Received: 5 May 2018 Revised: 24 October 2018 Accepted: 4 November 2018

DOI: 10.1111/jerd.12443

RESEARCH ARTICLE

Effect of hydrogen peroxide on color and whiteness of resin-

based composites
Oscar E. Pecho DDS, PhD1,2 | Josué Martos DDS, PhD3 | Karoline V. A. Pinto DDS4 |
Karine V. A. Pinto BE5 | Rudimar A. Baldissera DDS, MSc, PhD6

1
Post-graduate Program in Dentistry, Dental
School, University of Passo Fundo, Passo Abstract
Fundo, Rio Grande do Sul, Brazil Objective: To evaluate the influence of a 35% hydrogen peroxide gel on color and whiteness
2
Faculty of Science, Department of Optics, changes of resin-based composites (RBC).
University of Granada, Granada, Spain
Materials and Methods: Discs (n = 10; shade A3.5 enamel; and 8 mm diameter and 2 mm thick)
3
Department of Semiology and Clinics, School
were fabricated from three RBC (DF- Durafill, Heraeus Kulzer; ED- IPS Empress Direct, Ivoclar
of Dentistry, Federal University of Pelotas, Rio
Grande do Sul, Brazil Vivadent; and AP- Amelogen Plus, Ultradent Products). Three subgroups were obtained for each
4
Graduate Program in Dentistry, PET RBC: before bleaching (T0) and after first (T1) and second (T2) bleaching applications. A dental
Educational Program - School of Dentistry, spectrophotometer (VITA Easyshade, Vita Zahnfabrik) was used to obtain CIELAB color coordi-
Federal University of Pelotas, Rio Grande do *
nates and whiteness index for dentistry (WID) in all periods. CIELAB (ΔEab ) and CIEDE2000
Sul, Brazil
5
(ΔE00) color differences were also obtained. Perceptibility (PT) and acceptability (AT) thresholds
Graduate Program in Engineering, PET
*
Educational Program - School of Agricultural were used to analyze values of ΔEab , ΔE00, and ΔWID. Two-way analysis of variance (ANOVA;
*
Engineer, Federal University of Pelotas, Rio for L*, a*, b*, and WID) and one-way ANOVA and Tukey tests (for ΔEab and ΔE00) were used to
Grande do Sul, Brazil
analyzed the results (α = 0.05).
6
Department of Restorative Dentistry, Federal
Results: L* and WID values from all RBC did not change after bleaching applications (T1 and T2)
University of Pelotas, Rio Grande do Sul, Brazil
*
(P > .05). There were no significant differences in color differences (ΔEab and ΔE00) among all
Correspondence
Oscar E. Pecho, Post-graduate Program in RBC evaluated after bleaching applications (T1-T0 and T2-T0; P > .05). Regardless of the RBC,
Dentistry, Dental School, University of Passo mean values of ΔE00 between all different periods were always below 50%:50% PT value.
Fundo, Campus I, BR285, km 292.7, Passo
Conclusions: The 35% hydrogen peroxide bleaching gel influences on color and whiteness of
Fundo, RS 99052-900, Brazil.
Email: opecho25@gmail.com resin-based composites. However, color changes were not clinically perceived and whiteness
Funding information variations were clinically acceptable.
Coordenação de Aperfeiçoamento de Pessoal Clinical Significance: Patients should be advised that existing composite restorations might not
de Nível Superior, Grant/Award Number:
match the natural tooth color after bleaching, and their replacement may be required.
PNPD 42009014007P4; CAPES do Brasil,
Grant/Award Number: PNPD
42009014007P4 KEYWORDS

color, composite resins, hydrogen peroxide, tooth bleaching, whiteness index

1 | I N T RO D UC T I O N in-office bleaching (performed by a dentist using 35% hydrogen

One of the most popular dental treatments required by patients is
tooth bleaching.1 The bleaching agents that are derived from per-
oxides act as a strong oxidizing agent, producing free radicals, and
breaking chromophore macromolecules into smaller ones, thus pro-
2,3
moting the tooth whitening. The most common vital tooth
bleaching procedures include at-home bleaching (using 22%, 16%,
10%, and even of 6% carbamide peroxide concentrations) and
peroxide concentration).1,4
When in-office bleaching is performed, the hydrogen peroxide
directly acts with water and oxygen. On the other hand, when
at-home bleaching is performed, the carbamide peroxide comes into
contact with saliva, and hydrogen peroxide and urea are formed.
While the urea is decomposed into ammonium and carbon dioxide,
the hydrogen peroxide reacts with water and oxygen present in the
macromolecules from pigments.5 The longer the exposure time and

J Esthet Restor Dent. 2018;1–8. wileyonlinelibrary.com/journal/jerd © 2018 Wiley Periodicals, Inc. 1

