Inflammatory response of human dental pulp to at-home and in-office tooth bleaching

J Appl Oral Sci. 2016 Sep-Oct;24(5):509-517. doi: 10.1590/1678-775720160137.

Abstract

Objective:: This study evaluated the inflammatory responses of human dental pulp after the use of two bleaching techniques.

Material and methods:: Pulp samples were collected from human third molars extracted for orthodontic reasons and divided into three groups: control - no tooth bleaching (CG) (n=7); at-home bleaching with 15% carbamide peroxide (AH) (n = 10), and in-office bleaching with 38% hydrogen peroxide (IO) (n=12). Pulps were removed and stained with hematoxylin-eosin for microscopic analysis of inflammation intensity, collagen degradation, and pulp tissue organization. Immunohistochemistry was used to detect mast cells (tryptase+), blood vessels (CD31+), and macrophages (CD68+). Chi-square, Kruskal-Wallis, and Mann Whitney tests were used for statistical analysis. The level of significance was set at p<.05.

Results:: The inflammation intensity and the number of macrophages were significantly greater in IO than in AH and CG (p<0.05). The results of CD31+ (blood vessels per mm2) were similar in CG (61.39±20.03), AH (52.29±27.62), and IO (57.43±8.69) groups (p>0.05). No mast cells were found in the pulp samples analyzed.

Conclusion:: In-office bleaching with 38% hydrogen peroxide resulted in more intense inflammation, higher macrophages migration, and greater pulp damage then at-home bleaching with 15% carbamide peroxide, however, these bleaching techniques did not induce migration of mast cells and increased the number of blood vessels.

Publication types

  • Evaluation Study

MeSH terms

  • Antigens, CD
  • Antigens, Differentiation, Myelomonocytic
  • Blood Vessels / drug effects
  • Blood Vessels / pathology
  • Carbamide Peroxide
  • Cell Count
  • Collagen / drug effects
  • Dental Pulp / drug effects*
  • Dental Pulp / pathology
  • Humans
  • Hydrogen Peroxide / toxicity
  • Immunohistochemistry
  • Peroxides / toxicity
  • Platelet Endothelial Cell Adhesion Molecule-1
  • Pulpitis / chemically induced*
  • Pulpitis / pathology
  • Random Allocation
  • Statistics, Nonparametric
  • Time Factors
  • Tooth Bleaching / adverse effects*
  • Tooth Bleaching / methods
  • Tooth Bleaching Agents / toxicity*
  • Urea / analogs & derivatives
  • Urea / toxicity

Substances

  • Antigens, CD
  • Antigens, Differentiation, Myelomonocytic
  • CD68 antigen, human
  • Peroxides
  • Platelet Endothelial Cell Adhesion Molecule-1
  • Tooth Bleaching Agents
  • Carbamide Peroxide
  • Urea
  • Collagen
  • Hydrogen Peroxide