Journal of Dentistry (2004) 32, 3539

www.elsevier.com/locate/jdent

A SEM evaluation of a 6% hydrogen peroxide tooth

whitening gel on dental materials in vitro
lez-Cabezasa, Andrew Joinerb
Bruce Schemehorna,*, Carlos Gonza
a

Indiana University School of Dentistry, Oral Health Research Institute, 415 Lansing Street,
Indianapolis, Indiana 46202, USA
b
Unilever Oral Care, Quarry Road East, Bebington, Wirral CH63 3JW, UK
Received 4 September 2003; revised 14 October 2003; accepted 15 October 2003

KEYWORDS
Tooth bleaching; Tooth
whitening; Hydrogen
Peroxide; Alloys;
Composite; Amalgam;
Porcelain; Gold; In vitro
model

Summary Objectives. The aim of this study was to evaluate the effects of a novel 6%
hydrogen peroxide gel on the surface morphology of dental gold, amalgam, porcelain
and composite.
Methods. Admixed high-copper amalgam and hybrid resin composite specimens
were prepared in extracted teeth using standard clinical procedures. Feldspathic
porcelain and type III gold specimens were prepared in a mould using standard
laboratory procedures. One half of the specimens were covered with nail varnish to
serve as the control side, leaving the other half exposed. The specimens were
treated with pooled whole saliva (1 h), followed by the peroxide gel (20 min), rinsing
with water and returning to saliva. This cycling protocol was continued until a total
of 28 treatments with the peroxide gel were completed. The samples were prepared
for SEM.
Results. There were no observable differences at 200 and 2000 magnifications between the control and peroxide gel treated sides on any of the materials
tested.
Conclusions. There were no significant effects of the 6% hydrogen peroxide gel on
the surface morphology of any of the dental materials tested.
q 2003 Elsevier Ltd. All rights reserved.

Introduction
The use of patient-administered, peroxide containing bleaching products is becoming increasingly
popular for whitening stained teeth since their
introduction by Haywood and Heymann.1 As these
products contact tooth structures for extended
periods of time and possibly inadvertently come
into contact with dental materials, the effects of
bleaching products on dental hard tissues and dental
*Corresponding author. Tel.: 1-317-274-8822; fax: 1-317274-5425.
E-mail address: bschemeh@iupui.edu

materials has attracted much attention in the

literature. Some studies report alterations in the
surface morphology of the dental hard tissues and
dental materials, and also changes in their chemical
and physical properties, whereas other studies have
found no changes.2 5 With this contrasting picture,
it is therefore important for any new peroxide-based
formulation to be extensively evaluated for its
effects on dental hard tissues and dental materials.
The aim of the current study was to evaluate, using
SEM, the effects of a new tooth whitening product
containing 6% hydrogen peroxide on the surface
morphology of the following dental materials: Type
III gold alloy, porcelain, amalgam and composite.

0300-5712/$ - see front matter q 2003 Elsevier Ltd. All rights reserved.
doi:10.1016/j.jdent.2003.10.012

36

B. Schemehorn et al.

Materials and methods

Results

Specimens and treatments

Typical SEM images of the dental gold alloy,

amalgam, porcelain and composite are shown in
Figs. 1 4, respectively. No differences were
observed between the control and experimental
sides on any of the restorative materials tested. In
the porcelain group, one of the five specimens
presented an irregular area that did not seem to be
related to the treatment. In the composite group,
one specimen presented an apparent mild effect on
the control side (varnish covered side).

Admixed high-copper amalgam (Dispersalloy,

Dentsply, York, PA) and hybrid resin composite
specimens (Herculite, Kerr, Orange, CA) n 5=
group were prepared in extracted teeth using
standard clinical procedures. The feldspathic
porcelain (Creation, Jensen, North Haven, CT)
and type III gold (Firmilay, Jelenko, Armonk, NY)
specimens were prepared in a mould using
standard laboratory procedures. One-half of the
specimens were covered with nail varnish (Avon,
Regal Red, USA) to serve as the control side,
leaving the other half exposed. The specimens
were then treated by immersion into pooled
whole human saliva at 37 8C for 1 h to form an
initial pellicle layer. The five specimens of each
group were then immersed into the 6% hydrogen
peroxide gel (Xtra Whitea, Unilever Oral Care)
(5.0 g) at 37 8C for 20 min. The specimens were
then rinsed well and lightly brushed with a soft
toothbrush to remove any residual gel. They were
then placed back into saliva for 1 h at 37 8C. After
this period, the specimens were treated once
again with the peroxide gel as outlined above.
Overnight the specimens were immersed in saliva.
Four treatments were performed the first day and
six treatments were performed each of the
following four days for a total of 28 treatments
with at least 1 h of saliva immersion between
treatments.