2 PECHO ET AL.
the higher the concentration of the bleaching agent, the more satis-
factory will be the oxidation of macromolecules from pigments and
color change process.6
During the bleaching procedure, not only the teeth surfaces but
also the surface of pre-existing restorative materials, comes into con-
tact with the bleaching agents.4 These bleaching agents at high con-
centrations can promote a physical deterioration,7,8 mainly on surface
roughness, of resin-based composites (RBC).7,9 It has already been
demonstrated that surface roughness of RBC influence on optical
properties10 and bacterial adherence.11 These changes are influenced
by the type of RBC (composition and percentage of inorganic and
organic phases),9,11 by the type and concentration of bleaching agents
and the bleaching time,4,9,11 and by various erosive/abrasive proce-
12
dures related to oral hygiene and diet.
The influence of bleaching agents on the color of RBC has been
investigated in several in vitro studies.4,9,11,13 While some studies
did not find differences after application of 10%-20% carbamide per-
oxide, others found detectable changes using higher concentrations
(35%-38%).7 Although scientific studies show the effects of bleach-
ing agents in RBC artificially pigmented,4,12,14 there is little accurate
information regarding the fragmentation or intrinsic degradation of
RBC and their optical properties when exposed to bleaching agents
(peroxides). Based on these assumptions, the present study evalu-
ated the influence of 35% hydrogen peroxide bleaching gel on the
color and whiteness of three resin-based composites. Therefore, this
study tested the following hypotheses: (1) color changes; and
(2) whiteness variations of resin-based composites are not visually
perceived after tooth bleaching.
2 | MATERIALS AND METHODS
Three available RBC were evaluated in this study: a microfiller com-
posite (DF- Durafill, Heraeus Kulzer, Weihrheim, Germany), a micro-
hybrid composite (AP- Amelogen Plus, Ultradent Products, South
Jordan), and a nanohybrid composite (ED- IPS Empress Direct, Ivoclar
Vivadent AG, Schaan, Liechtenstein; Table 1).
2.1 | Specimens preparation
Specimens (8 mm diameter and 2 mm thick) from shade A3.5 enamel
(n = 10) were prepared using a split stainless steel mold. All specimens
were light-cured for 60 seconds on their top surfaces through a clear
polyester matrix strip using a light-curing unit (LCU) Emitter C (Schuster
Ind., Santa Maria, Brazil). The power of the LCU was measured
(1250 mW/cm2) before specimen preparation with a radiometer
(Curing Lightmeter 105, DMC Equipaments, São Carlos, Brazil). The top
surfaces of all specimens were ground with water-lubricated silicon-
carbide (SiC) papers (240, 320, 400, 600, 800, and 1200) and polished
with 2000 grit SiC paper (Wetordry, 3M Dental Products, St Paul,
Minnesota) using an automated polisher (Struers A/S, Copenhagen,
Denmark) to produce samples with smooth surfaces and standard-
ized thickness (2.00
0.01 mm). The final thickness of specimens
was measured with a digital caliper (Digimatic caliper, Mitutoyo
Corp., Tokyo, Japan) and finally stored in distilled water at 37 C.
2.2 | Bleaching procedure
Specimens were fixed on a wax plate before the application of the
bleaching gel (35% hydrogen peroxide, Mix One Supreme, Villevie,
Dentalville, Joinville, Brazil; Table 1). The bleaching gel was applied to
completely cover the top surface of all specimens following the manu-
facturer indications. Two simulated bleaching sessions, with a 1-week
interval, were performed for each specimen. Three applications (3x) of
the product for 15 minutes (45 minutes) on all specimens were per-
formed in each session. After each application, the bleaching agent
was gently wiped using gauze soaked in distilled water and then the
specimen surfaces were washed out and dried with absorbent paper.
Samples were not air-dried with any system that could dehydrate the
samples. After the first bleaching session, the specimens were kept
stored in 37 C distilled water until the second bleaching session.
2.3 | Color measurements
A dental spectrophotometer (Easyshade, VITA Zahnfabrick, Bad
Säckingen, Germany) and a black background were used for obtain-
ing the CIELAB color coordinates from all RBC specimens. Measure-
ments were performed by a single trained operator at a dental clinic
with standardized D65 light illumination. The spectrophotometer
was calibrated before each measurement to minimize measurement
uncertainty.
The first evaluation was 48 hours after specimen preparation and
immersed in distilled water (T0). The second and the third measure-
ments were performed after the first (T1) and the second (T2) bleach-
ing applications, respectively. The specimens were always stored in
distilled water at 37 C. Three records (3x) were performed for each
sample at different times and the mean values of color coordinates
were obtained.
2.4 | Color differences
*
CIELAB color difference metric (ΔEab ) was calculated according to the
following equation15:
qffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi
*
ΔEab ¼ ðΔL* Þ2 + ðΔa* Þ2 + ðΔb* Þ2 ð1Þ
where ΔL*, Δa*, and Δb* are the differences in the respective coordi-
nates for a pair of samples.
CIEDE2000 color difference metric (ΔE00) was calculated accord-
ing to the following equation15,16:
" 2  2  2   #1=2
ΔL0 ΔC0 ΔH0 ΔC0 ΔH0
ΔE00 ¼ + + + RT
KL SL KC SC KH SH KC SC KH SH
ð2Þ
0 0 0
where ΔL , ΔC , and ΔH are the differences in lightness, chroma, and
hue, respectively for a pair of specimens using CIEDE2000 metric. SL,
SC, and SH are considered weighting functions to adjust the total color
difference for variation in the location of the color difference pair in
0 0 0
L , a , and b coordinates. KL, KC, and KH, the parametric factors, are
correction terms for experimental conditions. And finally, RT is a rota-
tion function that accounts for the interaction between chroma and
hue differences in the blue region.15,16 To calculate ΔE00, discontinuities
PECHO ET AL. 3

