015.
Carpio-Salvatierra B, da Silva KL, Favoreto MW, González C, Ordóñez MCRB, Loguercio AD, et al. Effect of an experimental desensitizer with a hydroxyapatite-capsaicin composite applied before in-office dental bleaching on hydrogen peroxide diffusion, color and surface changes. Clin Oral Investig. 2024; 28(12): 659. DOI: https://doi.org/10.1007/s00784-024-06041-2
Demarco FF, Meireles SS, Masotti AS. Over-the-counter whitening agents: a concise review. Braz Oral Res. 2009; 23(Suppl 1): 64-70. DOI: https://doi.org/10.1590/s1806-83242009000500010
Eachempati P, Kumbargere Nagraj S, Kiran Kumar Krishanappa S, Gupta P, Yaylali IE. Home-based chemically-induced whitening (bleaching) of teeth in adults. Cochrane Database Syst Rev. 2018; 12(12): CD006202. DOI: https://doi.org/10.1002/14651858.cd006202.pub2
Gasparri F, Schemehorn BR, Zanardi A. Efficacy of teeth whitening with a mouthwash: in vitro and in vivo approaches. J Clin Dent. 2018; 29(1): 13-7.
Bordea IR, Lucaciu PO, Crişan B, Mîrza CM, Popa D, Mesaros AȘ, et al. The influence of chromophore presence in an experimental bleaching gel on laser assisted tooth whitening efficiency. Stud Univ Babes-Bolyai Chem. 2016; 61(2): 215–61.
Azrak B, Callaway A, Kurth P, Willershausen B. Influence of bleaching agents on surface roughness of sound or eroded dental enamel specimens. J Esthet Restor Dent. 2010; 22(6): 391-9. DOI: https://doi.org/10.1111/j.1708-8240.2010.00372.x
Orilisi G, Tosco V, Monterubbianesi R, Notarstefano V, Özcan M, Putignano A, et al. ATR-FTIR, EDS and SEM evaluations of enamel structure after treatment with hydrogen peroxide bleaching agents loaded with nano-hydroxyapatite particles. PeerJ. 2021; 9: e10606. DOI: https://doi.org/10.7717/peerj.10606
Alkahtani R, Stone S, German M, Waterhouse P. A review on dental whitening. J Dent. 2020; 100: 103423. DOI: https://doi.org/10.1016/j.jdent.2020.103423
Li Y, Shi X, Li W. Zinc-containing hydroxyapatite enhances cold-light-activated tooth bleaching treatment in vitro. BioMed Res Int. 2017. DOI: https://doi.org/10.1155/2017/6261248
Llena C, Esteve I, Rodríguez-Lozano FJ, Forner L. The application of casein phosphopeptide and amorphous calcium phosphate with fluoride (CPP-ACPF) for restoring mineral loss after dental bleaching with hydrogen or carbamide peroxide: an in vitro study. Ann Anat. 2019; 225: 48-53. DOI: https://doi.org/10.1016/j.aanat.2019.05.005
Kunam D, Sampath V, Manimaran S, Sekar M. Effect of indigenously developed nano-hydroxyapatite crystals from chicken egg shell on the surface hardness of bleached human enamel: an in vitro study. Contemp Clin Dent. 2019; 10(3): 489-93. DOI: https://doi.org/10.4103/ccd.ccd_810_18
Kavoor S, Ranjini MA, Aziz NA, Ashok HK, Nadig RR. In vitro evaluation of the effect of addition of biomaterials to carbamide peroxide on the bleaching efficacy and microhardness of enamel. J Conserv Dent Endod. 2024; 27(3): 310-4. DOI: https://doi.org/10.4103/jcde.jcde_310_23
Orsini G, Procaccini M, Manzoli L, Giuliodori F, Lorenzini A, Putignano A. A double-blind randomized-controlled trial comparing the desensitizing efficacy of a new dentifrice containing carbonate/hydroxyapatite nanocrystals and a sodium fluoride/potassium nitrate dentifrice: a new dentifrice desensitizing efficacy. J Clin Periodontol. 2010; 37(6): 510-7. DOI: https://doi.org/10.1111/j.1600-051x.2010.01558.x
Tschoppe P, Zandim DL, Martus P, Kielbassa AM. Enamel and dentine remineralization by nano-hydroxyapatite toothpastes. J Dent. 2011; 39(6): 430-7. DOI: https://doi.org/10.1016/j.jdent.2011.03.008
Lelli M, Putignano A, Marchetti M, Foltran I, Mangani F, Procaccini M, et al. Remineralization and repair of enamel surface by biomimetic Zn-carbonate hydroxyapatite containing toothpaste: a comparative in vivo study. Front Physiol. 2014; 5: 333. DOI: https://doi.org/10.3389/fphys.2014.00333
Vano M, Derchi G, Barone A, Genovesi A, Covani U. Tooth bleaching with hydrogen peroxide and nano-hydroxyapatite: a 9-month follow-up randomized clinical trial. Int J Dent Hyg. 2015; 13(4): 301-7. DOI: https://doi.org/10.1111/idh.12123
Sasaki RT, Catelan A, Bertoldo ES, Venâncio PC, Groppo FC, Ambrosano GMB, et al. Effect of 7.5% hydrogen peroxide containing remineralizing agents on hardness, color change, roughness and micromorphology of human enamel. Am J Dent. 2015; 28(5): 261-7.
