Evaluation of Internal Belaching with 35% Hydrogen Peroxide in Dentin Conditioned with 37% Phosphoric Acid and 17% EDTA

  • Fernando Peña-Bengoa Departamento de Endodoncia, Facultad de Odontología, Universidad Andres Bello. Quillota 980, Viña del Mar, Chile.
  • Nicolás Dufey Departamento de Endodoncia, Facultad de Odontología, Universidad Andres Bello. Quillota 980, Viña del Mar, Chile.
  • Germán Buchheister Departamento de Endodoncia, Facultad de Odontología, Universidad Andres Bello. Quillota 980, Viña del Mar, Chile.


Introduction: This study aimed to evaluate the effect of dentin surface treatment  with  37%  phosphoric acid or 17% ethylenedia-minetetraacetic acid (EDTA) before Internal Bleaching with 35% hydrogen peroxide using the walking bleach technique. Material and Methods: This experimental in vitro study used 66 human premolars extracted for orthodontic reasons, which were debrided, endodontically prepared, and pigmented with chromogens derived from blood decomposition. The samples were randomly divided into three groups (n=22). Group A: bleaching agent without dentin conditioning; group B: bleaching agent in dentin conditioned with phosphoric acid 37%; group C: bleaching agent in dentin conditioned with 17% EDTA. 4 applications of bleaching agent were used with a separation of 4 days between each session. The initial color (baseline) and after each application was determined by spectrophotometry, recording the CIE L*a*b* values and the total color variation between the initial parameters and the different evaluation times. Results: Data were statistically analyzed with the Wilcoxon test. This showed statistically significant differences for the total variation of the color between the study groups, with the control group in no case inferior to the rest. Conclusion: The application of 37% phosphoric acid increased the effectiveness of the bleaching agent when compared to 17% EDTA. However, these did not increase the effectiveness compared to the application of the bleaching agent without a previous dentin surface treatment.