TABLE 1 Description of the materials used in this study

Material Descriptiona Manufacturer

IPS Empress Direct (ED)
Amelogen Plus (AP)
Durafill VS (DF)
Emitter C
Mix One Supreme (Twist Pen)
Nanohybrid composite organic matrix: BisGMA Ivoclar Vivadent (Schaan, Leichestein)
(2.5-10 wt%), UDMA (10-20 wt%), and TCDD (<1 wt%).
Filler particles: Barium alumina fluorosilicate glass, barium
glass filler, mixed oxide, copolymer (0.04–3 μm, mean
0.55 μm)
(71.8 wt%)
Batch: T39359
Microhybrid composite Ultradent Products, Inc., (South Jordan, Utah)
Organic matrix: BisGMA (<60 wt%) and TEGDMA
(<40 wt%).
Filler particles: Boron glass, barium alumina silicate glass
(0.4-0.7 μm)
(61 vol.% and 76 wt.%)
Batch: 51382.3
Microfilled composite Heraeus Kulzer GmbH (Wehrheim, Germany)
Organic matrix: BisGMA, UDMA and TEGDMA
(5–10 wt%).
Filler particles: highly disperse silicon dioxide
(0.02–0.07 μm), and splinter polymer (<20 μm)
(60 vol% and 54 wt%)
Batch: 010216A
LED curing light Schuster Ind. (Santa Maria, Brazil)
Irradiance: 1250 mW/cm2; wavelength: 420–480 nm
35% hydrogen peroxide gel (pH = 3.5) Villevie, Dentalville Ltda., (Joinville, SC, Brazil)
Batch: L120

wt%: percentage by weight; vol.%: percentage by volume.

BisGMA, bisphenol A glycol dimethacrylate; TCDD, tricyclodecane dimethanol dimethacrylate; TEGDMA, triethylene glycol dimethacrylate; UDMA, ure-
thane dimethacrylate.
a
Data from manufacturers.

due to mean hue computation and hue-difference computation were
17
taken into consideration.
CIELAB and CIEDE2000 color differences were finally evaluated
with the most recent published data about 50%:50% perceptibility
*
(PT = 1.22 ΔEab units and 0.81 ΔE00 units) and 50%:50% acceptability
*
(AT = 2.66 ΔEab units and 1.77 ΔE00 units) thresholds.18 These visual
thresholds values were recently accepted by ISO.19
2.5 | Whiteness index for dentistry
The whiteness index for dentistry (WID), which is based on CIELAB
coordinates, was calculated as the following equation20:
*
composite. Color differences (ΔEab and ΔE00) were evaluated by one-
way ANOVA. The difference between groups were evaluated by Tukey´
s multiple comparison test (α = 0.05). A global significance level of
95% was applied. All statistical analyses were performed using a stan-
dard statistical software package (SPSS14.0, Chicago, Illinois).
3 | RE SU LT S
Mean and SD values of CIELAB color coordinates and WID from resin-
based composites (ED, AP, and DF) before bleaching application (T0) and
after different periods of bleaching application (T1 and T2) are shown in

WID ¼ 0:511L* −2:324a* − 1:100b* ð3Þ
Higher WID values indicate whiter samples (whiteness), while lower
WID values (including negative values) indicate darker samples (darkness).
Difference in whiteness index (ΔWID) were finally evaluated with
the whiteness 50%:50% perceptibility (WPT = 0.61 ΔWID units) and
50%:50% acceptability (WAT = 2.90 ΔWID units) thresholds, which
were obtained by a population of lay-people.21
2.6 | Statistical analysis
The means and SD values of L*, a*, b*, and WID were statistically ana-
lyzed using two-way analysis of variance (two-way ANOVA). The two
factors were period of bleaching application and type of resin-based
Table 2. The period of bleaching application (P ≤ .05) and the type of
RBC (P ≤ .05) significantly influenced on L*, a*, b*, and WID. In addition,
the interaction between these two factors were significant for a*
(P = .004), b* (P = .04), and WID (P = .005). For all RBC, values of L*, b*,
and WID did not change (P > .05), but values of a* did change (P ≤ .05),
after bleaching applications (T1 and T2). L* and WID values from RBC
decreased in the following order ED > DF > AP for each period of
bleaching application (T0, T1, and T2; P ≤ .05). The resin-based composite
AP showed the greatest values of a* and b* for each period of bleaching
application (T0, T1, or T2; P ≤ .05). ED showed the lowest values of b* for
T0, T1, and T2 (P ≤ .05; Table 2).
Table 3 and Figure 1 show mean and SD values of color differences
*
(ΔEab and ΔE00) between different periods of bleaching application
4 PECHO ET AL.