Jiang T, Ma X, Wang Z, Tong H, Hu J, Wang Y. Beneficial effects of hydroxyapatite on enamel subjected to 30% hydrogen peroxide. J Dent. 2008; 36(11): 907-14. DOI: https://doi.org/10.1016/j.jdent.2008.07.005
Monterubbianesi R, Tosco V, Bellezze T, Giuliani G, Özcan M, Putignano A, et al. A Comparative evaluation of nanohydroxyapatite-enriched hydrogen peroxide home bleaching system on color, hardness and microstructure of dental enamel. Materials (Base). 2021; 14(11): 3072. DOI: https://doi.org/10.3390/ma14113072
Gomes YSL, Alexandrino LD, Alencar CM, Alves EB, Faial KC, Silva CM. In situ effect of nanohydroxyapatite paste in enamel teeth bleaching. J Contemp Dent Pract. 2017; 18(11): 996-1003. DOI: https://doi.org/10.5005/jp-journals-10024-2164
Scribante A, Poggio C, Gallo S, Riva P, Cuocci A, Carbone M, et al. In vitro re-hardening of bleached enamel using mineralizing pastes: toward preventing bacterial colonization. Materials (Basel). 2020; 13(4): 818. DOI: https://doi.org/10.3390/ma13040818
Loguercio AD, Servat F, Stanislawczuk R, Mena-Serrano A, Rezende M, Prieto MV, et al. Effect of acidity of in-office bleaching gels on tooth sensitivity and whitening: a two-center double-blind randomized clinical trial. Clin Oral Investig. 2017; 21(9): 2811-8. DOI: https://doi.org/10.1007/s00784-017-2083-5
Grazioli G, Valente LL, Isolan CP, Pinheiro HA, Duarte CG, Münchow EA. Bleaching and enamel surface interactions resulting from the use of highly-concentrated bleaching gels. Arch Oral Biol. 2018; 87:157-62. DOI: https://doi.org/10.1016/j.archoralbio.2017.12.026
Rodríguez-Martínez J, Valiente M, Sánchez-Martín MJ. Tooth whitening: from the established treatments to novel approaches to prevent side effects. J Esthet Restor Dent Off Publ Am Acad Esthet Dent Al. 2019; 31(5): 431-40. DOI: https://doi.org/10.1111/jerd.12519
Jin J, Xu X, Lai G, Kunzelmann KH. Efficacy of tooth whitening with different calcium phosphate-based formulations. Eur J Oral Sci. 2013; 121(4): 382-8. DOI: https://doi.org/10.1111/eos.12063
Vargas-Koudriavtsev T, Herrera-Sancho ÓA. Effect of tooth-bleaching on the carbonate concentration in dental enamel by Raman spectroscopy. J Clin Exp Dent. 2017; 9(1): e101-6. DOI: https://doi.org/10.4317/jced.53145
Dicle AT, Dalkılıc EE, Akyol E. Effects of experimental nanohydroxyapatite gel on enamel surface after bleaching. Oper Dent. 2025; 50(2): 218-28. DOI: https://doi.org/10.2341/24-008-l
Kunam D, Manimaran S, Sampath V, Sekar M. Evaluation of dentinal tubule occlusion and depth of penetration of nano-hydroxyapatite derived from chicken eggshell powder with and without addition of sodium fluoride: an in vitro study. J Conserv Dent. 2016; 19(3): 239-44. DOI: https://doi.org/10.4103/0972-0707.181940
Cartagena AF, Parreiras SO, Loguercio AD, Reis A, Campanha NH. In-office bleaching effects on the pulp flow and tooth sensitivity: case series. Braz Oral Res. 2015; 29: S1806-83242015000100223. DOI: https://doi.org/10.1590/1807-3107bor-2015.vol29.0026
Chemin K, Rezende M, Loguercio A, Reis A, Kossatz S. Effectiveness of and dental sensitivity to at-home bleaching with 4% and 10% hydrogen peroxide: a randomized, triple-blind clinical trial. Oper Dent. 2018; 43(3): 232-40. DOI: https://doi.org/10.2341/16-260-c
Majeed A, Farooq I, Grobler SR, Rossouw RJ. Tooth-bleaching: a review of the efficacy and adverse effects of various tooth whitening products. J Coll Physicians Surg Pak. 2015; 25(12): 891-6.