1. Pedrollo Lise D, Siedschlag G, Bernardon JK, Baratieri LN. Randomized clinical trial of 2 nonvital tooth bleaching techniques: A 1-year follow-up. J Prosthet Dent. 2018;119(1):53–59.
2. Wongpraparatana I, Matangkasombut O, Thanyasrisung P, Panich M. Effect of Vital Tooth Bleaching on Surface Roughness and Streptococcal Biofilm Formation on Direct Tooth-Colored Restorative Materials. Oper Dent. 2018; 43(1), 51–59.
3. Del Curto F, Rocca GT, Krejci I. Restoration of discolored endodontically treated anterior teeth: a minimally invasive chemo- mechanical approach. Int J Esthet Dent. 2018;13(3):302-317.
4. Dufey N, Martínez M, Peña F. Comparación Espectrofotométrica de las Sesiones de Blanqueamiento Intracameral con Peróxido de Hidrógeno y Carbamida a Diferentes Concentraciones. Int J Odontostomat. 2018; 12(2):152-159
5. Moradas Estrada M. ¿Qué material y técnica seleccionamos a la hora de realizar un blanqueamiento dental y por qué? Protocolo para evitar hipersensibilidad dental posterior. Av Odontoestomatol. 2017; 33(3): 103-112.
6. Rodrigues LM, Vansan LP, Pécora JD, Marchesan MA. Permeability of different groups of maxillary teeth after 38% hydrogen peroxide internal bleaching. Braz Dent J. 2009; 20(4):303–306.
7. Kamble AB, Abraham S, Kakde DD, Shashidhar C, MehtaDL. Sacanning electron microscopic evaluation of efficacy of 17% Ethylenediaminetetraacetic acid and chitosan for smear layer removal with ultrasonics: An In vitro study. Contemp Clin Dent. 2017;8:621-6
8. Chowdhury AFMA, Islam R, Alam A, Matsumoto M, Yamauti M, Carvalho RM, Sano H. Variable Smear Layer and Adhesive Application: The Pursuit of Clinical Relevance in Bond Strength Testing. Int J Mol Sci. 2019;20(21):5381.
9. Khoroushi M, Ziaei S, Shirban F, Tavakol F. Effect of Intracanal Irrigants on Coronal Fracture Resistance of Endodontically Treated Teeth Undergoing Combined Bleaching Protocol: An In Vitro Study. J Dent. 2018;15(5):266–274.
10. Muana HL, Hiraishi N, Nakajima M, Kong K, Tagami J. Effect of the Dentin Chelating Agents Phytic Acid and EDTA on Degree of Conversion, Microhardness, and Bond Strength of Chemical-curing Self-adhesive Cements. J Adhes Dent. 2019;21(4):299-306.
11. Bacelar-Sá Renata, Giannini Marcelo, Ambrosano Glaucia Maria Bovi, Bedran-Russo Ana Karina. Dentin Sealing and Bond Strength Evaluation of Hema-Free and Multi-Mode Adhesives to Biomodified Dentin. Braz. Dent. J. 2017; 28(6):731-737.
12. Luque-Martinez I, Reis A, Schroeder M, Muñoz MA, Loguercio AD, Masterson D, Maia LC. Comparison of efficacy of tray-delivered carbamide and hydrogen peroxide for at-home bleaching: a systematic review and meta-analysis. Clin Oral Investig. 2016;20(7):1419-33
13. Bizhang M, Chun Y. H, Damerau K, et al. Comparative clinical study of the effectiveness of three different bleaching methods. Oper Dent. 2009.34(6): 635-41.
14. Zehnder M. Root canal irrigants. J Endod. 2006;32:389–98.
15. Freccia W, Peters D. A technique for staining extracted teeth: a research and teaching aid for bleaching. J Endod. 1982;8(2):67-9
16. Jordão-Basso KC, Kuga MC, Bandéca MC, Duarte MA, Guiotti FA. Effect of the time-point of acid etching on the persistence of sealer residues after using different dental cleaning protocols. Braz Oral Res. 2016;30(1):e133.
17. Martini EC, Parreiras SO, Gutierrez MF, Loguercio AD, Reis A. Effect of Different Protocols in Preconditioning With EDTA in Sclerotic Dentin and Enamel Before Universal Adhesives Applied in Self-etch Mode. Oper Dent. 2017;42(3):284-296.
18. Knezović D, Zlatarić D, Illeš IŽ, Alajbeg M, Žagar. In Vivo Evaluations of Inter-Observer Reliability Using VITA Easyshade® Advance 4.0 Dental Shade-Matching Device. Acta Stomatol Croat. 2016;50(1):34-9.
19. Gómez-Polo C, Gómez-Polo M, Martínez Vázquez de Parga JA, Celemín-Viñuela A. Clinical Study of the 3D-Master Color System among the Spanish Population. J Prosthodont. 2018;27(8):708-715.
20. Fundaoğlu Küçükekenci F, Çakici F, Küçükekenci AS. Spectrophotometric analysis of discoloration and internal bleaching after use of different antibiotic pastes. Clin Oral Investig. 2018; 23(1):161–167.
21. Cardenas AFM, Maran BM, Araújo LCR, de Siqueira FSF, Wambier LM, Gonzaga C, Loguercio AD, Reis A. Are combined bleaching techniques better than their sole application? A systematic review and meta-analysis. Clin Oral Investig. 2019; 23(10):3673-3689
22. Martin-de-las-Heras S, Del-Rey M, Molina A, Rubio L. Spectrophotometric dental colour measurement to assess age in living adults. Aust J Forensic Sci. 2016; 50(1): 82–89.
23. Basting R.T, Rodrigues AL, Serra MC. The effects of seven carbamide peroxide bleaching agents on enamel microhardness over time. The J Am Dent Assoc. 2003;134(10):1335–1342.
24. Wagner MH, da Rosa RA, de Figueiredo JAP, Duarte MAH, Pereira JR, Só MVR. Final irrigation protocols may affect intraradicular dentin ultrastructure. Clin Oral Investig. 2017;21(7):2173-2182.
25. Toledano M, Yamauti M, Osorio E, Osorio R. Bleaching agents increase metalloproteinases-mediated collagen degradation in dentin. J Endod. 2011; 37(12)1668-1672.
26. Ubaldini ALM, Pascotto RC, Sato F, Soares VO, Zanotto ED, Baesso ML. Effects of Bioactive Agents on Dentin Mineralization Kinetics After Dentin Bleaching. Oper Dent.2020; 45 (3): 286–296.
27. Carrasco LD, Pécora JD, Fröner IC. In vitro assessment of dentinal permeability after the use of ultrasonic-activated irrigants in the pulp chamber before internal dental bleaching. Dent Traumatol. 2004;20(3):164-8.
28. Casey LJ, Schindler WG, Murata SM, Burgess JO. The use of dentinal etching with endodontic bleaching procedures. J Endod. 1989 Nov;15(11):535-8.
29. Carrasco LD, Guerisoli DMZ, Pécora JD, Fröner IC. Evaluation of dentin permeability after light activated internal dental bleaching. Dent Traumatol. 2007;23:30-4.
30. de Oliveira Moreira PE, Pamplona LS, Nascimento GC, Esteves RA, Pessoa OF, Silva CM. Effects of Internal Bleaching on the Adhesion of Glass-Fiber Posts. Open Dent J. 2015 Dec 10;9:375-9
31. Klaric E, Rakic M, Sever I, Milat O, Par M, Tarle Z. Enamel and dentin microhardness and chemical composition after experimental light-activated bleaching. Oper Dent. 2015; 40(4): E132–E141.
32. Tam LE, Kim N, De Souza GM. Effect of tooth whitening strips on fatigue resistance and flexural strength of bovine dentin in vitro. PLoS One. 2017;12(3): e0173480.
33. Wei J, Wang Y, Li Q. Spectroradiometric and Chemical Analysis of Severely Discolored Endodontically Treated Teeth. Oper Dent. 2016;41(4):370-8.
How to Cite
PEÑA-BENGOA, Fernando; DUFEY, Nicolás; BUCHHEISTER, Germán. Evaluation of Internal Belaching with 35% Hydrogen Peroxide in Dentin Conditioned with 37% Phosphoric Acid and 17% EDTA. Journal of Oral Research, [S.l.], v. 9, n. 6, p. 490-499, dec. 2020. ISSN 0719-2479. Available at: <http://joralres.com/index.php/JOR/article/view/joralres.2020.095>. Date accessed: 24 feb. 2021. doi: https://doi.org/10.17126/joralres.2020.095.