TABLE 2 Mean and SD values of CIELAB coordinates (L*, a*, and b*) and whiteness index for dentistry (WID) for all resin-based composites (ED,
Empress Direct; AP, Amelogen Plus; and DF, Durafill VS) at different periods (T0—after 48 hours of specimens preparation and immersed in
distilled water at 37 C; T1—after the first bleaching gel application; or T2—after the second bleaching gel application)
Color coordinates
Resin-based composites Different periods L* a* b* WID
ED T0 80.72
0.74aA 12.31
0.40aA 36.89
0.58aC −27.95
1.21aA
T1 80.06
0.58aA 11.62
0.45bB 36.31
0.54aC −26.05
1.53aA
T2 80.33
0.88aA 12.07
0.39abA 37.05
0.64aC −27.76
1.50aA
AP T0 73.73
0.88aC 12.63
0.23aA 54.28
0.86aA −51.37
1.01aC
T1 73.12
0.65aC 12.26
0.25bA 54.54
0.79aA −51.11
1.19aC
T2 73.37
0.65aC 12.14
0.24bA 53.72
0.77aA −49.81
1.22aC
DF T0 76.71
0.46aB 10.31
0.33aB 48.56
0.72aB −38.16
1.48aB
T1 76.17
0.52aB 10.19
0.28bC 48.57
0.68aB −38.18
1.01aB
T2 75.91
0.39aB 9.80
0.19bB 48.26
0.83aB −37.06
1.16aB

Two-way ANOVA was performed for each bleaching application comparing composite and time of application (P ≤ .05).
Different lowercase letters show statistical differences for mean values (color parameters) within the same composite and different periods (T0, T1, and T2;
column).
Different capital letters show statistical differences for mean values (color parameters) at the same period (T0, T1, and T2) and for different composites
(column).

(T0, T1, or T2) for each RBC. There were no significant differences in
*
color differences (ΔEab and ΔE00) among all composites evaluated for
all different periods (T1-T0 and T2-T0; P > .05; Table 3). Mean values
*
of ΔEab between T2 and T0 were above 50%:50% PT value for all RBC
(Table 3 and Figure 1A). Regardless of the RBC, mean values of ΔE00
between all different periods were always below 50%:50% PT value
(Table 3 and Figure 1B).
4 | DISCUSSION
For improving dental esthetics, dental bleaching has become a com-
mon treatment in dental clinics. However, it is difficult to avoid the
contact of bleaching gels on all restorations during bleaching proce-
2
dures (in-office or at-home). Therefore, this study evaluated the
effects of a bleaching agent (35% hydrogen peroxide) on color dif-
ferences and whiteness variations of three different resin-based
composites (a microfiller composite, a microhybrid composite, and
a nanohybrid composite).
*
ΔEab is the most commonly used metric in dentistry to evaluate
color differences. However, CIELAB color space assumes equal weight
for all color coordinates.22 Recent studies23,24 demonstrated a
discrepancy on sensitivity for different color coordinates within
CIELAB color space. Thus, ΔE00, which considers parametric factors,
was proposed to evaluate color differences.15,16 In addition, it has
already been demonstrated that ΔE00 presents a better correlation
* 25–27
with visual perception than ΔEab .
When the results of the present study were analyzed using both
*
metrics (ΔEab and ΔE00), a similar tendency was observed. However,
the analyses of color difference values related to visual thresholds
*
were different for both metrics (ΔEab and ΔE00). Regardless of RBC,
*
when ΔEab was used, comparisons between T2 and T0 always showed
color differences above 50%:50% PT value (1.22).18 When ΔE00 was
used, all comparisons after bleaching applications (T1 and T2) on all
RBC were below 50%:50% PT value (0.81).18 This means that
although there were color changes after bleaching applications on all
composites, they would not be detected by standard observers. Thus,

