A.D. Odofin1, J. Taiwo2, I.A. Solanke3, O. Ibiyemi2, A.O Afolabi4
- Government Dental Centre, Oyo State Hospital Management Board, Dugbe, Ibadan, Nigeria.
- Department of Periodontology and Community Dentistry, University of Ibadan, Nigeria.
- Department of Restorative Dentistry, University of Ibadan, Nigeria.
- Department of Dental Services, Federal Medical Centre, Owo, Ondo State, Nigeria.
Abstract
Objective: To compare the effectiveness of sodium perborate mixed with distilled water and sodium perborate mixed with 30% hydrogen peroxide as non–vital bleaching agent of anterior discolored teeth.
Materials and methods: A randomized controlled trial was undertaken among 61 patients who presented with 70 discolored anterior teeth at the Conservative and Family Dentistry Clinics of the University College Hospital, Ibadan, Nigeria. The 70 teeth were randomly allocated into two groups of treatments. In Group A, the test group, the coronal part of endodontically treated teeth was further treated with sodium perborate mixed with distilled water while group B, the control group, the coronal part of endodontically treated teeth were also further treated with sodium perborate mixed with 30% hydrogen peroxide. Information on study participants biodata and satisfaction with treatment were obtained. Tooth shade assessment was done using shade guide units of the vitapan shade guide at baseline and during recall visits on days 7, 14, and 21. Frequencies, means and standard deviations were generated. Chi-squared test was used to determine the association between two categorical variables at p<0.05.
Results: In the control group the mean ± SD tooth shade was 12.5 ±3.2, 8.7 ± 3.8, 4.9 ± 2.8 and 3.1 ± 2.2 at baseline, Day 7, Day 14 and Day 21 respectively. In the test group, the corresponding values are 12.8 ± 3.2, 9.6 ± 3.9, 5.6 ± 3.0 and 4.0 ± 2.9. The mean ± SD tooth shade scores of control and test group was 12.5 ± 3.2 and 12.8 ± 3.2 respectively (p = 0.15). Twenty-two (62.9%) and 19(54.3%) of the study participants in the control and test groups respectively reported that they were extremely satisfied (p=0.60).
Conclusion: The effectiveness of sodium perborate mixed with distilled water and sodium perborate mixed with 30% hydrogen peroxide in lightening the coronal part of endodontically treated non-vital discolored anterior teeth were similar. Both bleaching agents demonstrated similar patient satisfaction.
Keywords: Sodium perborate, Distilled water, Hydrogen peroxide, Non-vital, Discolored teeth.
Correspondence:
Dr. O. Ibiyemi
Department of Periodontology
and Community Dentistry,
Faculty of Dentistry,
University of Ibadan,
Nigeria.
Email: shola_ibiyemi@yahoo.com Submission Date: 25th Jan., 2023
Date of Acceptance: 30th Dec., 2023
Publication Date: 30th Jan., 2024
Introduction
Tooth discolouration is the alteration in the color of a tooth which can either be extrinsic or intrinsic based on the aetiology and location of the stain.1-4
Extrinsic stains are stains from food and beverages such as coffee, tea, and wine deposited on the surfaces of teeth, therefore are not incorporated within the tooth substance.5 In intrinsic discolouration, the stains are incorporated within the tooth substance in a localized and generalized manner, based on etiology.5 The common cause of generalized intrinsic discolouration include amelogenesis imperfecta, dentinogenesis imperfecta, and tetracycline stain,3 while the most common cause of localized intrinsic discolouration is intra-pulpal hemorrhage secondary to trauma to teeth resulting in pulp necrosis and eventual loss of vitality.6
Anterior tooth discoloration is one of the most commonest reasons for dental consultation since concern about appearance is increasing among people worldwide.5 Several treatment options are available for intrinsic discolouration which include microabrasion, bleaching, veneers, and jacket crowns.4,7 Veneers and jacket crowns are invasive and expensive treatment options while tooth bleaching is more cost effective.8-10 In most developing countries especially in Africa, the less expensive and more conservative bleaching is a reasonable and common choice of treatment.6
Bleaching as a treatment option for non-vital tooth with intrinsic discoloration can be an in-office technique, a walking bleach technique, or a combination of both.11 These techniques can be intracoronal, extracoronal or a combination of both and studies have shown that they all give satisfactory results.8,12 Intracoronal bleaching involves the use of agents which are packed into the pulp chamber and then activated by heat or just sealed within the chamber for a number of days resulting in the release of oxidizing radicals that bring about the bleaching effect.4
Agents that are commonly used include hydroge peroxide, carbamide peroxide, and sodium perborate.6 Sodium perborate in its usual powder form decomposes when damp to release nascent oxygen as the oxidizing radical.9 It is used by mixing with hydrogen peroxide or distilled water.7
The use of sodium perborate and hydrogen as a bleaching agent has been reported to be associated with side effects such as alteration of the micro hardness of the tooth structure and cervical root resorption.9,13 This is well observed when the etiology of loss of tooth vitality is trauma.13 The combined effect of alteration in the structure of the tooth by sodium perborate and hydrogen peroxide requires the use of less destructive regimen like sodium perborate mixed with distilled water which has not been used as a tooth bleaching agent. However, there is a need for a study that will compare the effectiveness of sodium perborate mixed with distilled water and sodium perborate mixed with hydrogen peroxide as non-vital anterior tooth bleaching agent, which this present study sought to do.