Özcan M, Abdin S, Sipahi C. Bleaching induced tooth sensitivity: do the existing enamel craze lines increase sensitivity? A clinical study. Odontology. 2014; 102(2): 197-202. DOI: https://doi.org/10.1007/s10266-013-0104-7
Rezende M, Coppla FM, Chemin K, Chibinski AC, Loguercio AD, Reis A. Tooth sensitivity after dental bleaching with a desensitizer-containing and a desensitizer-free bleaching gel: a systematic review and meta-analysis. Oper Dent. 2019; 44(2): E58-74. DOI: https://doi.org/10.2341/17-253-l
Steinert S, Zwanzig K, Doenges H, Kuchenbecker J, Meyer F, Enax J. Daily application of a toothpaste with biomimetic hydroxyapatite and its subjective impact on dentin hypersensitivity, tooth smoothness, tooth whitening, gum bleeding, and feeling of freshness. Biomimetics (Basel). 2020; 5(2): 17. DOI: https://doi.org/10.3390/biomimetics5020017
Steinert S, Kuchenbecker J, Meyer F, Simader B, Zwanzig K, Enax J. Whitening effects of a novel oral care gel with biomimetic hydroxyapatite: a 4-week observational pilot study. Biomimetics (Basel). 2020; 5(4): 65. DOI: https://doi.org/10.3390/biomimetics5040065
Uspenskaya OA, Trefilova OV, Shevchenko EA. Study of clinical and histological features in professional teeth whitening. Stomatologiya (Mosk). 2020; 99(3): 11-7. DOI: https://doi.org/10.17116/stomat20209903111
Browning WD, Cho SD, Deschepper EJ. Effect of a nano-hydroxyapatite paste on bleaching-related tooth sensitivity. J Esthet Restor Dent. 2012; 24(4): 268-76. DOI: https://doi.org/10.1111/j.1708-8240.2011.00437.x
Dabanoglu A, Wood C, García-Godoy F, Kunzelmann KH. Whitening effect and morphological evaluation of hydroxyapatite materials. Am J Dent. 2009; 22(1).
Kheradmand E, Daneshkazemi A, Davari A, Kave M, Ghanbarnejad S. Effect of hydrogen peroxide and its combination with nano-hydroxyapatite or nano-bioactive glass on the enamel demineralization and tooth color: an in vitro study. Dent Res J (Isfahan). 2023; 20: 85.
Sarembe S, Enax J, Morawietz M, Kiesow A, Meyer F. In vitro whitening effect of a hydroxyapatite-based oral care gel. Eur J Dent. 2020; 14(3): 335-41. DOI: https://doi.org/10.1055/s-0040-1714759
Fabritius-Vilpoux K, Enax J, Herbig M, Raabe D, Fabritius HO. Quantitative affinity parameters of synthetic hydroxyapatite and enamel surfaces in vitro. Bioinspired Biomim Nanobiomaterials. 2019; 8(2): 141-53. DOI: https://doi.org/10.1680/jbibn.18.00035
Bommer C, Flessa HP, Xu X, Kunzelmann KH. Hydroxyapatite and self-assembling peptide matrix for non-oxidizing tooth whitening. J Clin Dent. 2018; 29(2): 57-63.
Hojabri N, Kaisarly D, Kunzelmann KH. Adhesion and whitening effects of P11-4 self-assembling peptide and HAP suspension on bovine enamel. Clin Oral Investig. 2021; 25(5): 3237-47. DOI: https://doi.org/10.1007/s00784-020-03654-1
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