*
TABLE 3 Mean and SD values of CIELAB (ΔEab ) and CIEDE2000 (ΔE00) color differences between different periods (T0—after 48 hours of
specimens preparation and immersed in distilled water at 37 C; T1—after the first bleaching gel application; or T2—after the second bleaching gel
application) for all resin-based composites (ED, Empress Direct; AP, Amelogen Plus; and DF, Durafill VS)
Different periods
Resin-based composites Color differences T1-T0 T2-T0 T2-T1
ED *
ΔEab 0.93
0.31A 1.32
0.16A‡ 0.99
0.22A,B
ΔE00 0.61
0.22a 0.78
0.08a 0.50
0.13a,b
AP *
ΔEab 1.07
0.30A 1.37
0.55A‡ 1.18
0.44A
ΔE00 0.69
0.22a 0.77
0.32a 0.63
0.26a
DF *
ΔEab 0.84
0.51A 1.27
0.29A‡ 0.77
0.47B
ΔE00 0.50
0.30a 0.76
0.19a 0.36
0.23b

One-way ANOVA was performed to compare color differences after different bleaching applications (column; P ≤ .05).
*
The same lowercase letter shows no statistical differences (P > .05) for mean values of ΔEab between two periods (T0, T1, or T2) and for different compos-
ites (column).
The same capital letter shows no statistical differences (P > 0.05) for mean values of ΔE00 between two periods (T0, T1, or T2) and for different composites
(column).
‡ *
Color differences above perceptibility threshold (PT = 1.22 ΔEab and 0.81 ΔE00; Paravina et al.18).
PECHO ET AL. 5

*
FIGURE 1 Mean and SD values of color differences using (A) ΔEab ; and (B) ΔE00 between different period of bleaching application (T0—after
48 hours of specimens preparation and immersed in distilled water at 37 C; T1—after first bleaching application; and T2—after second bleaching
application) for all resin-based composites (ED, Empress Direct; AP, Amelogen Plus; and DF, Durafill VS)