SEM analysis
Specimens were air-dried in a desiccator. The
resin composite and porcelain specimens were

coated with gold palladium alloy to a 200 A

thickness (Desk II Cold Sputter Unit, Denton
Vacuum LLC, Moorestown, NJ). Specimens were
analyzed in high vacuum conditions using a SEM
(JSM-5310LV, JEOL Ltd, Peabody, Mass) at 20 Kv,
10 spotsize, and a 12 , 14 mm working distance.
Digital images were obtained from secondary
electrons. Four secondary electron images were
taken from representative areas of the control
and treated sides of each specimen and at two
different magnifications (200 and 2000 ).
Images were coded and compared in a blind
fashion. Observable differences were classified as
mild, moderate or severe. The specimens were
then uncoded and the affected side and material
were identified.
a

Marketed as Signal/Mentadent/Pepsodent/Aim Xtra White.

Discussion
The use of the SEM for viewing the surface of
specimens is ubiquitous across all scientific disciplines and it offers a rapid method to identify any
morphological surface changes in the materials of
interest. In the current study, no significant effects
were observed on the surface morphology of gold,
porcelain, amalgam and a composite after
28 20 min treatments with a 6% hydrogen peroxide gel. Two specimens, one porcelain and one
resin composite, presented observable differences
between the control and experimental sides. The
porcelain specimen presented an irregular area in
the experimental side that seemed to be an artifact
created during the preparation of the specimen
rather than as a result of treatment. The resin
composite specimen showed the irregular area in
the control side. Since, it is very unlikely that a
treatment effect would have taken place under the
protective varnish, we hypothesized that the
observation is related to an incomplete removal of
the varnish before the SEM analysis.
These results contrast to in vitro studies where
changes have been observed using SEM.5,6 However,
even where changes have been observed by SEM the
clinical relevance has been described as uncertain.5
The reason for the contrasting results on dental
material properties by other workers is unclear. It
may be speculated that this is due to differences in
study design or the vast array of home-use bleaching products and their differences in formulation.2
Indeed, Price et al.7 reports large differences
between 26 commercially available tooth whitening
products in terms of their peroxide concentration
(up to 35%) and pH range (3.67 11.13). Thus, the
impact of any new tooth whitening product on
dental material integrity needs to be fully characterised prior to launch.
The quantity of bleaching product used in the
current study can be considered to be in excess of

A SEM evaluation of a 6% hydrogen peroxide tooth whitening gel on dental materials in vitro

37

Figure 1 SEM images of gold alloy; A 6% hydrogen peroxide gel, 200 ; B control, 200 ; C 6% hydrogen peroxide gel,
2000 ; D control, 2000 (original magnifications).

Figure 2 SEM images of amalgam; A 6% hydrogen peroxide gel, 200 ; B control, 200 ; C 6% hydrogen peroxide gel,
2000 ; D control, 2000 (original magnifications).

38

B. Schemehorn et al.

Figure 3 SEM images of porcelain; A 6% hydrogen peroxide gel, 200 ; B control, 200 ; C 6% hydrogen peroxide gel,
2000 ; D control, 2000 (original magnifications).

Figure 4 SEM images of composite; A 6% hydrogen peroxide gel, 200 ; B control, 200 ; C 6% hydrogen peroxide gel,
2000 ; D control, 2000 (original magnifications).

A SEM evaluation of a 6% hydrogen peroxide tooth whitening gel on dental materials in vitro

the in vivo situation since there was no elution of

the gel from the surface of the dental material. This
is in contrast to the in vivo situation where it is
known that peroxide levels within bleaching products are depleted during use.8 Thus, the experimental design in the current study was an
exaggeration of what is anticipated under normal
use, and can be used as further confirmation of the
safety of this product when used according to the
manufacturers instructions.
In conclusion, there were no observable significant effects of the 6% hydrogen peroxide gel on the
surface morphology of gold, porcelain, amalgam
and composite dental restorative materials tested.

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39

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