the first hypothesis that color changes of RBC after tooth bleaching 30 minutes,6 14% HP (strips) for 14 horas,28 6.5% HP (strips) for
are not visually perceived is accepted. 14 horas.28 Two studies7,13 did not use visual thresholds for analyzing
4,6,11,14,28,29
Most of the studies published on color stability of RBC their results. And finally, only one study12 used the most updated
*
after tooth bleaching used the value of 3.3 ΔEab units for acceptable visual thresholds for ΔE00 (PT = 0.8 and AT = 1.8).18 Lago et al. showed
color difference. Some studies showed that RBC presented color dif- that all RBC presented color differences below 0.8 ΔE00 units (PT) after
ferences above that value using 10% hydrogen peroxide (HP) for tooth bleaching using 16% CP for 14 hours and 35% HP for
112 11
or 14 hours29 and using 10% carbamide peroxide (CP) for 135 minutes,12 which were similar to the findings of the present study.
29
112 hours. The other studies showed color difference below that Previous studies showed that total bleaching time is more impor-
value using 10% CP for 112 11
or 42 hours, 28
16% CP for 56 hours,6
tant than the concentration of the bleaching agent.12,30 However,
*
20% CP for 48 hours,4 37% CP for 60 minutes,6 35% HP for another study28 did not show differences in ΔEab values between two
6 PECHO ET AL.
different periods of bleaching applications (1 and 2 weeks) for three
bleaching products (10% carbamide peroxide gel, 6.5% hydrogen per-
oxide strip, and 14% hydrogen peroxide strip) applied on hybrid and
nanohybrid resin composites. The present study did not show signifi-
*
cant color differences (ΔEab and ΔE00) after first (T1-T0) and second
(T2-T0) bleaching applications for all RBCs (P > .05). However, there
was a difference between both metrics when the results were ana-
*
lyzed using visual thresholds. The use of ΔEab showed values above
PT after the second bleaching application and the use of ΔE00 always
showed values below PT, after the first and the second bleaching
applications (Figure 1).
* 4–6,11,13,14,28–30
ΔEab and ΔE0012 have been traditionally used for
evaluating color changes after tooth bleaching. However, the analysis
of color differences did not provide information about the changes in
whiteness. Although previous studies31–34 used other indexes for
evaluating whiteness, the present study used a recently published
20
whiteness index for dentistry (WID). WID, which is based on CIELAB
color coordinates, was designed exclusively for dentistry and pre-
sented better correlation to visual perception of tooth whiteness,
when it was compared with other indexes.20 Although this index has
been recently published, it has already been cited in some
studies, 35–38
but it has not been used to compare bleaching
treatments.
WID values in all periods for the same RBC did not show statisti-
cal differences (P > .05; Table 2). However, whiteness thresholds
values were used for the analysis of visual perception. As the patients
(lay persons) are the evaluators of final results after dental bleaching
procedures, the present study used the whiteness thresholds values
for lay-persons (WPT = 0.61 ΔWID units and WAT = 2.90 ΔWID
21
units). Only whiteness variations (ΔWID) between T2-T0 for ED and
T1-T0 for AP and DF had values below WPT. All other comparisons,
were below WAT value (data from Table 2). This means that although
there were whiteness variations after bleaching applications on all
composites, few of them (T2-T0 for ED and T1-T0 for AP and DF)
would not be detected (below WPT) and most of them would be
detected (above WPT) but accepted as a good match (below WAT) by
standard observers. Thus, the second hypothesis that whiteness varia-
tions of RBC after tooth bleaching are not visually perceived is par-
tially accepted.
Hydrogen peroxide, either at-home or in-office, is an aggressive
oxidant that may affect the elution of monomers and other sub-
stances from composites.39–42 The carbon–carbon (C–C)-single or
(C–C)-double bonds, from polymer network of RBC, may react
with oxidants like hydroxide peroxide, increasing unpolymerized
monomers, and unspecific oxidative products release.41,42 Complete
polymerization of resin-based composites is still a challenge to over-
come. Thus, the lower the conversion rate of RBC, the more residual
monomers can be eluted.43 The properties of RBC are influenced by
the chemical structure of matrix phase. The present study analyzed
composites with different polymer networks: ED (BisGMA, UDMA,
and TCC), AP (BisGMA and TEGDMA) and DF (BisGMA, UDMA, and
TEGDMA; Table 1). All composites evaluated in the present study
were light activated under the same conditions (eg, light energy and
distance, and activation time), thus light-activating conditions should
not be considered as study variables. The percentage of filler can
also influence the degree of conversion of RBC. Thus, as the filler
loading increases, the degree of conversion increases and the water
sorption decreases. The percentage of filler from the RBCs analyzed
in the present study increases in the following order DF (54 wt%)
ED (71.8 wt%) AP (76 wt%; Table 1). Although it was not an objec-
*
tive of the present study, color differences (ΔEab and ΔE00) after both
bleaching applications (T2-T0 and T1-T0) did not show statistical differ-
ences (P > .05) for all RBC (Table 3). Thus, the resin-based composites
evaluated in the present study, even with different structures, showed
similar color differences after bleaching procedure.
Variations in L*, b*, and WID values for the different RBC in the
same Vita shade (A 3.5) can be attributed to the concentration of inor-
ganic filler, the monomer composition and the different types of inor-
ganic fillers (Table 1). The nanohybrid composite (ED) showed the
highest L* and WID values and the lowest b* values in all different
periods, that means that it may be considered the whiter composite
among all RBC analyzed in this study. Previous studies showed that
optical properties of RBC depend on their particle size.34,44 A higher
filler concentration or a lower concentration of monomer in the micro-
hybrid restorative materials could contribute to a greater resistance to
peroxides.5 Although it was already mentioned above, RBC did not
show significant color differences among them after the different
bleaching periods analyzed.
Considering a clinically esthetic failure, pigmentation or color
change is one of the most common reasons for the replacement of
aesthetic dental restorations. To maintain excellent esthetic proper-
ties, composite restorations must have good color stability. Under oral
conditions, esthetic restorations can be exposed to the combined
effects of light, moisture, oral habits, and certain dietary patterns, such
as caffeine consumption, which can lead to an external pigmentation.
Restorations can also become chromatically altered due to intrinsic
factors such as hydrolysis of the organic matrix and inorganic particles
lost due to a failure in the silanization.45 The present study also con-
sidered the color alteration that can be produced by water sorption as
showed in a previous study.38 Thus, the values of color differences
after both bleaching applications (T1 and T2) were obtained from the
comparison with a first color measuring after 48 hours of specimens
preparation and immersed in water at 37 C (T0).
Further and as mentioned above, an elution of monomers and other
substances from RBC was noted after bleaching procedure. This elution
may also affect the surface roughness of these materails.30 A previous
study showed changes in the value of L* coordinate with different sur-
face roughness values for the same RBC. Thus, L* values decreased when
Ra parameter increased.10 The RBC analyzed in the present study did not
show different L* values after bleaching applications.
One limitation of this study is the use of a simplified spectropho-
tometer instead of a spectrophotometer with an integrating sphere.
That means that is not possible to measure color in the Specular Com-
ponent Included (SCI) mode. This mode of measurement includes both
specular and diffused reflected light.46,47 Therefore, color measure-
ments are unaffected by any surface condition and the “true” color of
an object is obtained. Using the Specular Component Excluded (SCE)
mode, which is the most common mode used, the measurements
PECHO ET AL.
exclude any specular reflected light, making it more sensitive to surface
conditions.46,47
All specimens from the present study were polished
very carefully to obtain standardized surfaces. A previous study46
showed that the use of SCI or SCE modes influenced on L* values of
different RBC but the color differences affected by the outcome ana-
lyzed (ageing) were dependent on kind of RBC. The present study used
a dental spectrophotometer and the analysis of bleaching effect on
RBC with a CIELAB-based WID with the purpose of showing an easy
technique to reproduce in any dental clinic by any dental professional.
5 | CO NC LUSIO NS
Within the limitations of the present study, bleaching treatment with
35% hydrogen peroxide produced not perceptible color changes and
acceptable whiteness variations of resin-based composites.
ACKNOWLEDGMENTS
The authors do not have any financial interest in the companies whose
materials are included in this article. This work was partially supported
by CAPES do Brasil [grant number PNPD 42009014007P4].
ORCID
Oscar E. Pecho https://orcid.org/0000-0001-7314-5049
RE FE R ENC E S
1. Zekonis R, Matis BA, Cochran MA, et al. Clinical evaluation of in-office
and at-home bleaching treatments. Oper Dent. 2003;28(2):114-121.
2. Martos J, Kinalski MA. Combined in-office and take-home bleaching in
vital teeth. J Res Dent. 2014;2(3):149-153.
3. Kwon SR, Wertz PW. Review of the mechanism of tooth whitening.
J Esthet Restor Dent. 2015;27(5):240-257.
4. Çelik Ç, Yuzugullu B, Erkut S, et al. Effect of bleaching on staining sus-
ceptibility of resin composite restorative materials. J Esthet Restor
Dent. 2009;21(6):6407-6415.
5. Rosentritt M, Lang R, Plein T. Discoloration of restorative materials
after bleaching application. Quintessence Int. 2005;36(1):133-139.
6. Hubbezoglu I, Akaoglu B, Dogan A, et al. Effect of bleaching on color
change and refractive index of dental composite resins. Dent Mater J.
2008;27(1):1105-1116.
7. Yu H, Zhang CY, Wang YN, Cheng H. Hydrogen peroxide bleaching
induces changes in the physical properties of dental restorative materials:
effects of study protocols. J Esthet Restor Dent. 2018;30(2):E52-E60.
8. Jurema ALB, de Souza MY, Torres CRG, Borges AB, Caneppele TMF.
Effect of pH on whitening efficacy of 35% hydrogen peroxide and
enamel microhardness. J Esthet Restor Dent. 2018;30(2):E39-E44.
9. Attin T, Hannig C, Wiegand A, Attin R. Effect of bleaching on restor-
ative materials and restorations: a systematic review. Dent Mater.
2004;20(9):852-861.
10. Ghinea R, Ugarte-Alvan L, Yebra A, Pecho OE, Paravina RD,
Perez MM. Influence of surface roughness on the color of dental-resin
composites. J Zhejiang Univ Sci B. 2011;12(7):552-562.
11. Canay S, Çehreli MC. The effect of current bleaching agents on the
color of light-polymerized composites in vitro. J Prosthet Dent. 2003;
89(5):5474-5478.
12. Lago M, Mozzaquatro LR, Rodrigues C, Kaizer MR, Mallmann A,
Jacques LB. Influence of bleaching agents on color and translucency
of aged resin composites. J Esthet Restor Dent. 2017;29(5):368-377.
13. Torres CR, Ribeiro CF, Bresciani E, Borges AB. Influence of hydrogen
peroxide bleaching gels on color, opacity and fluorescence of compos-
ite resins. Oper Dent. 2012;37(5):526-531.
7
14. Villalta P, Lu H, Okte Z, Garcia-Godoy F, Powers JM. Effects of stain-
ing and bleaching on color change of dental composite resins.
J Prosthet Dent. 2006;95(2):137-142.
15. Commission Internationale de l´Eclairage. CIE Technical Report: Color-
imetry. CIE Pub No. 15.3. Vienna: CIE Central Bureau; 2004.
16. Luo MR, Cui G, Rigg B. The development of the CIE 2000 color differ-
ence formula: CIEDE2000. Color Res Appl. 2001;26(5):340-350.
17. Sharma G, Wu W, Dalal EN. The CIEDE2000 color-difference formula:
implementation notes, supplementary test data, and mathematical
observations. Color Res Appl. 2005;30(1):21-30.
18. Paravina RD, Ghinea R, Herrera LJ, et al. Color difference thresholds
in dentistry. J Esthet Restor Dent. 2015;27(S1):S1-S9.
19. International Organization for Standardization. ISO/TR 28642: Den-
tistry - Guidance on Colour Measurement. Geneva: International Organi-
zation for Standardization; 2016.
20. Pérez MM, Ghinea R, Rivas MJ, et al. Development of a customized
whiteness index for dentistry based on CIELAB color space. Dent
Mater. 2016;32(3):461-467.
21. Pérez MM, Pecho OE, Ghinea R, et al. Recent advances in color and
whiteness evaluations in dentistry. Curr Dent. In press. https://doi.
org/10.2174/2542579X01666180719125137.
22. Mangine H, Jakes K, Noel C. A preliminary comparison of CIE color
differences. Color Res Appl. 2005;30(4):288-294.
23. Perez MM, Ghinea R, Herrera LJ, et al. Dental ceramics: a CIEDE2000
acceptability thresholds for lightness, chroma and hue differences.
J Dent. 2011;39(S3):e37-e44.
24. Pecho OE, Pérez MM, Ghinea R, Della Bona A. Lightness, chroma
and hue differences on visual shade matching. Dent Mater. 2016;
32(11):1362-1373.
25. Ghinea R, Perez MM, Herrera LJ, et al. Color difference thresholds in
dental ceramics. J Dent. 2010;38(S2):e57-e64.
26. Pecho OE, Ghinea R, Alessandretti R, Pérez MM, Della Bona A. Visual
and instrumental shade matching using CIELAB and CIEDE2000 color
difference formulas. Dent Mater. 2016;32(1):82-92.
27. Pecho OE, Ghinea R, Perez MM, Della Bona A. Influence of gender
on visual shade matching in dentistry. J Esthet Restor Dent. 2017;
29(2):E15-E23.
28. Anagnostou M, Chelioti G, Chioti S, Kakaboura A. Effect of tooth-
bleaching methods on gloss and color of resin composites. J Dent.
2010;38(S2):e129-e136.
29. Kurtulmus-Yilmaz S, Cengiz E, Ulusoy N, Ozak ST, Yuksel E. The effect
of home-bleaching application on the color and translucency of five
resin composites. J Dent. 2013;41(S5):e70-e75.
30. Joiner A. The bleaching of teeth: a review of the literature. J Dent.
2006;34(7):412-419.
31. Ganz E. Whiteness measurement. J Color Appearance. 1972;1:33-41.
32. Ganz E, Pauli HKA. Whiteness and tint formulas of the commission
international de L'Eclairage: approximation in the L*a*b* color space.
Appl Opt. 1995;34(16):2998-2999.
33. Luo W, Westland S, Ellwood R, Pretty I, Cheung V. Development of a
whiteness index for dentistry. J Dent. 2009;37(S1):e21-e26.
34. Pecho OE, Ghinea R, do Amaral EA, et al. Relevant optical properties
for direct restorative materials. Dent Mater. 2016;32(5):e105-e112.
35. Joiner A, Luo W. Tooth colour and whiteness: a review. J Dent. 2017;
67(S):S3-S10.
36. Westland S, Luo W, Li Y, Pan Q, Joiner A. Investigation of the percep-
tual thresholds of tooth whiteness. J Dent. 2017;67(S):S11-S14.
37. Araujo FS, Barros MCR, Santana MLC, et al. Effects of adhesive used
as modeling liquid on the stability of the color and opacity of compos-
ites. J Esthet Restor Dent. 2018;30(5):427-433.
38. Alberton Da Silva V, Alberton Da Silva S, Pecho OE,
Bacchi A. Influence of composite type and light irradiance on color
stability after immersion in different beverages. J Esthet Restor Dent.
2018;30(5):390-396.
39. Hannig C, Duong S, Becker K, Brunner E, Kahler E, Attin T. Effect of
bleaching on subsurface microhardness of composite and a polyacid
modified composite. Dent Mater. 2007;23(2):198-203.
40. Polydorou O, Beiter J, Konig A, et al. Effect of bleaching on the elution
of monomers from modern dental composite materials. Dent Mater.
2009;25(2):254-260.
8 PECHO ET AL.

41. Durner J, Stojanovic M, Urcan E, et al. Effect of hydrogen peroxide on 46. Hosoya Y, Shiraishi T, Oshiro M, Ando S, Miyazaki M, Powers JM.
the three-dimensional polymer network in composites. Dent Mater. Effects of specular component on color differences of different filler
2011;27(6):573-580. type resin composites after aging. J Dent. 2009;37(8):585-590.
42. Durner J, Obermaier J, Ilie N. Investigation of different bleaching con- 47. Kun Y, Huimin Y, Shangzhong J. A type of spectrophotometer with
ditions on the amount of elutable substances from nano-hybrid com- both SCI and SCE measurement structures. Optik. 2014;125(17):
posites. Dent Mater. 2014;30(2):192-199. 4672-4677.
43. Miletic VJ, Santini A. Remaining unreacted methacrylate groups in
resin-based composite with respect to sample preparation and storing
conditions using micro-Raman spectroscopy. J Biomed Mater Res B
Appl Biomater. 2008;87(2):468-474.
44. Perez MM, Hita-Iglesias C, Ghinea R, et al. Optical properties of supra- How to cite this article: Pecho OE, Martos J, Pinto KVA,
nano spherical filled resin composites compared to nanofilled, nano-hybrid Pinto KVA, Baldissera RA. Effect of hydrogen peroxide on
and micro-hybrid composites. Dent Mater J. 2016;35(3):353-359.
color and whiteness of resin-based composites. J Esthet Restor
45. Dietschi D, Campanile G, Holz J, Meyer JM. Comparison of the color
stability of ten new-generation composites: an in vitro study. Dent Dent. 2018;1–8. https://doi.org/10.1111/jerd.12443
Mater. 1994;10(6):353-362.